Abstract
Purpose :
Corneal endothelial decompensation with Descemet’s membrane (DM) breaks secondary to obstetrical forceps trauma is a rare condition, for which endothelial keratoplasty may be technically challenging due to abnormal contour of the corneal endothelial side. This study aimed to characterize the corneal high-order aberration (HOA) and corneal topographic changes in corneal endothelial decompensation with DM breaks.
Methods :
This retrospective study included 18 healthy controls and 23 eyes of 21 patients diagnosed with corneal decompensation with DM breaks (nine men and 12 women; mean age of 54.0 ± 9.1 years) at Tokyo Dental College Ichikawa General Hospital. We classified the corneal topographic patterns obtained by anterior segment optical coherence tomography (AS-OCT, CASIA II, Tomey, Aichi, Japan) into five categories. We quantified HOA of the anterior and posterior surfaces and the total cornea using AS-OCT. We classified corneal topographic patterns (asymmetric, protruding, flat, posterior irregular pattern, and regular astigmatism) based on corneal topography maps. We evaluated the correlations between visual acuity and either corneal HOA, corneal opacity grading, or severity of corneal edema.
Results :
The logarithm minimum angle of resolution of visual acuity was 1.45 ± 0.84 in eyes with corneal decompensation with DM breaks. The most common topography patterns were protruding and regular astigmatism (six eyes, each 26.1 %), followed by asymmetric pattern (five eyes, 21.7 %).HOA and coma within the diameters of 4 and 6 mm in corneal decompensation with DM breaks were significantly larger than those in healthy controls (P<0.0001). We found positive correlations between visual acuity and coma of the total cornea of 6-mm diameter, opacity grade, and corneal edema severity.
(r=0.482, P=0.023, r=0.695, P=0.0003, r=0.675, P=0.0006, respectively)
Conclusions :
Corneal HOA of total cornea and anterior and posterior surfaces were larger in patients with DM breaks secondary to obstetrical forceps injury than in normal individuals. Furthermore, coma significantly correlated with visual acuity, indicating that coma may be a useful parameter for assessing visual function in eyes with DM breaks.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.