J Korean Ophthalmol Soc > Volume 57(9); 2016 > Article
Journal of the Korean Ophthalmological Society 2016;57(9):1361-1368.
DOI: https://doi.org/10.3341/jkos.2016.57.9.1361    Published online September 15, 2016.
Clinical Outcomes of Combined Descemet-stripping Endothelial Keratoplasty and Intraocular Lens Exchange.
Dong Jin Kang, Hong Kyun Kim
Department of Ophthalmology, Kyungpook National University School of Medicine, Daegu, Korea. okeye@knu.ac.kr
데스메막박리 각막내피층판 이식술과 인공수정체 교환술 병합수술의 임상결과
강동진⋅김홍균
경북대학교 의과대학 안과학교실
Correspondence:  Hong Kyun Kim,
Email: okeye@knu.ac.kr
Received: 24 March 2016   • Revised: 13 June 2016   • Accepted: 18 August 2016
Abstract
PURPOSE
To evaluate clinical outcomes after combined descemet-stripping endothelial keratoplasty (DSEK) and intraocular lens (IOL) exchange in a Korean population. METHODS: The medical records of 15 patients (15 eyes) with pseudophakic bullous keratopathy who underwent combined DSEK and IOL exchange from January 2011 to January 2015 and who were followed up for more than 12 months were reviewed retrospectively. RESULTS: In 14 eyes with successful results after surgery, the best corrective visual acuity (BCVA) was significantly improved from 2.01 ± 0.96 (log MAR, mean) to 0.68 ± 0.26 at 3 months (p = 0.001) except for one eye that received reoperation on the endothelial disc detachment. The BCVA at postoperative 6 and 12 months gradually increased (0.51 ± 0.26 and 0.40 ± 0.22 log MAR, mean). Central corneal thickness was significantly improved from 777 ± 139 µm to 605 ± 28 µm at 6 months (p = 0.003) and was maintained at 12 months. The mean endothelial cell count was 2,973 ± 281/mm2 in the donor lenticules and 1,790 ± 265/mm2 at 12 months. Endothelial cell loss was 40%. The target refraction was -0.81 ± 0.16 D and the 12 months postoperative spherical equivalent was -0.28 ± 0.36 D. Complications included intraocular pressure elevation in one eye and pupillary capture in one eye. CONCLUSIONS: Combined DSEK and IOL exchange may be a very efficient and safe option for surgically managing pseudophakic bullous keratopathy.
Key Words: Descemet-stripping endothelial keratoplasty (DSEK);Intraocular lens (IOL) exchange;Pseudophakic bullous keratopathy;Scleral fixation


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