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To evaluate outcomes of Descemet Membrane Endothelial Keratoplasty (DMEK) combined with anterior chamber intraocular lens (ACIOL) exchange and transscleral fixation in patients with pseudophakic bullous keratopathy (PBK)
Patients who underwent DMEK combined with ACIOL removal and trans scleral IOL fixation at Toronto Western Hospital, Canada, between 2015 and 2018 was included in this study. Demographic characteristics, intra-operative and post-operative complications, best-corrected visual acuity (BCVA) and endothelial cell density (ECD) were analyzed.
Thirteen eyes of 13 patients were included. Average age was 76.7 ± 12.7 years. BCVA prior to surgery and 6 months after surgery was 1.85 ± 0.96 logMAR and 0.47 ± 0.09 logMAR, respectively (p=0.02). Rebubble was performed in 4 eyes (32%). Two eyes (15%) developed hyphema. One eye (8%) was diagnosed with macular edema and one eye (8%) developed retinal detachment. Primary failure due to persistent hyphema was diagnosed in one eye (8%). Average ECD loss 6 months after surgery was 50% (p<0.05).
ACIOL replacement with a scleral-fixated IOL combined with DMEK is a viable option in cases of ACIOL and PBK. Associated complications were graft detachment, hyphema, macular edema and retinal detachment.
This presentation is from the session "SPS-101 Corneal Procedures & Diagnostics: EK, PK, CXL, Other" from the 2020 ASCRS Virtual Annual Meeting held on May 16-17, 2020.