Descemet Stripping Automated Endothelial Keratoplasty Combined with Phacoemulsification; a Follow up Study

Purpose: To evaluate the surgical outcome and refractive status after triple procedure in patients with Fuchs’ dystrophy combined with cataract. Patients and Methods: Thirty four consecutive eyes of 29 patients with coexisting cataract and Fuchs’ dystrophy entered the study. All patients underwent phacoemulsification and IOL implantation through a temporal incision followed by 4 Descemet stripping automated endothelial keratoplasty (DSAEK). Patients were assessed regarding best corrected visual acuity (BCVA), refractive cylinder and refractive sphere before surgery, after 3 months and 3 years of follow-up. Results: The mean BCVA was 0.87 ± 0.448 LogMAR pre-operatively which increased to 0.29 ± 0.164 LogMAR at three months (P < 0.001), and 0.19 ± 0.129 at three years (P < 0.001) post-operatively. The mean preoperative sphere was 0.758 ± 2.384, which reached 0.32 ± 0.55 and 0.24 ± 0.46; three months and three years after the simul-taneous surgery, respectively. The mean preoperative cylinder was -1.43 ± 1.141 which reached - 0.87 ± 0.55 and - 0.69 ± 0.39; three months and three years after the simultaneous surgery, respectively. Conclusion: Refractive and visual outcomes after triple surgery are favorable in terms of BCVA, refractive cylinder and refractive sphere. Therefore, triple procedure might be recommended in older patients due to its rapid visual rehabilitation.