Objective: To evaluate results and complications after Descemet stripping automated endothelial keratoplasty (DSAEK) combined with phacoemulsification and intraocular lens (IOL) implantation for phakic eyes with bullous keratopathy. Patients and Method: A prospective no controlled clinical trial study on 17 eyes of 16 patients underwent DSAEK and concurrent phacoemulsification with IOL implantation. The main outcome measures include surgical result (best spectacle corrected visual acuity (BSCVA), calculated and implanted IOL power, refractive status); intraoperative and postoperative complications. Results: Preoperatively, BSCVA of 14/17 eyes (82.4 percent) was lower than CF 3m. At 6 months postoperatively, surgical success rate was 14/17 eyes (82.4 percent), among them there were 13 eyes (92.9 percent) which had BSCVA more than 20/70. After adjustment of average +1,04D +/- 0.97D to calculated IOL power, postoperatively mean SE is +0.87D +/- 2.22D (from -3.0D to +S.88D). After suture removal, the mean astigmatism at 6 months postoperatively was only 1.27D +/- 0.86D. Surgical complications included up-side-down graft (1 eye), graft failure (3 eyes) and intraocular hypertension (5 eyes). Conclusion: DSAEK combined with phacoemulsification and IOl implantation is an effective method in management of phakic eyes with bullous keratopathy. Adjustment of intraocular lens power allows to compensate for the hyperopic shift. Complications found in the series were upside-down graft, graft failure and intraocular hypertension.
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