Dr.Rohit Dureja

Abstract

A 51-year-old female presented with a diminution of vision in her right eye (RE) for two months. She was diagnosed with irido-corneal endothelial syndrome and underwent descemets stripping automated endothelial keratoplasty (DSAEK) one year ago for corneal decompensation in RE. Her visual acuity was limited to counting fingers close to her face, and a slit lamp examination showed a failed DSAEK graft with a shallow anterior chamber and polycoria with a total white intumescent cataract. She underwent a repeat DSAEK with phacoemulsification in the right eye through a temporal clear corneal incision. Intraoperatively, challenges noted were a shallow anterior chamber, severe iris atrophy, old DSAEK lenticule densely adherent to the peripheral iris, which required synechiolysis with vannas and a vitrectomy cutter, and difficulty achieving air tamponade. Thus, we conclude that DSAEK in eyes with ICE syndrome is challenging.