Secondary sulcus IOL implantation for presbyopia correction following Descemet Membrane Endothelial Keratoplasty

Purpose: Report a case where the patient desired spectacle independence after phacoemulsification and Descemet membrane endothelial keratoplasty (DMEK) due to Fuchs’ endothelial dystrophy. Observations: A 52-year-old female presented with corrected distance visual acuity (CDVA) of 20/40 in both eyes...

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Main Authors: Luiza Moschetta Zimmermann, Guilherme Vieira Peixoto, Júlia Margoni Biluca, José Maurílio Tavares de Lucena, Ricardo Menon Nosé
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:American Journal of Ophthalmology Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2451993624001920
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author Luiza Moschetta Zimmermann
Guilherme Vieira Peixoto
Júlia Margoni Biluca
José Maurílio Tavares de Lucena
Ricardo Menon Nosé
author_facet Luiza Moschetta Zimmermann
Guilherme Vieira Peixoto
Júlia Margoni Biluca
José Maurílio Tavares de Lucena
Ricardo Menon Nosé
author_sort Luiza Moschetta Zimmermann
collection DOAJ
description Purpose: Report a case where the patient desired spectacle independence after phacoemulsification and Descemet membrane endothelial keratoplasty (DMEK) due to Fuchs’ endothelial dystrophy. Observations: A 52-year-old female presented with corrected distance visual acuity (CDVA) of 20/40 in both eyes with low ametropia. Slit lamp examination revealed corneal edema 1+/4+, guttae, and nuclear cataract 2+/4+ in both eyes. First, given the diagnostic suspicion of Fuchs’ endothelial corneal dystrophy and cataracts, phacoemulsification with monofocal toric intraocular lens (IOL) implantation combined with DMEK was performed in both eyes. Postoperatively, the patient was not satisfied with her near vision. Therefore, a supplementary trifocal sulcus IOL was implanted into the right eye. At 30 days postoperatively, the uncorrected distance visual acuity (UDVA) was 20/20 and the uncorrected near visual acuity (UCNVA) was J1, with clear cornea, centered IOL. Conclusions and importance: This is the first report of supplementary trifocal IOL implantation in a pseudophakic patient with a history of DMEK. This afforded spectacle-independence at all distances with high patient satisfaction. This procedure is safe, predictable, and reversible.
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spelling doaj-art-8eb9f389dcd544f68a9146afce41725c2024-12-18T08:50:42ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362024-12-0136102182Secondary sulcus IOL implantation for presbyopia correction following Descemet Membrane Endothelial KeratoplastyLuiza Moschetta Zimmermann0Guilherme Vieira Peixoto1Júlia Margoni Biluca2José Maurílio Tavares de Lucena3Ricardo Menon Nosé4Corresponding author.; Santa Casa de Misericórdia de São Paulo, Rua Dr Cesário Mota Jr 112, São Paulo, São Paulo, BrazilSanta Casa de Misericórdia de São Paulo, Rua Dr Cesário Mota Jr 112, São Paulo, São Paulo, BrazilSanta Casa de Misericórdia de São Paulo, Rua Dr Cesário Mota Jr 112, São Paulo, São Paulo, BrazilSanta Casa de Misericórdia de São Paulo, Rua Dr Cesário Mota Jr 112, São Paulo, São Paulo, BrazilSanta Casa de Misericórdia de São Paulo, Rua Dr Cesário Mota Jr 112, São Paulo, São Paulo, BrazilPurpose: Report a case where the patient desired spectacle independence after phacoemulsification and Descemet membrane endothelial keratoplasty (DMEK) due to Fuchs’ endothelial dystrophy. Observations: A 52-year-old female presented with corrected distance visual acuity (CDVA) of 20/40 in both eyes with low ametropia. Slit lamp examination revealed corneal edema 1+/4+, guttae, and nuclear cataract 2+/4+ in both eyes. First, given the diagnostic suspicion of Fuchs’ endothelial corneal dystrophy and cataracts, phacoemulsification with monofocal toric intraocular lens (IOL) implantation combined with DMEK was performed in both eyes. Postoperatively, the patient was not satisfied with her near vision. Therefore, a supplementary trifocal sulcus IOL was implanted into the right eye. At 30 days postoperatively, the uncorrected distance visual acuity (UDVA) was 20/20 and the uncorrected near visual acuity (UCNVA) was J1, with clear cornea, centered IOL. Conclusions and importance: This is the first report of supplementary trifocal IOL implantation in a pseudophakic patient with a history of DMEK. This afforded spectacle-independence at all distances with high patient satisfaction. This procedure is safe, predictable, and reversible.http://www.sciencedirect.com/science/article/pii/S2451993624001920Fuchs' endothelial corneal dystrophySupplementary intraocular lensDescemet membrane endothelial keratoplasty
spellingShingle Luiza Moschetta Zimmermann
Guilherme Vieira Peixoto
Júlia Margoni Biluca
José Maurílio Tavares de Lucena
Ricardo Menon Nosé
Secondary sulcus IOL implantation for presbyopia correction following Descemet Membrane Endothelial Keratoplasty
American Journal of Ophthalmology Case Reports
Fuchs' endothelial corneal dystrophy
Supplementary intraocular lens
Descemet membrane endothelial keratoplasty
title Secondary sulcus IOL implantation for presbyopia correction following Descemet Membrane Endothelial Keratoplasty
title_full Secondary sulcus IOL implantation for presbyopia correction following Descemet Membrane Endothelial Keratoplasty
title_fullStr Secondary sulcus IOL implantation for presbyopia correction following Descemet Membrane Endothelial Keratoplasty
title_full_unstemmed Secondary sulcus IOL implantation for presbyopia correction following Descemet Membrane Endothelial Keratoplasty
title_short Secondary sulcus IOL implantation for presbyopia correction following Descemet Membrane Endothelial Keratoplasty
title_sort secondary sulcus iol implantation for presbyopia correction following descemet membrane endothelial keratoplasty
topic Fuchs' endothelial corneal dystrophy
Supplementary intraocular lens
Descemet membrane endothelial keratoplasty
url http://www.sciencedirect.com/science/article/pii/S2451993624001920
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