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The iridocorneal endothelial (ICE) syndrome is potentially a blinding condition as a result of glaucoma and/or corneal decompensation. The basic pathology seems to be in the corneal endothelium, which many studies confirm takes on a characteristic slit lamp appearance of hammered silver and image reversal with the specular microscope. The origin and morphology of the abnormal cells are unknown. Many histopathological studies of keratoplasty and trabeculectomy specimens reveal as many cell types. This paper reports some general and specular microscopical data from 57 cases of the syndrome, argues that the reason for the variety of histopathological findings in other studies is due to poor sampling of the study material, deduces the morphology of the abnormal cells on specular microscopical criteria, and compares the specular and scanning electron microscopical images in one case with those of other reports. It is tentatively concluded that the appearance of the abnormal cells is a function of their three-dimensional shape and that they produce blister-like vesicles that rupture, collapse, and eventually invaginate.
Cornea 1991 May
PMID:On the morphology of cells of posterior cornea in the iridocorneal endothelial syndrome. 205 30

We describe a modified technique for performing Descemet stripping automated endothelial keratoplasty (DSAEK) in a patient with aphakia and vitrectomized eye. A 72-year-old woman presented with corneal decompensation after a complicated cataract surgery and a subsequent vitreoretinal procedure. Before commencing DSAEK, a pars plana infusion cannula was inserted 3 mm from the limbus. The infusion fluid in the vitrectomized posterior segment helped circumvent potential complications, such as recurrent globe collapse, posterior dislocation of the donor disc, and loss of air tamponade. Increasing the infusion pressure allowed the surgeon to levitate the air bubble, effectively vaulting the donor disc against the recipient host bed. This modified approach helps overcome the possible complications of DSAEK in aphakic vitrectomized eyes and enhances donor adherence.
Cornea 2012 Apr
PMID:Modified surgical technique for improving donor adherence in DSAEK in the aphakic vitrectomized eye. 2194 Nov 72

Although Descemet stripping automated endothelial keratoplasty (DSAEK) has become widespread as a first choice for the treatment of bullous keratopathy, corneal endothelial cell loss during the early postoperative period caused by intraoperative mechanical stress to the donor endothelium remains a clinical challenge. At present, a pull-through technique is the standard procedure for graft delivery in DSAEK. However, the anterior chamber is likely to collapse during graft delivery in patients with a small eye or shallow anterior chamber, as often seen in Asian patients, leading to endothelial cell damage. To solve this problem, we developed a new device for DSAEK, known as NS Endo-Inserter, in which the graft flows into the anterior chamber in a balanced salt solution in one step. This article reviews the features of NS Endo-Inserter and the outcomes of DSAEK using this device.
Cornea 2019 Nov
PMID:NS Endo-Inserter: A New Graft Inserter for Descemet Stripping Automated Endothelial Keratoplasty. 3140 31