Dr. SOHAM BASAK

Abstract

Visual rehabilitation in failed therapeutic keratoplasty(TKP) is challenging due to hazy media and distorted anterior chamber. Descemet stripping endothelial keratoplasty(DSEK) is preferred for re-grafting. This single surgeon case series evaluates role of manual small incision cataract surgery(MSICS) in facilitating DSEK triple in such situations.

14 patients planned for DSEK triple between Jan 2019 to Feb 2020 and at least 3 months follow-up were included. Outcome measures: visual acuity(VA), presence of synechia, successful rhexis, lens position, and complications.

MSICS-DSEK triple was done in 13 eyes(92.8%) and 1 converted to full-thickness graft. Mean pre-op VA was logMAR 2.1 and synechia present in 10 eyes. Rhexis and in-the-bag lens was done in 7 eyes. There were no PCRs. VA improved to logMAR 1.1(p<0.05) at 7 months mean follow-up. There were 2 graft failures. MSICS is safe technique in complex failed TPK eyes and makes DSEK triple possible with good outcomes.