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 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.

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

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.

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.

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.

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 Comparison of penetrating keratoplasty and deep anterior lamellar keratoplasty in keratoconus eyes with vernal keratoconjunctivitis

2021 ◽  
Vol 13 ◽  
pp. 251584142110105
Author(s):  
Sepehr Feizi ◽  
Mohammad Ali Javadi ◽  
Seyed-Mohamadmehdi Moshtaghion ◽  
Mohammad Abolhosseini
Keyword(s):  
Penetrating Keratoplasty ◽  
Survival Curve ◽  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Vernal Keratoconjunctivitis ◽  
Anterior Lamellar Keratoplasty ◽  
Disease Reactivation ◽  
Group 2 ◽  
Group 1

Purpose: The purpose of the study is to compare outcomes after penetrating keratoplasty (PK) against deep anterior lamellar keratoplasty (DALK) for keratoconus in patients with vernal keratoconjunctivitis (VKC). Methods: Keratoconic patients with VKC who received PK ( n = 55, group 1) or DALK ( n = 62, group 2) were retrospectively enrolled. The Student’s t test, Mann–Whitney test, Fisher’s exact test, chi-square test, and Kaplan–Meier survival curve were used to compare outcomes between the groups. Results: The follow-up period was 59.4 ± 44.1 and 62.4 ± 38.9 months in groups 1 and 2, respectively ( p = 0.70). Postoperative best spectacle-corrected visual acuity was 0.24 ± 0.18 and 0.29 ± 0.19 logMAR, respectively ( p = 0.13). Graft rejection occurred in 34.6% and 25.8% of eyes in groups 1 and 2, respectively ( p = 0.30). Groups 1 and 2 were comparable in the rates of cataract (3.6% and 12.9%, respectively, p = 0.07) and high intraocular pressure (3.6% and 8.1%, respectively, p = 0.31). Compared with the eyes with inactive VKC, PK eyes that experienced postoperative disease reactivation had a higher rate of suture abscesses (10.9% versus 50.0%, respectively, p = 0.01) and suture-tract vascularization (6.5% versus 33.3%, respectively, p = 0.03). Similarly, disease reactivation significantly increased suture abscesses from 27.3% to 51.7% ( p = 0.03) and suture-tract vascularization from 18.2% to 49.6% ( p = 0.005) in the DALK group. The graft survival rates were 95.3% in group 1 and 87.9% in group 2 at the 4-year follow-up, with mean durations of 14.4 and 11.1 months, respectively ( p = 0.20). Conclusion: The results indicate no difference in outcomes between PK and DALK for keratoconus in patients with VKC. Postoperative VKC reactivation increased the rate of suture-related problems after both techniques of keratoplasty.

Endothelial cell loss and graft survival after penetrating keratoplasty for laser iridotomy-induced bullous keratopathy

2018 ◽  
Vol 62 (4) ◽  
pp. 438-442
Author(s):  
Naoki Okumura ◽  
Ayaka Kusakabe ◽  
Noriko Koizumi ◽  
Koichi Wakimasu ◽  
Kanae Kayukawa ◽  
...  
Keyword(s):  
Endothelial Cell ◽  
Graft Survival ◽  
Penetrating Keratoplasty ◽  
Cell Loss ◽  
Bullous Keratopathy ◽  
Endothelial Cell Loss ◽  
Laser Iridotomy

Topographically Guided Two-Step LASIK and Standard LASIK in the Correction of Refractive Errors after Penetrating Keratoplasty

2009 ◽  
Vol 19 (4) ◽  
pp. 535-543 ◽  
Author(s):  
Leopoldo Spadea ◽  
Massimo Saviano ◽  
Angela Di Gregorio ◽  
Domenico Di Lodovico ◽  
Fabio De Sanctis
Keyword(s):  
Visual Acuity ◽  
Penetrating Keratoplasty ◽  
Laser In Situ Keratomileusis ◽  
Refractive Errors ◽  
Manifest Refraction ◽  
Uncorrected Visual Acuity ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Purpose To evaluate in a long-term period the effectiveness and safety of topographically guided two-step laser in situ keratomileusis (LASIK) and standard LASIK technique in the correction of refractive errors after successful penetrating keratoplasty (PKP) for keratoconus. Methods At least 2 years after PKP and 6 months after removal of all sutures, 15 eyes of 15 patients (Group 1; mean manifest refraction spherical equivalent (MRSE) −7.23 D ± 3.42 SD) were submitted to standard LASIK and 15 eyes of 15 patients (Group 2; mean MRSE −4.37 D ± 1.97 SD) to a topographically guided two-step LASIK procedure (first the flap and at least 2 weeks later the laser ablation). In all cases, a superior hinged corneal flap (160 μm/9.5 mm) was created. Results After a follow-up of 36 months, in Group 1 the mean uncorrected visual acuity (UCVA) was 0.51 logarithm of the minimum angle of resolution (logMAR) ± 0.41 SD and the mean best-corrected visual acuity (BCVA) was 0.03 logMAR ± 0.05 SD, with a mean MRSE of −1.57 D ± 2.65 SD. In Group 2, the mean UCVA was 0.28 logMAR ± 0.24 SD and the mean BCVA was 0.01 logMAR ± 0.03 SD, with a mean MRSE of −0.07 D ± 1.00 SD. In both groups, no complications were observed. Conclusions After a long follow-up period, both topographically guided two-step LASIK and standard LASIK could be considered effective and safe tools in the correction of refractive errors after successful PKP for keratoconus.

Endothelial Cell Loss During Penetrating Keratoplasty

1978 ◽  
Vol 85 (6) ◽  
pp. 760-766 ◽  
Author(s):  
William M. Bourne ◽  
W. Michael O'Fallon
Keyword(s):  
Endothelial Cell ◽  
Penetrating Keratoplasty ◽  
Cell Loss ◽  
Endothelial Cell Loss
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