title: Descemet-stripping automated endothelial keratoplasty in eyes with transscleral-sutured intraocular lenses.
abstract: To compare the clinical outcomes and complications of Descemet-stripping automated endothelial keratoplasty (DSAEK) with a transscleral-sutured intraocular lens (IOL) and solitary DSAEK.
  
  
  
  Department of Ophthalmology, Tokyo Dental College, Chiba, Japan.
  
  
  
  Retrospective case series.
  
  
  
  Cases with simultaneous transscleral-sutured IOLs or post-transscleral-sutured IOLs and solitary DSAEK cases were studied. The logMAR acuity, astigmatism, endothelial cell density (ECD), graft survival rate, and complications (eg, IOL dislocation, cystoid macular edema [CME]) were analyzed.
  
  
  
  Thirty-seven DSAEK cases with simultaneous transscleral-sutured IOLs or post-transscleral-sutured IOLs and 147 solitary DSAEK cases were evaluated. The logMAR corrected distance visual acuity (CDVA) improved significantly at 24 months, from 1.34 ± 0.49 (SD) to 0.48 ± 0.38 after DSAEK with transscleral-sutured IOLs and from 1.17 ± 0.69 to 0.17 ± 0.25 after solitary DSAEK. The logMAR CDVA after DSAEK with transscleral-sutured IOLs was significantly worse than that with solitary DSAEK at 6, 12, and 24 months (P < .01). The postoperative astigmatism with DSAEK with transscleral-sutured IOLs was significantly higher than with solitary DSAEK because of the larger sclerocorneal incision (P < .02). There were no significant differences in ECD or graft survival rates between DSAEK with transscleral-sutured IOLs and solitary DSAEK. The incidence of CME in DSAEK with transscleral-sutured IOLs (4/37 eyes [11%]) was higher than with solitary DSAEK (2/147 [1.4%]) (P = .02). The CME resolved with topical diclofenac and sub-Tenon injection of triamcinolone acetonide in all eyes.
  
  
  
  The graft survival rates after DSAEK with transscleral-sutured IOLs were equivalent to those after solitary DSAEK, although the incidence of CME was higher than after solitary DSAEK.
  
  
  
  None of the authors has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: From the Department of Ophthalmology (Yazu, Yamaguch, Dogru, Ishii, Satake, Shimazaki), Ichikawa General Hospital, Tokyo Dental College, Chiba, and the Department of Ophthalmology (Yazu, Yamaguchi, Dogru, Shimazaki), Keio University School of Medicine, Tokyo, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yazu
authors.affiliation: From the Department of Ophthalmology (Yazu, Yamaguch, Dogru, Ishii, Satake, Shimazaki), Ichikawa General Hospital, Tokyo Dental College, Chiba, and the Department of Ophthalmology (Yazu, Yamaguchi, Dogru, Shimazaki), Keio University School of Medicine, Tokyo, Japan. Electronic address: tym.i.eye.i@gmail.com.
authors.forename: Takefumi
authors.initials: T
authors.lastname: Yamaguchi
authors.affiliation: From the Department of Ophthalmology (Yazu, Yamaguch, Dogru, Ishii, Satake, Shimazaki), Ichikawa General Hospital, Tokyo Dental College, Chiba, and the Department of Ophthalmology (Yazu, Yamaguchi, Dogru, Shimazaki), Keio University School of Medicine, Tokyo, Japan.
authors.forename: Murat
authors.initials: M
authors.lastname: Dogru
authors.affiliation: From the Department of Ophthalmology (Yazu, Yamaguch, Dogru, Ishii, Satake, Shimazaki), Ichikawa General Hospital, Tokyo Dental College, Chiba, and the Department of Ophthalmology (Yazu, Yamaguchi, Dogru, Shimazaki), Keio University School of Medicine, Tokyo, Japan.
authors.forename: Nobuhito
authors.initials: N
authors.lastname: Ishii
authors.affiliation: From the Department of Ophthalmology (Yazu, Yamaguch, Dogru, Ishii, Satake, Shimazaki), Ichikawa General Hospital, Tokyo Dental College, Chiba, and the Department of Ophthalmology (Yazu, Yamaguchi, Dogru, Shimazaki), Keio University School of Medicine, Tokyo, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Satake
authors.affiliation: From the Department of Ophthalmology (Yazu, Yamaguch, Dogru, Ishii, Satake, Shimazaki), Ichikawa General Hospital, Tokyo Dental College, Chiba, and the Department of Ophthalmology (Yazu, Yamaguchi, Dogru, Shimazaki), Keio University School of Medicine, Tokyo, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Shimazaki
mesh_terms: D057111:Descemet Stripping Endothelial Keratoplasty; D004728:Endothelium, Corneal; D006801:Humans; D007564:Japan; D007910:Lenses, Intraocular; D012189:Retrospective Studies; D016896:Treatment Outcome