Endothelial keratoplasty with anterior chamber intraocular lens versus secondary posterior chamber intraocular lens

AimTo describe the long-term outcomes of Descemet stripping automated endothelial keratoplasty (DSAEK) with an anterior chamber intraocular lens (ACIOL) compared to secondary posterior chamber (PC) IOL.MethodsThis was a retrospective comparative cohort study. The clinical data of 82 eyes from 82 consecutive patients with pseudophakic (PBK) or aphakic bullous keratopathy (ABK) who either underwent DSAEK with retained or secondary ACIOL (n=23) or DSAEK with IOL exchange and/or secondary PCIOL (retropupillary iris-claw IOL, n=25; intrascleral-fixated IOL, n=29; or sulcus IOL, n=5) were analysed. The main outcome measures were graft survival and complications up to 5 years.ResultsThe graft survival in the secondary PCIOL group was superior than the ACIOL group over 5 years (year 1, 100.0% vs 100.0%; year 3, 94.7% vs 75.0%; year 5, 91.1% vs 60.6%, p=0.022). The presence of an ACIOL was a significant risk factor associated with graft failure (HR, 4.801; 95% CI, 1.406 to 16.396, p=0.012) compared to a secondary PCIOL. There was no significant difference in the rate of graft detachment and elevated intraocular pressure between the groups. There were five cases (9.3%) of IOL subluxation or dislocation in the retropupillary iris-claw and intrascleral-fixated IOL groups.ConclusionsEyes that underwent DSAEK with ACIOL in situ had poorer long-term graft survival compared with those with secondary PCIOL. Intraocular lens exchange was not associated with a higher complication rate. In ABK or PBK eyes with ACIOL, we recommend performing IOL exchange and/or secondary PCIOL implantation combined with endothelial keratoplasty.

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Dislocation of a Scleral-Fixated Posterior Chamber Intraocular Lens Into the Anterior Chamber Associated With Pseudophakic Bullous Keratopathy

Ophthalmic Surgery Lasers and Imaging Retina ◽

10.3928/1542-8877-20040101-15 ◽

2004 ◽

Vol 35 (1) ◽

pp. 67-69 ◽

Cited By ~ 1

Author(s):

Erdinç Aydin ◽

Hüseyin Bayramlar ◽

Yüksel Totan ◽

Mutlu Cihan Daglioglu ◽

Mehmet Borazan

Keyword(s):

Anterior Chamber ◽

Intraocular Lens ◽

Posterior Chamber ◽

Bullous Keratopathy ◽

Posterior Chamber Intraocular Lens ◽

Pseudophakic Bullous Keratopathy

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Clinical Outcomes of Penetrating Keratoplasty and Descemet Stripping Automated Endothelial Keratoplasty in Asian Population with American Corneas

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16224547 ◽

2019 ◽

Vol 16 (22) ◽

pp. 4547 ◽

Cited By ~ 1

Author(s):

Hsiao ◽

Chen ◽

Meir ◽

Tan ◽

Hsiao ◽

...

Keyword(s):

Survival Rate ◽

Graft Survival ◽

Penetrating Keratoplasty ◽

Survival Rates ◽

Asian Population ◽

Chang Gung Memorial Hospital ◽

Endothelial Keratoplasty ◽

Significant Difference ◽

Donor Corneas

To determine the comparative efficacy and safety of penetrating keratoplasty (PK) and Descemet stripping automated endothelial keratoplasty (DSAEK) in the Asian population receiving imported donor corneas, our single-center retrospective study provides analysis supporting the transition from PK to DSAEK in the Asian population using imported American donor corneas. We analyzed 259 patients with 241 and 57 cases of PK and DSAEK respectively during 2008 to 2017 using imported corneas at Chang Gung Memorial Hospital, Linkou, Taiwan. In terms of long-term graft survival analysis, there was no difference between PK and DSAEK (log-rank p = 0.386, HR = 0.920, 95% CI: [0.641–1.380]). However, Cox proportional regression analysis revealed that corneal survival rate of DSAEK group in the first 100 days after transplantation was inferior than that of PK group (log-rank p < 0.001, HR = 2.733, 95% CI: [1.501–4.977])]. Despite the inferior survival rate, there were significantly less neovascularization and Descemet membrane folds in the DSAEK group. Importantly, the non-complication rate of DSAEK was much higher than that of PK with significant difference (PK, 25.7% vs DSAEK 42.0%, p = 0.022). Collectively, DSAEK is suggested as an alternative surgical modality in Asian patients using imported American donor corneas because of less complication, and no difference in long-term corneal graft survival rates between PK and DSAEK.

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Anterior Chamber Iris Claw Lens for the Treatment of Aphakia in a Patient with Megalocornea

Case Reports in Ophthalmology ◽

10.1159/000431251 ◽

2015 ◽

Vol 6 (2) ◽

pp. 164-169 ◽

Cited By ~ 2

Author(s):

Norman Saffra ◽

Aleksandr Rakhamimov ◽

Robert Masini ◽

Kenneth J. Rosenthal

Keyword(s):

Anterior Chamber ◽

Intraocular Lens ◽

Crystalline Lens ◽

Posterior Chamber ◽

Cataract Formation ◽

Posterior Chamber Intraocular Lens ◽

Effective Option ◽

Iris Claw Lens ◽

Capsular Bag ◽

Iris Claw

Megalocornea in isolation is a rare congenital enlargement of the cornea greater than 13 mm in diameter. Patients with megalocornea are prone to cataract formation, crystalline lens subluxation, zonular deficiencies and dislocation of the posterior chamber intraocular lens (PCIOL) within the capsular bag. A 55-year-old male with megalocornea in isolation developed subluxation of the capsular bag and PCIOL. The PCIOL and capsular bag were explanted, and the patient was subsequently implanted with an anterior chamber iris claw lens. An anterior chamber iris claw lens is an effective option for the correction of aphakia in patients with megalocornea.

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Outcomes of Descemet Stripping Automated Endothelial Keratoplasty in Patients With an Anterior Chamber Versus Posterior Chamber Intraocular Lens

Cornea ◽

10.1097/ico.0000000000000131 ◽

2014 ◽

Vol 33 (7) ◽

pp. 686-690 ◽

Cited By ~ 7

Author(s):

Sagi Arieh Shpitzer ◽

Amir Rosenblatt ◽

Irit Bahar

Keyword(s):

Anterior Chamber ◽

Intraocular Lens ◽

Posterior Chamber ◽

Endothelial Keratoplasty ◽

Posterior Chamber Intraocular Lens

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Comparison of Outcomes of Posterior Chamber and Iris-Claw Anterior Chamber Phakic Intraocular Lens Implantation for Moderate to High Myopia

Journal of Clinical & Experimental Ophthalmology ◽

10.4172/2155-9570.1000263 ◽

2013 ◽

Vol 04 (01) ◽

Author(s):

Isil Bahar Sayman Muslubas

Keyword(s):

Anterior Chamber ◽

Intraocular Lens ◽

High Myopia ◽

Posterior Chamber ◽

Intraocular Lens Implantation ◽

Phakic Intraocular Lens ◽

Lens Implantation ◽

Iris Claw

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Iris-claw intraocular lens, scleral-fixated intraocular lens, and angle-supported anterior chamber intraocular lens in Hospital Melaka: a four-year retrospective analysis

Malaysian Journal of Ophthalmology ◽

10.35119/myjo.v2i2.71 ◽

2020 ◽

Vol 2 (2) ◽

pp. 83-95

Author(s):

Chin Sern Chan ◽

Szu May Chua ◽

Siti Zakiah Md Khair ◽

Nor Fadzillah Abdul Jalil ◽

Raja Norliza Raja Omar ◽

...

Keyword(s):

Visual Acuity ◽

Anterior Chamber ◽

Retrospective Analysis ◽

Intraocular Lens ◽

Demographic Data ◽

Cystoid Macular Oedema ◽

Visual Outcomes ◽

Significant Difference ◽

Duration Of Surgery ◽

Iris Claw

Introduction: Cataract surgery with insufficient capsular support has become an intense challenge to surgeons in intraocular lens (IOL) selection. Anterior chamber IOL (ACIOL), iris-claw (Artisan) IOL, and scleral-fixated IOL (SFIOL) are the three common types of IOL used. However, each type of IOL has its own characteristics and different clinical requirements. IOL selection is important in ensuring good visual outcome. Purpose: The purpose is to compare the duration or surgery, visual outcomes, and complications among ACIOL, Artisan IOL, and SFIOL. Study design: Retrospective comparative analysis. Material and methods: This is a four-year retrospective analysis of patients who underwent either ACIOL, Artisan IOL, or SFIOL implantation between January 2014 and January 2018. Patients were divided into ACIOL, Artisan, and SFIOL groups. Demographic data, duration of surgery, preoperative and postoperative visual acuity, and postoperative complications were identified and compared among the different groups. Results: Sixty-four eyes from 58 patients were analysed: twenty (31.3%) eyes with ACIOL, 28 (43.8%) eyes with Artisan, and 16 (25%) eyes with SFIOL. Mean surgery times for ACIOL, Artisan, and SFIOL were: 61 ± 27.8, 64 ± 26.9, and 104.1 ± 46.8, respectively. SFIOL showed significantly longer surgery time than the ACIOL and Artisan groups (p < 0.05). There was no significant difference in surgery time between the ACIOL and Artisan groups (p > 0.05). The Artisan group showed significantly better visual recovery at postoperative 1 week than both the ACIOL and SFIOL groups (Artisan vs ACIOL: 6/18 vs 6/24, p < 0.05; Artisan vs SFIOL: 6/18 vs 6/60, p < 0.05). However, final best-corrected visual acuity (BCVA) at two months was comparable among all three groups with a median BCVA of 6/9. Elevated intraocular pressure occurred in all IOL groups, retinal detachment developedin the Artisan and SFIOL groups, epiretinal membrane developed in the ACIOL and SFIOL groups, corneal decompensation developed in the ACIOL group only. Cystoid macular oedema and IOL tilt occurred in SFIOL only. Conclusions: All three groups of IOL showed comparable good visual outcomes. The decision of IOL selection should be based on patients’ clinical condition and availability of surgical skill and resources.

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Air-assisted Descemet-stripping automated endothelial keratoplasty with posterior chamber iris-fixation of aphakic iris-claw intraocular lens

Journal of Cataract & Refractive Surgery ◽

10.1016/j.jcrs.2010.11.021 ◽

2011 ◽

Vol 37 (2) ◽

pp. 224-228 ◽

Cited By ~ 10

Author(s):

Farid Karimian ◽

Mohammad Mahdi Sadoughi

Keyword(s):

Intraocular Lens ◽

Posterior Chamber ◽

Endothelial Keratoplasty ◽

Iris Fixation ◽

Iris Claw

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Graft Survival and Clinical Outcomes of Descemet Membrane Endothelial Keratoplasty: Long Term Results

10.21203/rs.3.rs-263813/v1 ◽

2021 ◽

Author(s):

NILAY KANDEMIR BESEK ◽

Gülay Yalçınkaya ◽

Ahmet Kırgız ◽

Semih Çakmak ◽

Selim Genç ◽

...

Keyword(s):

Clinical Outcomes ◽

Graft Survival ◽

Graft Failure ◽

Survival Rates ◽

Long Term Results ◽

Bullous Keratopathy ◽

Endothelial Keratoplasty ◽

Descemet Membrane Endothelial Keratoplasty ◽

Descemet Membrane

Abstract Purpose: The aim is to report long-term graft survival rates, clinical outcomes of Descemet membrane endothelial keratoplasty (DMEK).Methods: In this study 150 eyes, that underwent DMEK whether for Fuchs endothelial corneal dystrophy (FECD) or for bullous keratopathy (BK), surveilled for 7 years at 6 time-points to evaluate graft survival rates and clinical outcomes of post-corneal transplantation.Results: Overall, the estimated survival probability of 95% confidence interval at 7 years of post-DMEK was 0.58 (0.72-0.77) and the survival probabilities of eyes operated for FECD (0.53) were higher than eyes operated for BK (0.42) (Log Rank 26.87, [p=0.197]). Post-transplant eyes with FECD achieved better visual acuity levels than eyes with BK (p=0.006). Primary graft failure occurred in 11.3% eyes. Secondary graft failure rate was 9.3%, and allograft rejection rate was 4.7%.Conclusion: Although DMEK is effective, safe in long-term, visual results and graft survival rates are better in cases with FECD.

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