Droutsas Konstantinos, Lazaridis Apostolos, Kymionis George, Chatzistefanou Klio, Papaconstantinou Dimitris, Sekundo Walter, Koutsandrea Chryssanthi
First Department of Ophthalmology, National and Kapodistrian University of Athens, 11527, Athens, Greece.
Department of Ophthalmology, Philipps University, 35043, Marburg, Germany.
Int Ophthalmol. 2019 May;39(5):1027-1035. doi: 10.1007/s10792-018-0899-x. Epub 2018 Apr 4.
To describe the outcomes of endothelial keratoplasty (EK) for bullous keratopathy in eyes with a retained angle-supported anterior chamber intraocular lens (acIOL).
Among 263 consecutive EK procedures, 7 DMEK and 11 DSAEK procedures were identified in eyes with an acIOL and included in the present retrospective case series. Pre- and postoperative status including ocular history, anatomical outcome and complications as well as best-corrected visual acuity was evaluated.
Ocular history included complicated cataract surgery (n = 11), ocular trauma (n = 4) and primary intracapsular cataract extraction (n = 3). Surgery-related complications included primary graft failure (n = 1), graft detachment (n = 1), endophthalmitis (n = 1) and allograft rejection (n = 1). A clear cornea at the final examination (14 ± 4 months) was observed in 14/18 (78%), while the visual outcome was limited due to significant ocular comorbidity in 9 out of 14 uncomplicated procedures.
The presented short-term outcomes suggest that both DMEK and DSAEK are feasible in eyes with an angle-supported acIOL yielding an acceptable graft survival rate in the first postoperative year.
描述在保留有角支撑前房型人工晶状体（acIOL）的眼中，内皮角膜移植术（EK）治疗大泡性角膜病变的结果。
在连续263例EK手术中，确定7例Descemet膜内皮角膜移植术（DMEK）和11例深板层角膜内皮移植术（DSAEK）是在有acIOL的眼中进行的，并纳入本回顾性病例系列。评估术前和术后情况，包括眼部病史、解剖学结果和并发症以及最佳矫正视力。
眼部病史包括复杂白内障手术（n = 11）、眼外伤（n = 4）和原发性白内障囊内摘除术（n = 3）。与手术相关的并发症包括原发性植片失败（n = 1）、植片脱离（n = 1）、眼内炎（n = 1）和同种异体植片排斥反应（n = 1）。在最终检查时（14±4个月），14/18（78%）观察到角膜透明，而在14例无并发症的手术中，有9例因严重眼部合并症导致视力结果受限。
所呈现的短期结果表明，DMEK和DSAEK在有角支撑acIOL的眼中都是可行的，在术后第一年可获得可接受的植片存活率。
