Evaluation of the Effect of the First Generation iStent on Corneal Endothelial Cell Loss—A Match Case-Control Study

Glaucoma is the leading cause of irreversible blindness worldwide. The only proven factor in slowing the progression of glaucomatous neuropathy is lower intraocular pressure (IOP), which can be achieved with pharmacology, laser therapy, or surgery. However, these treatments are associated with various adverse effects, including corneal endothelial cell loss (CECL). In recent years, several novel surgeries for reducing the IOP, collectively referred to as minimally invasive glaucoma surgery (MIGS), have been developed, one of which is the iStent. However, the long-term effects of such surgeries remain unknown. We compared a group of patients with open-angle glaucoma and cataract who underwent phacoemulsification alone with a group of patients with similar demographic and clinical characteristics who underwent simultaneous phacoemulsification and iStent implantation. Overall, 26 eyes of 22 subjects who underwent a combined phacoemulsification-iStent procedure and 26 eyes of 24 subjects who underwent cataract surgery were included. Before surgery, endothelial cells accounted to 2228.65 ± 474.99 in iStent group and 2253.96 ± 404.76 in the control group (p = 0.836). After surgery, their number declined to 1389.77 ± 433.26 and 1475.31 ± 556.45, respectively (p = 0.509). There was no statistically significant difference in CECL between the two groups 18–24 months after surgery, despite increased manipulation in the anterior chamber and the presence of an implant in the trabecular meshwork in those with an iStent implant. Thus, iStent bypass implantation is a safe treatment in terms of CECL for mild-to-moderate open-angle glaucoma.

Download Full-text

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

Journal of Ophthalmology ◽

10.1155/2015/769289 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5 ◽

Cited By ~ 3

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.

Download Full-text

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.

Download Full-text

Serial corneal endothelial cell loss with lathe-cut and injection-molded posterior chamber intraocular lenses

American Intra-Ocular Implant Society Journal ◽

10.1016/s0146-2776(83)80060-3 ◽

1983 ◽

Vol 9 (3) ◽

pp. 301-305 ◽

Cited By ~ 9

Author(s):

Manus C. Kraff ◽

Donald R. Sanders ◽

Howard L. Lieberman

Keyword(s):

Endothelial Cell ◽

Cell Loss ◽

Corneal Endothelial Cell ◽

Intraocular Lenses ◽

Posterior Chamber ◽

Endothelial Cell Loss ◽

Injection Molded

Download Full-text

Corneal Endothelial Cell Loss after Baerveldt Glaucoma Implant Surgery

Ophthalmology Glaucoma ◽

10.1016/j.ogla.2020.06.012 ◽

2020 ◽

Author(s):

Scott Hau ◽

Catey Bunce ◽

Keith Barton

Keyword(s):

Endothelial Cell ◽

Cell Loss ◽

Corneal Endothelial Cell ◽

Endothelial Cell Loss ◽

Implant Surgery ◽

Baerveldt Glaucoma Implant

Download Full-text

Patients With Dry Eye Disease and Low Subbasal Nerve Density Are at High Risk for Accelerated Corneal Endothelial Cell Loss

Cornea ◽

10.1097/ico.0000000000001057 ◽

2017 ◽

Vol 36 (2) ◽

pp. 196-201 ◽

Cited By ~ 15

Author(s):

Ahmad Kheirkhah ◽

Vannarut Satitpitakul ◽

Pedram Hamrah ◽

Reza Dana

Keyword(s):

Endothelial Cell ◽

High Risk ◽

Dry Eye ◽

Cell Loss ◽

Corneal Endothelial Cell ◽

Dry Eye Disease ◽

Eye Disease ◽

Endothelial Cell Loss

Download Full-text

Prospective study of corneal endothelial cell loss after trabeculectomy

Acta Ophthalmologica ◽

10.1111/aos.14561 ◽

2020 ◽

Author(s):

Kentaro Iwasaki ◽

Shogo Arimura ◽

Yoshihiro Takamura ◽

Masaru Inatani

Keyword(s):

Endothelial Cell ◽

Prospective Study ◽

Cell Loss ◽

Corneal Endothelial Cell ◽

Endothelial Cell Loss

Download Full-text

Sodium Ferulate Attenuates Lidocaine-Induced Corneal Endothelial Impairment

Oxidative Medicine and Cellular Longevity ◽

10.1155/2018/4967318 ◽

2018 ◽

Vol 2018 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Guojian Jiang ◽

Tingjun Fan

Keyword(s):

Endothelial Cells ◽

Endothelial Cell ◽

Morphological Changes ◽

Corneal Thickness ◽

Cell Loss ◽

Corneal Endothelial Cell ◽

Corneal Endothelial Cells ◽

Endothelial Cell Loss ◽

Sodium Ferulate ◽

Human Corneal Endothelial Cells

The introduction of intracameral anaesthesia by injection of lidocaine has become popular in cataract surgery for its inherent potency, rapid onset, tissue penetration, and efficiency. However, intracameral lidocaine causes corneal thickening, opacification, and corneal endothelial cell loss. Herein, we investigated the effects of lidocaine combined with sodium ferulate, an antioxidant with antiapoptotic and anti-inflammatory properties, on lidocaine-induced damage of corneal endothelia with in vitro experiment of morphological changes and cell viability of cultured human corneal endothelial cells and in vivo investigation of corneal endothelial cell density and central corneal thickness of cat eyes. Our finding indicates that sodium ferulate from 25 to 200 mg/L significantly reduced 2 g/L lidocaine-induced toxicity to human corneal endothelial cells, and 50 mg/L sodium ferulate recovered the damaged human corneal endothelial cells to normal growth status. Furthermore, 100 mg/L sodium ferulate significantly inhibited lidocaine-induced corneal endothelial cell loss and corneal thickening in cat eyes. In conclusion, sodium ferulate protects human corneal endothelial cells from lidocaine-induced cytotoxicity and attenuates corneal endothelial cell loss and central corneal thickening of cat eyes after intracameral injection with lidocaine. It is likely that the antioxidant effect of sodium ferulate reduces the cytotoxic and inflammatory corneal reaction during intracameral anaesthesia.

Download Full-text

Corneal Endothelial Cell Density and Morphology After Phacoemulsification in Patients With Primary Open-Angle Glaucoma and Cataracts

Cornea ◽

10.1097/ico.0000000000001826 ◽

2019 ◽

Vol 38 (3) ◽

pp. 325-331 ◽

Cited By ~ 10

Author(s):

Tsontcho Ianchulev ◽

Stephen Lane ◽

Marisse Masis ◽

Jonathan H. Lass ◽

Beth Ann Benetz ◽

...

Keyword(s):

Endothelial Cell ◽

Cell Density ◽

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Corneal Endothelial Cell ◽

Endothelial Cell Density ◽

Open Angle ◽

Corneal Endothelial Cell Density

Download Full-text

Evaluation of Corneal Endothelium in Adolescents with Juvenile Glaucoma

Journal of Ophthalmology ◽

10.1155/2015/895428 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

Beata Urban ◽

Alina Bakunowicz-Łazarczyk ◽

Marta Michalczuk ◽

Małgorzata Krętowska

Keyword(s):

Endothelial Cell ◽

Carbonic Anhydrase ◽

Beta Blocker ◽

Corneal Endothelium ◽

Central Corneal Thickness ◽

Open Angle Glaucoma ◽

Corneal Thickness ◽

Control Group ◽

Open Angle ◽

Juvenile Glaucoma

Purpose. To evaluate the endothelial cell density (ECD) and central corneal thickness (CCT) in adolescents with juvenile open-angle glaucoma (JOAG) and ocular hypertension (OH) and to investigate the influence of topical antiglaucoma medications on ECD and CCT in adolescents with JOAG.Methods. ECD and CCT were investigated in 66 eyes of 33 adolescents with JOAG. Depending on the topical treatment the eyes were classified into 4 groups: (1) topical carbonic anhydrase inhibitor, (2) prostaglandin analogs, (3) beta-blocker, and (4) CAI-beta-blocker combination. ECD and CCT were also checked in 24 adolescents with OH and in control group (33 persons).Results. ECD was significantly lower in eyes with JOAG (2639.5 cells/mm2) compared with ECD in eyes with OH (2924.5 cells/mm2) and in control group (2955.5 cells/mm2). CCT was 0.554 mm in eyes with JOAG, 0.55 mm in eyes with OH, and 0.544 mm in control group. ECD in patients with JOAG was 2730 cells/mm2(1 group), 2773.5 cells/mm2(2 group), 2539.5 cells/mm2(3 group), and 2551 cells/mm2(4 group). CCT was 0.556 mm in 1 group, 0.558 mm in 2 group, 0.532 mm in 3 group, and 0.544 mm in 4 group.Conclusions. Our findings indicate that JOAG and OH did not affect CCT, but JOAG has influence on ECD in adolescents. There were no significant differences between ECD and CCT of eyes treated with different kinds of antiglaucoma medications.

Download Full-text