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Descemet stripping automated endothelial keratoplasty (DSAEK) has recently gained popularity as the procedure of choice in the management of corneal endothelial disease. The advantages of DSAEK over penetrating keratoplasty (PK) include the avoidance of open sky surgery, minimal induced postsurgical astigmatism and faster visual rehabilitation.1 2 Ongoing innovations in the surgical technique have significantly improved the most important outcome, which is, of course, donor endothelial survival.3 Most surgeons currently recommend, in cases of endothelial disease with the presence of an anterior chamber (AC) intraocular lens (IOL), the removal of the implant and the use of scleral fixated or iris fixated IOLs prior or simultaneous to the DSAEK in order to improve the endothelial survival. IOL exchange is associated with significant complications that include infections, haemorrhage, expulsive haemorrhage, cystoid macular oedema, iritis and late dislocations.
We report three cases of DSAEK successfully …
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