Phakic intraocular lens as a temporary barrier in aphakic Descemet’s membrane endothelial keratoplasty

Abstract

Background: Descemet’s membrane endothelial keratoplasty has a lower risk of endothelial rejection than Descemet’s stripping automated endothelial keratoplasty. In aphakic eyes requiring endothelial transplantation, approaches aimed at reducing the risk of posterior graft dislocation in Descemet’s stripping automated endothelial keratoplasty are not transferable to Descemet’s membrane endothelial keratoplasty. Technique: Here we describe the use of an implantable collamer lens placed over the iris to provide a temporary intraoperative platform, to facilitate graft unfolding and to avoid posterior graft dislocation in an aphakic, vitrectomised eye with a fixed, dilated pupil in a young patient with chronic uveitis and previous failed Descemet’s stripping automated endothelial keratoplasty.