*Department of Ophthalmology, Universidad Pontificia Bolivariana and CLOFAN, Medellín, Colombia; †Department of Ophthalmology and Vision Science, University of California Davis Eye Center, Sacramento, CA; ‡Department of Ophthalmology Universidad Mayor de San Marcos and Oftalmosalud, Lima, Perú; §Department of Ophthalmology, Universidad de Antioquia and CLOFAN, Medellín, Colombia; and ¶Department of Ophthalmology, Universidad Pontificia Bolivariana, Medellín, Colombia.
Cornea. 2014 Feb;33(2):197-200. doi: 10.1097/ICO.0b013e3182a9dffb.
The aim was to report the surgical outcomes of simultaneous Descemet stripping endothelial keratoplasty (DSEK) with a retropupillary fixated iris claw lens in patients with aphakic corneal edema without capsular support.
The clinical records of aphakic patients with corneal edema and no capsular support who underwent a combined DSEK and implantation of a retropupillary fixated iris claw lens (Artisan) were evaluated. Presurgical and postsurgical best-corrected visual acuity, postsurgical refraction, and endothelial cell count were analyzed at the first and sixth months after the surgery and were imaged with anterior segment ultrasound biomicroscopy.
A total of 9 eyes from 7 females and 2 males were analyzed. The average age was 72.1 years. The mean duration of the postoperative follow-up was 7.7 months. All the patients achieved corrected visual acuities over 0.60 logarithm of the minimum angle of resolution. There was no significant variation in the endothelial count between the first and sixth months. Astigmatism >1 D was induced in all the patients, with 7 patients having against the rule, and 2 patients having oblique astigmatism.
DSEK combined with a retropupillary fixated iris claw lens was shown to be a safe surgical technique in patients with aphakia without capsular support and corneal swelling. This surgery resulted in stable endothelial cell counts during the first 6 months after the surgery and an improvement in visual acuity.
报告在无囊支持的先天性白内障患者中，同时进行撕囊式内皮角膜移植术（DSEK）联合后房固定虹膜夹人工晶状体的手术结果。
评估了 7 名女性和 2 名男性共 9 只眼的无晶状体、角膜水肿且无囊支持的患者的临床资料，这些患者接受了联合 DSEK 和后房固定虹膜夹人工晶状体（Artisan）植入术。分别在术后第 1 个月和第 6 个月评估最佳矫正视力、术后屈光度和内皮细胞计数，并进行眼前节超声生物显微镜检查。
9 只眼中有 7 只为女性，2 只为男性，平均年龄为 72.1 岁。术后平均随访时间为 7.7 个月。所有患者术后矫正视力均超过 0.60 最小分辨角对数。术后第 1 个月和第 6 个月之间内皮细胞计数无明显差异。所有患者均产生了>1 D 的散光，其中 7 例为逆规散光，2 例为斜轴散光。
对于无囊支持的先天性白内障患者，DSEK 联合后房固定虹膜夹人工晶状体是一种安全的手术技术，可减轻角膜水肿。该手术可在术后 6 个月内稳定内皮细胞计数，提高视力。
