Article Text

PDF
Posterior iris-claw aphakic intraocular lens implantation and Descemet membrane endothelial keratoplasty
  1. Johannes Gonnermann,
  2. Anna-Karina B Maier,
  3. Matthias K J Klamann,
  4. Tobias Brockmann,
  5. Eckart Bertelmann,
  6. Antonia M Joussen,
  7. Necip Torun
  1. Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Berlin, Germany
  1. Correspondence to Dr Johannes Gonnermann, Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, Berlin 13353, Germany; johannes.gonnermann{at}charite.de

Abstract

Purpose To evaluate clinical outcomes and complications after Descemet membrane endothelial keratoplasty (DMEK) and posterior iris-claw aphakic intraocular lens (IOL) implantation.

Methods This prospective cohort study comprised seven consecutive eyes (seven patients) without adequate capsular support and bullous keratopathy undergoing posterior iris-claw aphakic IOL implantation and DMEK. Corneal transparency, central corneal thickness, endothelial cell density, visual outcomes and complication rates were measured during the follow-up.

Results The iris-claw IOLs were inserted during an IOL exchange in three eyes, and as a secondary IOL implantation in one aphakic eye during DMEK procedure. Three eyes had IOL exchange prior to secondary DMEK. Mean follow-up was 7 months (range 3–14 months). The final best spectacle-corrected visual acuity improved significantly (0.33±0.31 logMAR) compared with the preoperative best spectacle-corrected visual acuity (1.84±0.90 logMAR). The mean endothelial cell loss was 24.8% over the follow-up. Complications included graft dislocation in four eyes; which could be easily reattached with a rebubbling procedure. No graft failures, no cases of pupillary block glaucoma and no IOL dislocations were encountered.

Conclusions DMEK and retropupillar iris-claw IOL implantation provide good visual outcomes with a fast visual recovery and appear to be a feasible method for the management of bullous keratopathy but with higher graft detachment rates.

Trial registration number NCT02020044.

  • Cornea
  • Anterior chamber

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.