ABSTRACT
Aim: the aim of this study was to assess the effect of intracameral air on the endothelial cell morphometrics. Patients and methods: This is a retrospective controlled interventional cohort study of 26 patients [18 males and 8 females] who underwent unilateral deep anterior lamellar keratoplasty [DALK] for moderate keratoconus. The DALK patients were divided into two groups: a treatment group [14], which had micro perforations of the Descemet Membrane [DM] intraoperatively and received intracameral air at the end of the surgery; and an independent control group [12], which had no micro perforation and thus no intracameral air was injected. Postoperative best corrected visual acuity [BCVA], sphere, cylinder, spherical equivalent [SEQ], central corneal thickness, and endothelial cell morphometric features consisted of the endothelial cell density [ECD], polymegathism, and pleomorphism were compared between treatment and control groups
Results: the mean BCVA was 0.36 +/- 0.36 logMAR in the treatment group and 0.17 +/- 0.11 logMAR in the control group [p = 0.081], and the mean corneal thickness was 507.86 +/- 62.69 lm in the treatment group and 525.67 +/- 37.54 lm in the control group air [p = 0.399]. Furthermore, the mean sphere was _5.14 +/- 4.17D and _1.02 +/- 3.29D, the mean cylinder was _3.16 +/- 2.20D and _2.88 +/- 1.21D, and the mean SEQ was _6.72 +/- 4.66D and _2.46 +/- 3.14D and in the treatment and control groups respectively [p = 0.011, 0.693, and 0.013]. As to morphometric features, the mean ECD was 2176.76 +/- 549.18 cell/mm[2] and 2257.30 +/- 436.12 cell/mm[2] in the treatment and control groups respectively [p = 0.686], and the mean pleomorphism 0.48 +/- 0.09 and 0.54 +/- 0.10 in the treatment and control groups respectively [p = 0.139]. In contrast, the mean polymegathism was 0.37 +/- 0.06 and 0.31 +/- 0.05 in the treatment and control groups respectively [p = 0.009]
Conclusion: the presence of air inside the anterior chamber for a short term may not cause further endothelial cell loss and can be safely performed to prevent postoperative Descemet Membrane detachment in case of micro perforations
ABSTRACT
Aims: To determine the short-term efficacy of corneal collagen crosslinking [CXL] treatment in patients with progressive Keratoconus [KCN] in comparison with no treatment
Settings and design: This controlled clinical trial study was carried out at a tertiary eye hospital, Eastern Province, Saudi Arabia
Methods and material: A prospective controlled clinical study of patients being treated for Keratoconus at a tertiary eye care hospital in the Eastern province of Saudi Arabia. 51 eyes of 43 patients with progressive KCN who received corneal collagen crosslinking [treatment group] and 50 eyes of 34 patients with KCN and no treatment [control group] were included in our study.A one year clinical data were collected preoperatively as well as at 1, 3, 6 and 12 months postoperatively for the treatment group patients. A baseline and 1 year clinical data were collected for the control group patients. The short-term efficacy of the treatment in preventing progression of KCN in comparison with no treatment was analysed at one year
Results: At one year after crosslinking, there was significant flattening of the average keratometry by 0.61 D [p = 0.001] [95% CI: 0.25, 0.97] compared to 0.40 D [p = 0.210] steepening in the control group; difference between treatment and control was 1.01 D [p = 0.006] [95%CI: 0.29, 1.72]. Pachymetry in treatment group thinned by 20.21 microm [p < 0.0001] [95% CI: 12.77, 27.66] compared to 0.32 microm [p = 0.912] in the control group. Visual acuity remained stable at the preoperative level of 20/30 [p = 0.397] in the treatment group and 20/40 [p = 0.553] in the control group at one year
Conclusions: Corneal CXL is an effective treatment for halting the progression of KCN as shown by reduced keratometry and stability of vision