Endothelial survival after Descemet-stripping automated endothelial keratoplasty in eyes with retained anterior chamber intraocular lenses: Two-year follow-up

PURPOSE: To evaluate endothelial cell survival 2 years after Descemet-stripping automated endothelial keratoplasty (DSAEK) for the treatment of endothelial dysfunction in the presence of an anterior chamber intraocular lens (AC IOL). SETTING: LSU Eye Center, New Orleans, Louisiana, and Florida Eye Microsurgical Institute, Boynton Beach, Florida, USA. DESIGN: Case series. METHODS: This study comprised eyes with endothelial failure that had DSAEK in the presence of an AC IOL. Donor central endothelial cell density (ECD) was recorded 6 months, 1 year, and 2 years postoperatively and compared with preoperative ECD eye-bank values. RESULTS: The study evaluated 25 eyes; data from 20 eyes were available up to 2 years postoperatively. The mean preoperative ECD was 2606 cells/mm(2). At 1 year, the mean ECD was 1943 cells/mm(2) +/- 266 (SD), representing a mean cell loss from preoperative measurements of 24% +/- 12%. At 2 years, the mean ECD was 1831 +/- 291 cells/mm(2), representing a 28% +/- 13% cell loss from preoperative values. The additional cell loss between the first and second postoperative years was not statistically significant (P=.265). CONCLUSIONS: Descemet-stripping automated endothelial keratoplasty grafts in the presence of a well-centered AC IOL with an AC IOL-to-endothelial depth greater than 3.0 mm had a mean postoperative donor endothelial cell loss of 24% at 1 year and 28% at 2 years. There was no significant difference in cell loss in this series compared with ECD loss in DSAEK surgeries in the presence of a posterior chamber IOL.