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Descemet membrane endothelial keratoplasty combined with secondary sulcus hydrophobic intraocular lens implantation
Colya N Englisch1,2, Philip Wakili1, Clara E Englisch1
1Eye Clinic Sulzbach, Knappschaft Hospitals Saar, Sulzbach/Saar, 66280, Germany.
Purpose:
To report a case of combined Descemet membrane endothelial keratoplasty (DMEK) and secondary sulcus hydrophobic intraocular lens (IOL) implantation for hyperopic correction in a pseudophakic eye with Fuchs' endothelial corneal dystrophy.
Observation:
A 74-year-old woman with Fuchs' dystrophy and a history of phacoemulsification with a hydrophilic IOL in her left eye (refraction: +5.25 D/-1.00 D × 68°; best corrected visual acuity [BCVA]: 20/40) underwent a preparatory yttrium aluminum garnet (YAG) iridotomy followed by implantation of a hydrophobic add-on +8 D IOL in the ciliary sulcus through a 2.4 mm incision. DMEK was performed using a 90 % fill of 10 % sulfur hexafluoride (SF6). Two months after surgery, refraction improved to -0.25 D/-1.75 D × 62° (BCVA: 20/25), with restored corneal clarity and an endothelial cell density of 1920 cells/mm2. At 10 months, refraction was +0.75 D/-1.25 D × 54°, and BCVA further improved to 20/20, with an endothelial density of 1778 cells/mm2 and normalized corneal thickness. No IOL opacification was observed.
Conclusion And Importance:
This case indicates that combining DMEK with secondary sulcus hydrophobic IOL implantation can effectively correct hyperopia in pseudophakic eyes with Fuchs' dystrophy.
