A new treatment modality for corneal oedema

July 1, 2014

Currently, there is no treatment to promote the healing of endothelial cells, however, the extent of the corneal oedema can be controlled. In this article, Prof. Feinbaum discusses a new treatment option aimed at alleviating complications of visual loss and pain secondary to corneal oedema.

The endothelial cells of the cornea are arranged in a single layer. These cells rarely divide, therefore, when they are damaged they are not replaced. To mend the gap left by the damaged cells, the surviving cells change in size and shape to fill their places. In addition, fluids leak into the gaps left by the damaged cells.

Optical performance is diminished because:

Symptoms

Distorted or blurred vision is the most notable early symptom of corneal oedema. It may often become worse when the person wakes up after a night's sleep and then improves throughout the day.

Other notable symptoms of corneal oedema are: eye discomfort, halos around light, sensitivity to foreign particles and photophobia (increased sensitivity to light).

As corneal oedema progresses, it may become more painful and include blisters that form on the surface of the eye. The disorder may cause corneal nerves to rupture, resulting in severe pain.

Causes

This medical condition is caused by problems associated with dehydration, endothelial disorder, ocular surgery, viral infections, traumatic injury, increased ocular pressure and toxins.

Endothelial Fuch's dystrophy is the most common cause of this problem. It is a genetic disorder, which is characterized by the gradual loss of the endothelial cells. Women are usually at a higher risk of endothelial dystrophy than men.

An infection by the herpes virus may also result in an inflammatory response in the cornea, leading to corneal oedema. This condition may also occur right away or after a few years of undergoing any kind of ocular surgery.

Corneal oedema can develop as a postoperative condition after eye surgery. Cataract surgeries are the most likely procedures to present with corneal oedema complications. When it develops after a surgery to remove cataracts, it can be described as pseudophakic corneal oedema, pseudophakic bullous keratopathy or aphakic bullous keratopathy.

Corneal oedema is more commonly found in people who are 50 years and older.