The dimness of intraocular lens of endothelium keratoplasty

Abstract

The endothelium keratoplasty of various modifications (DSEKTDMEK) is the first operation of choice under endothelium pathology of cornea of different genesis. The endothelium transplantation is most often implemented against the background of pseudophakia or at the same time instant with extraction of cataract and implantation of artificial crystalline lens. The clinical cases of damage of transparency of artificial crystalline lens after a routine extraction of cataract are known for a long time while dimness after endothelium transplantation is a new occurrence and related publications are singular. The study was carried out to present cases of damage of transparency of artificial crystalline lens after endothelium transplantation. During 2006-2015 more than 500 patients underwent endothelium transplantations in modifications of DLEK, DS(A)EK, FS-DSEK, invFS-DSEK and DMEK. The most of them (n=291) continue to be under regular or periodic observation. During average period of observation (78±16.8 months) four cases of dimness of artificial crystalline lens after endothelium keratoplasty were established. The biomicroscopy, visiometry and photoregistration were the main analysis techniques of establishing and studying of dynamics of dimness of crystalline lens. It is extremely difficult to establish the nature of dimness of intraocular lens after endothelium keratoplasty because explantation of intraocular lens is required. The surgical inflammatory reaction and presence of air in front camera are common for all cases of dimness of intraocular lens. The damage of transparency of intraocular lens is a complication of remote period after endothelium transplantation. The application of original technique of pneumocorneopexia promotes significant reduction of recurrent injections of air and possibly decreasing of probability of damage of transparency of intraocular lens.