Descemet Stripping Automated Endothelial Keratoplasty Combined with Phacoemulsification; a Follow up Study
Journal of Ophthalmic and Optometric Sciences,
Vol. 1 No. 4 (2017),
24 June 2017
,
Page 1-7
https://doi.org/10.22037/joos.v1i4.21719
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 ± 0.448 logMAR pre-operatively which increased to 0.29 ± 0.164 logMAR at three months (p <0.001), and 0.19 ± 0.129 at three years (p <0.001). The mean preoperative spherical equivalent was 0.758 ± 2.384 which reached 0.32 ±0.55 (p <0.001) and 0.24 ± 0.46 (p <0.001) three months and three years after the simultaneous surgery, respectively. The mean preoperative cylinder was -1.43 ± 1.141 which reached -0.87 ±0.55 (p <0.001) and -0.69 ± 0.39 (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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References
Covert DJ, Koenig SB. New triple procedure: Descemet's stripping and automated endothelial keratoplasty combinedwith phacoemulsification and intraocular lens implantation. Ophthalmology. 2007;114(7):1272-7.
Gorovoy MS1, Gorovoy IR, Ullman S, Gorovoy JB. Descemet stripping automated endothelial keratoplasty for spontaneous descemet membrane detachment in a patient with osteogenesis imperfecta. Cornea. 2012;31(7):832-5.
Jastaneiah SS. Descemet's Stripping-Automated Endothelial Keratoplasty for Traumatic Aniridia and Aphakia. Case Rep Ophthalmol Med. 2012;2012:982657.
Das S, Langenbucher A, Jacobi C, Nguyen NX, Kruse FE, Naumann GO, et al. Long-term refractive and visual outcome after penetrating keratoplasty only versus the tripleprocedure in Fuchs' dystrophy. Graefes Arch Clin Exp Ophthalmol. 2006;244(9):1089-95.
Terry MA, Shamie N, Chen ES, Phillips PM, Shah AK, Hoar KL, et al. Endothelial keratoplasty for Fuchs' dystrophy with cataract: complications and clinical results with the new triple procedure. Ophthalmology. 2009;116(4):631-9.
Pineros OE, Cohen EJ, Rapuano CJ, Laibson PR. Triple vs nonsimultaneous procedures in Fuchs' dystrophy and cataract. Arch Ophthalmol. 1996;114(5):525-8.
Seitzman GD, Gottsch JD, Stark WJ. Cataract surgery in patients with Fuchs' corneal dystrophy: expanding recommendations for cataract surgery without simultaneous keratoplasty. Ophthalmology. 2005;112(3):441-6.
Cohen KL, Holman RE, Tripoli NK, Kupper LL. Effect of trephine tilt on corneal button dimensions. Am J Ophthalmol. 1986;101(6):722-5.
Terry MA, Ousley PJ. In pursuit of emmetropia: spherical equivalent refraction results with deep lamellar endothelialkeratoplasty (DLEK). Cornea. 2003;22(7):619-26.
Viestenz A, Seitz B, Langenbucher A. Intraocular lens power prediction for triple procedures in Fuchs' dystrophy using multipleregression analysis. Acta Ophthalmol Scand. 2005;83(3):312-5.
Zinger C, Borderie V. Cataract and Fuchs Dystrophy. Investigative Ophthalmology & Visual Science, 2013;54(15): 3009.
Pineros O, Cohen EJ, Rapuano CJ, Laibson PR. Long-term results after penetrating keratoplasty for Fuchs' endothelial dystrophy. Arch Ophthalmol. 1996;114(1):15-8.
Payant JA, Gordon LW, VanderZwaag R, Wood TO. Cataract formation following corneal transplantation in eyes with Fuchs' endothelial dystrophy. Cornea. 1990;9(4):286-9.
Klein BE, Klein R, Linton KL. Prevalence of age-related lens opacities in a population. The Beaver Dam Eye Study. Ophthalmology. 1992;99(4):546-52.
Davis EA, Azar DT, Jakobs FM, Stark WJ. Refractive and keratometric results after the triple procedure: experience with early and latesuture removal. Ophthalmology. 1998;105(4):624-30.
Javadi MA, Feizi S, Moein HR. Simultaneous penetrating keratoplasty and cataract surgery. J Ophthalmic Vis Res. 2013;8(1):39-46.
Scorcia V, Lucisano A, Beltz J, Busin M. Combined Descemet-stripping automated endothelial keratoplasty and phacoemulsification with toric intraocular lens implantation for treatment of failed penetrating keratoplasty with highregular astigmatism. J Cataract Refract Surg. 2012;38(4):716-9.
Das S, Langenbucher A, Jacobi C, Nguyen NX, Kruse FE, Naumann GO, et al. Long-term refractive and visual outcome after penetrating keratoplasty only versus the tripleprocedure in Fuchs' dystrophy. Graefes Arch Clin Exp Ophthalmol. 2006;244(9):1089-95.
Sykakis E, Lam FC, Georgoudis P, Hamada S, Lake D. Patients with Fuchs Endothelial Dystrophy and Cataract Undergoing Descemet StrippingAutomated Endothelial Keratoplasty and Phacoemulsification with Intraocular Lens Implant: Staged versus Combined Procedure Outcomes. J Ophthalmol. 2015;2015:172075.
Hayashi K1, Hayashi H.Simultaneous versus sequential penetrating keratoplasty and cataract surgery. Cornea. 2006;25(9):1020-5.
Terry MA, Shamie N, Chen ES, Phillips PM, Shah AK, Hoar KL, Endothelial keratoplasty for Fuchs' dystrophy with cataract: complications and clinical results with the new triple procedure. Ophthalmology. 2009;116(4):631-9.
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