New Horizons in the Treatment of Corneal Endothelial Dysfunction

Rocha‐de‐Lossada, Carlos; Rachwani-Anil, Rahul; Borroni, Davide; Sánchez‐González, José‐María; Esteves-Marques, Raquel; Soler-Ferrández, Fernando-Luis; Gegúndez-Fernández, Jose-Antonio; Romano, Vito; Livny, Eitan; Rodríguez‐Calvo‐de‐Mora, Marina

doi:10.1155/2021/6644114

Cited by 20 publications

(12 citation statements)

References 86 publications

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“…If the cell decline both in number and functional capability is substantial, the corneal thickness potentially increases causing suboptimal corneal transparency [64,65]. Symptoms can include a decreased acuity and contract sensitivity or increased glare [66][67][68].…”

Section: Dry Eyementioning

confidence: 99%

Vision through Healthy Aging Eyes

Erdinest

London²,

Lavy

et al. 2021

Vision

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As life expectancy grows, so too will the number of people adversely affected by age. Although it is acknowledged that many conditions and diseases are associated with age, this mini-review will present a current update of the various visual changes that generally occur in healthy individuals disregarding the possible effects of illness. These alterations influence how the world is perceived and in turn can affect efficiency or the ability to perform ordinary daily tasks such as driving or reading. The most common physical developments include a decreased pupil size and retinal luminance as well as changes both in intercellular and intracellular connections within the retina along the pathway to the visual cortex and within the visual cortex. The quantity and the physical location of retinal cells including photoreceptors, ganglion and bipolar retinal cells are modified. The clarity of intraocular organs, such as the intraocular lens, decreases. These all result in common visual manifestations that include reduced visual acuity, dry eyes, motility changes, a contraction of the visual field, presbyopia, reduced contrast sensitivity, slow dark adaptation, recovery from glare, variation in color vision and a decreased visual processing speed. Highlighting these prevalent issues as well as current and possible future innovations will assist providers to formulate treatments and thereby conserve maximum independence and mobility in the modern mature population.

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Section: Dry Eyementioning

confidence: 99%

Vision through Healthy Aging Eyes

Erdinest

London²,

Lavy

et al. 2021

Vision

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“…New options in FECD management such as DSO, bioengineered corneal grafts, gene therapy, and cell injection are in development to assess their therapeutic potential. 24 These new therapeutic options would all reduce the cost burden of the transplant tissue, which is a large cost component. Until new regimens become viable treatment options, EK may remain the standard of care for the management of FECD.…”

Section: Discussionmentioning

confidence: 99%

Cost Burden of Endothelial Keratoplasty in Fuchs Endothelial Dystrophy: Real-World Analysis of a Commercially Insured US Population (2014–2019)

Dhaliwal¹,

Chirikov²,

Schmier³

et al. 2022

OPTH

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Purpose To assess the incremental burden of corneal transplant surgery for US commercially insured patients with Fuchs endothelial corneal dystrophy (FECD) treated with endothelial keratoplasty (EK) compared to controls. Methods The study design was retrospective cohort using IBM ® MarketScan ® claims (January 2014–September 2019) and included EK-treated (N=1562) and control patients (N=23,485) having ≥12 months’ enrollment before and after diagnosis, who were subsequently matched on select characteristics. The index date was the beginning of the pre-operative period (3 months before EK); synthetic EK index was assigned for controls. All-cause, eye-disease, and complication-related healthcare resource utilization (HCRU) and costs were compared up to 36 months post index. For a small subset of patients, patient data were linked to the Health and Productivity Management supplemental database, which integrates data on productivity loss and disability payments. Results Matched cohorts included 804 EK-treated and 1453 controls with average age 65.7 years, 1383 (61%) female. Over 12 months of follow-up, all-cause ($41,199 vs $20,222, p<0.001) and eye-disease related costs ($22,951 vs $1389, p<0.001) were higher among EK-treated patients than controls. The cost differential increased additionally by $1000–$2000 per annum by 36 months of follow-up. While balanced at baseline, over follow-up EK-treated patients had higher prevalence of glaucoma, elevated intraocular pressure, cataract, cataract surgery, diagnosis of cornea transplant rejection, retinal edema. By 36 month of follow-up, EK-treated patients had 9 more short-term disability days, resulting in $2992 additional burden of disability payments. Conclusion This study found a higher cost burden among FECD patients receiving EK treatment versus those who did not. With a shift in management of FECD, cost burden estimates generated in this study could serve as an important benchmark for future studies.

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“…Additionally, long-term follow-up beyond 1-year postoperatively will help us to understand if grafts behave differently in thicker corneas. Descemet’s membrane endothelial keratoplasty (DMEK) has been introduced as an alternative to DSAEK for quicker visual recovery [ 11 , 12 ]. It would be interesting to compare DMEK and DSAEK in extremely thick recipient corneas in future studies.…”

Section: Discussionmentioning

confidence: 99%

Descemet Stripping Automated Endothelial Keratoplasty in Thick Corneas

Xiao

et al. 2022

JCM

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Purpose: To evaluate the outcomes of Descemet’s Stripping Automated Endothelial Keratoplasty (DSAEK) in corneas > 820 microns in thickness. Methods: This retrospective study included 30 eyes of 30 patients who underwent DSAEK. Endothelial cell destiny (ECD) and corneal thickness were recorded before surgery and at 1 and 12 months postoperatively. Patients were divided into two groups (≤ 820 microns and > 820 microns) based on median preoperative corneal thickness. Linear regression analyses were used to investigate the correlations between ECD and preoperative corneal thickness. Results: Recipient corneal thickness (RCT) and postoperative central cornea thickness had a statistically significant difference 1 month after surgery (p = 0.03, p = 0.08, respectively). BCVA and ECD did not have a statistical difference in the two groups at 1 month and 12 months after DSAEK. Conclusions: BCVA, ECD and corneal thickness were similar at 12 months after DSAEK in thick corneas. DSAEK is a viable surgical option in thick corneas.

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New Horizons in the Treatment of Corneal Endothelial Dysfunction

Cited by 20 publications

References 86 publications

Vision through Healthy Aging Eyes

Vision through Healthy Aging Eyes

Cost Burden of Endothelial Keratoplasty in Fuchs Endothelial Dystrophy: Real-World Analysis of a Commercially Insured US Population (2014–2019)

Descemet Stripping Automated Endothelial Keratoplasty in Thick Corneas

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