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Case Report
Descemet membrane endothelial keratoplasty after sequential radial keratotomies, LASIK, and cataract surgery with endothelial decompensation
1 Department of Ophthalmology, Saarland University Medical Center (UKS), Homburg/Saar, Germany
Address correspondence to:
Christian Joe Farah
Kirrbergerstr. 100, Ophthalmology Department, 22 Homburg/Saar,
Germany
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Article ID: 100019Z17CF2021
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How to cite this article
Farah CJ, El Halabi M, Daas L, Seitz B. Descemet membrane endothelial keratoplasty after sequential radial keratotomies, LASIK, and cataract surgery with endothelial decompensation. J Case Rep Images Opthalmol 2021;4:100019Z17CF2021.ABSTRACT
Introduction: To demonstrate a safe way to treat endothelial decompensation after sequential radial keratotomies (RKs), laser-in-situ-keratomileusis (LASIK), and cataract surgery, avoiding to compromise a favorable refraction.
Case Report: We report the case of a 66-year-old female with decreased visual acuity in the left eye after sequential ex domo RKs, LASIK, and cataract operation. We performed a DMEK to treat endothelial decompensation but also to maintain the favorable preoperative refraction. The Descemet membrane endothelial keratoplasty (DMEK) surgery was uneventful. The best corrected distance visual acuity (CDVA) improved from logMAR 1.8 [Snellen equivalent (SE): 20/1262] to logMAR 0.5 (SE: 20/63) in the left eye after only five weeks of follow-up. Slit lamp examination revealed a clear cornea with circularly attached graft. The corneal apex pachymetry decreased from 794 to 575 μm while the corneal anterior power slightly increased from 32.3 to 33.9 diopters, inducing a minor myopization. Initial corneal astigmatism changed from 4.8 to 2.8 diopters with a regular with-the-rule configuration axis sliding from 180° to 176°. This improved the postoperative refraction with a spherical equivalent (SEQ) changing from +1.25 to −1.50 diopters.
Conclusion: Performing a DMEK could restore the visual acuity without compromising the preoperative corneal refractive abilities after previous RK, LASIK, and phacoemulsification with intraocular lens (IOL) implantation.
Keywords: Cataract surgery, DMEK, Endothelial decompensation, LASIK, Radial keratotomy
SUPPORTING INFORMATION
Author Contributions
Christian Joe Farah - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Mohamed El Halabi - Acquisition of data, Drafting the article, Final approval of the version to be published
Loay Daas - Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Berthold Seitz - Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2021 Christian Joe Farah et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
