title: Simultaneous surgery for corneal edema and aphakia: DSEK and placement of a retropupillary iris claw lens.
abstract: OBJECTIVE
  The aim was to report the surgical outcomes of simultaneous Descemet stripping endothelial keratoplasty (DSEK) with a retropupillary fixated iris claw lens in patients with aphakic corneal edema without capsular support.
  
  
  METHODS
  The clinical records of aphakic patients with corneal edema and no capsular support who underwent a combined DSEK and implantation of a retropupillary fixated iris claw lens (Artisan) were evaluated. Presurgical and postsurgical best-corrected visual acuity, postsurgical refraction, and endothelial cell count were analyzed at the first and sixth months after the surgery and were imaged with anterior segment ultrasound biomicroscopy.
  
  
  RESULTS
  A total of 9 eyes from 7 females and 2 males were analyzed. The average age was 72.1 years. The mean duration of the postoperative follow-up was 7.7 months. All the patients achieved corrected visual acuities over 0.60 logarithm of the minimum angle of resolution. There was no significant variation in the endothelial count between the first and sixth months. Astigmatism >1 D was induced in all the patients, with 7 patients having against the rule, and 2 patients having oblique astigmatism.
  
  
  CONCLUSIONS
  DSEK combined with a retropupillary fixated iris claw lens was shown to be a safe surgical technique in patients with aphakia without capsular support and corneal swelling. This surgery resulted in stable endothelial cell counts during the first 6 months after the surgery and an improvement in visual acuity.
authors: *Department of Ophthalmology, Universidad Pontificia Bolivariana and CLOFAN, Medellín, Colombia; †Department of Ophthalmology and Vision Science, University of California Davis Eye Center, Sacramento, CA; ‡Department of Ophthalmology Universidad Mayor de San Marcos and Oftalmosalud, Lima, Perú; §Department of Ophthalmology, Universidad de Antioquia and CLOFAN, Medellín, Colombia; and ¶Department of Ophthalmology, Universidad Pontificia Bolivariana, Medellín, Colombia.
authors: Mauricio
authors: M
authors: Vélez F
authors: Mark J
authors: MJ
authors: Mannis
authors: Luis
authors: L
authors: Izquierdo
authors: Juan G
authors: JG
authors: Sánchez
authors: Luis F
authors: LF
authors: Velásquez
authors: Sebastián
authors: S
authors: Rojas
mesh_terms: D000328:Adult; D000368:Aged; D000869:Anterior Eye Segment / Q000000981:diagnostic imaging; D001036:Aphakia, Postcataract / Q000601:surgery*; D015715:Corneal Edema / Q000601:surgery*; D057111:Descemet Stripping Endothelial Keratoplasty / Q000379:methods*; D005260:Female; D006801:Humans; D007498:Iris / Q000601:surgery*; D019654:Lens Implantation, Intraocular / Q000379:methods*; D007910:Lenses, Intraocular; D008297:Male; D033401:Microscopy, Acoustic; D008875:Middle Aged; D014792:Visual Acuity / Q000502:physiology