Keratopathy, Pseudophakic Bullous Workup

  • Author: James V Aquavella, MD; Chief Editor: Hampton Roy Sr, MD   more...
 
Updated: Apr 27, 2010
 

Procedures

A number of studies can be helpful in confirming the diagnosis and in offering a reasonable prognosis for the patient.

  • A thorough slit lamp examination, confirming increased corneal stromal edema with the Descemet folds and, perhaps, secondary epithelial edema, is most important.
  • Pachymetry readings obtained either by optical methods or with ultrasound can confirm increases in corneal thickness. Central pachymetry values in excess of 590 microns in a pseudophakic eye may be associated with irreversible corneal edema.
  • Specular microscopic studies can also be used to determine the endothelial cell morphology.

In the final analysis, visual acuity and the patient's level of functional capacity determine the prognosis. Quite often, corneal edema, while progressive, can afford reasonable levels of visual acuity for many years. Consequently, surgical intervention should be based more upon the patient's needs than upon the degree of corneal decompensation.

Proceed to Treatment & Management
 
 
Contributor Information and Disclosures
Author

James V Aquavella, MD  Professor of Ophthalmology, Department of Ophthalmology, University of Rochester School of Medicine, University of Rochester Eye Institute

James V Aquavella, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, American Medical Association, Contact Lens Association of Ophthalmologists, and International College of Surgeons

Disclosure: Nothing to disclose.

Coauthor(s)

Holly Hindman, MD  Assistant Professor, Cornea and External Disease, Department of Ophthalmology, University of Rochester Eye Institute

Holly Hindman, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, Association for Research in Vision and Ophthalmology, Association of University Professors of Ophthalmology, Contact Lens Association of Ophthalmologists, and Cornea Society

Disclosure: Nothing to disclose.

Zoe R Williams, MD  Assistant Professor, Department of Ophthalmology, University of Rochester School of Medicine, Strong Memorial Hospital

Zoe R Williams, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Ophthalmology

Disclosure: Nothing to disclose.

Gregory J McCormick, MD  Consulting Staff, Corneal and Refractive Surgery, Vermont Laser Vision at Timber Lane and Ophthalmic Consultants of Vermont

Gregory J McCormick, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, International Society of Refractive Surgery, and Medical Society of the State of New York

Disclosure: Nothing to disclose.

Specialty Editor Board

Fernando H Murillo-Lopez, MD  Senior Surgeon, Unidad Privada de Oftalmologia CEMES

Fernando H Murillo-Lopez, MD is a member of the following medical societies: American Academy of Ophthalmology

Disclosure: Nothing to disclose.

Simon K Law, MD, PharmD  Assistant Professor of Ophthalmology, Jules Stein Eye Institute; Chief of Section of Ophthalmology Surgical Services, Department of Veterans Affairs Healthcare Center, West Los Angeles

Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology

Disclosure: Nothing to disclose.

Christopher J Rapuano, MD  Professor, Department of Ophthalmology, Jefferson Medical College of Thomas Jefferson University; Co-Chairman of the Cornea Service, Co-Chairman of Refractive Surgery Department, Wills Eye Institute

Christopher J Rapuano, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, Contact Lens Association of Ophthalmologists, Cornea Society, Eye Bank Association of America, International Society of Refractive Surgery, and Pan-American Association of Ophthalmology

Disclosure: Allergan Honoraria Speaking and teaching; Allergan Consulting fee Consulting; Alcon Honoraria Speaking and teaching; Inspire Honoraria Speaking and teaching; RPS Ownership interest Other; Vistakon Honoraria Speaking and teaching; EyeGate Pharma Consulting; Inspire Consulting fee Consulting; Bausch & Lomb Honoraria Speaking and teaching

Lance L Brown, OD, MD  Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri

Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD  Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

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