Accuracy of intraocular lens power calculations in patients undergoing combined cataract surgery with Descemet stripping only: a pilot study

OBJECTIVE: To investigate the accuracy of intraocular lens (IOL) calculations for patients with Fuchs' endothelial dystrophy (FED) undergoing Descemet stripping only (DSO) combined with cataract surgery. DESIGN: Retrospective case series METHODS: All FED patients who underwent combined DSO and cataract surgery between August 2020 and January 2023 and met the following criteria were included: guttae in the central 4-5 mm of the cornea, no corneal edema, a clinically healthy peripheral endothelium, and a desired emmetropic target. IOL calculations were made using the Barrett Universal II formula. RESULTS: Eleven eyes were included in the study. The mean age was 68.3 ± 7.9 years. All patients achieved corneal clearance with no observed decompensation. Corrected distance visual acuity improved significantly with sustained improvement at the most recent follow-up (0.59 ± 0.48 vs 0.18 ± 0.16 logMAR; median follow-up 16.5 months). A mean refractive target of -0.64 ± 0.14 D was selected on the basis of prior experience with Descemet membrane endothelial keratoplasty. The mean difference between postoperative MRSE and target refraction was +0.33 ± 0.53 D with a median of +0.18 D. There was no significant change in astigmatism. CONCLUSIONS: In select FED patients, DSO combined with cataract surgery can provide significant improvements in vision. In this cohort, combined surgery induced a mean hyperopic shift of 0.33 D. When selecting an IOL power for this population, one should take this into account to achieve optimal visual outcomes.