Posters

Simultaneous cataract surgery with IOL implantation and DSAEK, achieving the best refractive result with IOL calculation

Poster Details

First Author: A. Lotfi ARGENTINA

Co Author(s):    C. Gordillo   M. Erice   A. Cruz Fourcade   P. Adamek   A. Lotfi        

Abstract Details

Purpose:

To evaluate and describe outcomes of Descemet's stripping and automated endothelial keratoplasty (DSAEK) combined with phacoemulsification and intraocular lens (IOL) implantation in patients with coexisting Fuchs endothelial dystrophy and cataracts.

Setting:

Retrospective study, all the procedures were performed at Zaldivar Institute in Mendoza by the same surgeon.

Methods:

16 eyes of 16 consecutive patients with cataracts and Fuchs' corneal dystrophy with guttata of Descemet's membrane and corneal stromal edema were evaluated. All patients underwent phacoemulsification and posterior IOL implantation through temporal clear corneal incision (2,2 mm), followed by DSAEK. The IOL calculation was performed by using SRK-T, Holladay, HOFFER-Q and HAIGIS, depending on the axial length of the eye, the purpose was to achieve the IOL calculation as close to emmetropia as possible, considering hyperopic shift graft. Outcome measures included under and best corrected distance visual acuity (UDVA, CDVA), refractive outcomes, keratometrics values, and graft clarity.

Results:

Results: mean patient age was 60,43 years (range 44 – 80) and follow-up period of at least 12 months. Patient’s average pre-op CDVA was mean 0,45 logMAR SD 0,48 (0,1-0,9), the average pre-op spherical refractive error was mean -1,21 SD 4,3 (3/-7), and the average pre-op refractive astigmatism was -1,57 SD 1,4 (0,24/-1,75). Six months after the procedure, the CDVA mean 0,22 SD 0,32, the average post-op spherical refractive error was -0,18 SD 1,4 (2/-3,5), and the mean refractive astigmatism was - 1.37 SD 1, 23, excepting cylinder error all results were analysed and statistically significant.

Conclusions:

The triple procedure is a safe and effective approach that provides faster rehabilitation to restore vision in patients with coexisting fuchs corneal dystrophy and cataracts. IOL power can be calculated from theorical K values and previous spherical error for the surgeon as a safe method; however, postoperative refractive error can be anticipated.

Financial Disclosure:

NONE