title: Combined Descemet-stripping automated endothelial keratoplasty and phacoemulsification with toric intraocular lens implantation for treatment of failed penetrating keratoplasty with high regular astigmatism.
abstract: We present the case of a 57-year-old woman who had combined Descemet-stripping automated endothelial keratoplasty (DSAEK) and phacoemulsification with implantation of a toric intraocular lens (IOL). Surgery was intended to treat a cataract developing in a post-penetrating keratoplasty (PKP) eye with high astigmatism and endothelial decompensation. Six months after uneventful surgery, the cornea was clear and the corrected distance visual acuity was 20/20 with a refraction of +0.25 -1.00 × 10 (from -3.00 -8.50 × 12 preoperatively). The internal topography map (OPD-Scan) showed an IOL rotation of 4 degrees. The endothelial cell loss was 15% of the eye-bank value. Descemet-stripping automated endothelial keratoplasty combined with phacoemulsification and toric IOL implantation is a relatively simple and very effective procedure for eyes with endothelial failure and high post-PKP astigmatism. The speed of visual rehabilitation and final visual acuity achieved with this approach was superior to that obtained with other surgical procedures.
authors.affiliation: Department of Ophthalmology, Magna Graecia University, Catanzaro, Italy. vscorcia@libero.it
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Scorcia
authors.forename: Andrea
authors.initials: A
authors.lastname: Lucisano
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Beltz
authors.forename: Massimo
authors.initials: M
authors.lastname: Busin
mesh_terms: D001251:Astigmatism / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D002386:Cataract / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D019781:Corneal Topography; D057111:Descemet Stripping Endothelial Keratoplasty; D005260:Female; D006801:Humans; D007368:Interferometry; D015948:Keratoplasty, Penetrating; D019654:Lens Implantation, Intraocular; D008875:Middle Aged; D018918:Phacoemulsification; D011183:Postoperative Complications; D017211:Treatment Failure; D014792:Visual Acuity / Q000502:physiology