Abstract
Purpose :
Glaucoma patients with previous glaucoma surgery are at high risk for graft failure after endothelial keratoplasty (EK). EndoArt® (EyeYon Medical, Israel) is a novel keratoprosthesis for replacing decompensated corneal endothelium. EndoArt® is positioned at the posterior stromal surface after removal of Descemet’s membrane. Here it acts as a physical barrier for the aqueous humor. We present our first results with this device in glaucoma patients by analyzing the efficiacy in corneal deswelling.
Methods :
We retrospectively analyzed patients with glaucoma after EndoArt® implantation. After insertion and unfolding in the anterior chamber the device was attached to the posterior corneal surface by a gas bubble and secured with interrupted sutures. Since central corneal thickness (CCT) measurements were limited by image quality in very opaque corneas or by nystagmus, different measurement systems (Pentacam®, Oculus, Wetzlar, Germany; anterior segment spectral domain-OCT (AS-OCT); Heidelberg Engineering, Heidelberg, Germany) were evaluated to maximize the number of available readings.
Results :
A consecutive series of 12 glaucoma patients after EndoArt® implantation were analyzed. All patients had previous multiple glaucoma surgeries, with 7 of these patients having drainage device implantation. Additionally, 9 patients already had multiple previous Descemet membrane endothelial keratoplasties (DMEK). Among the included patients, 10 eyes were pseudophakic and 2 were aphakic.
11 out of 12 patients experienced an improvement in corneal opacity and a decrease in central corneal thickness. The average preoperative CCT was measured using Pentacam® (mean 885µm ± 206) and AS-OCT (mean 764µm ± 168). At 2-6 weeks postoperatively, the mean CCT was 712 µm ± 183 (Pentacam®) and 653µm ± 226 (AS-OCT). At 7-12 weeks postoperatively, the mean CCT was 784 µm ± 0 (Pentacam®) and 629 µm ± 267 (AS-OCT).
Conclusions :
EndoArt® leads to corneal deswelling in glaucoma patients without the risk of rejection. This new therapeutic approach may provide an important option for these high-risk patients, but long-term results are still pending.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.