{"title":"Intracellular dark endothelial spots: A new imaging biomarker for the development of bullous keratopathy after cataract surgery.","authors":"Taiyo Shijo, Yukari Yagi-Yaguchi, Osama Ibrahim, Hirotsugu Kasamatsu, Yurina Mori-Ogiwara, Daisuke Tomida, Hisashi Noma, Dogru Murat, Takefumi Yamaguchi","doi":"10.1007/s00417-025-06846-1","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Intracellular dark endothelial spots (IDES) on specular microscopy indicate corneal endothelial stress, and can be an imaging biomarker for subsequent endothelial cell density (ECD) loss after endothelial keratoplasty. This study evaluated the risk factors for the development of bullous keratopathy (BK) by comparing low ECD patients with or without IDES before cataract surgery.</p><p><strong>Methods: </strong>This retrospective study included 106 consecutive patients who underwent cataract surgery with a preoperative ECD of less than 1000 cells/mm<sup>2</sup>. The patients were divided into 2 groups according to presence of IDES. The medical charts were retrospectively reviewed for preoperative central corneal thickness (CCT), ECD, anterior chamber depth (ACD), presence of IDES, presence of guttae, grade of nuclear sclerosis, intraoperative posterior capsule rupture (PCR) and development of BK after cataract surgery. The clinical factors were compared in patients with or without IDES and the risk factors for BK after cataract surgery were evaluated.</p><p><strong>Results: </strong>The mean preoperative ECD was 687 ± 124 cells/mm<sup>2</sup>. IDES were observed in 41 eyes (38.7%). IDES were significantly more common in eyes with shallow ACD than in those with deep ACD (P = 0.033). Twenty-two eyes (20.8%) developed BK after cataract surgery. IDES were significantly associated with the development of BK (31.7%) compared to those without BK (13.9%, P = 0.03). CCT, nuclear sclerosis, PCR, and IDES were identified as significant risk factors for postoperative BK (P < 0.0083).</p><p><strong>Conclusion: </strong>IDES can be used as a new imaging biomarker that suggests a potential risk for development of BK in patients with shallow anterior chamber who are to undergo cataract surgery.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Graefe’s Archive for Clinical and Experimental Ophthalmology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00417-025-06846-1","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: Intracellular dark endothelial spots (IDES) on specular microscopy indicate corneal endothelial stress, and can be an imaging biomarker for subsequent endothelial cell density (ECD) loss after endothelial keratoplasty. This study evaluated the risk factors for the development of bullous keratopathy (BK) by comparing low ECD patients with or without IDES before cataract surgery.
Methods: This retrospective study included 106 consecutive patients who underwent cataract surgery with a preoperative ECD of less than 1000 cells/mm2. The patients were divided into 2 groups according to presence of IDES. The medical charts were retrospectively reviewed for preoperative central corneal thickness (CCT), ECD, anterior chamber depth (ACD), presence of IDES, presence of guttae, grade of nuclear sclerosis, intraoperative posterior capsule rupture (PCR) and development of BK after cataract surgery. The clinical factors were compared in patients with or without IDES and the risk factors for BK after cataract surgery were evaluated.
Results: The mean preoperative ECD was 687 ± 124 cells/mm2. IDES were observed in 41 eyes (38.7%). IDES were significantly more common in eyes with shallow ACD than in those with deep ACD (P = 0.033). Twenty-two eyes (20.8%) developed BK after cataract surgery. IDES were significantly associated with the development of BK (31.7%) compared to those without BK (13.9%, P = 0.03). CCT, nuclear sclerosis, PCR, and IDES were identified as significant risk factors for postoperative BK (P < 0.0083).
Conclusion: IDES can be used as a new imaging biomarker that suggests a potential risk for development of BK in patients with shallow anterior chamber who are to undergo cataract surgery.
期刊介绍：
Graefe''s Archive for Clinical and Experimental Ophthalmology is a distinguished international journal that presents original clinical reports and clini-cally relevant experimental studies. Founded in 1854 by Albrecht von Graefe to serve as a source of useful clinical information and a stimulus for discussion, the journal has published articles by leading ophthalmologists and vision research scientists for more than a century. With peer review by an international Editorial Board and prompt English-language publication, Graefe''s Archive provides rapid dissemination of clinical and clinically related experimental information.
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