Deep Lamellar Endothelial Keratoplasty for Iridocorneal Endothelial Syndrome in Phakic Eyes

Abstract

To evaluate the efficacy and postoperative complications of deep lamellar endothelial keratoplasty (DLEK) for treating iridocorneal endothelial (ICE) syndrome in phakic eyes. Retrospective noncomparative interventional case series. Seven consecutive patients (7 eyes) having ICE syndrome with clear or mildly opaque lens were treated using DLEK and were followed up for 9 to 20 months. Data collected included best spectacle-corrected visual acuity, intraocular pressure, corneal astigmatism, endothelial cell density, and peripheral iris and anterior chamber angles using ultrasonographic biomicroscopy. Corneas were clear in all eyes. No graft dislocation or lens injury occurred. During the follow-up period, 2 eyes developed cataract, 1 of which underwent phacoemulsification and intraocular lens implantation; 2 eyes had elevated intraocular pressure, 1 of which underwent filtering valve implant surgery; and 3 eyes showed progressive peripheral anterior synechiae. At the last follow-up, best spectacle-corrected visual acuity ranged from 20/67 to 20/30; the mean (SD) corneal astigmatism was 2.0 (0.7) diopters (D); and the mean (SD) corneal curvature was 44.6 (1.5) D. The mean (SD) endothelial cell density was 1917 (156) cells/mm(2) 9 months after surgery. DLEK is efficacious in the treatment of ICE syndrome in phakic eyes, with rapid visual rehabilitation and low incidence of postoperative complications. DLEK may be a good option for ICE syndrome in phakic eyes.