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Войти в исследования International ophthalmology · 2026
Descemet stripping only combined with cataract surgery and extended-depth-of-focus intraocular lens implantation: a surgical strategy and exploratory clinical evidence.
СтатьяКлинический случайНазвание и аннотация: Перевод пока не подготовлен
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Prados-Carmona Juan J, Villalba-González Marta, Sánchez-Ventosa Álvaro, Villarrubia-Cuadrado Alberto, Jiménez-Gómez Yolanda, Cano-Ortiz Antonio
Аннотация
PURPOSE: To describe a surgical strategy combining Descemet stripping only (DSO), phacoemulsification, and implantation of an extended depth-of-focus (EDOF) intraocular lens (IOL) in carefully selected patients with Fuchs endothelial dystrophy (FED) and concomitant cataract.
METHODS: A surgical and refractive protocol was developed for patients with FED, preserved peripheral endothelium, visually significant cataract, and favorable ocular characteristics. The technique comprised combined DSO, phacoemulsification, and implantation of a Vivity® EDOF IOL. Preliminary clinical observations from four eyes of three patients, with follow-up ranging from 2 to 4 years, are reported to illustrate the feasibility of this strategy. Postoperative evaluation included visual acuity, refraction, corneal tomography, specular microscopy, and intra- and postoperative complications.
RESULTS: The procedure was successfully completed in all eyes without significant intraoperative or postoperative complications. Transient corneal edema resolved within weeks, followed by progressive visual recovery. These preliminary clinical observations illustrate the feasibility of this approach. Final postoperative spherical equivalent remained within a narrow range (- 0.25 to + 0.75 D). Final best-corrected visual acuity was ≤ 0.15 LogMAR in all eyes except one eye affected by posterior capsule opacification. Near visual acuity reached 0.0 LogMAR with a + 1.75 D near addition. Specular microscopy demonstrated endothelial repopulation, while corneal tomography showed no clinically relevant progressive structural deterioration during the available follow-up.
CONCLUSIONS: This surgical strategy may expand the refractive options for patients with central FED and concomitant cataract in an era of increasing refractive expectations. Appropriate patient selection appears essential when considering this approach, which aims to combine corneal recovery with an extended range of functional vision. Larger studies are required to further validate this hypothesis.
METHODS: A surgical and refractive protocol was developed for patients with FED, preserved peripheral endothelium, visually significant cataract, and favorable ocular characteristics. The technique comprised combined DSO, phacoemulsification, and implantation of a Vivity® EDOF IOL. Preliminary clinical observations from four eyes of three patients, with follow-up ranging from 2 to 4 years, are reported to illustrate the feasibility of this strategy. Postoperative evaluation included visual acuity, refraction, corneal tomography, specular microscopy, and intra- and postoperative complications.
RESULTS: The procedure was successfully completed in all eyes without significant intraoperative or postoperative complications. Transient corneal edema resolved within weeks, followed by progressive visual recovery. These preliminary clinical observations illustrate the feasibility of this approach. Final postoperative spherical equivalent remained within a narrow range (- 0.25 to + 0.75 D). Final best-corrected visual acuity was ≤ 0.15 LogMAR in all eyes except one eye affected by posterior capsule opacification. Near visual acuity reached 0.0 LogMAR with a + 1.75 D near addition. Specular microscopy demonstrated endothelial repopulation, while corneal tomography showed no clinically relevant progressive structural deterioration during the available follow-up.
CONCLUSIONS: This surgical strategy may expand the refractive options for patients with central FED and concomitant cataract in an era of increasing refractive expectations. Appropriate patient selection appears essential when considering this approach, which aims to combine corneal recovery with an extended range of functional vision. Larger studies are required to further validate this hypothesis.