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Descemet membrane endothelial keratoplasty for corneal decompensation caused by a phakic anterior chamber intraocular lens implantation

  • Cornea
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Abstract

Purpose

To describe the clinical outcomes of Descemet membrane endothelial keratoplasty combined with phacoemulsification/posterior chamber intraocular lens implantation (triple procedure) for treatment of corneal decompensation induced by a phakic anterior chamber intraocular lens (AC IOL) implantation.

Methods

Ten patients (10 eyes) with corneal decompensation due to phakic AC IOL implantation that had undergone the triple procedure were included in this study. Among the 10 eyes, 5 eyes underwent explantation of AC IOL prior to the transplantation, and then underwent the triple procedure. The remaining 5 eyes with a phakic AC IOL in situ underwent the triple procedure with concurrent explantation of AC IOL. Corrected distance visual acuity (CDVA), subjective refraction, endothelial cell density (ECD), and complications were documented.

Results

The triple procedure was performed across all eyes without any adverse events. The average CDVA improved from 1.32 ± 0.24 preoperatively to 0.15 ± 0.05 logarithm of the minimum angle of resolution (logMAR), which represents an improvement in Snellen equivalent from 20/400 (0.05) preoperatively to 20/28 (0.71) at 12 months after surgery. At 12 months, all eyes reached a CDVA of 20/32 (0.63) or better, and 50% of eyes reached a CDVA of 20/25 (0.8) or better. The mean donor ECD±SD was 2868.7 ± 67.9 cells/mm2, which decreased to 1724.1 ± 84.6 cells/mm2 at 12 months, representing 39.9% of endothelial cell loss. Patients did not experience any severe adverse events.

Conclusion

The triple procedure is a safe and effective option for corneal decompensation induced by a phakic AC IOL implantation, helping achieve a satisfactory visual rehabilitation with few complications.

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References

  1. Huang D, Schallhorn SC, Sugar A, Farjo AA, Majmudar PA, Trattler WB, Tanzer DJ (2009) Phakic intraocular lens implantation for the correction of myopia: a report by the American Academy of Ophthalmology. Ophthalmology 116:2244–2258

    Article  Google Scholar 

  2. Dick HB, Budo C, Malecaze F, Güell JL, Marinho AA, Nuijts RM, Luyten GP, Menezo JL, Kohnen T (2009) Foldable Artiflex phakic intraocular lens for the correction of myopia: two-year follow-up results of a prospective European multicenter study. Ophthalmology 116:671–677

    Article  Google Scholar 

  3. Alio JL, Peña-García P, Pachkoria K, Alio JL, EI Aswad A (2013) Intraocular optical quality of phakic intraocular lenses: comparison of angle-supported, iris-fixated, and posterior chamber lenses. Am J Ophthalmol 156:789–799

    Article  Google Scholar 

  4. Guerra MG, Silva AMM, Marques SHM, Melo SH, Póvoa JA, Lobo C, Murta JN (2017) Phakic intraocular lens implantation: refractive outcome and safety in patients with anterior chamber depth between 2.8 and 3.0 versus ≥3.0 mm. Ophthalmic Res 57:239–246

    Article  Google Scholar 

  5. Pechméja J, Guinguet J, Colin J, Binder PS (2012) Severe endothelial cell loss with anterior chamber phakic intraocular lenses. J Cataract Refract Surg 38:1288–1292

    Article  Google Scholar 

  6. Bouheraoua N, Bonnet C, Labbé A, Sandali O, Lecuen N, Ameline B, Borderie V, Laroche L (2015) Iris-fixated phakic intraocular lens implantation to correct myopia and a predictive model of endothelial cell loss. J Cataract Refract Surg 41:2450–2457

    Article  Google Scholar 

  7. Shajari M, Scheffel M, Koss MJ, Kohnen T (2016) Dependency of endothelial cell loss on anterior chamber depth within first 4 years after implantation of iris-supported phakic intraocular lenses to treat high myopia. J Cataract Refract Surg 42:1562–1569

    Article  Google Scholar 

  8. Jonker SMR, Berendschot TTJM, Ronden AE, Saelens IEY, Bauer NJC, Nuijts RMMA (2018) Five year endothelial cell loss after implantation with Artiflex myopia and Artiflex toric phakic intraocular lenses. Am J Ophthalmol 194:110–119

    Article  Google Scholar 

  9. Kohnen T, LaFontaine L, Andrew R (2017) Long–term safety follow-up of an anterior chamber angle-supported phakic intraocular lens. J Cataract Refract Surg 43:1163–1170

    Article  Google Scholar 

  10. Kim M, Kim JK, Lee HK (2008) Corneal endothelial decompensation after iris-claw phakic intraocular lens implantation. J Cataract Refract Surg 34:517–519

    Article  Google Scholar 

  11. Sikder S, Patel V, Holz HA, Mifflin MD, Davis S, Moshirfar M (2011) Management of corneal endothelial decompensation caused by iris-fixated phakic intraocular lenses with Descemet stripping automated endothelial keratoplasty. Cornea 30:1045–1047

    Article  Google Scholar 

  12. Liarakos VS, Ham L, Dapena I, Tong CM, Quilendrino R, Yeh RY, Melles GR (2013) Endothelial keratoplasty for bullous keratopathy in eyes with an anterior chamber intraocular lens. J Cataract Refract Surg 39:1835–1845

    Article  Google Scholar 

  13. Tannan A, Vo RC, Chen JL, Yu F, Deng SX, Aldave AJ (2015) Comparison of ACIOL retention with IOL exchange in patients undergoing Descemet stripping automated endothelial keratoplasty. Cornea 34:1030–1034

    Article  Google Scholar 

  14. Wylegala E, Tarnawska D (2008) Management of pseudophakic bullous keratopathy by combined Descemet stripping endothelial keratoplasty and intraocular lens exchange. J Cataract Refract Surg 34:1708–1714

    Article  Google Scholar 

  15. Sáles CS, Terry MA, Veldman PB, Mayko ZM, Straiko MD (2016) Relationship between tissue unscrolling time and endothelial cell loss. Cornea 35:471–476

    Article  Google Scholar 

  16. Hamzaoglu EC, Straiko MD, Mayko ZM, Sáles CS, Terry MA (2015) The first 100 eyes of standardized Descemet stripping automated endothelial keratoplasty versus standardized Descemet membrane endothelial keratoplasty. Ophthalmology 122:2193–2199

    Article  Google Scholar 

  17. Terry MA, Straiko MD, Veldman PB, Talajic JC, VanZyl C, Sales CS, Mayko ZM (2015) Standardized DMEK technique: reducing complications using prestripped tissue, novel glass injector, and sulfur hexafluoride (SF6) gas. Cornea 34:845–852

    Article  Google Scholar 

  18. Schlögl A, Tourtas T, Kruse FE, Weller JM (2016) Long-term clinical outcome after Descemet membrane endothelial keratoplasty. Am J Ophthalmol 169:218–226

    Article  Google Scholar 

  19. Coullet J, Mahieu L, Malecaze F, Fournié P, Leparmentier A, Moalic S, Arne JL (2007) Severe endothelial cell loss following uneventful angle-supported phakic intraocular lens implantation for high myopia. J Cataract Refract Surg 33:1477–1481

    Article  Google Scholar 

  20. Saxena R, Boekhoom SS, Mulder PGH, Noordzij B, van Rij G, Luyten GP (2008) Long-term follow-up of endothelial cell change after Artisan phakic intraocular lens implantation. Ophthalmology 115:608–613

    Article  Google Scholar 

  21. Coli A, Price FW, Whitson WE (1993) Intraocular lens exchange for anterior chamber intraocular lens-induced corneal endothelial damage. Ophthalmology 100:384–393

    Article  CAS  Google Scholar 

  22. Fernandez-Vega L, Alfonso JF, Villacampa T (2003) Clear lens extraction for the correction of high myopia. Ophthalmology 110:2349–2354

    Article  Google Scholar 

  23. Pucci V, Morselli S, Romanelli F, Pignatto S, Scandellari F, Bellucci R (2001) Clear lens phacoemulsification for correction of high myopia. J Cataract Refract Surg 27:896–900

    Article  CAS  Google Scholar 

  24. Arne JL (2004) Phakic intraocular lens implantation versus clear lens extraction in highly myopic eyes of 30- to 50-year-old patients. J Cataract Refract Surg 30:2092–2096

    Article  Google Scholar 

  25. Horgan N, Condon PI, Beatty S (2005) Refractive lens exchange in high myopia: long term follow up. Br J Ophthalmol 89:670–672

    Article  CAS  Google Scholar 

  26. Colin J, Robinet A, Cochener B (1999) Retinal detachment after clear lens extraction for high myopia. Ophthalmology 106:2281–2285

    Article  CAS  Google Scholar 

  27. Hole HA, Meyer JJ, Espandar L, Tabin GC, Mifflin MD, Moshirfar M (2008) Corneal profile analysis after Descemet stripping endothelial keratoplasty and its relationship to postoperative hyperopic shift. J Cataract Refract Surg 34:211–214

    Article  Google Scholar 

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Funding

This work was supported by the National Natural Science Foundation of China (grant number 81870628).

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Authors and Affiliations

  1. State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510060, China

    Ting Huang, Jing Wu, Xiaojuan Dong, Jianping Ji, Chen Ouyang, Lijie Xie & Chao Hou

Authors
  1. Ting Huang
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  2. Jing Wu
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  3. Xiaojuan Dong
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  4. Jianping Ji
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  5. Chen Ouyang
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  6. Lijie Xie
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  7. Chao Hou
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Corresponding author

Correspondence to Ting Huang.

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Conflicts of interest

The authors declare that they have no conflicts of interest.

Ethics approval

This study adhered to the tenets of the Declaration of Helsinki. The Ethics Committee of Zhongshan Ophthalmic Center (Guangzhou, China) approved the study protocol.

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Written informed consent forms for research participation were signed by all participants prior to surgery.

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Written informed consent forms for research participation were signed by all participants prior to surgery.

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Huang, T., Wu, J., Dong, X. et al. Descemet membrane endothelial keratoplasty for corneal decompensation caused by a phakic anterior chamber intraocular lens implantation. Graefes Arch Clin Exp Ophthalmol 258, 2761–2766 (2020). https://doi.org/10.1007/s00417-020-04928-w

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  • DOI: https://doi.org/10.1007/s00417-020-04928-w

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