Alkatan Hind M, Aljenaidel Abdullah M, Maktabi Azza My, Abusayf Mohammed M, Alfawaz Abdullah M
Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.
Sci Rep. 2025 Apr 13;15(1):12751. doi: 10.1038/s41598-025-97873-9.
Corneal endothelial cell dysfunction is a common cause of corneal decompensation in elderly. We describe a non-guttata corneal endothelial dystrophy with correlation of the clinical features to the histopathological and ultrastructural characteristics in a cohort of Saudi patients. A retrospective study of all consecutive cases of primary corneal decompensation in phakic eyes due to endothelial attenuation, in the absence of guttata is conducted. Patients were treated by either penetrating keratoplasty (PKP) or Descemet's Stripping Automated Endothelial Keratoplasty (DSAEK) as a primary procedure between 2002 and 2016. Clinical and demographic data were obtained through chart review and the histopathological data were collected by reviewing Descemet's membrane (DM) in the corneal tissue samples of the affected eyes. We included 17 eyes from 17 patients (10 females and 7 males), with a mean age of 67.17 ± 8.98 years. All patients were phakic, and decreased vision was the patients' main complaint at presentation. The pre-operative endothelial cell count was obtained in 3 eyes with a mean of 531.7 ± 309.5/mm. Histopathology of the 17 corneal specimens showed thick multi-laminated DM and attenuated endothelium. The success rate of the primary procedure was 70%. The cornea of the other eye remained clear in 12/17 patients. This is a type of corneal endothelial cell dysfunction with a late onset of presentation, spontaneous corneal decompensation in phakic eyes or a rapid onset of decompensation following uncomplicated surgery. It seems to be asymmetrically bilateral among our Saudi patients. Fellow eyes are at the same risk of decompensation. DM lacks the presence of guttata clinically and histopathologically.
角膜内皮细胞功能障碍是老年人角膜失代偿的常见原因。我们描述了一组沙特患者中一种非滴状角膜内皮营养不良，并将其临床特征与组织病理学和超微结构特征相关联。对所有因内皮细胞变薄导致的有晶状体眼原发性角膜失代偿且无滴状病变的连续病例进行了回顾性研究。在2002年至2016年期间，患者接受穿透性角膜移植术（PKP）或深板层内皮角膜移植术（DSAEK）作为主要手术治疗。通过查阅病历获得临床和人口统计学数据，并通过检查患眼角膜组织样本中的Descemet膜（DM）收集组织病理学数据。我们纳入了17例患者的17只眼（10例女性和7例男性），平均年龄为67.17±8.98岁。所有患者均为有晶状体眼，视力下降是患者就诊时的主要主诉。3只眼获得了术前内皮细胞计数，平均值为531.7±309.5/mm²。17个角膜标本的组织病理学显示DM增厚且多层，内皮细胞变薄。主要手术的成功率为70%。17例患者中有12例对侧眼的角膜保持透明。这是一种角膜内皮细胞功能障碍类型，表现为发病较晚，有晶状体眼角膜自发失代偿或在无并发症的手术后迅速发生失代偿。在我们的沙特患者中似乎呈不对称双侧性。对侧眼有相同的失代偿风险。DM在临床和组织病理学上均无滴状病变。
