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Am J Ophthalmol Case Rep. 2018 Jan 5;9:34-37. doi: 10.1016/j.ajoc.2018.01.010. eCollection 2018 Mar.

Descemet membrane endothelial keratoplasty for corneal decompensation due to iridoschisis.

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Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, Iowa City, IA 52242, United States.
Cornea Research Center, University of Iowa Carver College of Medicine, Iowa City, IA 52242, United States.



To report a case of bilateral iridoschisis with cataracts and corneal decompensation in a patient who underwent cataract extraction and superficial iridectomy followed by Descemet membrane endothelial keratoplasty (DMEK).


A 58-year-old man with previously diagnosed iridoschisis, cataracts, and diabetes mellitus experienced progressive vision loss bilaterally due to corneal decompensation. Slit lamp examination revealed iridoschisis with iris fibrils contacting the corneal endothelium, stromal edema, and mild guttate changes bilaterally. Corneal findings were more severe in the right eye, including the presence of bullous keratopathy at the time of presentation. Cataract extraction with intraocular lens implantation and superficial iridectomy were performed in the right eye, followed by DMEK. These same procedures were performed subsequently in the left eye. Postoperatively, the patient had significant improvement in visual acuity and corneal edema.

Conclusions and importance:

DMEK can be performed safely and successfully after staged cataract surgery with superficial iridectomy in eyes with endothelial decompensation caused by iridoschisis.


Corneal edema; Descemet membrane endothelial keratoplasty; Diabetes mellitus; Iridoschisis

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