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Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology 2/2024

12.06.2023 | Review Article

Emerging treatments for corneal endothelium decompensation — a systematic review

verfasst von: Noel Cheong, Siu Wa Chui, Stephanie Hiu Ling Poon, Ho Lam Wong, Kendrick Co Shih, Yau Kei Chan

Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology | Ausgabe 2/2024

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Abstract

Purpose

Endothelial keratoplasty (EK) is the conventional treatment to improve visual acuity of corneal endothelium decompensation (CED) patients, with other therapies mainly for symptomatic relief. However, the shortage of corneal grafts and other limitations to EK urge the development of novel alternative treatments. In the last decade, novel options have been proposed, yet only a limited number of reviews have systematically reported on outcomes. Therefore, this systematic review evaluates the existing clinical evidence of novel surgical approaches for CED.

Method

We identified 24 studies that illustrated the clinical observations of the surgical approaches in interest. We included Descemet stripping only (DSO), Descemet membrane transplantation (DMT) where Descement membrane alone instead of corneal endothelium with cells is transplanted, and cell-based therapy.

Results

In general, these therapies may provide visual outcomes comparable with EK under specific conditions. DSO and DMT target CED with relatively healthy peripheral corneal endothelium like Fuchs’ corneal endothelial dystrophy, while cell-based therapy offers more versatile applications. Side effects of DSO would decrease with modifications to surgical techniques. Moreover, Rho-associated protein kinase inhibitor adjuvant therapy could enhance clinical results in DSO and cell-based therapy.

Conclusion

Long-term controlled clinical trials with larger sample size on the therapies are needed. The simplicity of DSO and the high translational potential of cell-based therapy to treat CED of most etiologies made these two treatment strategies promising.
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Metadaten
Titel
Emerging treatments for corneal endothelium decompensation — a systematic review
verfasst von
Noel Cheong
Siu Wa Chui
Stephanie Hiu Ling Poon
Ho Lam Wong
Kendrick Co Shih
Yau Kei Chan
Publikationsdatum
12.06.2023
Verlag
Springer Berlin Heidelberg
Erschienen in
Graefe's Archive for Clinical and Experimental Ophthalmology / Ausgabe 2/2024
Print ISSN: 0721-832X
Elektronische ISSN: 1435-702X
DOI
https://doi.org/10.1007/s00417-023-06129-7

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