Deep Lamellar Endothelial Keratoplasty for Iridocorneal Endothelial Syndrome in Phakic Eyes

Objective: To evaluate the efficacy and postoperative complications of deep lamellar endothelial keratoplasty (DLEK) for treating iridocorneal endothelial (ICE) syndrome in phakic eyes. Methods: Retrospective noncomparative interventional case series. Seven consecutive patients (7 eyes) having ICE syndrome with clear or mildly opaque lens were treated using DLEK and were followed up for 9 to 20 months. Data collected included best spectacle-corrected visual acuity, intraocular pressure, corneal astigmatism, endothelial cell density, and peripheral iris and anterior chamber angles using ultrasonographic biomicroscopy. Results: Corneas were clear in all eyes. No graft dislocation or lens injury occurred. During the follow-up period, 2 eyes developed cataract, 1 of which underwent phacoemulsification and intraocular lens implantation; 2 eyes had elevated intraocular pressure, 1 of which underwent filtering valve implant surgery; and 3 eyes showed progressive peripheral anterior synechiae. At the last follow-up, best spectacle-corrected visual acuity ranged from 20/67 to 20/30; the mean (SD) corneal astigmatism was 2.0 (0.7) diopters (D); and the mean (SD) corneal curvature was 44.6 (1.5) D. The mean (SD) endothelial cell density was 1917 (156) cells/mm(2) 9 months after surgery. Conclusions: DLEK is efficacious in the treatment of ICE syndrome in phakic eyes, with rapid visual rehabilitation and low incidence of postoperative complications. DLEK may be a good option for ICE syndrome in phakic eyes.