CORNEAL ENDOTHELIAL POLISHING FOR PIGMENT DEPOSIT REMOVAL, FOLLOWING CATARACT SURGERY: A NOVEL APPROACH.

To present a novel technique to remove corneal endothelial pigment deposits, following uneventful phacoemulsification and IOL implantation in a 77-year-old male patient.

Cornea Department, State Ophthalmology Clinic, GHA G. Gennimatas, Athens, Greece

This is a case report of a Caucasian 77-year-old male patient, referred to the Cornea Department of our hospital for cornea evaluation and scheduling of complex cataract surgery in the right eye (OD). The left eye (OS) was already pseudophakic. Best corrected visual acuity (BCVA) was 4/10 and 7/10 in the right and left eye respectively, while IOP (intraocular pressure) was 14 mm Hg in both eyes. Slit lamp examination revealed a temporal wedged-shaped area of endothelial pigment deposits on the right cornea, extending to the visual axis, as well as a corneal scar and neovascularization at the temporal limbus. Anterior chamber was deep and quiet, iris presented temporal stromal atrophy, while nuclear and cortical cataract was diagnosed upon examination. Dilated fundus examination was unremarkable. Slit lamp examination of the left eye was also unremarkable. The patient’ s ocular history only revealed penetrating ocular trauma (OD) forty years before.

Patient was originally scheduled for a combined phacoemulsification surgery with descemet stripping only (DSO) OD. However, the surgical approach was modified intraoperatively: bimanual endothelial polishing was performed following phacoemulsification instead of DSO. The area was successfully cleared, using low flow bimanual I/A. On the first postoperative day slit lamp examination revealed local corneal oedema that resolved on the sixth postoperative day. BCVA OD was 7/10 one month postoperatively.

Bimanual polishing is herewith first described as a novel technique to remove corneal endothelial pigment deposits.