Clinical Outcomes of Combined Descemet-stripping Endothelial Keratoplasty and Intraocular Lens Exchange

Purpose: To evaluate clinical outcomes after combined descemet-stripping endothelial keratoplasty (DSEK) and intraocular lens (IOL) exchange in a Korean population. Methods: The medical records of 15 patients (15 eyes) with pseudophakic bullous keratopathy who underwent combined DSEK and IOL exchange from January 2011 to January 2015 and who were followed up for more than 12 months were reviewed retrospectively. Results: In 14 eyes with successful results after surgery, the best corrective visual acuity (BCVA) was significantly improved from 2.01 +/- 0.96 (log MAR, mean) to 0.68 +/- 0.26 at 3 months (p= 0.001) except for one eye that received reoperation on the endothelial disc detachment. The BCVA at postoperative 6 and 12 months gradually increased (0.51 +/- 0.26 and 0.40 +/- 0.22 log MAR, mean). Central corneal thickness was significantly improved from 777 +/- 139 mu m to 605 +/- 28 mu m at 6 months (p= 0.003) and was maintained at 12 months. The mean endothelial cell count was 2,973 +/- 281/mm(2) in the donor lenticules and 1,790 +/- 265/mm(2) at 12 months. Endothelial cell loss was 40%. The target refraction was -0.81 +/- 0.16 D and the 12 months postoperative spherical equivalent was -0.28 +/- 0.36 D. Complications included intraocular pressure elevation in one eye and pupillary capture in one eye. Conclusions: Combined DSEK and IOL exchange may be a very efficient and safe option for surgically managing pseudophakic bullous keratopathy.