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
Fetomaternal hemorrhage refers to the entry of fetal blood into the maternal circulation before or during delivery. Very small amount of fetal red cells are normally detectable in all pregnancies. Massive fetomaternal bleed is very rare and even rarer is the resultant severe anemia causing early neonatal death, despite an uneventful normal pregnancy until the end. Antenatal fetomaternal hemorrhage is a pathological condition with a wide spectrum of clinical variation. Secondary to the resultant anemia, fetomaternal hemorrhage may have devastating consequences for the fetus such as neurologic injury, stillbirth, or neonatal death. The Presentation is frequently without an evident precipitating factor. Recognition may become apparent only after injury has occurred, if at all. The most common antenatal presentation is decreased fetal activity and a heightened index of suspicion is warranted in cases of persistent maternal perception of decreased fetal movements