International Ophthalmology

, Volume 36, Issue 3, pp 305–311 | Cite as

Simultaneous Descemet’s membrane endothelial keratoplasty and posterior iris-claw-fixated intra ocular lens implantation (IOL) in management of aphakic bullous keratopathy

  • Vipul Bhandari
  • Jagdeesh K. Reddy
  • K. S. Siddharthan
  • Nidhi Singhania
Original Paper


To evaluate the efficacy of combined procedure of Descemet’s membrane endothelial keratoplasty (DMEK) and posterior iris-claw-fixated intra ocular lens (IOL) implantation in the management of aphakic bullous keratopathy (ABK). Sankara eye centre, a tertiary eye care centre. A prospective case series analysis. A prospective study comprised ten eyes of ten patients who underwent DMEK and posterior iris-claw-fixated IOL. Mean follow-up period was 12–36 months. Pre-operative and post-operative best corrected visual acuity (BCVA), endothelial cell density (ECD) and complications were noted. A total ten eyes of ten patients underwent DMEK. Out of ten patients BCVA improved from 1.00 to 1.60 LogMAR with mean and SD of 1.40 ± 0.20 to +0.20–0.40 LogMAR with mean and SD of 0.30 ± 0.07, with a significant p value of <0.001, Mean ECD of the donor tissue pre-operatively was 2367 cells, whereas 24 months post-operatively it was reduced to 1798 cells. Mean reduction in ECD pre procedure and post procedure was 569 (24 %). Iris-fixated IOL appears to offer simplicity in implantation and may be combined with DMEK in ABK. This procedure provides a faster visual recovery than other endothelial keratoplasties with iris-fixated IOL.


DMEK Iris claw ABK 


Compliance with ethics standards

Conflict of interest



  1. 1.
    Teng H, Zhang H (2014) Comparison of Artisan iris-claw intraocular lens implantation and posterior chamber intraocular lens sulcus fixation for aphakic eyes. Int J Ophthalmol 7(2):283–287PubMedPubMedCentralGoogle Scholar
  2. 2.
    Gonnermann J, Torun N, Klamann MK et al (2013) Visual outcomes and complications following posterior iris-claw aphakic intraocular lens implantation combined with penetrating keratoplasty. Graefes Arch Clin Exp Ophthalmol 251(4):1151–1156CrossRefPubMedGoogle Scholar
  3. 3.
    Vélez FM, Mannis MJ, Izquierdo L Jr et al (2014) Simultaneous surgery for corneal edema and aphakia: DSEK and placement of a retropupillary iris claw lens. Cornea 33(2):197–200CrossRefGoogle Scholar
  4. 4.
    Cagini C, Fiore T, Leontiadis A et al (2011) Simultaneous Descemet stripping automated endothelial keratoplasty and aphakic iris-fixated intraocular lens implantation: a case series. Cornea 30(10):1167–1169CrossRefPubMedGoogle Scholar
  5. 5.
    Gonnermann J, Maier AK, Klamann MK et al (2014) Posterior iris-claw aphakic intraocular lens implantation and Descemet membrane endothelial keratoplasty. Br J Ophthalmol 98:1291–1295CrossRefPubMedGoogle Scholar
  6. 6.
    Gorovoy MS (2014) DMEK complications. Cornea 33(1):101–104CrossRefPubMedGoogle Scholar
  7. 7.
    Ciechanowski PP, Droutsas K, Baydoun L et al (2014) Standardized Descemet membrane endothelial keratoplasty (DMEK): technique and latest results. Ophthalmologe 111(11):1041–1049. doi: 10.1007/s00347-013-3014-8 CrossRefPubMedGoogle Scholar
  8. 8.
    Guerra FP, Anshu A, Price MO et al (2011) Descemet’s membrane endothelial keratoplasty: prospective study of 1 year visual outcomes, graft survival, and endothelial cell loss. Ophthalmology 118(12):2368–2373CrossRefPubMedGoogle Scholar
  9. 9.
    Aung T, Nolan WP, Machin D, Seah SK et al (2005) Anterior chamber depth and the risk of primary angle closure in 2 East Asian populations. Arch Ophthalmol 123(4):527–532CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2015

Authors and Affiliations

  1. 1.Sankara Eye CentreCoimbatoreIndia

Personalised recommendations