Posters

Irvine-Gass syndrome and pseudophakic bullous keratopathy: which one to treat first?

Poster Details

First Author: A.Tzamalis GREECE

Co Author(s): A. Karamitsos   A. Diafas   I. Tsinopoulos   C. Sekeris   N. Ziakas        

Abstract Details

Purpose:

To describe a case of pseudophakic bullous keratopathy along with pseudophakic cystoid macular edema that was treated only with Descemet Membrane Endothelial Keratoplasty.

Setting:

2nd Department of Ophthalmology, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece

Methods:

A 73-year-old female presented to our clinics complaining of vision loss in her right eye, gradually deteriorating 6 months after phacoemulsification surgery that was complicated with posterior capsular rupture. Upon ophthalmic examination, cornea was found hazy and edematous (720μm central corneal thickness) minimizing visualization of the sulcus-placed IOL and the posterior segment. Best corrected visual acuity was finger counting at 1m distance. A macular optical coherence tomography (OCT) revealed an extensive pseudophakic macular edema with multiple cystoid spaces, which was resistant to topical treatment with NSAIDs over a 2-months course.

Results:

An uneventful Descemet Membrane Endothelial Keratoplasty (DMEK) was performed in order to restore corneal clarity and enhance visualization of the posterior segment prior to further management of the Irvine-Gass syndrome. 3 months postoperatively, best corrected distance visual acuity was 20/25 without any further subjective complaints. The posterior segment OCT demonstrated a full regression of the cystoid macular edema which was probably attributed to the topical steroids prescribed for the keratoplasty, only with minimal residual ellipsoid zone disruption.

Conclusions:

This interesting case report describing the simultaneous treatment of pseudophakic bullous keratopathy and pseudophakic cystoid macular edema after Descemet Membrane Endothelial Keratoplasty highlights the possibility of treating both pathologies in one step even without the need for further intervention.

Financial Disclosure:

None