scholarly journals Endothelial Cell Loss Rate Following Penetrating Keratoplasty: Optical versus Therapeutic Grafts

2021 ◽  
Author(s):  
Abdelrhman Shams ◽  
Ayman Gaafar ◽  
Rania Elkitkat ◽  
Mohamed Yousif
Keyword(s):  
Endothelial Cell ◽  
Graft Rejection ◽  
Penetrating Keratoplasty ◽  
Cell Loss ◽  
P Value ◽  
Specular Microscopy ◽  
Endothelial Cell Loss ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Abstract Purpose: To compare the rate of endothelial cell loss (ECL) following penetrating keratoplasty (PKP) for optical and therapeutic indications and to state whether therapeutic PKP is inferior to optical PKP or not.Methods: This is a Prospective, observational, comparative study that included patients who sought medical advice at the Cornea Outpatient Clinic of Ain Shams University Hospitals. The study enrolled two groups; group 1 included 30 corneas of 30 patients who performed optical PKP for various purposes, while group 2 comprised 30 corneas of 30 patients who were planned for performing therapeutic PKP for unhealed, resistant corneal infections. Specular microscopy was done to all the patients at the 3-, 6- and 12-months visits using Nidek CEM-530 (NIDEK Co., Ltd. Japan) specular microscope. Results: There were no statistically significant differences between both groups as regards to the timing of the graft clarity following surgery or the rate of ECL at the 3- and 6- months intervals, yet the rate of ECL was significantly higher in group 2 compared to group 1 at the 12 months interval (P-value <0.05), though the statistical difference was narrow from a clinical point of view. There was also no statistically significant difference between both groups regarding the rate of graft rejection.Conclusion: Therapeutic PKP can be considered non-inferior to optical PKP regarding the graft viability, the rate of ECL, and the rate of graft rejection along a follow up interval of one year.

scholarly journals Endothelial cell loss rate after penetrating keratoplasty: Optical versus therapeutic grafts

2021 ◽  
Vol 10 (2) ◽  
pp. 74-79
Author(s):  
Abdelrhman Shams ◽  
Ayman Abdelmoneim Gaafar ◽  
Rania Serag Elkitkat ◽  
Mohamed Omar Yousif
Keyword(s):  
Endothelial Cell ◽  
Graft Rejection ◽  
Penetrating Keratoplasty ◽  
Cell Loss ◽  
Specular Microscopy ◽  
Endothelial Cell Loss ◽  
Group 2 ◽  
Cell Loss Rate ◽  
Group 1

Background: This study aimed to compare the rate of endothelial cell loss (ECL) after penetrating keratoplasty (PKP) for optical versus therapeutic grafts at 3-, 6-, and 12-month postoperatively. Furthermore, the study aimed to investigate postoperative graft viability and the rate of graft rejection during the first year of follow-up for both indications. Methods: This was a prospective, observational, comparative study that included patients who sought medical advice at the cornea outpatient clinic of Ain Shams University Hospitals, Cairo, Egypt. The study recruited 60 patients: group 1 included 30 transplanted corneas of 30 patients who underwent optical PKP for various indications, while group 2 included 30 transplanted corneas of 30 patients who underwent therapeutic PKP for unhealed, resistant infectious keratitis. Specular microscopy was performed for all patients at the 3-, 6-, and 12-month follow-up visits using Nidek CEM-530 specular microscopy. Postoperative clinical examinations were performed at the same follow-up visits to detect graft rejection. Results: There were no statistically significant differences between the groups concerning the postoperative timing of graft clarity or the rate of ECL at 3- and 6-months postoperatively; however, the rate of ECL was significantly greater in group 2 than in group 1 at 12-months postoperatively (P = 0.03), although the difference was small from a clinical point of view. Moreover, there was no statistically significant difference between the groups in terms of the graft rejection rate. Conclusions: Therapeutic PKP results were comparable to optical PKP with respect to graft viability, the rate of ECL, and the rate of graft rejection 1 year after grafting. How to cite this article: Shams A, Abdelmoneim Gaafar A, Elkitkat RS, Omar Yousif M. Endothelial cell loss rate after penetrating keratoplasty: Optical versus therapeutic grafts. Med Hypothesis Discov Innov Ophthalmol. 2021 Summer; 10(2): 74-79. https://doi.org/10.51329/mehdiophthal1424

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

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.

scholarly journals A Comparison of Endothelial Cell Loss in Combined Cataract and MIGS (Hydrus) Procedure to Phacoemulsification Alone: 6-Month Results

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Antonio M. Fea ◽  
Giulia Consolandi ◽  
Giulia Pignata ◽  
Paola Maria Loredana Cannizzo ◽  
Carlo Lavia ◽  
...  
Keyword(s):  
Endothelial Cell ◽  
Cataract Surgery ◽  
Open Angle Glaucoma ◽  
Glaucoma Surgery ◽  
Cell Loss ◽  
Endothelial Cell Loss ◽  
Age Related ◽  
Before And After ◽  
Group 2 ◽  
Group 1

Purpose. To compare the corneal endothelial cell loss after phacoemulsification, alone or combined with microinvasive glaucoma surgery (MIGS), in nonglaucomatous versus primary open angle glaucoma (POAG) eyes affected by age-related cataract.Methods. 62 eyes of 62 patients were divided into group 1 (n=25, affected by age-related cataract) and group 2 (n=37, affected by age-related cataract and POAG). All patients underwent cataract surgery. Group 2 was divided into subgroups A (n=19, cataract surgery alone) and B (n=18, cataract surgery and MIGS). Prior to and 6 months after surgery the patients’ endothelium was studied. Main outcomes were CD (cell density), SD (standard deviation), CV (coefficient of variation), and 6A (hexagonality coefficient) variations after surgeries.Results. There were no significant differences among the groups concerning preoperative endothelial parameters. The differences in CD before and after surgery were significant in all groups: 9.1% in group 1, 17.24% in group 2A, and 11.71% in group 2B. All endothelial parameters did not significantly change after surgery.Conclusions. Phacoemulsification determined a loss of endothelial cells in all groups. After surgery the change in endothelial parameters after MIGS was comparable to the ones of patients who underwent cataract surgery alone.

scholarly journals Comparative study of anatomic and functional changes of the corneal endothelium in cataract patients undergoing phacoemulsification and MSICS

2021 ◽  
Vol 7 (2) ◽  
pp. 358-362
Author(s):  
Gurvinder Khosa ◽  
Karanijit Singh ◽  
Prempal Kaur ◽  
Rajesh Kumar ◽  
Upasna Ajmani
Keyword(s):  
Visual Acuity ◽  
Endothelial Cell ◽  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Cell Loss ◽  
P Value ◽  
Corrected Visual Acuity ◽  
Group 2 ◽  
Best Corrected Visual Acuity ◽  
Group 1

The purpose of this study was to compare the effect of Phacoemulsification and Manual small incision cataract surgery (MSICS) on the corneal endothelium and to assess its impact on visual acuity and induced astigmatism. In this prospective randomized study, 100 cases were randomly selected with the help of lottery system. 50 cases underwent phacoemulsification (group 1) and 50 underwent MSICS (group 2) by a single surgeon. The endothelial cell count, central corneal thickness, best corrected visual acuity and induced astigmatism was measured preoperatively and postoperatively on day 1, 7, 28 and on day 42. Mean endothelial cell loss (cells/mm2) in group 1 at the end of six weeks was 538.64 (20.59%) and in group 2 was 485.66 (19.20%) which was statistically insignificant (p &#62;0.05). The mean central corneal thickness was reduced in both the groups with a mean of 0.51±0.04 mm in group 1 and 0.50±0.03 mm in group 2 which was statistically insignificant. Postoperative best corrected visual acuity of more than 6/18 was found in 49 (98%) cases in each group at six weeks, and was statistically insignificant (p value &#62; 0.05). Phacoemulsification group had statistically significant less mean postoperative astigmatism than MSICS group (p value &#60; 0.05). Both groups gave similar statistically insignificant results in relation to endothelial cell loss, central corneal thickness and best corrected visual acuity at the end of six weeks, although the mean astigmatism was more in group 2 in comparison to group 1 with a statistically significant difference.

scholarly journals Corneal status following modified Blumenthal technique of manual small incision cataract surgery (MSICS) compared to phacoemulsification in treatment of grade III or more nuclear sclerosis-cohort study

2015 ◽  
Vol 7 (1) ◽  
pp. 47-51 ◽  
Author(s):  
K Jain ◽  
K PS Malik ◽  
S Gupta
Keyword(s):  
Endothelial Cell ◽  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Cell Loss ◽  
Specular Microscopy ◽  
Endothelial Cell Loss ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Grade Iii

Objective: To evaluate the endothelial cell loss and central corneal thickness in modified Blumenthal technique of MSICS and Phacoemulsification. Method: A prospective study in which 50 cases of nuclear sclerosis grade III (LOCS III) or more were randomized in two groups of 25 each. Group A underwent modified Blumenthal MSICS. Lens expression was facilitated by viscoelastic injection through ACM and scleral pressure by iris repositor. Group B underwent 2.8 mm phacoemulsi¿cation. Specular microscopy and pachymetry were done at 1st POD, 1st, 3rd and 6th week.Results: No significant difference in endothelial cell loss and central corneal thickness between group A and group B (p > 0.05) was found.Conclusion: This technique of MSICS is not inferior, an innovative, safe and highly effective in hard cataracts.

scholarly journals Mean Corneal Endothelial Cell Loss in Type 2 Diabetic Cataract Patients After Phacoemulsification.

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Syed Abdullar Mazhar ◽  
Sehar Zahid ◽  
Junaid Hanif ◽  
Muhammad Asharib Arshad ◽  
Rana Naveed Iqbal
Keyword(s):  
Type 2 Diabetes ◽  
Endothelial Cell ◽  
Cell Count ◽  
Cell Loss ◽  
Corneal Endothelial Cell ◽  
P Value ◽  
Specular Microscopy ◽  
Endothelial Cell Loss ◽  
Endothelial Cell Count

Purpose:  To assess the mean corneal endothelial cell loss after Phacoemulsification in patients of type 2 diabetes. Study Design:  Cross-sectional study. Place and Duration of Study:  Layton Rahmatullah Benevolent Trust Free Eye and Cancer Hospital for a period of six months, from May 2015 to November 2015. Material and Methods:  Three hundred and fifty-five patients were selected by non-probability convenience sampling. Patients with cataract, diagnosed at least after 6 months of diagnosis of type 2 diabetes were included in this study. Patients with any systemic disease or ocular disease other than senile cataract were excluded from the study. Endothelial cell count was measured with Specular microscopy one day before surgery. One experienced surgeon with post-graduate experience of at least five years performed all the procedures. Follow up by specular microscopy was done at 6 weeks after phacoemulsification. Statistical analysis was done using SPSS version 23. Results:  Mean age of the patients was 59.32 ± 7.60 years. There were 41.97% males and 58.03% females. Mean endothelial cell count before phacoemulsification was 2177.21 ± 591.078 and 6 weeks after surgery was 1984 ± 597.51. Age, gender, laterality, duration of diabetes and type of cataract was not significantly related with endothelial cell loss, p-value > 0.05. Mean endothelial cells loss was higher in patients with HbA1c > 7 as compared to those with HbA1c < 7 (p-value = 0.01). Conclusion:  Patients with poor control of diabetes have higher endothelial cell loss after phacoemulsification than patients with good control.

scholarly journals Non-contact specular microscopy in aphakic and pseudophakic dogs

2014 ◽  
Vol 44 (4) ◽  
pp. 682-687 ◽  
Author(s):  
Claudia Emi Nagatsuyu ◽  
Priscila Barreto de Abreu ◽  
Karina Kamachi Kobashigawa ◽  
Luciano Fernandes da Conceição ◽  
Adriana Morales ◽  
...  
Keyword(s):  
Endothelial Cell ◽  
Cell Density ◽  
Cell Loss ◽  
Endothelial Cell Density ◽  
Intraocular Lenses ◽  
Specular Microscopy ◽  
Cell Area ◽  
Endothelial Cell Loss ◽  
Significant Difference ◽  
Posterior Capsular Opacity

Cataract is one of the most common ocular diseases in dogs, and phacoemulsification is considered its treatment of choice. Posterior capsular opacity (PCO) is a frequent complication and may occur weeks or months after the surgery. It is known that intraocular lenses (IOL) used for the correction of post-operative hypermetropia are an adjunctive aid in the prevention of PCOs, mainly the foldable acrylics designs with square and truncated edges. However, IOL placement may result in endothelial cell loss. This study evaluated the morphology and cellularity of the endothelium by non-contact specular microscopy in aphakic and pseudophakic dogs. Endothelial cell density, endothelial cell area, coefficient of variation and hexagonal cells percent were analyzed for each group and between groups. During all evaluation periods, endothelial cell density did not alter in any group. From days 7 to 30, endothelial cell density was higher in pseudophakic dogs. However, values returned to normal and, by the end of the study, no significant difference was observed. Cell area and variation coefficient did not differ in each group or between groups. Hexagonal cells percent significantly reduced after phacoemulsification in both groups. With time, this condition returned to initial values. When both groups were compared, hexagonal cells percent were decreased in the pseudophakic group, immediately after the surgeries.

Comparison of endothelial cell changes by specular microscopy between Ringer’s and Ringer’s lactate during phacoemulsification

2020 ◽  
Vol 1 (4) ◽  
pp. 218-223
Author(s):  
Eman Desoky ◽  
◽  
Hany Ahmed Helaly ◽  
Keyword(s):  
Endothelial Cell ◽  
Corneal Thickness ◽  
Cell Loss ◽  
Specular Microscopy ◽  
Ringer’S Solution ◽  
Age Related ◽  
Ringer’S Lactate ◽  
The Difference ◽  
Group 2 ◽  
Group 1

AIM: To compare the difference between using Ringer’s and Ringer’s lactate (RL) solutions as irrigating solutions during phacoemulsification and investigate their effect on corneal endothelium. METHODS: This was a prospective interventional double blinded clinical study that included 100 eyes of 100 patients aged between 50 to 65y suffering from a visually significant age-related cataract and scheduled for routine uncomplicated phacoemulsification. The included eyes were randomly divided into two equal groups (each group included 50 eyes). Group 1 received Ringer’s solution and group 2 received Ringer’s lactate as an irrigating solution. RESULTS: The first group with Ringer’s solution had a mean age of 57.5±8y and the second group with RL solution had a mean age of 58.6±9y. After 3mo, endothelial cell density decreased in group 1 by a mean of 8.5%, and in group 2 by a mean of 3.6% (P=0.013). Additionally, central corneal thickness increased in group 1 by a mean of 6.9% and in group 2 by a mean of 1.5% (P=0.006). By correlating the percentage of change in pachymetry and specular microscopic parameters with volume of irrigation solution used, there was no significant correlation. CONCLUSION: The use of Ringer’s lactate as an irrigating solution is associated with less endothelial cell loss postoperatively in comparison to Ringer’s solution and associated with decreased postoperative edema.

A Comparative Study Between Preoperative Subconjunctival Bevacizumab Injection And Postoperative Topical Application In Prevention Of Recurrence After Excision Of Primary Pterygium In Egyptian Patients

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Basma Helal Mohamed ◽  
Othman Ali Othman Ziko ◽  
Hisham M Khairy Abd El Dayem ◽  
Nancy Ezzelregal Khamis Ahmed
Keyword(s):  
Corneal Thickness ◽  
Anterior Segment ◽  
P Value ◽  
Eye Drops ◽  
Subconjunctival Injection ◽  
Fibrovascular Tissue ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1 ◽  
Primary Pterygium

Abstract Purpose to compare between recurrence incidence after primary pterygium excision when using preoperative subconjunctival injection of Bevacizumab (Avastin) and using it as a postoperative eye drops. Methods thirty two eyes of thirty patients (two patients had bilateral pterygium) with primary pterygia were clinically examined, classified into 3 groups and operated by simple excision with bare sclera technique. Group 1 included 10 patients received Bevacizumab (Avastin) in the form of eye drops (10 mg/ml) 3 times daily for 6 days postoperative. Group 2 included 10 patients received preoperative Bevacizumab in the form of subconjunctival injection (1.25 mg/0.05ml) single dose 1 week preoperative. Group 3 included 10 patients (12 eyes) 2 patients with bilateral Pterygium didn’t receive any form of Bevacizumab. Postoperative follow up was done clinically and by serial photography at 1 week, 1 month, 3 months and 6 months searching for signs of recurrence and/or complications. Results The results showed different grades of recurrence in 18 eyes of 32.True recurrence was seen in 7 patients of 18 (1 patient in group 1, 2 in group 2 and 4 in group3).Recurrence grades in group 1and 2 who used the Bevacizumab (20%grade II, 50% grade III, and 30% grade IV). Recurrence could be predicted by 100% depending on fibrovascular tissue appearing in the surgical bed at 3 months postoperative (P value 0.038).Preoperative fleshy pterygium has high statistical significance in realation to recurrence(P value = 0.006).Patient’s sex, residence and occupation had no statistically significant value in the process of recurrence (P value &gt; 0.05). Patients with recurrent Pterygia (in group 1&2) had statistically significant changes in the corneal K- readings at 3 months and 6 months.No significant difference in the limbal or central corneal thickness in the operated eye and the other eye (Pvalue &gt; 0.05). Conclusion Bevacizumab (Avastin) is a well tolerated drug with multiple drug delivery methods.The eye drops give better results than the subconjunctival injection.Appearance of fibrovascular tissue in the surgical bed at 3 months predict the recurrence by 100%. Preoperative fleshy pterygia will mostly recur again whatever Bevacizumab form was used .The corneal thickness by anterior segment OCT has no role in prediction or detection of early pterygium recurrence.

scholarly journals The difference in outcome of patients with open inguinal hernia repair by using delayed absorbable sutures instead of non-absorbable sutures for mesh fixation

2020 ◽  
Vol 8 (1) ◽  
pp. 24
Author(s):  
Ali G. Mohammed Redha ◽  
Adil A. Jaber ◽  
Aqeel M. Nasser
Keyword(s):  
Hernia Repair ◽  
Mesh Fixation ◽  
Good Alternative ◽  
P Value ◽  
Absorbable Sutures ◽  
Significant Difference ◽  
The Difference ◽  
Group 2 ◽  
One Year ◽  
Group 1

Background: Different methods are found for mesh fixation in inguinal hernioplasty both open and laparoscopic. In open technique, sutures have been the method of choice for their reduced costs and surgeons’ habits. Whether absorbable instead of non-absorbable sutures can be used still a matter of debate in view of hernia recurrence and post-operative complications.Methods: This is a prospective done on 158 male patients with uncomplicated unilateral inguinal hernias. Two groups of 69 patients were evaluated after periods up to 1 year after open hernioplasty by using delayed absorbable sutures in one group (group 1) and non-absorbable sutures in the other group (group 2) for fixation of mesh.Results: In spite of a noticeable reduction in complication in the group 1 in term of number and percentage when compared with group 2 mainly chronic pain, there is no significant difference (p value>0.05). However, these results are associated with zero recurrence in both groups during a period of one year follow up.Conclusions: Delayed absorbable sutures are good alternative of non-absorbable sutures in open mesh hernia repair associated with less complications and almost no increase in chance of recurrence.  

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