Glued Intrascleral Fixation of Intraocular Lens With Pupilloplasty and Pre-Descemet Endothelial Keratoplasty: A Triple Procedure

Purpose:To describe a surgical approach of glue-assisted intrascleral fixation of an intraocular lens (IOL) with pupilloplasty and pre-Descemet endothelial keratoplasty as a single-stage procedure.Methods:Glue-assisted intrascleral fixation of an IOL is performed initially because it helps to secure the IOL fixation, followed by pupilloplasty that imparts stability to the anterior chamber and prevents air diversion into the vitreous cavity, thereby facilitating the pre-Descemet endothelial keratoplasty procedure that is performed to complete the surgical repair.Results:The procedure was performed in 5 eyes of 5 patients, and the donor age ranged from 9 months to 65 years. There was a significant change in the uncorrected (P = 0.034) and corrected (P = 0.043) distance visual acuities in the postoperative period. The mean graft size was 7.6 0.4 mm (range, 7-8 mm). The mean preoperative and postoperative specular endothelial counts were 2788 +/- 204 cells per square millimeter and 1898 +/- 90 cells per square millimeter, respectively. No incidence of primary graft failure or graft rejection during the entire follow-up period was reported in any of the eyes.Conclusions:The combined procedure serves as an effective method in select cases of endothelial decompensation that require a secondary IOL implantation or an IOL exchange with good postoperative results.