Amantadine-related corneal edema and endothelial cell loss: Four case reports

Purpose: To evaluate the visual outcomes, safety, efficacy, and causes of bilensectomy for iris fixated phakic intraocular lenses (pIOLs). Methods: This was a two center consecutive retrospective study that included 43 eyes that underwent iris-claw pIOL bilensectomy. Patients with follow up less than 4 months were excluded from the study. Uncorrected, corrected visual acuity (UCVA, CDVA), refractive outcomes, efficacy, safety (number of eyes in which the postoperative CDVA was worse than the preoperative CDVA), endothelial cell density (ECD), causes of bilensectomy, the time between the implantation of the pIOL and bilensectomy, intra and postoperative complications were analyzed. Results: There was a statistically significant improvement in UCVA and CDVA after surgery ( p = 0.001). The efficacy index was 0.7, four eyes had a postoperative CDVA worse than the preoperative CDVA. The mean spherical equivalent 1 year after bilensectomy was −0.78 ± 1.70 D. There was a statistically significant endothelial cell loss after iris claw lens bilensectomy ( p = .003). Cataract development and endothelial cell loss were the only reasons for bilensectomy. The mean time between pIOL implantation and bilensectomy was 12.2 ± 5.5 years. One patient had corneal edema 8 months after surgery and one had a retinal detachment 11 months after surgery. Conclusion: Bilensectomy was successful in improving UCVA and CDVA with an acceptable refractive outcome. Significant loss of ECD was found after surgery. The results recommend a larger ACD as selection criteria when choosing to implant an Artisan lens, and a close postoperative monitoring of the endothelial cell count.

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Outcomes of Descemet Membrane Endothelial Keratoplasty (DMEK) Using Surgeon’s Prepared Donor DM-Roll in Consecutive 100 Indian Eyes

The Open Ophthalmology Journal ◽

10.2174/1874364101812010134 ◽

2018 ◽

Vol 12 (1) ◽

pp. 134-142 ◽

Cited By ~ 5

Author(s):

Samar K Basak ◽

Soham Basak ◽

Viraj R Pradhan

Keyword(s):

Endothelial Cell ◽

Corneal Edema ◽

Cell Loss ◽

Bullous Keratopathy ◽

Endothelial Keratoplasty ◽

Descemet Membrane Endothelial Keratoplasty ◽

Endothelial Cell Loss ◽

Corneal Surgery ◽

Descemet Membrane ◽

Visual Outcomes

Background:Descemet Membrane Endothelial Keratoplasty (DMEK) is now becoming the popular form of endothelial keratoplasty using only donor DM with healthy endothelium as true component lamellar corneal surgery.Objective:To analyze the results of visual outcomes, endothelial cell loss and complications of Descemet membrane endothelial keratoplasty in first consecutive 100 Indian eyes.Methods:100 eyes of 95 consecutive patients with endothelial dysfunctions of different etiologies scheduled for DMEK, were included in this study. In each case, surgeon prepared tissue using McCarey Kaufman medium- or Cornisol-preserved donor cornea with a cell count of ≥2500 cells/mm2. Surgical complications, Best Spectacle Corrected Visual Acuity (BSCVA); Endothelial Cell Density (ECD) and Endothelial Cell Loss (ECL) were analyzed for each patient after a minimum follow-up of three months.Results:The Main indication was pseudophakic corneal edema or bullous keratopathy in 52 (52%) eyes. 38 (38%) eyes had Fuchs′ dystrophy with various grades of cataract. In 43 phakic eyes, DMEK was combined with cataract surgery and intraocular lens implantation. Mean DM-roll preparation time was 7.5 ± 2.8 min and in 3 eyes, DM-graft were damaged. After 3-months, BSCVA was ≥20/25 in 57 (57.6%) cases. Mean ECD was 2123 ± 438/mm2(range: 976 - 3208/ mm2) and the mean endothelial cell loss after 3-months was 26.92 ± 13.40 (range: 4.90 - 66.6%). Partial DM detachment occurred in 8 (8.0%) eyes and rebubbling required in 4 eyes. Iatrogenic primary graft failure occurred in one eye.Conclusion:Descemet membrane endothelial keratoplasty is a safe and effective procedure in several types of endothelial diseases among Indian patients with encouraging surgical and visual outcomes. Complications are less and endothelial cell loss percentage is acceptable.

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The effect of topical steroid on postoperative corneal edema and endothelial cell loss after intracapsular cataract extraction

Acta Ophthalmologica ◽

10.1111/j.1755-3768.1993.tb04967.x ◽

2009 ◽

Vol 71 (1) ◽

pp. 89-94 ◽

Cited By ~ 6

Author(s):

J. N. Nissen ◽

N. Ehlers ◽

K. Frost-Larsen ◽

T. Sørensen

Keyword(s):

Endothelial Cell ◽

Topical Steroid ◽

Corneal Edema ◽

Cataract Extraction ◽

Cell Loss ◽

Endothelial Cell Loss

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Influence of rebubbling on anterior segment parameters and refractive outcomes in eyes with DMEK for Fuchs endothelial dystrophy

Graefe s Archive for Clinical and Experimental Ophthalmology ◽

10.1007/s00417-021-05114-2 ◽

2021 ◽

Author(s):

Bishr Agha ◽

Raimund Forster ◽

Thomas Kohnen ◽

Ingo Schmack

Keyword(s):

Visual Acuity ◽

Endothelial Cell ◽

Anterior Segment ◽

Cell Loss ◽

Endothelial Cell Loss ◽

Refractive Outcome ◽

Refractive Outcomes ◽

Scheimpflug Imaging ◽

Fuchs Endothelial Dystrophy ◽

Anterior Segment Parameters

Abstract Purpose To evaluate the potential impact of rebubbling on the anterior segment parameters and refractive outcomes in patients with graft detachment following uneventful DMEK for Fuchs endothelial dystrophy (FED). Methods Retrospective institutional cohort study of comparing 34 eyes of 31 patients with rebubbling for graft detachment following Descemet membrane endothelial keratoplasty (DMEK) to 33 eyes of 28 patients with uneventful DMEK. Main outcome parameters were various corneal parameters obtained by Scheimpflug imaging, refractive outcome, corrected distance visual acuity (CDVA), and endothelial cell density (ECD). Results Anterior and posterior corneal astigmatism, corneal densitometry, central corneal thickness, and anterior chamber depth and volume showed no significant differences. Preoperative distribution of astigmatism axis orientations showed a high proportion of anterior corneal with-the-rule astigmatism (71%) in eyes requiring rebubbling. Mean postoperative cylinder in the rebubbling group (1.21 ± 0.85 D) was significantly higher compared to the controls (p = 0.04), while differences in spherical equivalent (SE) were insignificant (p = 0.24). Postoperative CDVA was 0.11 ± 0.11 in the control group compared to 0.21 ± 0.17 in the rebubbling group (p = 0.03). Eyes with subsequent rebubbling demonstrated a significantly higher endothelial cell loss (56% versus 37%) (p < 0.001). Conclusion Apart from higher cylinder values, refractive outcome and corneal parameters assessed by Scheimpflug imaging were comparable in eyes with rebubbling and controls. However, a reduced visual acuity and an increased endothelial cell loss should be taken into consideration prior to rebubbling especially in eyes with circumscribed graft detachment.

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Comparison of Long-Term Outcomes of the Lamellar and Penetrating Keratoplasty Approaches in Patients with Keratoconus

Journal of Clinical Medicine ◽

10.3390/jcm10112421 ◽

2021 ◽

Vol 10 (11) ◽

pp. 2421

Author(s):

Dominika Janiszewska-Bil ◽

Barbara Czarnota-Nowakowska ◽

Katarzyna Krysik ◽

Anita Lyssek-Boroń ◽

Dariusz Dobrowolski ◽

...

Keyword(s):

Endothelial Cell ◽

Adverse Events ◽

Penetrating Keratoplasty ◽

Corneal Thickness ◽

Cell Loss ◽

Lamellar Keratoplasty ◽

Deep Anterior Lamellar Keratoplasty ◽

Endothelial Cell Loss ◽

Anterior Lamellar Keratoplasty ◽

Significant Difference

We compared the visual and refractive outcomes, intraocular pressure (IOP), endothelial cell loss (ECL), and adverse events in keratoconus patients after deep anterior lamellar keratoplasty (DALK) and penetrating keratoplasty (PK) with the best corrected visual acuity (BCVA) below 0.3 (logMAR 0.52). This is a prospective, comparative cohort study of 90 eyes (90 patients) with a clinical diagnosis of keratoconus. Patients underwent a complete eye examination before the surgical approach, 6 and 12 months postoperatively that consisted of BCVA, refractive astigmatism (AS), central corneal thickness (CCT), IOP, and ECL. Secondary outcomes were adverse events related to the surgical procedure. With lower ECL and less adverse events, DALK was revealed to be beneficial over PK with similar visual outcomes. Results: There was no significant difference between the BCVA in the DALK and PK groups (at 6 months: 0.49 ± 0.17 vs. 0.48 ± 0.17; p = 0.48; at 12 months: 0.54 ± 0.17 vs. 0.52 ± 0.14; p = 0.41). The mean value of AS was significantly lower after the PK procedure when compared to DALK, after both 6 and 12 months of follow up (p < 0.001). The CCT in the DALK group was significantly lower when compared to the PK group (at 6 months: 452.1 ± 89.1 µm vs. 528.9 ± 69.9 µm, p < 0.0001; at 12 months: 451.6 ± 83.5 µm vs. 525.5 ± 37.1 µm). The endothelial cell loss at 12 months after surgery was significantly lower after DALK when compared to PK (p < 0.0001). DALK transplantation should be considered as an alternative procedure in the surgical treatment of keratoconus.

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Endothelial cell density change in fully dislocated XEN Gel IMPLANT after trabeculectomy: A case report

European Journal of Ophthalmology ◽

10.1177/1120672121989632 ◽

2021 ◽

pp. 112067212198963

Author(s):

Martina Menchini ◽

Francesco Sartini ◽

Filippo Tatti ◽

Enrico Peiretti ◽

Michele Figus

Keyword(s):

Endothelial Cell ◽

Anterior Chamber ◽

Cell Density ◽

Cell Loss ◽

Endothelial Cell Density ◽

Endothelial Cell Loss ◽

Density Reduction ◽

History Of ◽

Cell Loss Rate

Purpose: To report a case of fully dislocated XEN Gel Implant device into the anterior chamber, 18 months after its implantation and its impact on endothelial cell density. Result: A 75-year-old man with a history of multiple glaucoma surgeries during the last three years presented with an entirely dislocated XEN Gel implant into the anterior chamber. An endothelial cell density reduction was observed over 18 months. Thus, the implant was removed. In the short-term after surgery, the endothelial cell loss rate reduced. Conclusion: XEN Gel Implant can dislocate into the anterior chamber, increasing endothelial cell loss in an eye already underwent multiple surgical procedures with subsequent adverse events. Therefore, if the implant seems displaced, the endothelial cell density should be monitored, and the length of the free-tube segment within the anterior chamber should be measured, during the patient’s follow-up.

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