Posters

Atypical presentation of iridocorneal endothelial syndrome with band keratopathy but no corneal edema managed with DMEK

Poster Details

First Author: D.Santander-Garcia SPAIN

Co Author(s):    V. Zygoura   I. Lavi   R. Verdijk   L. Baydoun   I. Dapena   G. Melles     

Abstract Details

Purpose:

To report an unusual presentation of iridocorneal endothelial (ICE) syndrome associated with band keratopathy and its management with ethylenediamine-tetraacetic acid (EDTA) chelation and Descemet membrane endothelial keratoplasty (DMEK).

Setting:

The Netherlands Institute for Innovative Ocular Surgery / Tertiary referral center.

Methods:

A 57-year-old female patient presented with unilateral progressing painless visual impairment, corneal band keratopathy and morphological corneal endothelial changes without corneal edema or any previous ophthalmic, medical or family history. Routine specular and confocal microscopy imaging, as well as biomicroscopy, best-corrected visual acuity (BCVA) and pachymetry measurements were performed before and after the surgical procedures. Histopathologic and immunohistochemical evaluations of the surgically excised diseased Descemet membrane-endothelium were performed.

Results:

Superficial epithelial keratectomy with EDTA chelation was carried out. Following an initial few months period of corneal clearance, the patient presented with a visually significant band keratopathy recurrence. One year later, she underwent re-treatment with superficial epithelial keratectomy and EDTA chelation, followed by DMEK. Histopathologic and immunohistochemical analysis showed ICE syndrome. Two years after DMEK surgery, the cornea was still clear and the band keratopathy had not recurred.

Conclusions:

To the best of our knowledge this is the first case in literature which reports the association of ICE syndrome with band keratopathy. As the band keratopathy recurred shortly after the EDTA chelation, endothelial keratoplasty (DMEK) may be indicated to successfully treat such cases.

Financial Disclosure:

receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented