Spokewise iridotomy combined with Descemet stripping automated endothelial keratoplasty in iridocorneal endothelial syndrome
PurposeIridocorneal endothelial (ICE) syndrome is a progressive anterior segment disorder that can be tricky to treat. Keratoplasty is commonly used to treat corneal edema in ICE syndrome. However, glaucoma is an important risk factor affecting graft survival. To address this question, we designed a...
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Frontiers Media S.A.
2023-07-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2023.1187009/full |
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| author | Jiaxin Zhang Jiaxin Zhang Rongmei Peng Rongmei Peng Gege Xiao Gege Xiao Minshu Wang Minshu Wang Jing Hong Jing Hong |
| author_facet | Jiaxin Zhang Jiaxin Zhang Rongmei Peng Rongmei Peng Gege Xiao Gege Xiao Minshu Wang Minshu Wang Jing Hong Jing Hong |
| author_sort | Jiaxin Zhang |
| collection | DOAJ |
| description | PurposeIridocorneal endothelial (ICE) syndrome is a progressive anterior segment disorder that can be tricky to treat. Keratoplasty is commonly used to treat corneal edema in ICE syndrome. However, glaucoma is an important risk factor affecting graft survival. To address this question, we designed a retrospective cohort study to evaluate the effect of Spokewise Iridotomy (SI) on Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) Grafts in Iridocorneal Endothelial (ICE) Syndrome.MethodsThis was a retrospective cohort study. A total of 29 patients were included; 31 eyes with ICE syndrome underwent DSAEK at Peking University Third Hospital between June 2015 and June 2022, including 11 eyes with combined SI during DSAEK. The aim was to explore the effect of SI on vision, glaucoma control, complications, peripheral anterior synechiae recurrence, endothelial cell count, and graft survival.ResultsThe median follow-up time was 30.83 months (mo.) in the SI+Endothelial Keratoplasty (EK) group and 6.17 mo in the EK group. The 2-year cumulative survival rate of grafts in the SI+EK group was 100%, compared with the 6-month and 1-year cumulative survival rates of 80.2 and 63.2%, respectively, in the EK group (p = 0.043). The SI+EK group had a lower incidence of immediate postoperative complications (p = 0.005), fewer postoperative anti-glaucoma medications (AGMs) (p = 0.029), smaller peripheral anterior synechiae recurrence (p = 0.001), and significant visual acuity improvement (p < 0.05). More AGMs were used in failed grafts (p = 0.002).ConclusionSI can help control intraocular pressure, improve visual acuity, and increase graft survival after DSAEK in ICE syndrome patients. |
| first_indexed | 2024-03-13T01:03:20Z |
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| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-03-13T01:03:20Z |
| publishDate | 2023-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-c0d0a7832b7d4e77b8b90c8fb24a06b02023-07-06T10:05:56ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2023-07-011010.3389/fmed.2023.11870091187009Spokewise iridotomy combined with Descemet stripping automated endothelial keratoplasty in iridocorneal endothelial syndromeJiaxin Zhang0Jiaxin Zhang1Rongmei Peng2Rongmei Peng3Gege Xiao4Gege Xiao5Minshu Wang6Minshu Wang7Jing Hong8Jing Hong9Department of Ophthalmology, Peking University Third Hospital, Beijing, ChinaBeijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, ChinaDepartment of Ophthalmology, Peking University Third Hospital, Beijing, ChinaBeijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, ChinaDepartment of Ophthalmology, Peking University Third Hospital, Beijing, ChinaBeijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, ChinaDepartment of Ophthalmology, Peking University Third Hospital, Beijing, ChinaBeijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, ChinaDepartment of Ophthalmology, Peking University Third Hospital, Beijing, ChinaBeijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, ChinaPurposeIridocorneal endothelial (ICE) syndrome is a progressive anterior segment disorder that can be tricky to treat. Keratoplasty is commonly used to treat corneal edema in ICE syndrome. However, glaucoma is an important risk factor affecting graft survival. To address this question, we designed a retrospective cohort study to evaluate the effect of Spokewise Iridotomy (SI) on Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) Grafts in Iridocorneal Endothelial (ICE) Syndrome.MethodsThis was a retrospective cohort study. A total of 29 patients were included; 31 eyes with ICE syndrome underwent DSAEK at Peking University Third Hospital between June 2015 and June 2022, including 11 eyes with combined SI during DSAEK. The aim was to explore the effect of SI on vision, glaucoma control, complications, peripheral anterior synechiae recurrence, endothelial cell count, and graft survival.ResultsThe median follow-up time was 30.83 months (mo.) in the SI+Endothelial Keratoplasty (EK) group and 6.17 mo in the EK group. The 2-year cumulative survival rate of grafts in the SI+EK group was 100%, compared with the 6-month and 1-year cumulative survival rates of 80.2 and 63.2%, respectively, in the EK group (p = 0.043). The SI+EK group had a lower incidence of immediate postoperative complications (p = 0.005), fewer postoperative anti-glaucoma medications (AGMs) (p = 0.029), smaller peripheral anterior synechiae recurrence (p = 0.001), and significant visual acuity improvement (p < 0.05). More AGMs were used in failed grafts (p = 0.002).ConclusionSI can help control intraocular pressure, improve visual acuity, and increase graft survival after DSAEK in ICE syndrome patients.https://www.frontiersin.org/articles/10.3389/fmed.2023.1187009/fullspokewise iridotomyiridocorneal endothelial syndromeDescemet stripping automated endothelial keratoplasty (DSAEK)secondary glaucomagraft survival |
| spellingShingle | Jiaxin Zhang Jiaxin Zhang Rongmei Peng Rongmei Peng Gege Xiao Gege Xiao Minshu Wang Minshu Wang Jing Hong Jing Hong Spokewise iridotomy combined with Descemet stripping automated endothelial keratoplasty in iridocorneal endothelial syndrome Frontiers in Medicine spokewise iridotomy iridocorneal endothelial syndrome Descemet stripping automated endothelial keratoplasty (DSAEK) secondary glaucoma graft survival |
| title | Spokewise iridotomy combined with Descemet stripping automated endothelial keratoplasty in iridocorneal endothelial syndrome |
| title_full | Spokewise iridotomy combined with Descemet stripping automated endothelial keratoplasty in iridocorneal endothelial syndrome |
| title_fullStr | Spokewise iridotomy combined with Descemet stripping automated endothelial keratoplasty in iridocorneal endothelial syndrome |
| title_full_unstemmed | Spokewise iridotomy combined with Descemet stripping automated endothelial keratoplasty in iridocorneal endothelial syndrome |
| title_short | Spokewise iridotomy combined with Descemet stripping automated endothelial keratoplasty in iridocorneal endothelial syndrome |
| title_sort | spokewise iridotomy combined with descemet stripping automated endothelial keratoplasty in iridocorneal endothelial syndrome |
| topic | spokewise iridotomy iridocorneal endothelial syndrome Descemet stripping automated endothelial keratoplasty (DSAEK) secondary glaucoma graft survival |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2023.1187009/full |
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