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Updated: Apr 30, 2026
Corneal Donor Tissue Preparation for Descemet's Membrane Endothelial Keratoplasty
Published on: September 17, 2014
Posterior iris-claw aphakic intraocular lens implantation and Descemet membrane endothelial keratoplasty
Johannes Gonnermann1, Anna-Karina B Maier1, Matthias K J Klamann1
1Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
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.
