March 2012
Volume 53, Issue 14
Free
ARVO Annual Meeting Abstract  |   March 2012
Confocal Microscopy Findings In Surgically Induced Endothelial Trauma After Anterior Segment Surgery
Author Affiliations & Notes
  • Talay Koylu
    Ophthalmology, Gulhane Military Medical Academy, Ankara, Turkey
  • Volkan Hurmeric
    Ophthalmology, Gulhane Military Medical Academy, Ankara, Turkey
  • Fazil C. Erdurman
    Ophthalmology, Gulhane Military Medical Academy, Ankara, Turkey
  • Osman M. Ceylan
    Ophthalmology, Gulhane Military Medical Academy, Ankara, Turkey
  • Ali H. Durukan
    Ophthalmology, Gulhane Military Medical Academy, Ankara, Turkey
  • Uzeyir Erdem
    Ophthalmology, Gulhane Military Medical Academy, Ankara, Turkey
  • Fatih M. Mutlu
    Ophthalmology, Gulhane Military Medical Academy, Ankara, Turkey
  • Footnotes
    Commercial Relationships  Talay Koylu, None; Volkan Hurmeric, None; Fazil C. Erdurman, None; Osman M. Ceylan, None; Ali H. Durukan, None; Uzeyir Erdem, None; Fatih M. Mutlu, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 84. doi:
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      Talay Koylu, Volkan Hurmeric, Fazil C. Erdurman, Osman M. Ceylan, Ali H. Durukan, Uzeyir Erdem, Fatih M. Mutlu; Confocal Microscopy Findings In Surgically Induced Endothelial Trauma After Anterior Segment Surgery. Invest. Ophthalmol. Vis. Sci. 2012;53(14):84.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose:
 

is to analyze in-vivo confocal microscopy findings of surgically induced endothelial trauma after anterior segment surgery.

 
Methods:
 

Ten eyes of ten patients with intraoperative endothelial trauma were included in the study. Patient acquisition and data collection have been completed between January 2006 and November 2011. Nine patients underwent phacoemulsification; one patient underwent anterior chamber parasynthesis for traumatic hyphema. Endothelial trauma was noted during the surgery in six patients and at postoperative controls in four patients. Patients were scanned with confocal microscopy at the postoperative period. In selected patients Scheimpflug imaging was used to confirm Descemet’s membrane detachment. Confocal microscopy images were used to analyze in-vivo morphology of corneal lesions observed in slit lamp examination. Composite pictures of the confocal images were prepared in 6 patients.

 
Results:
 

Seven patients had Descemet’s membrane tear and three patients had Descemet’s membrane detachment. Endothelial trauma was noted during the preparation of clear corneal incisions, capsulorhexis, IOL implantation and stromal hydration. Postoperatively patients demonstrated scarring, wrinkles, tears and detachment of the Descemet’s membranes. Scheimpflug imaging confirmed Descemet’s membranes detachment in four patients. Detached Descemet’s membranes demonstrated acellular and fibrotic appearance in confocal microscopy (figure-d). Scarring and tear of Descemet’s membrane demonstrated different in-vivo confocal microscopic findings. In two patients endothelial cells were observed at the area of Descemet’s tear suggesting migration of endothelial cells (asterix in the figure). Composite confocal microscopy images demonstrated more information about the nature of endothelial lesions.

 
Conclusions:
 

Confocal microscopy can be used in the differential diagnosis of patients after surgically induced endothelial trauma. Exact diagnosis and description of endothelial trauma after anterior segment surgery is beneficial in the education of ocular surgeons and in the management of these complications.  

 
Keywords: cornea: endothelium 
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