1
|
Roberts PK, Keane M, Yang G, Chan E, Harkin DG, McKirdy N, Daniell M. Comparison of penetrating and endothelial keratoplasty in patients with iridocorneal endothelial syndrome: A registry study. Clin Exp Ophthalmol 2023; 51:663-672. [PMID: 37608637 DOI: 10.1111/ceo.14283] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 06/27/2023] [Accepted: 07/16/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND To compare graft survival of endothelial keratoplasty (EK) versus penetrating keratoplasty (PK) in patients with iridocorneal endothelial (ICE) syndrome and identify ocular features associated with graft survival. METHODS Observational, prospective, cohort study. A total of 30 806 first grafts performed between 1985 and 2020 were identified through the Australian Corneal Graft Registry and included in this observational, prospective cohort study. A total of 196 eyes underwent a primary corneal graft for ICE syndrome. Kaplan-Meier graft survival plots and Chi-squared tests were performed to identify graft survival rates for EK and PK. A history of raised intraocular pressure (IOP) was also recorded and analysed. Graft survival of eyes with ICE syndrome were compared to that of other indications. RESULTS Grafts performed for ICE syndrome increased to 0.8% of all cases during the 2005 to 2020 period compared with 0.5% between 1985 to 2004 (χ2 =9.35, p = 0.002). From 2010, EK surpassed PK as the preferred graft type. Survival of primary grafts in eyes with ICE syndrome was lower than for other indications (log-rank = 56.62, p < 0.001). Graft survival was higher following PK than Descemet stripping (automated) endothelial keratoplasty (DS(A)EK) (log-rank = 10.56, p = 0.001). Graft survival was higher in eyes without a history of raised IOP compared to those with a reported history of raised IOP (log-rank = 13.06, p < 0.001). CONCLUSIONS ICE syndrome carries a poor prognosis for graft survival. DS(A)EK had a poorer prognosis than PK. A history of raised IOP is associated with higher risk of graft failure.
Collapse
Affiliation(s)
- Philipp K Roberts
- Corneal Unit, Department of Ophthalmology, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
- Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
| | - Miriam Keane
- Australian Corneal Graft Registry, Department of Ophthalmology, Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Gink Yang
- Centre for Eye Research Australia, University of Melbourne, Melbourne, Victoria, Australia
| | - Elsie Chan
- Corneal Unit, Department of Ophthalmology, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
- Centre for Eye Research Australia, University of Melbourne, Melbourne, Victoria, Australia
| | - Damien G Harkin
- School of Biomedical Sciences, Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Natalie McKirdy
- School of Biomedical Sciences, Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Mark Daniell
- Corneal Unit, Department of Ophthalmology, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
- Centre for Eye Research Australia, University of Melbourne, Melbourne, Victoria, Australia
| |
Collapse
|
2
|
Deng Y, Zhang S, Ye W, Gu J, Lin H, Cheng H, Xie Y, Le R, Tao Y, Zhang W, Chen W, Tham CC, He M, Wang N, Liang Y. Achieving inner aqueous drain in glaucoma secondary to iridocorneal endothelial syndrome: One year results of penetrating canaloplasty. Am J Ophthalmol 2022; 243:83-90. [PMID: 35870489 DOI: 10.1016/j.ajo.2022.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 07/01/2022] [Accepted: 07/01/2022] [Indexed: 11/01/2022]
Abstract
PURPOSES To report the efficacy of a bleb-independent penetrating canaloplasty in the management of glaucoma secondary to iridocorneal endothelial syndrome (GS-ICE). DESIGN Prospective, non-comparative clinical study. METHODS Penetrating canaloplasty was performed on 35 eyes from 35 patients with GS-ICE and medically uncontrolled IOP between January 2018 and April 2020. Patients were followed up at one week, month 1, 3, 6, 12 postoperatively, and semi-annually thereafter. Intraocular pressure (IOP), number of anti-glaucoma medication and surgery-related complications were recorded. Surgical success was defined as IOP ≥5 and ≤21mmHg without (complete success) or with/without (qualified success) IOP-lowering medications. RESULTS A total of 29 eyes (82.9%) had 360° catheterization and successfully received penetrating canaloplasty. Of these eyes, 24 (82.8%) achieved qualified success and 22 (75.9%) achieved qualified success at 12 months after surgery. The mean IOP decreased from 39.5±11.8 mmHg on 2.9±1.0 medications before surgery to 16.6±5.3 mmHg (P<0.001) on 0.2±0.6 medications (P<0.001) at 12 months post-operation, respectively. Hyphema (37.9%), transient hypotony (34.5%) and transient post-operative IOP elevation (≥30mmHg, 17.9%) were the most commonly observed early complications at the one week and one month visits. From one month and beyond, all treated eyes showed no obvious bleb at the operation quadrant. CONCLUSIONS Penetrating canaloplasty rescued the inner aqueous outflow in ICE eyes and demonstrated quite acceptable success in IOP control with few complications, providing a new option for the management of GS-ICE.
Collapse
Affiliation(s)
- Yuxuan Deng
- National Clinical Research Center for Ocular Diseases; The Eye Hospital of Wenzhou Medical University; Glaucoma Research Institute of Wenzhou Medical University, Zhejiang, China; Qingdao Municipal Hospital, Qingdao, Shandong, China
| | - Shaodan Zhang
- National Clinical Research Center for Ocular Diseases; The Eye Hospital of Wenzhou Medical University; Glaucoma Research Institute of Wenzhou Medical University, Zhejiang, China
| | - Wenqing Ye
- National Clinical Research Center for Ocular Diseases; The Eye Hospital of Wenzhou Medical University; Glaucoma Research Institute of Wenzhou Medical University, Zhejiang, China
| | - Juan Gu
- National Clinical Research Center for Ocular Diseases; The Eye Hospital of Wenzhou Medical University; Glaucoma Research Institute of Wenzhou Medical University, Zhejiang, China
| | - Haishuang Lin
- National Clinical Research Center for Ocular Diseases; The Eye Hospital of Wenzhou Medical University; Glaucoma Research Institute of Wenzhou Medical University, Zhejiang, China
| | - Huanhuan Cheng
- National Clinical Research Center for Ocular Diseases; The Eye Hospital of Wenzhou Medical University; Glaucoma Research Institute of Wenzhou Medical University, Zhejiang, China; Wuhu First People's Hospital, Wuhu, Anhui, China
| | - Yanqian Xie
- National Clinical Research Center for Ocular Diseases; The Eye Hospital of Wenzhou Medical University; Glaucoma Research Institute of Wenzhou Medical University, Zhejiang, China
| | - Rongrong Le
- National Clinical Research Center for Ocular Diseases; The Eye Hospital of Wenzhou Medical University; Glaucoma Research Institute of Wenzhou Medical University, Zhejiang, China
| | - Yan Tao
- National Clinical Research Center for Ocular Diseases; The Eye Hospital of Wenzhou Medical University; Glaucoma Research Institute of Wenzhou Medical University, Zhejiang, China
| | - Wei Zhang
- Biomedical Informatics and Statistics Center, School of Public Health, Fudan University, Shanghai, China
| | - Wei Chen
- National Clinical Research Center for Ocular Diseases; The Eye Hospital of Wenzhou Medical University; Glaucoma Research Institute of Wenzhou Medical University, Zhejiang, China
| | - Clement C Tham
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Mingguang He
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China; Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
| | | | - Yuanbo Liang
- National Clinical Research Center for Ocular Diseases; The Eye Hospital of Wenzhou Medical University; Glaucoma Research Institute of Wenzhou Medical University, Zhejiang, China.
| |
Collapse
|
3
|
Ahluwalia NS, Shakya R, Parikh D. Bilateral laser peripheral iridotomy in a co-occurrence of unilateral iridocorneal endothelial syndrome and chronic angle closure glaucoma. Eur J Ophthalmol 2021; 33:11206721211067885. [PMID: 34923859 DOI: 10.1177/11206721211067885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To report a case of unilateral Iridocorneal endothelial (ICE) syndrome- Progressive iris atrophy (PIA) with an overlapping chronic angle closure glaucoma (CACG) and to highlight the effect of bilateral Laser peripheral iridotomy (LPI) in such a co-occurrence. CASE DESCRIPTION A patient presented to us with bilateral gradual painless progressive diminution of vision. Both eyes (BE) had a clear cornea, shallow peripheral anterior chamber depth, grade 2 nuclear sclerosis, raised intraocular pressure and glaucomatous optic neuropathy. In addition, the Left eye (LE) had an irregular anterior chamber, peripheral anterior synechiae (PAS) extending to cornea, patchy iris atrophy, subtle corectopia and a low endothelial cell count on specular microscopy. Indentation gonioscopy led to the diagnoses of CACG BE with ICE syndrome- PIA LE. LPI was performed bilaterally. On Anterior Segment Optical Coherence Tomography (ASOCT), there was evident widening of the angle away from PAS in the Right eye as well as in the LE with PIA post LPI. CONCLUSION This is a unique case of unilateral PIA with an associated CACG in BE. It is the first case demonstrating the effect of bilateral LPI in such a case scenario. Though not indicated in ICE syndrome, LPI did show short term evidence of significant widening of the angle away from areas of PAS even in the eye with PIA having a limited high PAS and a concurrent primary (chronic) angle closure disease.
Collapse
Affiliation(s)
- Navjot Singh Ahluwalia
- Department of Glaucoma, 161204Shri Sadguru Seva Sangh Trust, Chitrakoot Centre, Jankikund, Chitrakoot, India
| | - Rakesh Shakya
- Department of Glaucoma, 161204Shri Sadguru Seva Sangh Trust, Chitrakoot Centre, Jankikund, Chitrakoot, India
| | - Dhairya Parikh
- Department of Glaucoma, 161204Shri Sadguru Seva Sangh Trust, Chitrakoot Centre, Jankikund, Chitrakoot, India
| |
Collapse
|
5
|
Wang Y, Yan Y, Zhang J, Li J. Uveal effusion and transient myopia as the initial presentation of systemic lupus erythematosus patient with pulmonary arterial hypertension: case report. Lupus 2019; 28:560-564. [PMID: 30791856 DOI: 10.1177/0961203319829819] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
We reported uveal effusion and transient myopia as the initial presentation of systemic lupus erythematosus with pulmonary arterial hypertension. Choroidal retinopathy is rare but extremely destructive to visual function. Therefore, prompt diagnosis and effective treatments will result in complete resolution of the uveal effusion and functional restoration of vision.
Collapse
Affiliation(s)
- Y Wang
- Department of Ophthalmology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Y Yan
- Department of Ophthalmology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - J Zhang
- Department of Ophthalmology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - J Li
- Department of Ophthalmology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| |
Collapse
|
6
|
Na JH, Lee HK. Iridocorneal Endothelial Syndrome with Features of Posterior Polymorphous Corneal Dystrophy. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2019. [DOI: 10.3341/jkos.2019.60.9.909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Jeong Ho Na
- Department of Ophthalmology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Hyo Kyung Lee
- Department of Ophthalmology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| |
Collapse
|