Non-Descemet stripping endothelial keratoplasty for treating iridocorneal endothelial syndrome in phakic eyes

Abstract

To investigate the feasibility and clinical effects of non-Descemet stripping endothelial keratoplasty (nDSEK) on treating iridocorneal endothelial (ICE) syndrome in phakic eyes. Retrospective noncomparative interventional case series. 7 patients (7 eyes) with ICE syndrome at the Affiliated Xiamen Eye Center of Xiamen University from January 2008 to December 2009 underwent non-Descemet stripping endothelial keratoplasty. All patients were followed up for 3 - 12 months, pre- and postoperative best corrected visual acuity (BCVA) were compared, the adherence of the donor disc to the recipient endothelium and postoperative donor disc dislocation were monitored during the follow-up period. Graft clearance and endothelial cell density (ECD) were observed, too. After nDSEK, no primary graft failures dislocation and decentered graft occurred during the follow-up period. Study group intraoperative complications included 3 case with elevated intraocular pressure 2 day postoperatively. Subepithelial haze, donor-recipient interface haze, and interface particles were observed in all measurable cases by in vivo laser confocal microscopy. Anterior segment optical coherence tomography and ultrasound biomicroscopy showed the adherence of the donor disc to the recipient endothelium and peripheral anterior synechiae were separated. All corneas remained clear during the follow-up. 6 patients had improved BCVA while 1 patient had the same BCVA. The reason for poor VA was optic atrophy due to glaucoma. Postoperative mean EDC was (2176.6 ± 267.6) cells/mm(2). nDSEK for iridocorneal endothelial (ICE) syndrome is feasible, technically easy, safe and effective. It can be one of the surgical treatment option for bullous keratopathy.