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

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...

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Main Authors: Irene Abicca, Marta Gilardi, Daniela Giannini, Rossella Anna Maria Colabelli Gisoldi, Augusto Pocobelli, Domenico Schiano Lomoriello
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Journal of Ophthalmology
Online Access:http://dx.doi.org/10.1155/2021/5098272
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author Irene Abicca
Marta Gilardi
Daniela Giannini
Rossella Anna Maria Colabelli Gisoldi
Augusto Pocobelli
Domenico Schiano Lomoriello
author_facet Irene Abicca
Marta Gilardi
Daniela Giannini
Rossella Anna Maria Colabelli Gisoldi
Augusto Pocobelli
Domenico Schiano Lomoriello
author_sort Irene Abicca
collection DOAJ
description 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.
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spelling doaj-art-9904ce3ed7964d8d84ebb01ffa1932c02025-08-20T02:10:17ZengWileyJournal of Ophthalmology2090-004X2090-00582021-01-01202110.1155/2021/50982725098272Corneal Subbasal Plexus in Eyes with Fuchs’ Endothelial Corneal Dystrophy after Two Different Endothelial SurgeriesIrene Abicca0Marta Gilardi1Daniela Giannini2Rossella Anna Maria Colabelli Gisoldi3Augusto Pocobelli4Domenico Schiano Lomoriello5IRCCS–Fondazione Bietti, Rome, ItalyRome Eye Hospital, Rome, ItalyIRCCS–Fondazione Bietti, Rome, ItalySan Giovanni Addolorata Hospital, UOC Oftalmologia-Banca degli occhi, Rome, ItalySan Giovanni Addolorata Hospital, UOC Oftalmologia-Banca degli occhi, Rome, ItalyIRCCS–Fondazione Bietti, Rome, ItalyPurpose. 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.http://dx.doi.org/10.1155/2021/5098272
spellingShingle Irene Abicca
Marta Gilardi
Daniela Giannini
Rossella Anna Maria Colabelli Gisoldi
Augusto Pocobelli
Domenico Schiano Lomoriello
Corneal Subbasal Plexus in Eyes with Fuchs’ Endothelial Corneal Dystrophy after Two Different Endothelial Surgeries
Journal of Ophthalmology
title Corneal Subbasal Plexus in Eyes with Fuchs’ Endothelial Corneal Dystrophy after Two Different Endothelial Surgeries
title_full Corneal Subbasal Plexus in Eyes with Fuchs’ Endothelial Corneal Dystrophy after Two Different Endothelial Surgeries
title_fullStr Corneal Subbasal Plexus in Eyes with Fuchs’ Endothelial Corneal Dystrophy after Two Different Endothelial Surgeries
title_full_unstemmed Corneal Subbasal Plexus in Eyes with Fuchs’ Endothelial Corneal Dystrophy after Two Different Endothelial Surgeries
title_short Corneal Subbasal Plexus in Eyes with Fuchs’ Endothelial Corneal Dystrophy after Two Different Endothelial Surgeries
title_sort corneal subbasal plexus in eyes with fuchs endothelial corneal dystrophy after two different endothelial surgeries
url http://dx.doi.org/10.1155/2021/5098272
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AT martagilardi cornealsubbasalplexusineyeswithfuchsendothelialcornealdystrophyaftertwodifferentendothelialsurgeries
AT danielagiannini cornealsubbasalplexusineyeswithfuchsendothelialcornealdystrophyaftertwodifferentendothelialsurgeries
AT rossellaannamariacolabelligisoldi cornealsubbasalplexusineyeswithfuchsendothelialcornealdystrophyaftertwodifferentendothelialsurgeries
AT augustopocobelli cornealsubbasalplexusineyeswithfuchsendothelialcornealdystrophyaftertwodifferentendothelialsurgeries
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