Abstract
Purpose
To assess corneal endothelial cell loss after penetrating keratoplasty (PK) treatment for laser iridotomy (LI)-induced bullous keratopathy (BK).
Methods
A retrospective study conducted on consecutive patients who underwent PK between March 2000 and December 2011. Patients who had undergone more than 24 months of follow-up were included. Patients who underwent PK were subcategorized into two groups based on their diagnosis of BK prior to PK; PK was performed to treat either LI-BK or non LI-BK. The cell density of the central corneal endothelium and the graft survival were evaluated during follow-up.
Results
Corneal endothelial cell density decreased in a similar fashion in both the LI-BK and non LI-BK patients, though the cell density decreased significantly faster in the LI-BK group than in the non LI-BK group throughout the 108 months of the study (p = 0.026). The mean cell loss at 36 months for the LI-BK group was 57.7% vs. 63.2% for the non LI-BK, 76.9% vs. 70.1% at 72 months, and 85.6% vs. 72.0% at 108 months. No eye among 21 eyes in the LI-BK group (0%) had failed grafts, whereas 4 of 25 eyes in the non LI-BK group (16.0%) had failed grafts at 60 months (p = 0.114).
Conclusions
The outcome of PK for BK secondary to LI was no worse than the outcome of PK for other types of BK. However, our long-term follow-up after PK showed that cell density decreased faster in the LI-BK group than in the non LI-BK, suggesting that cell loss might be involved in the existence of LI prior to PK.
Similar content being viewed by others
References
Ramulu PY, Corcoran KJ, Corcoran SL, Robin AL. Utilization of various glaucoma surgeries and procedures in Medicare beneficiaries from 1995 to 2004. Ophthalmology. 2007;114:2265–70.
Wang PX, Koh VT, Loon SC. Laser iridotomy and the corneal endothelium: a systemic review. Acta Ophthalmol. 2014;92:604–16.
Pollack IP. Current concepts in laser iridotomy. Int Ophthalmol Clin. 1984;24:153–80.
Schwartz AL, Martin NF, Weber PA. Corneal decompensation after argon laser iridectomy. Arch Ophthalmol. 1988;106:1572–4.
Jeng S, Lee JS, Huang SC. Corneal decompensation after argon laser iridectomy—a delayed complication. Ophthalmic Surg. 1991;22:565–9.
Lim LS, Ho CL, Ang LP, Aung T, Tan DT. Inferior corneal decompensation following laser peripheral iridotomy in the superior iris. Am J Ophthalmol. 2006;142:166–8.
Ang LP, Higashihara H, Sotozono C, Shanmuganathan VA, Dua H, Tan DT, et al. Argon laser iridotomy-induced bullous keratopathy a growing problem in Japan. Br J Ophthalmol. 2007;91:1613–5.
Shimazaki J, Uchino Y, Tsubota K. Late irreversible corneal oedema after laser iridotomy. Br J Ophthalmol. 2009;93:125–6.
Kashiwagi K, Tsukahara S. Examination and treatment of patients with angle-closure glaucoma in Japan: results of a nationwide survey. Jpn J Ophthalmol. 2004;48:133–40.
Shimazaki J, Amano S, Uno T, Maeda N, Yokoi N, Japan Bullous Keratopathy Study G. National survey on bullous keratopathy in Japan. Cornea. 2007;26:274–8.
Eye Bank Association of America. Eye banking statistical report. Washington, DC. 2016.
Kaji Y, Oshika T, Usui T, Sakakibara J. Effect of shear stress on attachment of corneal endothelial cells in association with corneal endothelial cell loss after laser iridotomy. Cornea. 2005;24:S55–8.
Yamamoto Y, Uno T, Shisida K, Xue L, Shiraishi A, Zheng X, et al. Demonstration of aqueous streaming through a laser iridotomy window against the corneal endothelium. Arch Ophthalmol. 2006;124:387–93.
Higashihara H, Sotozono C, Yokoi N, Inatomi T, Kinoshita S. The blood-aqueous barrier breakdown in eyes with endothelial decompensation after argon laser iridotomy. Br J Ophthalmol. 2011;95:1032–4.
Kobayashi A, Yokogawa H, Sugiyama K. Descemet stripping with automated endothelial keratoplasty for bullous keratopathies secondary to argon laser iridotomy–preliminary results and usefulness of double-glide donor insertion technique. Cornea. 2008;27(Suppl 1):S62–9.
Kobayashi A, Yokogawa H, Sugiyama K. Non-descemet stripping automated endothelial keratoplasty for endothelial dysfunction secondary to argon laser iridotomy. Am J Ophthalmol. 2008;146:543–9.
Kobayashi A, Yokogawa H, Yamazaki N, Masaki T, Sugiyama K. The use of endoillumination probe-assisted Descemet membrane endothelial keratoplasty for bullous keratopathy secondary to argon laser iridotomy. Clin Ophthalmol. 2015;9:91–3.
Hirayama M, Yamaguchi T, Satake Y, Shimazaki J. Surgical outcome of Descemet’s stripping automated endothelial keratoplasty for bullous keratopathy secondary to argon laser iridotomy. Graefes Arch Clin Exp Ophthalmol. 2012;7:1043–50.
Nakatani S, Murakami A. Three-year outcome of Descemet stripping automated endothelial keratoplasty for bullous keratopathy after argon laser iridotomy. Cornea. 2014;33:780–4.
Ho T, Fan R. Sequential argon-YAG laser iridotomies in dark irides. Br J Ophthalmol. 1992;76:329–31.
Acknowledgements
The authors wish to thank Dr. Hiroko Nakagawa for her valuable assistance with the collection of patient data, Dr. Kengo Yoshii and Mr. Ryousuke Hayashi for assistance with statistical analysis, and Mr. John Bush for editing the manuscript.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflicts of interest
N. Okumura, None; A. Kusakabe, None; N. Koizumi, None; K. Wakimasu, None; K. Kayukawa, None; M. Kondo, None; K. Mori, None; C. Sotozono, None; S. Kinoshita, None.
Electronic supplementary material
Below is the link to the electronic supplementary material.
About this article
Cite this article
Okumura, N., Kusakabe, A., Koizumi, N. et al. Endothelial cell loss and graft survival after penetrating keratoplasty for laser iridotomy-induced bullous keratopathy. Jpn J Ophthalmol 62, 438–442 (2018). https://doi.org/10.1007/s10384-018-0598-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10384-018-0598-1