Combined surgery enables better graft fixation

A stable IOL, decreased pseudophacodonesis and improved graft fixation are the benefits of combining Descemet membrane endothelial keratoplasty with glued intrascleral haptic fixation of a posterior-chamber IOL in patients with aphakic or pseudophakic bullous keratopathy, according to recently published research.

The researchers base their conclusions on a study of 6 patients who had corneal decompensation and inadequate capsular support requiring implantation/exchange of an IOL; all underwent the single-staged procedure at a tertiary care centre. The investigators injected air during surgery to judge the stability of the anterior chamber and structure of the iris diaphragm–IOL complex. They performed iridoplasties in two of the patients. They observed patients after surgery.

Regarding other complications, 1 patient had a partial graft detachment that had to be re-bubbled, and 1 patient had a small peripheral detachment that spontaneously resolved. The graft remained attached in all patients.

Visual acuity (VA) improved in all patients and corrected distance VA significantly changed following surgery. Mean preoperative corrected distance VA was 0.11 ± 0.07, and mean postoperative corrected distance VA was 0.7 ± 0.17.

The mean postoperative endothelial cell density at 6 months was 1710.3 ± 205.8 cells/mm².

To read the abstract of the study, go to the Journal of Refractive Surgery.