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Home > Anterior Segment > Anterior chamber IOLs tied to higher graft failure risk after DSEK in eyes without glaucoma

Anterior chamber IOLs tied to higher graft failure risk after DSEK in eyes without glaucoma

Ophthalmology 360

Key Takeaways

  1. Visual acuity gains and most postoperative complication rates were similar between ACIOL and PCIOL groups.
  2. Anterior chamber IOLs were associated with a higher risk of secondary graft failure in eyes without glaucoma.
  3. No increased secondary graft failure risk was seen in eyes with prior glaucoma surgery

Anterior chamber intraocular lenses were linked to a higher risk of secondary graft failure after Descemet stripping endothelial keratoplasty (DSEK) in eyes without glaucoma, according to a study.

The study included 132 DSEK procedures in eyes with anterior chamber intraocular lenses (ACIOLs) and 608 procedures in eyes with posterior chamber intraocular lenses (PCIOLs).

Visual acuity improvement and rates of primary graft failure, graft dislocation, endothelial rejection, and postoperative intraocular pressure elevation were similar between groups. However, glaucoma surgery was performed more often in the ACIOL group than in the PCIOL group.

Secondary graft failure occurred at similar rates overall in the ACIOL and PCIOL groups, but outcomes differed based on glaucoma status. In eyes without glaucoma, the presence of an ACIOL significantly increased the risk of secondary graft failure, and a trend toward increased risk was seen in eyes with medically treated glaucoma. No increased risk was observed in eyes with prior glaucoma surgery. Prior graft failure and endothelial rejection were also associated with a greater risk of secondary graft failure.

The investigators concluded that intraocular lens exchange should be considered before DSEK in eyes with an ACIOL if the eye has not undergone prior glaucoma surgery.

Reference
Ghaffari R, Kong AW, Duong HNV, et al. Outcomes of Descemet Stripping Endothelial Keratoplasty in Eyes With Anterior Chamber Intraocular Lenses. Cornea. 2026;doi: 10.1097/ICO.0000000000004168. Epub ahead of print. PMID: 42385227.

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