Descemet Stripping Automated Endothelial Keratoplasty Combined with Phacoemulsification; a Follow up Study

Affiliation: Basir Eye Health Research Center

Authors : Abbas Abolhassani, Rama Pourmatin, Ahmad Shojaei, Fatemeh Vafaei

 

Abstract
Purpose: To evaluate the surgical outcome and refractive status after triple procedure in patients with Fuchs’ dystrophy combined with cataract.Patients and Methods: Thirty four consecutive eyes of 29 patients with coexisting cataract and Fuchs’ dystrophy entered the study. All patients underwent phacoemulsification and IOL implantation through a temporal incision followed by Descemet stripping automated endothelial keratoplasty  (DSAEK). Patients were assessed regarding best corrected visual acuity (BCVA), refractive cylinder and refractive spherical equivalent before surgery, after 3 months and 3 years of follow-up.Results: The mean BCVA was 0.87 ± ۰٫۴۴۸ logMAR pre-operatively which increased to 0.29 ± ۰٫۱۶۴ logMAR at three months (p <0.001), and 0.19 ± ۰٫۱۲۹ at three years (p <0.001). The mean preoperative spherical equivalent was 0.758 ± ۲٫۳۸۴ which reached 0.32 ±۰٫۵۵ (p <0.001) and 0.24 ± ۰٫۴۶ (p <0.001) three months and three years after the simultaneous surgery, respectively. The mean preoperative cylinder was -1.43 ± ۱٫۱۴۱ which reached -0.87 ±۰٫۵۵ (p <0.001) and -0.69 ± ۰٫۳۹ (p <0.001); three months and three years after the simultaneous surgery, respectively.Conclusion: Refractive and visual outcomes after triple surgery are favorable in terms of BCVA, refractive cylinder and refractive spherical equivalent. Therefore, triple procedure might be recommended in older patients due to its rapid visual rehabilitation.Keywords: Descemet stripping automated endothelial keratoplasty; phacoemulsification; best corrected visual acuity; refractive cylinder; spherical equivalent.

Purpose: To evaluate the surgical outcome and refractive status after triple procedure in patients with Fuchs’ dystrophy combined with cataract.
Patients and Methods: Thirty four consecutive eyes of 29 patients with coexisting cataract and Fuchs’ dystrophy entered the study. All patients underwent phacoemulsification and IOL implantation through a temporal incision followed by Descemet stripping automated endothelial keratoplasty  (DSAEK). Patients were assessed regarding best corrected visual acuity (BCVA), refractive cylinder and refractive spherical equivalent before surgery, after 3 months and 3 years of follow-up.
Results: The mean BCVA was 0.87 ± ۰٫۴۴۸ logMAR pre-operatively which increased to 0.29 ± ۰٫۱۶۴ logMAR at three months (p <0.001), and 0.19 ± ۰٫۱۲۹ at three years (p <0.001). The mean preoperative spherical equivalent was 0.758 ± ۲٫۳۸۴ which reached 0.32 ±۰٫۵۵ (p <0.001) and 0.24 ± ۰٫۴۶ (p <0.001) three months and three years after the simultaneous surgery, respectively. The mean preoperative cylinder was -1.43 ± ۱٫۱۴۱ which reached -0.87 ±۰٫۵۵ (p <0.001) and -0.69 ± ۰٫۳۹ (p <0.001); three months and three years after the simultaneous surgery, respectively.
Conclusion: Refractive and visual outcomes after triple surgery are favorable in terms of BCVA, refractive cylinder and refractive spherical equivalent. Therefore, triple procedure might be recommended in older patients due to its rapid visual rehabilitation.

Keywords: Descemet stripping automated endothelial keratoplasty; phacoemulsification; best corrected visual acuity; refractive cylinder; spherical equivalent.

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