Corneal Endothelial Decompensation

Gupta, Krishnendu; Deng, Sophie X.

doi:10.1055/a-1128-4445

Cited by 6 publications

(5 citation statements)

References 56 publications

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“…Because the scarring of the donor corneas in our collective was superficial, peripheral, or without precise localization (also regarding the depth), the influence on the ECC was difficult to assess. However, according to the literature, ocular trauma can lead to ECL, [34][35][36] which was reflected in the significantly lower donor ECC of this subgroup. Postoperatively, however, the development of ECL was comparable to that of phakic donor tissue.…”

Section: Discussionmentioning

confidence: 81%

Impact of Previous Cataract Surgery in Corneal Donors on the Outcome of Descemet Membrane Endothelial Keratoplasty

Trouvain,

Szurman,

Wahl

et al. 2023

Cornea

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Purpose: The aim of this study was to investigate differences between phakic, pseudophakic, and scarred stromal donor tissue for their influence on complication rates during preparation or implantation and on the postoperative outcome of Descemet membrane endothelial keratoplasty (DMEK). Methods: We retrospectively compared 484 eyes undergoing DMEK, divided into 3 subgroups of donor tissue (1: phakic, 2: pseudophakic, and 3: scarred stromal). Visual acuity, central corneal thickness (CCT), and endothelial cell count were monitored preoperatively and postoperatively at 6 weeks and 3, 6, 12, and 24 months. The incidence of intraoperative and postoperative complications was analyzed. Results: The risk of adherence and tearing during preparation was significantly higher in group 2 than in the other groups (p’s < 0.001). No significant difference was found for visual acuity (p’s ≥ 0.368) and long-term CCT, but CCT recovery took longer in group 2 (P = 0.003), normalizing after 3 months (p’s ≥ 0.096). The overall mean endothelial cell count was lower in group 2 compared with the other groups (P = 0.011). No difference in the rebubbling rate was detected (P = 0.890). However, the risk of repeat keratoplasty for phakic grafts was lower compared with group 2 (P = 0.008). Conclusions: Pseudophakic donor grafts are more difficult to prepare and implant, resulting in longer recovery times and a higher risk of graft failure. However, when the preparation is uneventful and no graft failure occurs, pseudophakic grafts show a comparable outcome. Given the shortage of corneal donors and the high prevalence of pseudophakic corneal donors, they should not generally be excluded from corneal donation for DMEK.

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Section: Discussionmentioning

confidence: 81%

Impact of Previous Cataract Surgery in Corneal Donors on the Outcome of Descemet Membrane Endothelial Keratoplasty

Trouvain,

Szurman,

Wahl

et al. 2023

Cornea

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“…The preoperative quantification of corneal endothelial cells was not feasible in this patient, presumably attributed to prolonged contact between the lens nucleus and corneal endothelium, leading to a decline in corneal endothelial cell count and impaired functionality of the corneal endothelial pump. For patients with early-stage corneal edema, conservative treatment using local eye drops can be employed; however, when the disease progresses to an advanced stage, corneal transplantation remains the sole effective curative measure 6 . Therefore, following the surgical removal of the etiology, this patient primarily received local treatment.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Dislocation of the Lens Nucleus Into the Anterior Chamber Observed in a Patient With Overmature Senile Cataract

Yu,

Chen,

Dai

2024

Journal of Craniofacial Surgery

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Overmature cataract refers to the advanced stage of cataract where timely surgical intervention is not performed, leading to further progression characterized by decreased water content in the lens, degradation of fibers, and liquefaction within its structure, which can cause a reduction in volume, wrinkling of the capsule, as well as calcification or cholesterol crystallization on its surface. In addition, it may result in deepening of the anterior chamber. If left promptly untreated, these complications may result in visual impairment or even blindness. The occurrence of spontaneous complete dislocation of the lens nucleus into the anterior chamber in overmature cataracts is extremely uncommon. The authors present a case study involving a 74-year-old female patient who was diagnosed with complete dislocation of the lens nucleus in an overmature senile cataract without any apparent ocular injury or any relevant medical records. After undergoing cataract removal combined with anterior vitrectomy, the patient experienced relief from eye discomfort and expressed satisfaction with the surgical outcome; however, her visual acuity did not show significant improvement.

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“…We speculate that the traumatic history by spectacles of case 1 or severe firecracker wound and subsequent intraocular surgeries of case 4 contributed to preoperative endothelial cell loss (ECL). ECL can result from inherited, inflammatory, traumatic, immunological, intraocular manipulation, and infectious etiologies [12][13][14] . Mechanical injury in infants caused significant ECL with a higher annual decrease compared to the fellow eye [15] .…”

Section: Discussionmentioning

confidence: 99%

Small incision lenticule extraction and femtosecond-assisted laser in situ keratomileusis in patients with deep corneal opacity: case series

Fang¹,

Han²

2023

Int J Ophthalmol

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AIM: To report the safety, efficacy, and accuracy of small-incision lenticule extraction (SMILE) or femtosecond-assisted laser in situ keratomileusis (FS-LASIK) for the correction of myopia or myopic astigmatism in patients with deep corneal opacity denoted by anterior segment optical coherence tomography (AS-OCT). METHODS: Four patients with monocular corneal opacity (3 due to mechanical injury, 1 due to a firecracker wound) were recruited and treated with refractive surgery (3 for SMILE, 1 for FS-LASIK combined with limbal relaxing incision (LRI). Preoperative ocular manifestations, surgical details, postoperative visual outcomes, corneal opacity parameters, and corneal topography were analyzed. RESULTS: Preoperatively, spherical diopter ranged from -3.0 D to -4.75 D with cylinder ranging from -0.75 to -5.0 D, and corrected distance visual acuity (CDVA) ranging from 20/25 to 20/20. One eye’s corneal opacity was located in the central zone and three were in the mid-peripheral optical zone. Three patients underwent uneventful SMILE in both eyes, whilst one patient underwent FS-LASIK for high astigmatism in both eyes and LRI in the right eye. CDVA of the eye with corneal opacity ranged from 20/22 to 20/20 one to six weeks postoperatively. Two patients achieved better CDVA and no patients lost Snellen lines. The postoperative diopter was within ±0.75 D for all eyes. Significant edema existed above the corneal opacity in one eye and dissipated soon. No eccentric corneal topography or morphological anomaly of the corneal cap or flap was observed. CONCLUSION: The cases demonstrate that SMILE or FS-LASIK is safe and effective to treat myopic astigmatism combined with deep corneal opacity lesions after comprehensive preoperative evaluation and appropriate candidate selection. FS-LASIK combined with LRI is also sufficient for correcting high astigmatism due to corneal scarring.

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Corneal Endothelial Decompensation

Cited by 6 publications

References 56 publications

Impact of Previous Cataract Surgery in Corneal Donors on the Outcome of Descemet Membrane Endothelial Keratoplasty

Impact of Previous Cataract Surgery in Corneal Donors on the Outcome of Descemet Membrane Endothelial Keratoplasty

Spontaneous Dislocation of the Lens Nucleus Into the Anterior Chamber Observed in a Patient With Overmature Senile Cataract

Small incision lenticule extraction and femtosecond-assisted laser in situ keratomileusis in patients with deep corneal opacity: case series

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