Abstract
This report describes the use of Descemet membrane endothelial keratoplasty for the management of endothelial decompensation after multifocal intraocular lens implantation. In this retrospective study, we reviewed and assessed the surgical outcomes of 9 patients (9 eyes) who underwent Descemet membrane endothelial keratoplasty after multifocal intraocular lens implantation. Corneal edema occurred due to Fuchs endothelial corneal dystrophy (n=3), pseudophakic bullous keratopathy (n=3), Descemet's membrane detachment (n=2), and toxic anterior segment syndrome (n=1). The Descemet membrane endothelial keratoplasty surgeries were uneventful in all eyes, but rebubbling procedures were necessary in 2 eyes. One month after the surgery, all the corneas were clear. After 6 months, excluding 1 eye with amblyopia, the mean distance corrected visual acuity was 0.10 logMAR, with all eyes achieving 0.18 logMAR or better. This is the first report of Descemet membrane endothelial keratoplasty after multifocal intraocular lens implantation, and it suggests that good results can be achieved without multifocal intraocular lens exchange.
Highlights
Multifocal intraocular lenses (MIOLs) achieve a high incidence of spectacle independence by delivering satis factory far and near uncorrected vision to well selected patients[1,2]
After 6 months, excluding 1 eye with amblyopia, the mean distance corrected visual acuity was 0.10 logarithm of the minimal angle of resolution (logMAR), with all eyes achieving 0.18 logMAR or better. This is the first report of Descemet membrane endothelial keratoplasty after multifocal intraocular lens implantation, and it suggests that good results can be achieved without multifocal intraocular lens exchange
Descemet membrane endothelial keratoplasty in multifocal pseudophakic eyes such as Fuchs endothelial corneal dystrophy (FECD), or secondary complications, such as pseudophakic bullous keratopathy (PBK) or severe cases of toxic anterior seg ment syndrome (TASS), which may lead to permanent endothelial damage[5]
Summary
Multifocal intraocular lenses (MIOLs) achieve a high incidence of spectacle independence by delivering satis factory far and near uncorrected vision to well selected patients[1,2]. Intraocular cataract surgery may cause or accelerate endothelial decompensation due to primary disorders, This content is licensed under a Creative Commons Attributions 4.0 International License. Descemet membrane endothelial keratoplasty in multifocal pseudophakic eyes such as Fuchs endothelial corneal dystrophy (FECD), or secondary complications, such as pseudophakic bullous keratopathy (PBK) or severe cases of toxic anterior seg ment syndrome (TASS), which may lead to permanent endothelial damage[5]. Descemet membrane endothelial keratoplas ty (DMEK) has shown better visual results and a faster recovery[6,7]. The present report presents the clinical outcomes of 9 patients with previously implanted MIOLs who had endothelial decompensation managed by DMEK without MIOL exchange
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