Pseudophakic bullous keratopathy: Relationship with endothelial cell density and use of a predictive cell loss model. A preliminary report

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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Comparison of Endothelial Cell Loss following the Big Bubble versus the Microbubble Incision Technique during Deep Anterior Lamellar Keratoplasty in Eyes with Keratoconus

Journal of Ophthalmology ◽

10.1155/2020/5604242 ◽

2020 ◽

Vol 2020 ◽

pp. 1-5

Author(s):

Amro Abuelkheir ◽

Mohamed Bahgat Goweida ◽

Nada Medhat ◽

Hany Ahmed Helaly

Keyword(s):

Endothelial Cell ◽

Cell Density ◽

Statistical Difference ◽

Cell Loss ◽

Endothelial Cell Density ◽

Lamellar Keratoplasty ◽

Deep Anterior Lamellar Keratoplasty ◽

Endothelial Cell Loss ◽

Anterior Lamellar Keratoplasty ◽

Big Bubble

Introduction. Deep anterior lamellar keratoplasty (DALK) is now becoming an increasingly popular surgical technique in treating corneal stromal pathologies with healthy endothelium. Several advantages of DALK over penetrating keratoplasty (PKP) have been described such as maintenance of globe integrity, absence of endothelial rejection, and a low rate of chronic endothelial cell loss (ECL). ECL following PKP results in 50% cell loss after 2 years from the estimated graft endothelial cell density (ECD). Although there are several reports confirming that ECL following DALK is similar to the physiologic cell loss 2 years after surgery, few reports discussed the surgically induced ECL due to difficulty in preoperative imaging of ECD. Materials and Methods. This prospective, interventional study included 20 eyes of 20 patients, who underwent DALK surgery. 11 eyes underwent DALK using the big bubble technique, while 9 eyes underwent the microbubble technique. Postoperative evaluation was done 3 months after surgery and included best spectacle corrected visual acuity (BSCVA), keratometric readings, and refraction measured using an autokeratorefractometer (Topcon KR800, Japan) and endothelial cell density (ECD) using noncontact specular microscopy (Nidek CEM-530, Japan). Results. Regarding postoperative parameters such as postoperative logMAR visual acuity, postoperative mean K, and postoperative K max, there was no statistical difference found between both groups ( P = 0.754 , P = 0.119 , and P = 0.970 , respectively). Regarding change in specular endothelial cell density and percent change in the specular endothelial cell density, again there was no statistical difference between both groups with P = 0.057 and P = 0.126 , respectively (significance defined as P < 0.05 ). Conclusion. ECD is not affected by failure of the big bubble to form and continuing DALK via the microbubble technique.

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Corneal Thickness and Endothelial Morphology in Normal Thai Eyes

10.21203/rs.2.21265/v1 ◽

2020 ◽

Author(s):

Napaporn Tananuvat ◽

Natawan Khumchoo

Keyword(s):

Endothelial Cell ◽

Cell Density ◽

Central Corneal Thickness ◽

Corneal Thickness ◽

Age Groups ◽

Inverse Correlation ◽

Cell Loss ◽

Endothelial Cell Density ◽

Specular Microscopy ◽

The Mean

Abstract Background: This study aimed to determine the influence of age on central corneal thickness and corneal endothelial morphology as well as to identify the relationship between them in normal Thai eyes.Methods: Non-contact specular microscopy was performed in volunteers stratified into seven age groups ranging from 11-88 years. The corneal endothelial parameters studied included central corneal thickness (CCT), endothelial cell density (ECD), coefficient of variation in cell size (CV), cell area (CA) and percentage of regular hexagonal cells.Results: In a total of 501 subjects (1002 eyes), the mean age was 43.12 ± 18.80 years and 347(69.3%) were females. The mean CCT, ECD, CV, CA, and hexagonality was 533.80 ± 33.00 μm, 2,732±258 cell/mm2, 37.61 ± 6.76%, 369.04 ± 37.90 mm, and 49.03% ± 7.53%, respectively. There was a statistically significant inverse correlation between age and CCT (r = -0.212, P <0.001), ECD (r = -0.484, P <0.001), and hexagonality (r = -0.193, P <0.001). The estimate rate of endothelial cell loss was 0.2% per year, whereas CV and CA had statistically significant correlation with age (r = 0.200, P <0.001 and r = 0.475, P <0.001). CCT correlated directly with ECD (r = 0.177, P <0.001).Conclusion: Normative data for corneal endothelial morphology in healthy Thai eyes showed that ECD, CCT, and hexagonality were significantly decreased, while CV and CA were increased with aging. The central corneal thickness was correlated with the endothelial cell density.

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EFFECTS OF THE DONOR??S AGE AND ENDOTHELIAL CELL DENSITY ON GRAFT SURVIVAL AND ENDOTHELIAL CELL LOSS AFTER CORNEAL TRANSPLANTATION

Cornea ◽

10.1097/00003226-199501000-00050 ◽

1995 ◽

Vol 14 (1) ◽

pp. 116

Author(s):

David C. Musch ◽

Roger F. Meyer ◽

Alan Sugar

Keyword(s):

Endothelial Cell ◽

Cell Density ◽

Graft Survival ◽

Corneal Transplantation ◽

Cell Loss ◽

Endothelial Cell Density ◽

Endothelial Cell Loss

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Study of Changes in Corneal Thickness and Corneal Endothelial Cell Density after Phacoemulsification Cataract Surgery

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2021/187 ◽

2021 ◽

Vol 10 (12) ◽

pp. 866-872

Author(s):

Rajiv Pardasani ◽

Sohan Lohiya

Keyword(s):

Endothelial Cell ◽

Cell Density ◽

Coefficient Of Variation ◽

Central Corneal Thickness ◽

Corneal Thickness ◽

Cell Loss ◽

Corneal Endothelial Cell ◽

Endothelial Cell Density ◽

P Value ◽

Corneal Endothelial Cell Density

BACKGROUND Phacoemulsification is a common surgery for cataract. The endothelium comprises of hexagonal cells which in single layer is essential for maintaining the transparency of the cornea. We wanted to compare endothelial cell density (ECD), central corneal thickness (CCT), coefficient of variability, and hexagonality of endothelial cells before and after phacoemulsification surgery. we also wanted to evaluate the endothelial cell loss after phacoemulsification surgery. METHODS A rural hospital-based prospective observational study with 120 patients was conducted in a hospital based setting utilising the data of patient’s eye by considering inclusion and exclusion criteria, before and after phacoemulsification surgery by using noncontact specular microscope. RESULTS The mean endothelial cell density significantly decreased postoperatively at day one, 4th week, 12th week. The mean central corneal thickness increased significantly at postoperative day one, then subsequently decreased at postoperative 4th week and 12th week (P value = 0.0001), but never reached the preoperative value. There was a significant change in coefficient of variation and hexagonality postoperatively (P value = 0.0001). CONCLUSIONS The primary result is the change in corneal endothelial cell density (cells per square millimetre of the corneal surface) which is decreased, and the central corneal thickness calculated in micro meter is increased. As endothelial cells do not replicate, to reimburse cell loss there are changes in coefficient of variation and hexagonality after phacoemulsification surgery. KEY WORDS Corneal Endothelial Cell Density, Central Corneal Thickness, Coefficient of Variation, Hexagonality, Phacoemulsification, Specular Microscope

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XEN Gel Stent versus trabeculectomy: Short-term effects on corneal endothelial cells

European Journal of Ophthalmology ◽

10.1177/1120672120924339 ◽

2020 ◽

pp. 112067212092433

Author(s):

Ali Olgun ◽

Eyup Duzgun ◽

Aysegul Mavi Yildiz ◽

Fatih Atmaca ◽

A Atakhan Yildiz ◽

...

Keyword(s):

Endothelial Cell ◽

Cell Density ◽

Stent Implantation ◽

Cell Loss ◽

Corneal Endothelial Cell ◽

Endothelial Cell Density ◽

Short Term ◽

Xen Gel Stent ◽

Corneal Endothelial Cell Density ◽

A Cell

Purpose To compare the short-term changes in corneal endothelial cells after trabeculectomy or XEN Gel Stent implantation. Design Prospective, interventional, comparative study. Methods Changes in corneal endothelium in patients that underwent XEN Gel Stent implantation or trabeculectomy were prospectively evaluated. Eighty eyes of 62 diagnosed with open-angle glaucoma were divided into two the trabeculectomy and XEN Gel Stent groups. Corneal specular microscopy was performed at the central cornea using a noncontact specular microscope preoperatively and 3 months after surgery. Results The baseline mean corneal endothelial cell density in the trabeculectomy group was 2390.3 ± 324.8 cells/mm2, and this was significantly reduced to 2148 ± 352.5 cells/mm2 3 months after surgery, representing a cell loss of 10.0% (p < 0.001). The baseline mean corneal endothelial cell density in the XEN Gel Stent group was 2156.2 ±559.7 cells/mm2, and this was significantly reduced to 2098.4 ± 556.2 cells/mm2 3 months after surgery, representing a cell loss of 2.1% (p = 0.002). The corneal endothelial cell density change rate of the trabeculectomy group (−10.0% ± 9.7%) was statistically higher than the XEN Gel Stent group (−2.1% ± 13.8%) (p = 0.002). A statistically significant difference was observed in the trabeculectomy group between the baseline and postoperative values in the coefficient of variation (p = 0.029). Conclusion Trabeculectomy caused more endothelial cell damage than XEN Gel Stent implantation in the short-term follow-up period. The XEN Gel Stent may be the treatment of choice in patients with a significantly low preoperative corneal endothelial cell density.

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