Posters

Descemet's membrane endothelial keratoplasty (DMEK) in the presence of iris prosthesis

Poster Details

First Author: N. Gerber-Hollbach SWITZERLAND

Co Author(s):    D. Goldblum                    

Abstract Details

Purpose:

Descemet membrane endothelial keratoplasty (DMEK) is gaining popularity not only as a primary treatment for endothelial dysfunction but also as secondary treatment option after complicated primary DMEK surgery, in the presence of glaucoma devices or anterior chamber lenses. We first present a new DMEK surgery technique in the presence of an artificial iris diaphragm.

Setting:

University Eye Hospital Basel, Primary Care Center

Methods:

DMEK surgery was performed in a 89-year-old patient that presented after complicated cataract surgery with a subtotal iatrogenic iridodialysis. Ten months after implantation of an artificial iris he developed a bullous pseudophakic keratopathy. Endothelial keratoplasty was performed using a new modified “No-touch” surgery technique with continuous air flow and a 7.75mm graft.

Results:

BCVA improved to 0.9 at three months after keratoplasty. Endothelial cell density counting showed a 29% decrease, central corneal thickness a 19% decrease at three months after surgery compared to preoperative values.

Conclusions:

Due to the shallow anterior chamber and the stiff iris/lens diaphragm manipulation of the graft, fluid/air exchanges and pressurization of the eye were challenging. With some modifications and the use of an anterior chamber maintainer DMEK is a feasible and successful treatment option in the presence of an iris prothesis. Clinical outcomes at 3 months seem comparable with standard DMEK surgery.

Financial Disclosure:

NONE