Air-Assisted Descemet Stripping Automated Endothelial Keratoplasty with Posterior Chamber Fixation of an Aphakic Iris.Claw Lens

Endothelial keratoplasty (ek) is the most exciting recent development in cornealtransplantation. it has experienced surprisingly rapid growth in a very short periodof time. one of the indications for ek is pseudophakic bullous keratopathy. however,concomitant intraocular lens (iol) exchange, if indicated, may prove challenging.some surgeons routinely perform iol exchange with a scleral-fixated posteriorchamber iol, together with descemet’s stripping endothelial keratoplasty (dsek);however, this combined procedure is time-consuming, difficult and fraught withcomplications. another option is aphakic artisan iol fixation, but this is usually notacceptable because of the increased risk of endothelial cell loss and difficulty in fillingthe anterior chamber with the air bubble. herein, we introduce a new technique foriol exchange with an aphakic artisan iol fixated posterior to the iris, combined withdsek. this surgical technique was designed to preserve anterior segment anatomic features as much as possible.