Endothelial keratoplasty in eyes with a retained angle-supported intraocular lens

  • Konstantinos Droutsas
  • Apostolos Lazaridis
  • George Kymionis
  • Klio Chatzistefanou
  • Dimitris Papaconstantinou
  • Walter Sekundo
  • Chryssanthi Koutsandrea
Original Paper



To describe the outcomes of endothelial keratoplasty (EK) for bullous keratopathy in eyes with a retained angle-supported anterior chamber intraocular lens (acIOL).


Among 263 consecutive EK procedures, 7 DMEK and 11 DSAEK procedures were identified in eyes with an acIOL and included in the present retrospective case series. Pre- and postoperative status including ocular history, anatomical outcome and complications as well as best-corrected visual acuity was evaluated.


Ocular history included complicated cataract surgery (n = 11), ocular trauma (n = 4) and primary intracapsular cataract extraction (n = 3). Surgery-related complications included primary graft failure (n = 1), graft detachment (n = 1), endophthalmitis (n = 1) and allograft rejection (n = 1). A clear cornea at the final examination (14 ± 4 months) was observed in 14/18 (78%), while the visual outcome was limited due to significant ocular comorbidity in 9 out of 14 uncomplicated procedures.


The presented short-term outcomes suggest that both DMEK and DSAEK are feasible in eyes with an angle-supported acIOL yielding an acceptable graft survival rate in the first postoperative year.


Endothelial keratoplasty DMEK DSAEK Anterior chamber intraocular lens Graft survival 


Authors’ contribution

KD designed and conducted the study. KD, AL, KC and GK analyzed the results and prepared the manuscript. All authors reviewed and approved the manuscript.

Compliance with ethical standards

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media B.V., part of Springer Nature 2018

Authors and Affiliations

  • Konstantinos Droutsas
    • 1
    • 2
  • Apostolos Lazaridis
    • 1
    • 2
  • George Kymionis
    • 1
    • 3
  • Klio Chatzistefanou
    • 1
  • Dimitris Papaconstantinou
    • 1
  • Walter Sekundo
    • 2
  • Chryssanthi Koutsandrea
    • 1
  1. 1.First Department of OphthalmologyNational and Kapodistrian University of AthensAthensGreece
  2. 2.Department of OphthalmologyPhilipps UniversityMarburgGermany
  3. 3.Jules Gonin Eye Hospital, Faculty of Biology and MedicineUniversity of LausanneLausanneSwitzerland

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