title: Manual Medium Incision Cataract Surgery with Descemet's Stripping Endothelial Keratoplasty: A Novel Triple Procedure.
abstract: Purpose. To describe the surgical technique and outcomes of combined Descemet's stripping endothelial keratoplasty and medium incision manual cataract surgery (MICS) in Chinese eyes. Methods. Surgery was performed in 8 eyes of 7 patients (5 females, 2 males). Primary outcomes included success of the surgery and final outcomes. Results. Surgery was performed in patients with Fuchs' endothelial dystrophy and cataract (mean age 75.5 ± 3.64 years). MICS tunnel was used to insert the donor lenticule into the anterior chamber. All surgeries were performed successfully. Graft dislocation was seen in 1 eye requiring repositioning with intracameral sulfur hexafluoride gas on the first postoperative day. Graft rejection was noted in one patient at the end of one year. The mean decimal best-corrected visual acuity improved from 0.1 ± 0.07 to 0.3 ± 0.15. Suboptimal visual acuity in 2 cases was due to radiotherapy-related optic neuropathy (n = 1) and myopic maculopathy (n = 1). The mean target spherical refraction was -1.11 ± 0.17 diopters (myopic) and the mean achieved spherical refraction was 1.18 ± 0.87 diopters (hyperopic) resulting in a mean hyperopic shift of 2.2 diopters. Conclusions. The approach of combined Descemet's stripping endothelial keratoplasty and MICS is a viable surgical technique for cases with endothelial dysfunction and cataract.
authors.affiliation: Department of Ophthalmology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong; Alice Ho Miu Ling Nethersole Hospital, Tai Po, New Territories, Hong Kong.
authors.forename: Alvin L
authors.initials: AL
authors.lastname: Young
authors.affiliation: Department of Ophthalmology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong; Alice Ho Miu Ling Nethersole Hospital, Tai Po, New Territories, Hong Kong.
authors.forename: Prudence P C
authors.initials: PP
authors.lastname: Chow
authors.affiliation: Department of Ophthalmology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong.
authors.forename: Vishal
authors.identifier: 0000-0002-4429-2004
authors.initials: V
authors.lastname: Jhanji