scholarly journals Double-Glide Method Using Cathereep Protective Sheet As a Substitute in Descemet's Stripping Automated Endothelial Keratoplasty

2013 ◽  
Vol 2013 ◽  
pp. 1-5
Author(s):  
Hiroshi Toshida ◽  
Rio Honda ◽  
Asaki Matsui ◽  
Yusuke Matsuzaki ◽  
Yusuke Shimizu ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Perioperative Complications ◽  
Endothelial Damage ◽  
Bullous Keratopathy ◽  
Endothelial Keratoplasty ◽  
Postoperative Course ◽  
Polyurethane Film ◽  
Donor Graft ◽  
Graft Insertion

Purpose. For the insertion of the donor graft in Descemet's stripping automated endothelial keratoplasty (DSAEK), the double-glide method using a Busin glide and intraocular lens (IOL) glide concomitantly has been shown to be effective. The aim of this report is to evaluate the results for the double-glide method using Cathereep (Nichiban, Tokyo, Japan), a protective sheet made of polyurethane film for medical use, as a substitute for an IOL glide. Materials and Methods. The subjects were 10 eyes of 10 patients with bullous keratopathy. The DSAEK operation was performed, and the double-glide method was used for the donor graft insertion. During the operation, an IOL glide was used for the 5 eyes, and the Cathereep protection sheet was used for the remaining 5 eyes. We trimmed approximately 5 mm wide strips from the nonadhesive area surrounding the Cathereep protection sheet. Results. The donor graft was inserted equally easily with the Cathereep protective sheet and IOL glides and improvement of visual acuity was noted in both groups significantly. A favorable postoperative course was obtained with no perioperative complications including endothelial damage. Conclusions. Cathereep protective sheet can be used as a substitute for an IOL glide for double-glide method in DSAEK.

Effect of preoperative duration of stromal edema in bullous keratopathy on early visual acuity after endothelial keratoplasty

2012 ◽  
Vol 38 (2) ◽  
pp. 303-308 ◽  
Author(s):  
Naoyuki Morishige ◽  
Tai-ichiro Chikama ◽  
Naoyuki Yamada ◽  
Norihisa Takahashi ◽  
Yukiko Morita ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Bullous Keratopathy ◽  
Endothelial Keratoplasty ◽  
Stromal Edema

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

2020 ◽  
pp. bjophthalmol-2020-316711
Author(s):  
Jyh Haur Woo ◽  
Anshu Arundhati ◽  
Soon-Phaik Chee ◽  
Weihan Tong ◽  
Lim Li ◽  
...  
Keyword(s):  
Anterior Chamber ◽  
Graft Survival ◽  
Intraocular Lens ◽  
Posterior Chamber ◽  
Bullous Keratopathy ◽  
Endothelial Keratoplasty ◽  
Significant Difference ◽  
Iris Claw ◽  
Iol Exchange

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.

scholarly journals Simultaneous phacoemulsification, lens implantation and endothelial keratoplasty: Triple procedure

2011 ◽  
Vol 68 (9) ◽  
pp. 800-803
Author(s):  
Ljubisa Nikolic ◽  
Vesna Jovanovic
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Corneal Thickness ◽  
Good Choice ◽  
Endothelial Keratoplasty ◽  
Finger Counting ◽  
Triple Procedure ◽  
Lens Implantation ◽  
Lens Power ◽  
Fuchs Dystrophy

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.

scholarly journals 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

2021 ◽  
Author(s):  
Jaya Kaushik ◽  
Ankita Singh ◽  
Rakesh Shetty ◽  
Jitendra Kumar Singh Parihar ◽  
Divya Kochhar ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Visual Outcome ◽  
Bullous Keratopathy ◽  
Endothelial Keratoplasty ◽  
Ocular Lens ◽  
Descemet Stripping Endothelial Keratoplasty ◽  
Lens Subluxation ◽  
Preoperative Visual Acuity ◽  
Endothelial Decompensation

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.

scholarly journals Spontaneous Corneal Clearance in the Presence of a Partially Detached Graft after Non-Descemet Stripping Automated Endothelial Keratoplasty

2016 ◽  
Vol 7 (2) ◽  
pp. 320-326 ◽  
Author(s):  
Konstantinos Droutsas ◽  
Apostolos Lazaridis ◽  
Chrysanthi Koutsandrea ◽  
Klio I. Chatzistefanou ◽  
Marilita M. Moschos ◽  
...  
Keyword(s):  
Endothelial Cells ◽  
Visual Acuity ◽  
Bullous Keratopathy ◽  
Spontaneous Clearance ◽  
Endothelial Keratoplasty ◽  
Invasive Treatment ◽  
Corrected Visual Acuity ◽  
Simplex Virus ◽  
The Right

Purpose: To report the explantation of a detached and opaque donor disc as an alternative to secondary keratoplasty in a case of persistent graft detachment followed by spontaneous clearance of the recipient cornea after non-Descemet stripping automated endothelial keratoplasty (non-DSAEK). Methods: A 57-year-old man with cataract and bullous keratopathy after herpes simplex virus endotheliitis of the right eye and best spectacle-corrected visual acuity (BSCVA) of 0.1 underwent simultaneous phacoemulsification and non-DSAEK. Due to early detachment of the donor disc, two additional intracameral air injections were necessary in order to achieve graft attachment. However, the donor disc gradually detached and became fibrotic while the recipient cornea anterior to the detached graft became transparent and without any edema. Therefore, a mere explantation of the DSAEK graft was performed. Results: Four months after graft explantation, BSCVA was 0.5 and endothelial cell density (ECD) was 1,221 cells/mm2. After 13 months, BSCVA was still 0.6 while ECD had fell to 800, and 2 years later, the endothelium decompensated. BSCVA was 0.3 and ECD was not measurable. Conclusions: To our knowledge this is the first report of explantation of an endothelial graft as an alternative to re-keratoplasty in a case of spontaneous corneal clearance. This minimally invasive treatment may be considered in similar cases. However, due to the ongoing loss of endothelial cells after endothelial keratoplasty, a re-keratoplasty may still be needed in the long term.

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