Posters

Iris-sutured intraocular lens fixation combined with Descemet’s stripping automated endothelial keratoplasty

Poster Details

First Author: D.Dzhaber USA

Co Author(s):    O. Mustafa   Y. Daoud                 

Abstract Details

Purpose:

To evaluate the outcomes of combined iris suture fixation of posteriorly dislocated intraocular lens (IOL) and Descemet’s Stripping Automated Endothelial Keratoplasty (DSAEK) for aphakic (ABK) and pseudophakic bullous keratopathy (PBK).

Setting:

Cornea division, Wilmer Eye Institute, Johns Hopkins University School of Medicine.

Methods:

Retrospective chart review and analysis of patients who underwent combined DSAEK and iris suture fixation of posteriorly dislocated IOLs was performed. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and intraocular pressure (IOP) were evaluated at baseline, post-operative month one (POM1) and post-operative month three (POM3). Intra-operative events were recorded in all cases. Other post-operative complications, such as DSAEK graft decentration, episodes of rejection, graft failure, IOL status, cystoid macular edema, epiretinal membrane formation, and newly-developed glaucoma were evaluated at POM1 and POM3.

Results:

Fifteen eyes were examined. The mean pre-operative UDVA (LogMAR) improved from 1.61±0.76 to 1.42±0.66 at POM1 and to 1.35±0.77 at POM3. Mean CDVA improved from 1.43±0.78 pre-operatively to 0.81±0.42 at POM1 and to 0.51±0.26 at POM3. Compared to an average of 12.03±5.12 mmHg at baseline, IOP was higher at POM1 and POM3 (15.89±8.68 mmHg and 14.88±8.43 mmHg, respectively). Early IOP spike was noted in one case. There was one case of DSAEK graft rejection at post-operative week two, and two cases of graft decentration. IOL was centered post-operatively in all cases.

Conclusions:

Iris suture fixation of a posteriorly dislocated IOL combined with DSAEK is a safe and effective method to manage ABK and PBK. Iris suture fixation of an IOL in such cases is strong enough to sustain the manipulation required for corneal procedures. Higher IOP changes in post-operative period in such eyes require further investigation.

Financial Disclosure:

None