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Intraocular lens opacification after Descemet's stripping automated endothelial keratoplasty
Meng-Sheng Lee1, I-Lun Tsai1, Ching-Yao Tsai2, Li-Lin Kuo3, Shiow-Wen Liou4, Lin-Chung Woung5
1 Department of Ophthalmology, Taipei City Hospital, Taipei, Taiwan
2 Department of Ophthalmology, Taipei City Hospital; Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
3 Department of Ophthalmology, Taipei City Hospital; Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan
4 Department of Ophthalmology, Taipei City Hospital; Department of Ophthalmology, Shin Kong Wu Ho-Su Memorial Hospital; Department of Ophthalmology, Taipei Medical University; Department of Ophthalmology, University Hospital, Taipei, Taiwan
5 Department of Ophthalmology, Taipei City Hospital, Taipei, ; Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
Correspondence Address:
I-Lun Tsai
6-F, No. 145, Zheng Zhou Road, Datong District, Taipei City 103
Taiwan
 Source of Support: None, Conflict of Interest: None  | 3 |
DOI: 10.4103/tjo.tjo_54_17
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Compared with conventional penetrating keratoplasty, Descemet's stripping automated endothelial keratoplasty (DSAEK) more effectively maintain global integrity and rapid vision rehabilitation with less ocular surface disorders in patients with endothelial dysfunction. Here, we report a case of a 76-year-old woman who experienced opacification of a hydrophilic intraocular lens (IOL) approximately 10 months after DSAEK. The patient with no history of systemic disease developed pseudophakic bullous keratopathy in the right eye 2 years after undergoing cataract surgery. The best-corrected visual acuity (BCVA) of the right eye was Snellen 0.01 when presented to our hospital. DSAEK was arranged and performed smoothly. However, the graft detached over the upper part of the cornea on postoperative day 1. Thus, rebubbling was performed immediately. After the procedure, the graft was well attached, and the cornea became clear gradually. The BCVA returned to Snellen 0.6. However, progressive opacification over the anterior surface of the IOL was observed 10 months postoperatively. Vision deteriorated to 0.5 with various refractive errors during 2-year follow-up. IOL exchange may be considered if the vision is getting worse. IOL opacification may result from a direct contact between the IOL surface and exogenous air, particularly in a hydrophilic IOL, and can be a rare but significant complication after DSAEK. Clinicians planning to perform DSAEK should consider the composition of the IOL, the amount of intracameral air, duration of air filling, and high intraocular pressure.
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