Introduction. Simultaneous Descemet stripping endothelial keratoplasty,
phacoemulsification, and intraocular lens implantation are indicated in
Fuchs? dystrophy with associated cataract. Compared to the standard method of
the triple procedure which includes penetrating keratoplasty, this new method
has the advantages of sutureless surgery, small limbal incision, faster
recovery, less surface problems, less astigmatism, stronger tensile strength
and more predictable calculation of the intraocular lens power. This is the
first report of such a combination of procedures in our literature. Case
report. A 76-year-old woman suffered from a gradual bilateral visual loss.
The best corrected visual acuity was 20/60 (right eye) and finger counting at
1m (left eye). Corneal thickness was 590 ?m and 603 ?m, respectively. A
marked cornea guttata and nuclear cataract were present in both eyes.
Phacoemulsification, lens implantation, and Descemet stripping were done in
the left eye. The posterior lamellar corneal graft, 8.0 mm in diameter and
about 150 ?m thick, was bent and inserted through the limbal incision. The
air was injected into the anterior chamber to attach the graft to the
recipient stroma. The cornea remained clear, and the transplant was attached
during a two-year follow-up. Visual acuity was 20/40 after two months, and
20/25 after one year. Conclusion. The new technique proved itself as a good
choice for the treatment of a mild Fuchs? dystrophy associated with cataract.
Ultrastructural findings in graft failure after Descemet membrane endothelial keratoplasty (DMEK) and new triple procedure
