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DSAEK with AC-IOL yields high endothelial cell loss, graft failure rates
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Descemet’s stripping automated endothelial keratoplasty with a retained anterior-chamber IOL resulted in high rates of endothelial cell loss and graft failure at 3 years in eyes with pseudophakic bullous keratopathy, according to a study.
The prospective study included 132 eyes with pseudophakic bullous keratopathy. Eighteen eyes underwent DSAEK with a retained anterior-chamber IOL (AC-IOL). A control group comprised 114 eyes that underwent DSAEK with posterior-chamber IOLs left in place.
Eyes in the AC-IOL group had been implanted with a similar angle-supported, open-loop AC-IOL with an optic size of 6 mm and length of 13.75 mm (Bausch + Lomb).
Endothelial cell loss and graft survival were the primary study endpoints.
The difference in endothelial cell loss between the two groups at 1 year was found to be insignificant, at 31.9% in the DSAEK/AC-IOL group and 24.5% in the control group, according to the researchers.
However, at 3 years, endothelial cell loss was significantly greater in the DSAEK/AC-IOL group at 55.3%, compared with 33.3% in the control group.
Also at 3 years, graft survival rates were significantly lower in the DSAEK/AC-IOL group than in the control group.
A significantly higher percentage of eyes in the DSAEK/AC-IOL group developed glaucoma within 1 year, according to the researchers.
Disclosure: Tan and Mehta are inventors of the EndoGlide and have financial interests in the device (AngioTech / Network Medical Products).
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