Corneal Artificial Endothelial Layer (Endoart®) In Outstanding Patients : Outcomes From A Case Series

To describe the surgical approach and outcomes following artificial endothelial layer (Endoart®) implantation in chronic corneal edema.

Retrospective study 

Fifteen eyes of fifteen patients with chronic corneal edema, were implanted with an artificial endothelial keratoprothesis (EndoArt®, EyeYon Medical, Israel) several months after at least one DMEK failure or as a first-line procedure to improve anterior segment visibility ahead of a second procedure (PKE+DMEK) in outstanding procedures with a modified technique. The EndoArt® was retained on the posterior surface of the cornea using an air bubble mixed with SF6 gas, and one to four transcorneal sutures. Outcomes included changes in central corneal thickness, best-corrected visual acuity (logMAR), rebubbling rate and postoperative complications.

Preoperative central corneal thickness (844 ± 236µm) decreased significantly postoperatively in all patients (618 μm ± 251μm; p<0.05). 53,3% (8/15) of patients required at least one rebubbling. 80% of patients (12/15) were pseudophakic at the time of surgery.

Mean corrected AV improved significantly from ... ± ... LogMAR preoperatively to ...±... LogMAR at final follow-up.

EndoArt® is a highly promising treatment for chronic corneal edema in complex cases where conventional endothelial keratoplasty has failed or is at high risk of not being successful. It improves visual acuity and significantly reduces corneal thickness within 3 to 6 months of surgery.