Abstract

Descemet-stripping automated endothelial keratoplasty (DSAEK) combined with cataract surgery was performed in a 55-year-old man who had bilateral phakic intraocular lens (pIOL) implantation in Moscow, Russia, for high myopia when he was 26 years old. In 2015, he had DSAEK in Nagoya, Japan, after examinations showed the presence of bullous keratopathy in the right eye. In August 2017, he was referred to the Baptist Eye Institute in Kyoto, Japan, because the DSAEK graft had failed. The failed graft and the pIOL were extracted, after which lensectomy, IOL implantation, and anterior capsule staining were performed. A fresh DSAEK graft was attached to the posterior corneal surface via an air injection. By 6 months postoperatively, the corrected distance visual acuity had improved from 20/2000 to 20/20. These outcomes suggest that this surgical procedure would be safe, effective, and applicable in similar complicated cases.

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