PloS one · 2026
Bullous keratopathy associated with a shallow anterior chamber: An anatomical risk phenotype for corneal endothelial decompensation.
СтатьяМногоцентровое исследованиеНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Takeda Masato, Mizuki Yuki, Igarashi Ami, Shimizu Toshiki, Okumura Naoki, Mizuki Nobuhisa, Yamagami Satoru, Hayashi Takahiko
Аннотация
PURPOSE: To characterize bullous keratopathy (BK) associated with a shallow anterior chamber (AC) and to examine whether a shallow AC itself may be associated with corneal endothelial decompensation, even in the absence of acute primary angle closure (APAC) or argon laser iridotomy (ALI).
METHODS: This multicenter retrospective observational study included 96 eyes that underwent Descemet membrane endothelial keratoplasty (DMEK) for endothelial dysfunction between 2015 and 2025 with ≥12 months of follow-up. The primary comparative analyses compared eyes with Fuchs endothelial corneal dystrophy (FECD) and eyes with endothelial dysfunction associated with a shallow AC. The shallow anterior chamber phenotype group comprised eyes with a documented history of APAC or ALI (PACD/ALI) and those without a documented history of either condition (shallow-AC). Anterior chamber depth (ACD), axial length, corneal thickness, endothelial parameters, and postoperative outcomes were compared between groups.
RESULTS: Pre-cataract ACD was significantly shallower in the shallow anterior chamber phenotype group than in the FECD group (1.93 ± 0.40 mm vs. 2.28 ± 0.27 mm, P < 0.001), and this relative difference persisted after cataract surgery. Within the shallow anterior chamber phenotype group, 10 eyes were classified as shallow-AC and had no documented history of APAC or ALI. Five-year graft survival after DMEK exceeded 90% and did not differ significantly between the shallow anterior chamber phenotype and FECD groups, nor between PACD/ALI and shallow-AC subgroups.
CONCLUSIONS: A shallow anterior chamber may be associated with corneal endothelial decompensation, even in the absence of APAC or ALI. With appropriate perioperative management, DMEK may provide favorable long-term outcomes in these eyes.
METHODS: This multicenter retrospective observational study included 96 eyes that underwent Descemet membrane endothelial keratoplasty (DMEK) for endothelial dysfunction between 2015 and 2025 with ≥12 months of follow-up. The primary comparative analyses compared eyes with Fuchs endothelial corneal dystrophy (FECD) and eyes with endothelial dysfunction associated with a shallow AC. The shallow anterior chamber phenotype group comprised eyes with a documented history of APAC or ALI (PACD/ALI) and those without a documented history of either condition (shallow-AC). Anterior chamber depth (ACD), axial length, corneal thickness, endothelial parameters, and postoperative outcomes were compared between groups.
RESULTS: Pre-cataract ACD was significantly shallower in the shallow anterior chamber phenotype group than in the FECD group (1.93 ± 0.40 mm vs. 2.28 ± 0.27 mm, P < 0.001), and this relative difference persisted after cataract surgery. Within the shallow anterior chamber phenotype group, 10 eyes were classified as shallow-AC and had no documented history of APAC or ALI. Five-year graft survival after DMEK exceeded 90% and did not differ significantly between the shallow anterior chamber phenotype and FECD groups, nor between PACD/ALI and shallow-AC subgroups.
CONCLUSIONS: A shallow anterior chamber may be associated with corneal endothelial decompensation, even in the absence of APAC or ALI. With appropriate perioperative management, DMEK may provide favorable long-term outcomes in these eyes.