Resolution of Corneal Fibrosis After Descemet’s Stripping Automated Endothelial Keratoplasty: A Case Report

Zola, Marta; Kim, Jae Hui; Petrelli, Myrsini; Schmutz, Lydia; Hashemi, Kattayoon; Kymionis, George D.

doi:10.1007/s40123-020-00244-y

Cited by 3 publications

(2 citation statements)

References 14 publications

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“…However, in case 1, by prescribing Ripasudil after surgery, the corneal edema was almost completely solved, but the usual PBK sequelae, such as sub-epithelial fibrosis, could not be avoided furtherly. Since a slowly recover and regression of fibrosis has been proven after corneal endothelial lamellar surgery, 11 ut-DSAEK has been performed to maximize visual outcomes in such patient. Case 2 and 3 were both at high risk of disease progression after cataract surgery according to corneal pachymetry and IVCM assessments.…”

Section: Discussionmentioning

confidence: 99%

Rho-Associated Kinase Inhibitor Eye Drops in challenging cataract surgery

Antonini

Coassin

Gaudenzi

et al. 2022

American Journal of Ophthalmology Case Reports

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Purpose To report the impact of Rho-Associated Kinase Inhibitor Eye Drops in cases of cataract surgery performed in severe Fuchs’ endothelial corneal dystrophy (FECD). Observations A patient affected by FECD stage II underwent femtosecond laser-assisted cataract surgery (FLACS), developed postsurgical corneal failure and was scheduled for endothelial keratoplasty. Compassionate treatment with Rho-Associated Kinase Inhibitor Eye Drops 4 times per day was started. A significant improvement in visual acuity and corneal failure was recorded. Thereafter, other two patients affected by FECD stage II were prophylactically treated with Rho-Associated Kinase Inhibitor Eye Drops 4 times per day for three months before FLACS with good visual and clinical outcome. Conclusions and Importance These cases expand upon the reported effects of rho-associated kinase inhibitor Ripasudil in the FECD, suggesting a role as adjuvant medical therapy in patients advised for intraocular surgery to improve endothelial function and reduce the risk of pseudophakic bullous keratopathy (PBK).

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Section: Discussionmentioning

confidence: 99%

Rho-Associated Kinase Inhibitor Eye Drops in challenging cataract surgery

Antonini

Coassin

Gaudenzi

et al. 2022

American Journal of Ophthalmology Case Reports

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“…A number of explanations for this can be suggested, but the mechanism remains to be elucidated. Interestingly, Zola et al 7 demonstrated improved corneal clarity and reduced density of anterior subepithelial fibrosis following endothelial keratoplasty in non-aniridic eyes. They proposed a cascade of corneal remodeling following resolution of stromal edema after Descemet stripping automated endothelial keratoplasty, amongst other factors, as a possible mechanism for this improvement, which suggests that a similar interaction could be the reason behind the great improvement seen in our case.…”

Section: Discussionmentioning

confidence: 99%

Descemet Stripping Endothelial Keratoplasty for Congenital Aniridia: An Interesting and Challenging Story

Tsatsos

Athanasiadis

Ziakas

2022

tjo

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Congenital aniridia is a rare condition affecting a wide range of ocular structures, from the ocular surface to the retina. We present the case of a 59-year-old woman with PAX6- and WT1-negative congenital aniridia who developed aniridia-associated keratopathy and progressive endothelial dysfunction with corneal decompensation after cataract surgery. The patient underwent successful ultrathin Descemet stripping endothelial keratoplasty. Despite the challenges faced with an unstable iridolenticular diaphragm, we were pleasantly surprised to see improvement not only of corneal edema and endothelial function but also of the whole cornea, including anterior corneal anatomy and appearance. In conclusion, endothelial transplantation in a patient with aniridia resulted in improvement of all the corneal structures from the endothelium to the stroma, epithelium, and possibly even the ocular surface.

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Femtoassisted posterior lamellar keratoplasty in bullous keratopathy of stage IV–V (clinical application experience)

Терещенко

Demyanchenko

Trifanenkova

et al. 2022

Ophthalmology Reports

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BACKGROUND: Bullous keratopathy is a chronic edema of the cornea, accompanied by a significant visual acuity loss and pain. The cause of bullous keratopathy is a pathological irreversible decrease in the number of endothelial cells, in which the endothelial layer cannot perform its main barrier and pumping functions. AIM: To evaluate the reproducibility and functional results of femto-assisted posterior lamellar keratoplasty using intraoperative OCT at the stage IVV of bullous keratopathy. MATERIALS AND METHODS: The study was conducted on 23 eyes of 23 patients diagnosed with stage IVV of bullous keratopathy. The mean age of patients was 69 12 years, there were 14 male patients and 9 female patients. Before surgery, light perception with correct light projection was recorded in 15 cases, in 5 cases the count of fingers at the face (0.005), in 3 cases visual acuity was 0.01. The central corneal thickness varied from 981 m to 1960 m and averaged 1008 96 m. Femto LDV Z8 femtosecond laser (Ziemer, Switzerland) was used to form an endothelial graft. All surgeries were performed using the Hi-R Neo 900 operating microscope with an integrated third-generation OCT module (Haag-Streit Surgical, Germany). RESULTS: No intraoperative complications were noted. The presence of objective control in the form of intraoperative OCT made it possible in all cases to clearly differentiate stromal and endothelial surfaces of the posterior layered graft located in the anterior chamber of the eye. The postoperative course was standard for posterior lamellar keratoplasty, accompanied by resorption of corneal edema with restoration of its transparency. The normalization of corneal thickness was noted by 1 month after surgery, and the restoration of corneal optical properties was noted by 36 months and was accompanied by gradual increase in visual acuity. Corrected visual acuity by 1 month was 0.05 0.03, by 3, 6, 12 months 0.1 0.05, 0.15 0.05 and 0.15 0.04, respectively. By 12 months after surgery, the central corneal thickness was 596 42 m, the thickness of the ultrathin graft tended to decrease somewhat to 67 8 m, the loss of endothelial cells was 59.3%. Endothelial graft survival was achieved in 82.6% of cases. CONCLUSIONS: The use of intraoperative OCT allows expanding the indications for posterior lamellar keratoplasty in bullous keratopathy, including the stage IVV of the disease.

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Resolution of Corneal Fibrosis After Descemet’s Stripping Automated Endothelial Keratoplasty: A Case Report

Cited by 3 publications

References 14 publications

Rho-Associated Kinase Inhibitor Eye Drops in challenging cataract surgery

Rho-Associated Kinase Inhibitor Eye Drops in challenging cataract surgery

Descemet Stripping Endothelial Keratoplasty for Congenital Aniridia: An Interesting and Challenging Story

Femtoassisted posterior lamellar keratoplasty in bullous keratopathy of stage IV–V (clinical application experience)

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