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Simultaneous Surgery for Corneal Edema and Aphakia: DSEK and Placement of a Retropupillary Iris Claw Lens

Vélez F, Mauricio MD; Mannis, Mark J. MD; Izquierdo, Luis Jr PhD; Sánchez, Juan G. MD; Velásquez, Luis F. MD; Rojas, Sebastián MD

doi: 10.1097/ICO.0b013e3182a9dffb
Case Report

Purpose: The aim was to report the surgical outcomes of simultaneous Descemet stripping endothelial keratoplasty (DSEK) with a retropupillary fixated iris claw lens in patients with aphakic corneal edema without capsular support.

Methods: The clinical records of aphakic patients with corneal edema and no capsular support who underwent a combined DSEK and implantation of a retropupillary fixated iris claw lens (Artisan) were evaluated. Presurgical and postsurgical best-corrected visual acuity, postsurgical refraction, and endothelial cell count were analyzed at the first and sixth months after the surgery and were imaged with anterior segment ultrasound biomicroscopy.

Results: A total of 9 eyes from 7 females and 2 males were analyzed. The average age was 72.1 years. The mean duration of the postoperative follow-up was 7.7 months. All the patients achieved corrected visual acuities over 0.60 logarithm of the minimum angle of resolution. There was no significant variation in the endothelial count between the first and sixth months. Astigmatism >1 D was induced in all the patients, with 7 patients having against the rule, and 2 patients having oblique astigmatism.

Conclusions: DSEK combined with a retropupillary fixated iris claw lens was shown to be a safe surgical technique in patients with aphakia without capsular support and corneal swelling. This surgery resulted in stable endothelial cell counts during the first 6 months after the surgery and an improvement in visual acuity.

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*Department of Ophthalmology, Universidad Pontificia Bolivariana and CLOFAN, Medellín, Colombia;

Department of Ophthalmology and Vision Science, University of California Davis Eye Center, Sacramento, CA;

Department of Ophthalmology Universidad Mayor de San Marcos and Oftalmosalud, Lima, Perú;

§Department of Ophthalmology, Universidad de Antioquia and CLOFAN, Medellín, Colombia; and

Department of Ophthalmology, Universidad Pontificia Bolivariana, Medellín, Colombia.

Reprints: Mauricio Vélez F, Carrera 48 # 19 A 40, Consultorio 1517, Torre Médica, Ciudad del Río, Medellín, Colombia (e-mail:

The authors have no funding or conflicts of interest to disclose.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (

Received May 20, 2013

Accepted August 22, 2013

Copyright © 2014 Wolters Kluwer Health, Inc. All rights reserved.