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Scheimpflug Tomography as a Predictor of Corneal Edema After Phacoemulsification in Fuchs Endothelial Corneal Dystrophy.
Eleiwa, Taher K; Mohammed, Mona Abd El-Azim; Bayoumy, Ahmed Sherin M.
Afiliación
  • Eleiwa TK; Department of Ophthalmology, Benha University, Benha, Egypt.
  • Mohammed MAE; Department of Ophthalmology, Magrabi Eye and Dental Hospital, Qassim, Kingdom of Saudi Arabia.
  • Bayoumy ASM; Department of Ophthalmology, Mansoura Ophthalmic hospital, Mansoura, Egypt.
Clin Ophthalmol ; 18: 2303-2311, 2024.
Article en En | MEDLINE | ID: mdl-39185362
ABSTRACT

Purpose:

To determine if Scheimpflug tomography pachymetry map and posterior elevation map patterns can predict the occurrence of corneal edema following uneventful phacoemulsification surgery in Fuchs endothelial corneal dystrophy (FECD).

Design:

Observational prospective case-control study.

Participants:

Fifty FECD eyes (50 patients) with visually significant cataract 25 with subclinical corneal edema (SCE) versus 25 without SCE.

Methods:

Preoperatively, FECD was clinically assessed, and only patients devoid of clinical corneal edema were enrolled. Utilizing the Mayo Clinic classification for subclinical corneal edema (SCE), eligible FECD eyes were stratified based on Scheimpflug imaging pachymetry map and posterior elevation map characteristics, including loss of regular isopachs, displacement of the cornea's thinnest point, and the presence of posterior surface depression, into two groups Group A representing FECD with SCE, and Group B FECD without SCE. One week postoperatively, clinical and tomographic evaluation was performed. Regression analysis was conducted to evaluate predictors of corneal edema after uneventful phacoemulsification surgery in both groups.

Results:

All patients were successfully imaged before and 1 week after surgery. Visual acuity was significantly improved in both groups (P < 0.001). No postoperative clinical edema was observed in Group B, while 23 (92%) had mild edema and 2 (8%) had moderate edema in Group A. Both groups showed a significant increase in postoperative central corneal thickness (CCT) and thinnest corneal thickness (TCT) (both P < 0.001). Compared to Group B, Group A showed a significant central flattening of the anterior corneal surface (P = 0.007 and P = 0.04 for K1 and K2 respectively), and a significant increase in the postoperative posterior surface depression. Multivariate analysis showed that 94% of postoperative corneal edema could be predicted by the presence of preoperative posterior surface depression (P = 0.04, ARR = 5.8 (1.89-35.7)).

Conclusion:

Scheimpflug tomography pachymetry map and posterior elevation map patterns can predict corneal edema after uneventful phacoemulsification surgery in FECD with subclinical corneal edema.
Palabras clave

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Clin Ophthalmol Año: 2024 Tipo del documento: Article País de afiliación: Egipto Pais de publicación: Nueva Zelanda

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Clin Ophthalmol Año: 2024 Tipo del documento: Article País de afiliación: Egipto Pais de publicación: Nueva Zelanda