The study was done for the sake of reporting the two cases of coexisting keratoconus and Fuchs endothelial dystrophy treated with intrastromal corneal ring segments (ICRS) implantation and Descemet membrane endothelial keratoplasty (DMEK).
Two patients with coexisting keratoconus and Fuchs endothelial dystrophy underwent ICRS implantation and DMEK, in a two-stage procedure. Follow-up evaluation included Scheimpflug tomography and optical coherence tomography.
In both cases, ICRS implantation improved corneal topography and DMEK restored normal corneal thickness. Corrected distance visual acuity improved from 20/100 to 20/30 and from 20/60 to 20/25. Turrets-Zavalía syndrome was diagnosed in one case and addressed with colored contact lens fitting.
The study concluded that the low vision resulting from coexisting keratoconus and Fuchs endothelial dystrophy might be addressed more selectively with posterior lamellar keratoplasty and ICRS implantation which will prove to be the effective treatment options to provide optimal outcomes. Turrets-Zavalía syndrome must be considered as a possible complication after DMEK, especially in patients with keratoconus because there are chances of its development as suggested by the results of this study.
Reference: https://doi.org/10.3928/1081597X-20200828-01
