Moura-Coelho, NunoCunha, João PauloDias-Santos, ArnaldoDutra-Medeiros, MarcoPapa-Vettorazzi, RenatoManero, FelicidadGüell, José2023-04-202023-04-202023-03Moura-Coelho N, Cunha JP, Dias-Santos A, Dutra-Medeiros M, Papa-Vettorazzi R, Manero F, et al. Descemet’s membrane endothelial keratoplasty for corneal endothelial failure secondary to three types of phakic intraocular lens: retrospective study. Clin Ophthalmol. 2023;17:931-40.http://hdl.handle.net/10400.21/15913Purpose: To analyze the outcomes of Descemet's membrane endothelial keratoplasty (DMEK) for corneal endothelial failure secondary to phakic intraocular lens implantation (PIOL) at a reference center for corneal transplantation in Spain. Design: Retrospective, single-surgeon case series. Methods: Single-center analysis of patients who underwent DMEK for PIOL-related corneal decompensation between July 2011 and July 2020 with at least 6 months of follow-up postoperatively. The primary outcome was the final best-corrected visual acuity (BCVA, logMAR) compared to pre-DMEK BCVA. Secondary outcomes analyzed included post-DMEK refractive spherical equivalent, endothelial cell loss (%ECL), and graft failure. Results: Sixteen eyes (14 patients) underwent DMEK for PIOL-related corneal decompensation. The Mean (SD) time to PIOL explantation was 9.3 (5.0) years, and the median (P25-P75) time between PIOL explantation and DMEK surgery was 3 (2-4) months. Median pre-DMEK BCVA was 0.80 (1.08-0.60) logMAR. A statistically significant improvement in BCVA was observed 1 month after DMEK (p = 0.001), and the median final BCVA was 0.15 (0.0-0.35) logMAR (p = 0.002). The mean %ECL was 55.6 (18.7) % at 2-year follow-up and 61.7 (11.7) % in eyes with over 4 years of follow-up. Two eyes required re-bubbling (12.5%), one of which ended in primary graft failure (6.2%) and one eye had late endothelial graft failure (LEGF) at 4-year follow-up (1/15 grafts, 6.7%). Conclusion: In patients with PIOL-related corneal decompensation, DMEK leads to good and clinically significant refractive and visual outcomes in the medium-long term, with a good safety profile. Prospective studies are encouraged to ascertain whether these cases are at increased risk of accelerated endothelial cell loss and LEGF.engOphthalmologyCorneal endothelial failureDescemet membrane endothelial keratoplastyEndothelial keratoplastyPhakic intraocular lensjournal article10.2147/OPTH.S401387