Cornea最新文献

{"title":"Eye Donation From Individuals Receiving Medical Assistance in Dying: Retrospective Chart Review of the Eye Bank of Canada (Ontario Division).","authors":"Irina Sverdlichenko, Christine Humphreys, Brendan G Ko, Mor Bareket, Clara C Chan","doi":"10.1097/ICO.0000000000003936","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003936","url":null,"abstract":"<p><strong>Purpose: </strong>In Canada, Medical Assistance in Dying (MAiD) became a legal option for patients in 2016. The characteristics of MAiD donors, specifically for ocular tissue transplantation, have not been studied. The goal of this study was to explore the demographics and health status of these individuals.</p><p><strong>Methods: </strong>A retrospective chart review of MAiD donors from the Eye Bank of Canada (Ontario Division) from January 2019 to March 2024 was conducted. Variables recorded included demographics, medical status, mechanism of death, consent and referral process, and tissue utilization.</p><p><strong>Results: </strong>There were 475 eye donors (6.1% of all eye donors) who underwent the MAiD provision. The average age of donors was 70 years (SD: 5.42), and 50.5% (240/475) were male. Cancer was the most common mechanism of death, in 70% (332) of cases. First-person consent was obtained only 35% (164/474) of the time for ocular tissue donation, and 90% of donors (428/475) were referred from hospitals. Sixty-three percent of eyes were eligible for transplantation, while 37% were eligible for research and training. The most common surgical indication for transplant was endothelial dystrophies/failure (35%, 167/484).</p><p><strong>Conclusions: </strong>This study highlights the unique characteristics of eye donors who chose the MAiD provision. Hospitals made up 90% of MAiD referrals, and only 35% of MAiD donors consented on their own behalf. Efforts should be made to expand referrals for MAiD donation from nonhospital organizations. Furthermore, once MAiD eligibility has been determined, support should be provided to health care providers to navigate difficult discussions around donation.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144689143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine Learning Model for Predicting Visual Acuity Improvement After Intrastromal Corneal Ring Surgery in Patients With Keratoconus.","authors":"Eva Perez, Nassim Louissi, Sofiene Kallel, Quentin Hays, Nacim Bouheraoua, Malika Hamrani, Anatole Chessel, Vincent Borderie","doi":"10.1097/ICO.0000000000003933","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003933","url":null,"abstract":"<p><strong>Background: </strong>Keratoconus is a progressive, degenerative corneal disease that can lead to significant visual impairment. The intrastromal ring segment implantation procedure is effective in reshaping the cornea and improving vision. However, vision does not improve postoperatively in all operated eyes, and the results vary widely among patients, making it challenging to predict postoperative visual gain.</p><p><strong>Purpose: </strong>This study investigated the potential of machine learning in predicting postoperative visual acuity in keratoconus patients undergoing intrastromal ring segment implantation with the aim of enhancing surgical decision-making.</p><p><strong>Methods: </strong>This retrospective study analyzed 120 eyes of 102 patients with keratoconus who underwent ring segment implantation (1 symmetric or asymmetric segment, 150-300 μm thick, 150 degrees, or 160 degrees-arc). Preoperative and postoperative refraction, corneal topography, and tomographic data were collected. Various models were trained to predict postoperative visual acuity improvements.</p><p><strong>Results: </strong>The models demonstrated excellent performance, with XGBoost achieving perfect results in predicting whether vision will improve after surgery (R2 = 1.0, Youden Index = 1.0; all test observations being correctly classified). The CatBoost model achieved an R2 of 0.59 [0.7-line mean absolute error (MAE)] for predicting postoperative visual acuity, an R2 of 0.76 (MAE, 1.08 D) for predicting keratometry, and an R2 of 0.54 (MAE, 0.29) for predicting corneal asphericity. Key features for accurate predictions included preoperative keratometry values (K1, K2, Kmax), corneal asphericity, and visual acuity, whereas segment characteristics featured low importance.</p><p><strong>Conclusions: </strong>This study shows the strong potential of machine learning for selecting candidates for surgery and predicting postoperative visual improvements after ring segment implantation in keratoconus eyes.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144689089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Muraine Sutures for Hydrops in Patients After Penetrating Keratoplasty.","authors":"Lukas Neuhann, Carina Neuhann, Diana Vogel, Aylin Garip-Kuebler, Thomas Neuhann, Irmingard Neuhann","doi":"10.1097/ICO.0000000000003946","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003946","url":null,"abstract":"<p><strong>Purpose: </strong>To report the clinical characteristics of 7 cases of corneal hydrops after penetrating keratoplasty (PKP) for keratoconus and the postoperative results for 6 of these patients treated with predescemetal sutures (also known as Muraine sutures).</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of all patients who presented at our center with secondary hydrops after PKP for keratoconus from 2023 to 2025.</p><p><strong>Results: </strong>Seven patients (6 male) presented with corneal hydrops on average 26.8 years (range 20-32 years) after initial PKP. The time between symptom onset and surgery ranged from 1 day to 1 year (mean 12.3 weeks). In all cases, a tear in Descemet membrane could be identified at the temporal or inferotemporal graft-host interface using anterior segment OCT and/or slit-lamp examination. We performed Muraine sutures in 6 patients, all of whom showed significant clearing and reduction of corneal swelling within a few days. Best-corrected visual acuity improved from a mean preoperative value of logMAR 2.17 to logMAR 0.62 at the final follow-up (mean: 10.8 months; range: 6-17 months).</p><p><strong>Conclusions: </strong>This is the first description of the use and surgical results of Muraine sutures for the treatment of corneal hydrops after PKP. Owing to its rarity and potential confounding with graft failure and late rejection, this condition may be underdiagnosed. In all cases, corneal edema resolved rapidly, resulting in a sustained significant improvement in visual acuity. Therefore, repeat keratoplasty could be avoided in all cases until now.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144689090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid Dehydration of Corneal Allogeneic Intrastromal Ring Segments (CAIRSs) by Thermal Energy Conduction and Heating to Facilitate Implantation.","authors":"Shady T Awwad, Soosan Jacob, Karen E Asfar, Jad F Assaf, Rajesh Fogla, Yara Bteich, Nawwaf Jurdi","doi":"10.1097/ICO.0000000000003941","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003941","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to describe a new technique for rapid extensive dehydration of corneal allogeneic intrastromal ring segments (CAIRSs) using thermal energy conduction to facilitate implantation.</p><p><strong>Methods: </strong>Donor corneas were trephined into annular stromal rings, halved, and placed into a titanium mold with a semicircular recess. The mold was positioned on a sterile polyethylene drape covering a USB-powered cup heater with a tempered glass surface (Tangxi, Guangzhou, China, set to 55°C). Segments were covered with a 1 oz plastic medicine cup (Amsino International, Pomona, CA) for 5 minutes, after which their temperature was monitored using a laser thermometer and found to be 47.5 ± 0.8°C. Resulting segments were rigid and maintained their arc shape, allowing for forceps-only insertion into femtosecond laser-created stromal tunnels. Insertion time (from tunnel creation to segment ironing) was measured through surgical video. Segment dimensions were assessed using optical coherence tomography at 1 week, 1 month, and 3 months. Four dehydrated segments underwent histopathologic analysis.</p><p><strong>Results: </strong>A total of 33 eyes from 29 patients underwent single-segment CAIRS implantation using the thermal dehydration technique. The mean combined insertion and repositioning time was 86 ± 19 seconds. Optical coherence tomography showed segment thickness and width of 498 ± 72 μm and 1119 ± 175 μm at 1 week, and 443 ± 67 μm and 1292 ± 220 μm at 3 months. Histopathology revealed preserved stromal architecture without evidence of thermal damage.</p><p><strong>Conclusions: </strong>Controlled thermal energy conduction significantly reduces CAIRS dehydration time and simplifies insertion, enhancing surgical efficiency while preserving tissue integrity.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144689091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Analysis of Inflammatory Dermatologic Conditions and Their Association With Keratoconus.","authors":"Jawad Muayad, James A Madsen, Tarun R Sontam, Asad Loya, Andrew G Lee, Masih Ahmed","doi":"10.1097/ICO.0000000000003931","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003931","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate whether inflammatory skin conditions-including atopic dermatitis, psoriasis, seborrheic dermatitis, contact dermatitis, urticaria, and rosacea-are associated with an increased risk of keratoconus (KC).</p><p><strong>Methods: </strong>We used data from the TriNetX Global Collaborative Network, which aggregates electronic health records from approximately 165 million patients across 19 countries. Adults aged 18 to 40 years diagnosed with each inflammatory skin condition (with no history of corneal disorders) between April 1, 2016, and August 1, 2019, were matched 1:1 with controls on demographics and known KC risk factors. Five-year KC incidence was evaluated using Kaplan-Meier and hazard ratio (HR) analyses, adjusting for potential confounders.</p><p><strong>Results: </strong>Compared with controls, patients with atopic dermatitis had a significantly higher 5-year risk of KC (HR = 2.32, 95% CI, 1.54-3.50), followed by psoriasis (HR = 1.93, 95% CI, 1.23-3.04), seborrheic dermatitis (HR = 1.64, 95% CI, 1.06-2.53), contact dermatitis [HR = 1.55, 95% confidence interval (CI), 1.09-2.21], and urticaria (HR = 1.56, 95% CI, 1.02-2.38). By contrast, rosacea showed no significant association with KC (HR = 0.93, 95% CI, 0.49-1.78).</p><p><strong>Conclusions: </strong>In this large multicenter cohort, inflammatory skin diseases, except rosacea, were associated with increased risk of KC development. These findings underscore the potential shared inflammatory mechanisms in KC pathogenesis and highlight the importance of vigilant ocular monitoring in high-risk populations.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Topical Hepatocyte Growth Factor Accelerates Wound Healing and Inhibits Scarring in Experimental Corneal Injury.","authors":"Elsayed Elbasiony, Sharad K Mittal, Vinay K Pulimamidi, Tomi Luan, Susan Orr, Reza Dana, Sunil K Chauhan","doi":"10.1097/ICO.0000000000003932","DOIUrl":"10.1097/ICO.0000000000003932","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to compare the rates of healing, scar formation, and regression of preexisting scars using topical murine hepatocyte growth factor (mHGF), recombinant human deleted HGF (dHGF), murine nerve growth factor (mNGF), and phosphate-buffered saline (PBS).</p><p><strong>Methods: </strong>Mechanical corneal epithelial and stromal injury was induced in C57BL/6 mice. Five groups of mice were studied in each of phase I (wound healing and scar formation) and phase II (regression of preexisting scars). Each group received topical 0.1% mHGF, 0.1% dHGF, 0.2% dHGF, 0.1% mNGF, or PBS. In phase I, animals were dosed 4 times/day (QID) on days 0 to 7. In phase II, a corneal injury was induced, and no treatment was administered for 10 days to allow scar formation. Mice with scars were then dosed QID on days 11 to 21. Ocular assessments included slit-lamp photography (phase I and II) and fluorescein staining (phase I).</p><p><strong>Results: </strong>In phase I, eyes treated with mHGF exhibited significantly faster epithelial healing and decreased scar formation compared with both mNGF-treated and PBS-treated eyes 7 days after treatment. Consistent with that seen in mHGF-treated eyes, 0.1% and 0.2% dHGF-treated eyes each showed significantly faster epithelial healing compared with PBS-treated eyes. Scars formed in dHGF-treated eyes were also significantly smaller than PBS-treated eyes 7 days after treatment. In phase II, both mHGF-treated and dHGF-treated eyes showed a significant decrease in the size of preexisting scars compared with PBS-treated eyes.</p><p><strong>Conclusions: </strong>Topical HGF significantly accelerates corneal wound healing, reduces scar formation, and can reverse preexisting scars.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":"1296-1302"},"PeriodicalIF":2.1,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated With Perfluorohexyloctane Treatment Response in Dry Eye Disease Associated With Meibomian Gland Dysfunction.","authors":"Hao Gu, Zhanrong Li, Lei Zhu","doi":"10.1097/ICO.0000000000003927","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003927","url":null,"abstract":"<p><strong>Purpose: </strong>To explore critical factors associated with perfluorohexyloctane eye drop (SHR8058) treatment response in patients with dry eye disease associated with meibomian gland dysfunction.</p><p><strong>Methods: </strong>The post hoc analysis was performed from a phase 3, randomized controlled trial (NCT05515471). Treatment response was defined as achieving 1) a ≥ 3-point reduction from baseline in total corneal fluorescein staining (tCFS response), 2) a ≥30% reduction from baseline in eye dryness score (EDS response), or 3) both tCFS and eye dryness score (EDS) responses (tCFS&EDS response) at day 57. Univariate and multivariate logistic regression analyses using stepwise selection were conducted. Optimal cutoff values were also investigated.</p><p><strong>Results: </strong>Among the 156 patients treated with SHR8058, 114 achieved a tCFS response, 127 achieved an EDS response, and 98 achieved a tCFS&EDS response. Multivariate analysis revealed tCFS score was associated with tCFS, EDS, and tCFS&EDS responses, with odds ratios (ORs) of 1.37 [95% confidence interval (CI), 1.08-1.73], 1.36 (95% CI, 1.05-1.77), and 1.39 (95% CI, 1.13-1.72), respectively. Ametropia was associated with tCFS and tCFS&EDS responses, with ORs of 3.03 (95% CI, 1.27-7.25) and 2.32 (95% CI, 1.10-4.88), respectively. Moreover, patients with baseline a tCFS score ≥6 were more likely to achieve a tCFS&EDS response compared with those with a tCFS score <6 [OR 3.25 (95% CI, 1.62-6.53)].</p><p><strong>Conclusions: </strong>Baseline tCFS score and ametropia are critical factors associated with SHR8058 treatment response. Patients with a baseline tCFS score ≥6 and those with ametropia are more likely to achieve greater overall improvements of corneal surface condition and dry eye symptoms.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Indolent Inflammatory Myofibroblastic Tumor of the Conjunctiva.","authors":"Yue Li, Rongrong Cai, Yan Wang","doi":"10.1097/ICO.0000000000003928","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003928","url":null,"abstract":"<p><strong>Purpose: </strong>Inflammatory myofibroblastic tumor (IMT) is a mesenchymal neoplasm of intermediate biological potential, predominantly affecting children and young adults. While IMT most commonly involves the lungs, abdomen, pelvis, and retroperitoneum, primary occurrences in the orbit or ocular surface are rare.</p><p><strong>Methods: </strong>Case report.</p><p><strong>Results: </strong>Here we present a case of a 26-year-old woman with a small, indolent conjunctival IMT harboring anaplastic lymphoma kinase rearrangement. Following surgical resection, the patient showed no evidence of recurrence after 9 months of follow-up. Notably, this report firstly provided anterior segment optical coherence tomography scan and ultrasound biomicroscope images of conjunctival IMT.</p><p><strong>Conclusions: </strong>IMT should be considered in the differential diagnosis of localized conjunctival lesions unresponsive to steroid therapy. Anterior segment optical coherence tomography and ultrasound biomicroscope serve as valuable tools, aiding in differential diagnosis, surgical planning, and postoperative recurrence monitoring.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144552538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantifying Corneal Endothelial Cell Damage During Descemet Membrane Endothelial Keratoplasty Graft Loading and Ejection Using a Calcein-AM Imaging Method.","authors":"Sung Lee, Ching Yuan, Peter Bedard, Joshua H Hou","doi":"10.1097/ICO.0000000000003925","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003925","url":null,"abstract":"<p><strong>Purpose: </strong>(1) To compare total endothelial cell damage from loading and ejection of Descemet membrane endothelial keratoplasty (DMEK) grafts through Straiko and Lions World Vision Institute (LWVI) glass cannulas. (2) To isolate and quantify endothelial cell damage from loading or ejection alone in Straiko tubes.</p><p><strong>Methods: </strong>DMEK grafts were peeled, stained with Calcein-AM (CAM), and imaged under fluorescence microscopy to evaluate baseline endothelial damage. Grafts were then loaded and ejected from Straiko and LWVI glass cannulas, and reimaged. Loss of CAM fluorescence signal was evaluated to calculate change in Area of Cell Damage (ACD). ACD changes were compared between Straiko and LWVI cannulas. Custom-made Straiko \"half-tubes,\" consisting of only the loading or ejection end of a Straiko tube, were used to isolate graft loading from ejection, and CAM-based ACD was again assessed.</p><p><strong>Results: </strong>Loading and ejection resulted in a significant increase in ACD for both Straiko (4.88% ± 0.53%) and LWVI (4.22% ± 0.57%) cannulas, but this was not statistically different between cannulas (P = 0.42). For Straiko half-tubes, ejection alone (3.08% ± 0.31%) resulted in a significantly greater increase in ACD compared with loading alone (1.38% ± 0.36%) (P = 0.004).</p><p><strong>Conclusions: </strong>Ejection of DMEK grafts through a Straiko tube causes more endothelial cell damage than loading. Loading and ejection of DMEK grafts through Straiko and LWVI tubes were associated with similar endothelial cell damage. Bore size alone cannot explain these results. The overall damage, measured using CAM, was lower than previously reported studies that relied on different methods for quantifying damage.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144552539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous Descemet Membrane Detachment After Necrotizing Scleritis: A Case Report.","authors":"Kyle S Margulies, Victoria Kiavash, Zeba A Syed","doi":"10.1097/ICO.0000000000003930","DOIUrl":"10.1097/ICO.0000000000003930","url":null,"abstract":"<p><strong>Purpose: </strong>We report a case of spontaneous Descemet membrane detachment (DMD) in a patient with a history of necrotizing scleritis and discuss the management approach and outcome.</p><p><strong>Methods: </strong>This was a case report and review of literature.</p><p><strong>Results: </strong>A 50-year-old man with a history of rheumatoid arthritis, ankylosing spondylitis, and necrotizing scleritis on systemic methotrexate, rituximab, and prednisone presented with 6 weeks of photophobia, pain, and decreased vision in his left eye. Visual acuity on presentation was 20/80 in the left eye, and intraocular pressure was 18 mm Hg. Slit lamp examination demonstrated scleral injection most significantly in an area of superonasal epithelialized scleral thinning with underlying uveal visibility, indicating prior necrotizing scleritis. Bullous corneal edema extended from the limbus superonasally into the visual axis. The remainder of the anterior and posterior segment evaluations was unremarkable. Anterior segment optical coherence tomography confirmed the presence of DMD underlying the area of corneal edema. The patient was treated with an increased dose of oral prednisone with subsequent taper for systemic autoimmune control given active nonnecrotizing scleritis, followed 2 months later by air bubble injection in the anterior chamber and face-up positioning for 2 days. This led to reattachment of Descemet membrane and complete clearance of corneal edema, with improvement of vision to 20/25 on follow-up.</p><p><strong>Conclusions: </strong>This is the first report of spontaneous DMD in a patient with a history of necrotizing scleritis. A possible mechanism may include shearing forces secondary to scleral ectasia, which may result in focal Descemet membrane tears and subsequent detachment.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}