Morphometric analysis of corneal endothelium following radial keratotomy

Chiba, Keizo; Oak, Setsuko S.; Tsubota, Kazuo; Laing, Ronald A.; Goldstein, Joseph H.; Hecht, Sanford D.

doi:10.1016/s0886-3350(87)80068-8

Cited by 26 publications

(9 citation statements)

References 15 publications

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“…Specular microscopy had previously docu mented endothelial cell loss of between 5% and 8%. 17,18 This is in line with other stud ies1 9 ,20 and its measurement had been discon tinued prior to this series.…”

Section: Complicationssupporting

confidence: 89%

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Radial keratotomy: 500 consecutive cases

Jory¹

1989

Eye

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A report on 500 consecutive eyes having radial keratotomy for myopia and myopic astigmatism is presented. Surgery was on an out-patient basis under local anaesthetic, with a follow-up of 99.2% of cases, 91.8% of the 294 patients elected to have radial keratotomy on the fellow eye. The surgical protocol was designed to minimise side effects and complications rather than maximise the reduction in myopia. 6/12 unaided vision or better was achieved by 99% of cases in the low myopia group, 91% in the middle and 41% in the high myopia group. Persistent hypermetropia of +1.00D or greater occurred in only 0.4% of cases and secondary astigmatism of 1.00D or greater in 1% of cases. Corneal perforations were minimised by single-pass incisions, but this was at the cost of lesser myopic corrections in the higher myopic group. Centering on the visual axis rather than the centre of the pupil minimised glare sensitivity. No patient developed potentially blinding complications.

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Section: Complicationssupporting

confidence: 89%

“…(16) Guttae Gentamycin and Guttae Cyclogyl 1 % were instilled in the operated eyes. (17) The eye was lightly patched for three hours only. (18) Post-operative pain was controlled with tablets OF118 for 12 to 18 hours only.…”

Section: Technique Of Radial Keratotomymentioning

confidence: 99%

Radial keratotomy: 500 consecutive cases

Jory¹

1989

Eye

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“…Although endothelial loss has been reported after RK,6,7 some studies suggest that the rate of endothelial loss stabilizes over time 8,9. We report seven cases (13 eyes) with a previous history of RK presenting with various degrees of guttata and endothelial dysfunction.…”

Section: Introductionmentioning

confidence: 77%

“…Ten years after surgery, 60 of 80 eyes developed bullous keratopathy 7. Chiba et al reported a post-RK endothelial cell loss of 14.1% with significant pleomorphism associated with microperforation and a smaller central clear zone of treatment, 6 to 30 months after surgery 6. In animal models, no difference between the reported 14%–15% endothelial cell loss was seen in eight versus 16 incision RK at 6 months 10…”

Section: Discussionmentioning

confidence: 99%

Radial keratotomy associated endothelial degeneration

Moshirfar

Ollerton²,

Semnani³

et al. 2012

OPTH

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PurposeTo describe the presentation and clinical course of eyes with a history of radial keratotomy (RK) and varying degrees of endothelial degeneration.MethodsRetrospective case series were used.ResultsThirteen eyes (seven patients) were identified with clinical findings of significant guttata and a prior history of RK. The mean age of presentation for cornea evaluation was 54.3 years (range: 38–72 years), averaging 18.7 years (range: 11–33 years) after RK. The presentation of guttata varied in degree from moderate to severe. Best corrected visual acuity (BCVA) ranged from 20/25 to 20/80. All patients had a history of bilateral RK, except one patient who did not develop any guttata in the eye without prior RK. No patients reported a family history of Fuch’s Dystrophy. One patient underwent a penetrating keratoplasty in one eye and a Descemet’s stripping automated endothelial keratoplasty (DSAEK) in the other eye.ConclusionsRK may induce a spectrum of endothelial degeneration. In elderly patients, the findings of guttata may signify comorbid Fuch’s dystrophy in which RK incisions could potentially hasten endothelial decomposition. In these select patients with stable cornea topography and prior RK, DSAEK may successfully treat RK endothelial degeneration.

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“…По данным разных авторов степень потери эндоте-лиальных клеток в период от 1 месяца до 7 лет после ПРК составляет от 3 до 10% [7,10,11]. На степень сни-жения плотности эндотелия влияет количество над-резов, маленький диаметр центральной оптической зоны вне рубцов, грубые манипуляции на роговице кератотомическим ножом с «тупым» металлическим лезвием, применение больших усилий во время вы-полнения надрезов с прогибанием участков роговицы, длительность послеоперационной воспалительной ре-акции.…”

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