title: Descemet's stripping automated endothelial keratoplasty with anterior chamber intraocular lenses: complications and 3-year outcomes.
abstract: OBJECTIVE
  To describe outcomes and complications following Descemet's stripping automated endothelial keratoplasty (DSAEK) in eyes with pseudophakic bullous keratopathy (BK) while retaining the anterior chamber intraocular lenses (ACIOL).
  
  
  METHODS
  We included consecutive patients who underwent DSAEK for BK at a single tertiary centre from 1 January 2008 to 1 April 2010, from our prospective cohort (Singapore Corneal Transplant Study). We compared eyes with BK, which underwent DSAEK while retaining ACIOL (n=18), to those with DSAEK alone with the posterior chamber intraocular lenses left in place as a comparison group (n=114). Main outcome measures were endothelial cell (EC) loss and graft survival.
  
  
  RESULTS
  The percentage EC loss at 1 year was 31.9±21.3% in the DSAEK with ACIOL group compared to 24.5±21.2% in the DSAEK group (p=0.516); however, this figure was significantly greater in the DSAEK with ACIOL group at 3 years compared to the DSAEK group (55.3±29.2% vs 33.3±20.8%; p=0.01 respectively). Graft survival was also significantly poorer in the DSAEK ACIOL group compared to the DSAEK group over 3 years (log rank p=0.002).
  
  
  CONCLUSIONS
  We found that although eyes with BK and ACIOL that underwent DSAEK while retaining the ACIOL suffered EC loss which was not significantly greater at 1 year, EC loss and graft survival were significantly poorer compared to DSAEK controls at 3 years postoperatively.
authors.affiliation: Singapore National Eye Centre, Singapore, Singapore Singapore Eye Research Institute, Singapore, Singapore.
authors.forename: Marcus
authors.initials: M
authors.lastname: Ang
authors.affiliation: Singapore National Eye Centre, Singapore, Singapore Singapore Eye Research Institute, Singapore, Singapore.
authors.forename: Lim
authors.initials: L
authors.lastname: Li
authors.affiliation: Singapore National Eye Centre, Singapore, Singapore.
authors.forename: Daniel
authors.initials: D
authors.lastname: Chua
authors.affiliation: Singapore National Eye Centre, Singapore, Singapore Singapore Eye Research Institute, Singapore, Singapore.
authors.forename: Cheewai
authors.initials: C
authors.lastname: Wong
authors.affiliation: Singapore Eye Research Institute, Singapore, Singapore.
authors.forename: Hla M
authors.initials: HM
authors.lastname: Htoon
authors.affiliation: Singapore National Eye Centre, Singapore, Singapore Singapore Eye Research Institute, Singapore, Singapore Department of Ophthalmology, National University Health System, Singapore, Singapore Duke, NUS Graduate Medical School, Singapore, Singapore.
authors.forename: Jodhbir S
authors.initials: JS
authors.lastname: Mehta
authors.affiliation: Singapore National Eye Centre, Singapore, Singapore Singapore Eye Research Institute, Singapore, Singapore Department of Ophthalmology, National University Health System, Singapore, Singapore.
authors.forename: Donald
authors.initials: D
authors.lastname: Tan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000867:Anterior Chamber / Q000601:surgery*; D016022:Case-Control Studies; D003316:Corneal Diseases / Q000473:pathology / Q000601:surgery*; D055954:Corneal Endothelial Cell Loss; D057111:Descemet Stripping Endothelial Keratoplasty / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006085:Graft Survival; D006801:Humans; D019654:Lens Implantation, Intraocular / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D019591:Pseudophakia / Q000601:surgery*; D014792:Visual Acuity
keywords: Cornea