Descemet membrane endothelial keratoplasty after cataract surgery with presbyopia-correcting intraocular lens for coexisting Fuchs endothelial corneal dystrophy and cataract.

PURPOSE: To assess the outcomes of Descemet membrane endothelial keratoplasty (DMEK) staged after implantation of presbyopia-correcting intraocular lenses (IOLs) in patients with coexisting Fuchs endothelial corneal dystrophy (FECD) and cataract.

STUDY DESIGN: Retrospective, interventional case series METHODS: We enrolled six eyes of three patients with coexisting FECD and cataract (3 women, age 67.8 ± 6.5 years) treated with presbyopia-correcting IOL implantation, followed by DMEK. The modified Krachmer grade, visual outcomes, and incidence of intra- and postoperative complications were analyzed.

RESULTS: Modified Krachmer FECD grades 4, 5, and 6 were observed in one, two, and three eyes, respectively. The mean best-corrected visual acuity (BCVA) was dissatisfactory with the primary presbyopia-correcting IOL (decimal 0.45), it improved significantly (decimal 1.0, P = 0.027) after DMEK and all eyes acquired satisfactory uncorrected distance and near (30 cm) vision (mean, decimal, distance 0.85 and near 0.56). The manifest spherical equivalent after DMEK was within the acceptable range (-0.375 D to 0.0 D). Rebubbling was required in four eyes, but no instances of other postoperative complications or primary graft failure were encountered.

CONCLUSION: DMEK staged after implantation of presbyopia-correcting IOLs is a viable option for patients with coexisting FECD and cataract.