Corneal Subbasal Plexus in Eyes with Fuchs' Endothelial Corneal Dystrophy after Two Different Endothelial Surgeries.

Autor: Abicca I; IRCCS-Fondazione Bietti, Rome, Italy., Gilardi M; Rome Eye Hospital, Rome, Italy., Giannini D; IRCCS-Fondazione Bietti, Rome, Italy., Colabelli Gisoldi RAM; San Giovanni Addolorata Hospital, UOC Oftalmologia-Banca degli occhi, Rome, Italy., Pocobelli A; San Giovanni Addolorata Hospital, UOC Oftalmologia-Banca degli occhi, Rome, Italy., Schiano Lomoriello D; IRCCS-Fondazione Bietti, Rome, Italy.
Jazyk: angličtina
Zdroj: Journal of ophthalmology [J Ophthalmol] 2021 Oct 04; Vol. 2021, pp. 5098272. Date of Electronic Publication: 2021 Oct 04 (Print Publication: 2021).
DOI: 10.1155/2021/5098272
Abstrakt: Purpose: To evaluate the morphological features and density of corneal subbasal plexus (SBP) using in vivo corneal confocal microscopy (IVCCM) in patients affected by Fuchs' endothelial corneal dystrophy (FECD) six months after Descemet membrane endothelial keratoplasty (DMEK) and Descemet-stripping automated endothelial keratoplasty (DSAEK).
Methods: We included patients affected by FECD, requiring corneal endothelial surgery due to corneal oedema occurred from 3 to 6 months. 7 eyes underwent DMEK and 7 eyes DSAEK. All patients performed IVCCM preoperative and in six months postoperative. We analyzed SBP parameters, using CS4 Nerves Tracking Tool, and we studied the differences between the two endothelial keratoplasties.
Results: Comparing the eyes treated with DMEK with those treated with DSAEK, preoperative corneal thickness, corrected distance visual acuity (CDVA), and age were similar in both groups. SBP was not detectable at preoperative IVCCM in any eye. Postoperatively, the nerve fibers length, the nerve fibers density, the tortuosity, and the number of fibers and of branching did not differ in the eyes that underwent DMEK compared to DSAEK. The corneal beadings density was higher after DMEK than DSAEK, and this difference was statistically significant ( P  = 0.004). The type of endothelial keratoplasty was not associated with the presence or absence of postoperative corneal SBP (Pearson' chi-square, 0.755).
Conclusions: Postoperative corneal reinnervation should be easily and noninvasively studied using IVCCM. Morphological postoperative features of SBP did not differ between two different types of endothelial keratoplasty, DMEK and DSAEK, despite the different sizes of the corneal incision. The lower beading density in the DSAEK group should be the consequence of a different distribution of mitochondria along the nerve fibers, as expression of a supposed higher metabolic distress in the DSAEK group.
Competing Interests: The authors declare that they have no conflicts of interest.
(Copyright © 2021 Irene Abicca et al.)
Databáze: MEDLINE
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