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Descemet's stripping automated endothelial keratoplasty with anterior chamber intraocular lenses: complications and 3-year outcomes.

The British journal of ophthalmology (2014-03-29)
Marcus Ang, Lim Li, Daniel Chua, Cheewai Wong, Hla M Htoon, Jodhbir S Mehta, Donald Tan
ABSTRACT

To describe outcomes and complications following Descemet's stripping automated endothelial keratoplasty (DSAEK) in eyes with pseudophakic bullous keratopathy (BK) while retaining the anterior chamber intraocular lenses (ACIOL). We included consecutive patients who underwent DSAEK for BK at a single tertiary centre from 1 January 2008 to 1 April 2010, from our prospective cohort (Singapore Corneal Transplant Study). We compared eyes with BK, which underwent DSAEK while retaining ACIOL (n=18), to those with DSAEK alone with the posterior chamber intraocular lenses left in place as a comparison group (n=114). Main outcome measures were endothelial cell (EC) loss and graft survival. The percentage EC loss at 1 year was 31.9±21.3% in the DSAEK with ACIOL group compared to 24.5±21.2% in the DSAEK group (p=0.516); however, this figure was significantly greater in the DSAEK with ACIOL group at 3 years compared to the DSAEK group (55.3±29.2% vs 33.3±20.8%; p=0.01 respectively). Graft survival was also significantly poorer in the DSAEK ACIOL group compared to the DSAEK group over 3 years (log rank p=0.002). We found that although eyes with BK and ACIOL that underwent DSAEK while retaining the ACIOL suffered EC loss which was not significantly greater at 1 year, EC loss and graft survival were significantly poorer compared to DSAEK controls at 3 years postoperatively.

MATERIALS
Product Number
Brand
Product Description

Prednisolone acetate for peak identification, European Pharmacopoeia (EP) Reference Standard
Sigma-Aldrich
Dexamethasone 21-phosphate disodium salt, ≥98%
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USP
Prednisolone acetate, United States Pharmacopeia (USP) Reference Standard