Cultured Human Corneal Endothelial Cell Injection Therapy in Phakic Eyes with Bullous Keratopathy.

Abstract

To evaluate the safety and efficacy of cultured human corneal endothelial cell (cHCEC) injection therapy in phakic eyes with bullous keratopathy (BK), for which endothelial keratoplasty may accelerate cataract progression due to intraoperative manipulation and postoperative gas tamponade. Multicenter retrospective interventional case series. Five consecutive phakic eyes of 5 patients with BK who underwent cHCEC injection therapy and completed 6 months of follow-up. Best-corrected visual acuity (BCVA), central corneal thickness (CCT), endothelial cell density (ECD), intraocular pressure (IOP) and cataract progression. Mean logMAR best-corrected visual acuity (BCVA) improved from 1.06 ± 0.57 preoperatively to 0.22 ± 0.36 at 6 months (mean change, -0.84; 95% CI, -1.32 to -0.36; P = .008). Mean central corneal thickness (CCT) decreased from 782 ± 104 μm to 578 ± 61 μm (mean change, -204 μm; 95% CI, -306 to -102 μm; P = .005). Corneal clarity improved in all eyes and remained stable throughout the 6-month follow-up. Endothelial cell density (ECD) was not measurable preoperatively because of severe corneal edema. At 6 months, postoperative ECD ranged from 693 to 1622 cells/mm². Mean intraocular pressure (IOP) changed from 10.1 ± 4.3 mm Hg to 11.7 ± 3.1 mm Hg (mean change, 1.54 mm Hg; 95% CI, -4.39 to 7.47 mm Hg; P = .511). No intraoperative or postoperative complications, including cystoid macular edema, were observed. No clinically significant cataract progression was noted during follow-up. cHCEC injection therapy demonstrated favorable short-term clinical outcomes in phakic eyes with BK and may represent a promising lens-preserving treatment option. Larger controlled studies with longer follow-up are warranted.