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Toshiki Shimizu, Takahiko Hayashi, Kentaro Yuda, Hidenori Takahashi, Kenichiro Yamazaki, itaru oyakawa, Nobuhisa Mizuki, Naoko Kato; Correlation between iris posterior synechia severity and anterior chamber volume following Descemet’s Membrane Endothelial Keratoplasty. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1319. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Iris posterior synechia may interfere with the functionality of ocular fundus, as well as the maintenance of adequate intraocular pressure[A1] , increasing the risk of overlooking retinal diseases such as retinal detachment, cystoid macular edema, and age-related macular degeneration. The purpose of the present study was to evaluate the frequency and severity of the iris posterior synechia following Descemet’s Membrane Endothelial Keratoplasty (DMEK), and to investigate the possible causes.
Seventeen eyes from 17 consecutive patients with corneal endothelial decompensation who underwent DMEK after phacoemulsification and intracapsular intraocular lens implantation surgery were studied. Pre-existing iris damage score was defined as iris depigmentation and classified into 5 grades before the DMEK. Six months after DMEK, the iris posterior synechia severity score was evaluated based on the extent of posterior synechia according to every 45° of the pupillary rim (posterior synechia score; 0–8). The correlation between the posterior synechia scores and the pre-existing factors [pre-exiting iris damage score, axial length (AL), anterior chamber depth (ACD), and anterior chamber volume (ACV)] of the operated eyes was analyzed.
Iris posterior synechia was observed in 14 of the 17 eyes (82.4%). Best spectacle-corrected visual acuity, which was 0.91±0.62 preoperatively, significantly improved to 0.08±0.16 6 months after DMEK (p<0.01); the endothelial cell density (ECD) was 1,589±593[A1] cells/mm2 (p<0.01), and the ECD loss rate was 36.7±19.9%. Pre-DMEK ACD and ACV did not correlate with the posterior synechia score. However, the posterior synechia score significantly correlated with AL (p=0.004, r=-0.658), pre-existing iris damage score (p<0.001, r=0.750), and ACV before cataract surgery (p=0.01, r=-0.713). The ACD and ACV before cataract surgery were positively correlated (p<0.001, r=0.782).
A high frequency of iris posterior synechia was observed following DMEK, with a greater tendency to occur in the eyes with shorter AL and smaller ACD, and damaged irides.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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