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Combined DSAEK-IOL exchange and DSAEK alone have similar results
Am J Ophthalmol. 2010;149(3):390-397.
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IOL exchange combined with Descemet stripping automated endothelial keratoplasty compared favorably with DSAEK alone in treating endothelial cell loss stemming from poorly fitting IOLs, according to a study.
"The rates of complications for both this combined procedure and the standard DSAEK alone are very low and comparable," the authors said.
The retrospective study included 19 eyes that underwent DSAEK with concurrent exchange of an anterior chamber IOL for a posterior chamber IOL. A comparator group comprised 188 eyes that underwent DSAEK alone with the posterior chamber IOL left in place.
The study group had a mean age of 76.5 years. The control group had a mean age of 75.6 years.
Most eyes in the study group underwent DSAEK for pseudophakic bullous keratopathy. The control group underwent DSAEK primarily for underlying Fuchs' endothelial dystrophy.
The study group had a mean preoperative Snellen best corrected visual acuity of 20/202 and mean preoperative endothelial cell density of 2,740 cells/mm².
The control group had a mean preoperative BCVA of 20/125 and mean preoperative endothelial cell density of 2,764 cells/mm².
Study data showed that at 6 months, mean BCVA was 20/73 in the study group and 20/45 in the control group. The difference was statistically significant (P = .01). The study group had a mean donor cell loss of 33%, and the control group had a mean loss of 26%. No eyes in the study group and five eyes in the control group experienced graft dislocation; the difference was statistically insignificant.
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