PMC3704543_01
Slit lamp photographs, anterior segment optical coherence tomography (AS-OCT) image, and specular micrograph of the left eye before surgery. Slit lamp microscopy reveals iridoschisis in the inferior quadrant (A) and partial corneal edema in this portion (B). AS-OCT depicts a shallow anterior chamber with a separated anterior leaf of the iris touching the corneal endothelium (C). Specular microscopy of superior cornea shows endothelial cell loss (D).
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A localized area of diffuse corneal edema was observed, at the site where the separated anterior iris leaf touched the corneal endothelium (Figure 1A and B). Tomey Corporation, Nagoya, Japan) confirmed that the anterior leaf was separated and touched the corneal endothelium (Figure 1C). The superior cornea could be evaluated by specular microscopy (Nonconrobo II, FA3809, Konan Medical, Inc., Hyogo, Japan) but not the central and inferior cornea because of corneal edema. The endothelial cell density at superior cornea was 354 cells/mm2 (Figure 1D).
Slit lamp photographs of the left eye after cataract surgery with iridectomy. After the first surgery, slit lamp microscopy shows the implanted intraocular lens and partial removal of the iris in the lower quadrant (A). Corneal edema with Descemet's folds are observed even in central corneal stroma (B).. Note: The pupil appears slightly dilated due to the sphincterotomy and use of iris-retractor hooks during operation.
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A slit lamp photograph after surgery showed that the separated anterior iris leaf had been removed by iridectomy (Figure 2A), but the area of corneal edema was enlarged (Figure 2B).
Slit lamp photograph, anterior segment optical coherence tomography (AS-OCT) image, and specular micrograph of the left eye after surgery. Slit lamp photograph at 6 months after nDSAEK shows that corneal edema has resolved (A). The pupil is slightly dilated with irregular margin due to sphincterotomy, and inferior iris atrophy is due to iridectomy. Other part of the iris is normal. AS-OCT image at 6 months post-nDSAEK shows adherence of the transplanted graft to recipient's cornea, and iris defect due to iridectomy (B). Specular micrograph at 18 months post-nDSAEK shows high endothelial cell density in the center of the cornea (C).
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A slit lamp photograph taken at 6 months after operation showed that the recipient and grafted cornea were transparent (Figure 3A). AS-OCT revealed good adherence of the graft to the recipient cornea (Figure 3B). The BCVA of her left eye improved to 1.0 and endothelial cell density of central cornea was 2174 cells/mm2 at 18 months after transplantation (Figure 3C).