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Descemet-stripping automated endothelial keratoplasty with intrascleral haptic-fixated intraocular lens in a sequential vs simultaneous approach
- Source :
- Journal of cataract and refractive surgery. 47(6)
- Publication Year :
- 2020
-
Abstract
- Purpose To compare the outcomes of Descemet-stripping automated endothelial keratoplasty (DSAEK) with intrascleral haptic-fixated intraocular lens (IOL) in a sequential and simultaneous approach. Setting Tertiary eyecare center. Design Prospective randomized comparative study. Methods Patients with aphakic or complicated pseudophakic bullous keratopathy visiting a tertiary eyecare center were included in the study. A total of 40 patients were randomized into 2 groups of 20 each. Group 1 had subjects who underwent scleral-fixated IOL (SF IOL) implantation by intrascleral haptic fixation technique, followed by DSAEK (sequential procedure) with an interval of at least 3 months. Group 2 (simultaneous) had subjects who underwent DSAEK with SF IOL as a combined procedure. Graft survival, endothelial cell loss (ECL), corrected distance visual acuity (CDVA), and need for any intervention such as rebubbling were evaluated for both the groups at the end of 6 months. Results At 6 months, the sequential group had significantly better CDVA of 0.62 ± 0.17 logMAR compared with 0.87 ± 0.19 logMAR in the simultaneous group (P = .002). Group 1 had significantly better overall cumulative graft survival (100% vs 60%, P = .002), significantly lower ECL (P = .006), lesser mean central corneal thickness (P = .03), and significantly thinner donor lenticule (P = .009). Rebubbling rate was significantly higher in Group 2 (P = .025). The mean hyperopic shift was significantly more in Group 2 (P = .02). Conclusion The sequential procedure of SF IOL followed by DSAEK has better visual outcomes and graft survival when compared with simultaneous procedure in cases of aphakic or complicated pseudophakic bullous keratopathy.
- Subjects :
- medicine.medical_specialty
Distance visual acuity
genetic structures
medicine.medical_treatment
Intraocular lens
Corneal Diseases
03 medical and health sciences
0302 clinical medicine
Lens Implantation, Intraocular
Ophthalmology
medicine
Humans
Prospective Studies
Pseudophakic bullous keratopathy
Fixation (histology)
Retrospective Studies
Lenses, Intraocular
business.industry
Endothelium, Corneal
Graft Survival
Combined procedure
Descemet stripping automated endothelial keratoplasty
eye diseases
Sensory Systems
030221 ophthalmology & optometry
Surgery
Graft survival
sense organs
business
030217 neurology & neurosurgery
Descemet Stripping Endothelial Keratoplasty
Subjects
Details
- ISSN :
- 18734502
- Volume :
- 47
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- Journal of cataract and refractive surgery
- Accession number :
- edsair.doi.dedup.....ae3e48ced3599336e9bde93b3f7e4074