Combined DSAEK and phaco improved vision in patients with Fuchs’ dystrophy and cataract

This small retrospective study found that Descemet stripping automated endothelial keratoplasty (DSAEK) combined with phacoemulsification and IOL implantation improved BSCVA without incurring progressive time-dependent complications after at least one year in patients with Fuchs' endothelial dystrophy and cataract. However, patients experienced a mean hyperopic shift of 1.46 D, which significantly correlated with the ratio of central graft thickness to mean peripheral donor corneal lenticule thickness at 3 mm. The authors speculated that improvements in the shape of the donor graft lenticule used in this combination surgery might improve the predictability of refractive outcomes in these patients.

Twelve eyes of 11 patients were included in the study. They were followed for between 12 and 18 months. Anterior segment optical coherence tomography was used to measure central graft thickness and peripheral graft thickness at 3 mm, which was calculated as the mean of four peripheral corneal DSAEK button measurements at two perpendicular axes. The statistical analysis included data from the last follow-up visit for each patient.

BSCVA improved by a mean of 3.3 lines, with improvements seen in 11 eyes and no change in one. BCVA gains ranged up to eight lines.