Cultured Human Corneal Endothelial Cell Injection (Vyznova) in Eyes with Extremely Low Intraocular Pressure After Glaucoma Surgery: Case Reports.
Rintaro Ogino, Mariko Shirane, Osama Ibrahim et al.
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Case in brief
Two patients with bullous keratopathy and intraocular pressure (IOP) of ≤4 mm Hg after glaucoma-filtering surgery received cultured human corneal endothelial cell (cHCEC) injection with Vyznova. In both eyes, corneal clarity improved, visual acuity increased, and central corneal thickness decreased; endothelial cell density was maintained through 3 months. IOP remained low in both patients. The authors report that cHCEC therapy may offer an alternative for bullous keratopathy when conventional endothelial keratoplasty is considered high risk because of very low IOP.
What made this case unusual
The treatment was used in eyes with extremely low IOP, where inadequate anterior chamber support can make endothelial keratoplasty prone to graft detachment and early failure.
Diagnostic / clinical pearl
In bullous keratopathy after glaucoma surgery, very low IOP may complicate graft-based endothelial keratoplasty; cHCEC injection was associated with corneal and visual improvement in these two cases.
Why it matters
These cases suggest a potential graft-free option when low IOP makes conventional endothelial keratoplasty high risk, although the report does not establish comparative efficacy.