Descemet membrane stripping endothelial keratoplasty for Descemet membrne detachment following phacoemulsification

Objective: To report successful vision restoration after Descemet membrane stripping endothelial keratoplasty (DSEK) for 3 cases with extensive Descemet membrane detachment (DMD) after phacoemulsification. Design: Retrospective case series. Participants: Three patients with extensive DMD after phacoemulsification. Methods: Three patients with DMD after phacoemulsification were reviewed. All patients developed DMD affecting more than 70% of the cornea and showed significant corneal edema, which did not resolve with air bubble tamponade. To resolve corneal edema, we performed DSEK. Results: Successful postoperative resolution of corneal edema was achieved for all 3 patients. Best corrected visual acuity improved from 2.20 +/- 0.72 (logMAR) to 0.24 +/- 0.06 (logMAR). No complications were noted during 24.7 +/- 3.2 months of follow-up (range 21-27 months). The change in spherical equivalent from pre-DSEK to 1 year postoperatively was +0.87 D (range +0.63 to +1.25 D). Conclusions: DSEK may be a viable surgical option for treatment of patients with extensive DMD after phacoemulsification. However, when DSEK is contemplated, intraocular lens exchange for hyperopic shift after DSEK must be considered.