Accuracy of intraocular lens power calculations in patients undergoing combined cataract surgery with Descemet stripping only: a pilot study.

OBJECTIVE

To investigate the accuracy of intraocular lens (IOL) calculations for patients with Fuchs' endothelial dystrophy (FED) undergoing Descemet stripping only (DSO) combined with cataract surgery.

DESIGN

Retrospective case series

METHODS

All FED patients who underwent combined DSO and cataract surgery between August 2020 and January 2023 and met the following criteria were included: guttae in the central 4-5 mm of the cornea, no corneal edema, a clinically healthy peripheral endothelium, and a desired emmetropic target. IOL calculations were made using the Barrett Universal II formula.

RESULTS

Eleven eyes were included in the study. The mean age was 68.3 ± 7.9 years. All patients achieved corneal clearance with no observed decompensation. Corrected distance visual acuity improved significantly with sustained improvement at the most recent follow-up (0.59 ± 0.48 vs 0.18 ± 0.16 logMAR; median follow-up 16.5 months). A mean refractive target of -0.64 ± 0.14 D was selected on the basis of prior experience with Descemet membrane endothelial keratoplasty. The mean difference between postoperative MRSE and target refraction was +0.33 ± 0.53 D with a median of +0.18 D. There was no significant change in astigmatism.

CONCLUSIONS

In select FED patients, DSO combined with cataract surgery can provide significant improvements in vision. In this cohort, combined surgery induced a mean hyperopic shift of 0.33 D. When selecting an IOL power for this population, one should take this into account to achieve optimal visual outcomes.