Outcomes of Descemet-Stripping Endothelial Keratoplasty for Corneal Edema in Iridocorneal Endothelial Syndrome

Sunday, April 19, 2015: 3:36 PM
Room 5A (San Diego Convention Center)
Samar K. Basak, MD, FRCS
Ayan Mohanta, MS

Iridocorneal endothelial (ICE) syndrome is characterized by abnormality in iridocorneal angle and iris surface associated with corneal edema. Secondary glaucoma may affect the long-term prognosis following Descemet stripping endothelial keratoplasty. The purpose of this study was to evaluate the clinical outcomes of Descemet stripping endothelial keratoplasty (DSEK) to treat corneal oedema in ICE syndrome.

Retrospective interventional case series. Clinical course of consecutive 15 patients who underwent DSEK for corneal edema in ICE syndrome between 2007 and 2013 were reviewed retrospectively. Best corrected visual acuity (BCVA), presence of PAS, control of IOP, Glaucoma Rx prior to DSEK were noted. Types of surgery prior to DSEK, combined with DSEK and postoperatively after DSEK were also noted. The median follow-up of 29.1 months (range: 5 – 60 months).

Ten patients had glaucoma before DSEK. Cataract surgery required in 11 eyes (DSEK-Triple) and additional trabeculectomy with MMC (DSEK Quadruple) was done  in 6 eyes. Grafts remained clear in 9 eyes (60%) with BCVA of ≥20/40 in 7 eyes (46.7%) with median follow up of 29.1 months. Poor outcomes after DSEK included uncontrolled glaucoma and late graft failure. Two eye became absolute in the course and required cyclocryotherpy.

Outcomes of DSEK in ICE syndrome are not always favorable because of continuous nature of disease. Poor outcomes after DSEK included uncontrolled glaucoma and late graft failure.