Combined Deep Sclerectomy and Descemet Stripping Automated Endothelial Keratoplasty

Vaiano, Agostino Salvatore; Salgarello, Tommaso; Giudiceandrea, Andrea; Riso, Monica; Sammarco, Maria Grazia; Caramello, Guido

doi:10.1097/ico.0000000000000268

Cited by 1 publication

(2 citation statements)

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“…After graft centration, tissue apposition was enhanced by filling the AC with air from the AC maintainer, which was subsequently removed. 12…”

Section: Methodsmentioning

confidence: 99%

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Efficacy and safety of UT-DSAEK combined with Carlevale's sutureless scleral fixation IOL

Vaiano¹,

Greco²,

Greco³

et al. 2023

European Journal of Ophthalmology

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Purpose To evaluate a novel surgical combination of ultrathin Descemet stripping automated endothelial keratoplasty (UT-DSAEK) and sutureless scleral fixation for Carlevale intraocular lens (SSF-Carlevale IOL) implantation to manage corneal endothelial decompensation when there is a concomitant need for secondary IOL fixation. Methods Clinical data collected from 10 eyes of 9 patients with bullous keratopathy (BK) who underwent combined UT-DSAEK and SSF-Carlevale IOL implantation in a single procedure were retrospectively analyzed. Anterior chamber IOL (4 cases), aphakia (4 cases, 1 of which associated with PEX), and previous trauma (2 cases) were the conditions responsible for BK. Corrected distance visual acuity (CDVA), intraocular pressure (IOP), endothelial cell density (ECD), central corneal thickness (CCT), graft thickness (GT) and complications were recorded over a 12-month follow-up period. Results In 90% (9/10) of eyes graft clarity was maintained during follow-up. The mean CDVA improved significantly (p < 0.0001) from 1.78 ± 0.76 logMAR preoperatively to 0.53 ± 0.3 logMAR at 12 months. ECD on average decreased from 2575 ± 125.3 cells/mm2 (donor tissue) to 1697 ± 133.3 cells/mm2 in 12 months. The mean CCT decreased from 870 ± 200 µm to 650 µm ± 9 at 12 months (ANOVA, p = 0.0005). Conclusions Combined UT-DSAEK and SSF-Carlevale IOL implantation was associated with good corneal graft survival and IOP control, with few complications. These findings suggest that this surgical approach is a practical option for patients requiring both treatment for corneal endothelial dysfunction and secondary IOL implantation.

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“…After graft centration, tissue apposition was enhanced by filling the AC with air from the AC maintainer, which was subsequently removed. 12…”

Section: Methodsmentioning

confidence: 99%

“…After graft centration, tissue apposition was enhanced by filling the AC with air from the AC maintainer, which was subsequently removed. 12 The main corneal incision and infusion line sclerotomy were sutured with 10-0 nylon and vicryl 7-0, respectively. Finally, the scleral flap and conjunctiva were closed using fibrin glue.…”

Section: Surgical Techniquementioning

confidence: 99%