Endothelial keratoplasty (EK) with anterior chamber intraocular lens (ACIOL) versus secondary posterior chamber lens (PCIOL)
Reviewed by Jonathan Chan

This is a retrospective study of 82 eyes (23 ACIOL, 59 PCIOL) with a history of either pseudophakic (PBK) or aphakic (ABK) bullous keratopathy, who had descemet stripping automated endothelial keratoplasty (DSAEK) with retained or secondary ACIOL, or DSAEK with IOL exchange and / or secondary PCIOL (retropupillary iris-claw IOL= 25, intrascleral-fixated IOL= 29, or sulcus IOL=5). The main outcome measures were graft survival and complications up to five years. The graft survival in the secondary PCIOL was superior to the ACIOL group over five years, at year five, 91.1% versus 60.6%, p=0.022. There were five cases (9.3%) of IOL subluxation or dislocation in the retropupillary iris-claw and intrascleral-fixated IOL groups. An ACIOL presence was a significant risk factor of graft failure (HR 4.801). There was no significant difference between the two groups in the rate of graft detachment and raised IOP. The authors recommended to perform IOL exchange / or secondary PCIOL combined with EK. – JC

Endothelial keratoplasty with anterior chamber intraocular lens versus secondary posterior chamber lens.
Woo JH, Arunghati A, Chee SP, et al.
BRITISH JOURNAL OF OPHTHALMOLOGY
2022;106(2):203-10.