Photorefractive keratectomy after DMEK for corneal decompensation by phakic IOL

• Autor(a) principal: Moura-Coelho, Nuno
• Data de Publicação: 2022
• Outros Autores: Manero, Felicidad, Papa, Renato, Amich, Nicolas, Cunha, João Paulo, Güell, José Luis
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10400.21/14207
• topic: Ophthalmology; Descemet membrane endothelial keratoplasty; Photorefractive keratectomy; Keratorefractive surgery

Purpose: To provide the first description of photorefractive keratectomy (PRK) for the correction of mild residual refractive error after Descemet membrane endothelial keratoplasty (DMEK). Methods: A case report. Results: A 45-year-old woman presenting with a phakic intraocular lens (PIOL)-related corneal decompensation underwent staged DMEK surgery following PIOL explantation and cataract surgery. Eighteen months after DMEK, uncorrected distance visual acuity (UDVA) was 20/60 and best-corrected visual acuity (BCVA) was 20/22, with stable refraction. The patient requested refractive surgery to decrease spectacle dependence, and wavefront-optimized PRK was performed. At the last follow-up observation thirty-three months after PRK (54 months after DMEK surgery), UDVA was 20/20, the cornea remained clear without signs of rejection or endothelial failure, and the endothelial cell loss rate was not accelerated after PRK. Conclusion: Since long-term visual and refractive stability can be expected after DMEK, PRK may be a particularly safe and effective approach for the correction of mild residual refractive errors after DMEK. However, we consider that surgeons must exercise caution when considering keratorefractive surgery in these eyes due to postoperative changes in corneal curvature and thickness, and further studies are encouraged.