CC BY-NC-ND 4.0 · Ann Natl Acad Med Sci 2021; 57(04): 220-225
DOI: 10.1055/s-0041-1739036
Original Article

Visual Outcome of Combined Descemet Stripping Endothelial Keratoplasty and Sutured Scleral Fixated Intraocular Lens in Endothelial Decompensation with Coexistent Aphakia or Intra Ocular Lens Subluxation

1   Department of Ophthalmology, Armed Forces Medical College, Pune, Maharashtra, India
,
Ankita Singh
1   Department of Ophthalmology, Armed Forces Medical College, Pune, Maharashtra, India
,
Rakesh Shetty
1   Department of Ophthalmology, Armed Forces Medical College, Pune, Maharashtra, India
,
Jitendra Kumar Singh Parihar
2   Glaucoma Unit, Centre for Sight, New Delhi, India
,
Divya Kochhar
1   Department of Ophthalmology, Armed Forces Medical College, Pune, Maharashtra, India
,
Aanchal Singhal
1   Department of Ophthalmology, Armed Forces Medical College, Pune, Maharashtra, India
› Author Affiliations

Abstract

Purpose To elucidate visual outcome of patients after combined Descemet stripping endothelial keratoplasty (DSEK) with scleral fixated intra ocular lens (SFIOL) implantation in patients of endothelial decompensation with coexistent aphakia or lens subluxation.

Materials and Methods A prospective interventional study of combined DSEK with sutured SFIOL in the patients who have undergone surgery at our center over 6-month follow-up period. Preoperative visual acuity and slit lamp findings were documented. Postoperative follow-up was done at days 1, 3, and 7 subsequently, months 1 and 3, and thereafter monthly till the sixth month.

Results Mean age of the patients was 60.47 years. Six patients had aphakic bullous keratopathy, while 11 patients had pseudophakic bullous keratopathy with subluxated posterior chamber IOL (PCIOL). Preoperative visual acuity ranged from hand movements close to face (LogMar 2.4) with accurate projection of rays to 1/60 (LogMar 2) due to existing corneal edema and aphakia. Postoperatively uncorrected visual acuity at 6 months improved up to 6/36 (LogMar 0.8) in all cases. There was gradual improvement in corneal clarity and compactness during the follow-up. A good donor tissue endothelial count and an adequate IOP control were vital prognostic factors for the successful outcome.

Conclusion This novel surgical merger reduces the complications of lenticule dislocation into vitreous and repeated surgeries and shows results akin to when performed in a staged manner.



Publication History

Article published online:
26 October 2021

© 2021. National Academy of Medical Sciences (India). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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