Unexpected corneal endothelial cell decompensation after intraocular surgery with instruments sterilized by plasma gas.
OBJECTIVE
Ten cases of unexpected corneal endothelial cell decompensation occurring after routine intraocular surgery using instruments sterilized with a new plasma gas protocol are described.


METHODS
A retrospective observational case series with 1 year of follow-up was conducted.


RESULTS
All patients had corneal decompensation and nonreactive pupils after surgery. Six patients required penetrating keratoplasty. Three patients partially recovered pupillary function. Visual acuity at 1 year ranged from 20/20 to hand motion (HM). One patient with an anterior chamber intraocular lens (ACIOL) experienced optic atrophy and HM vision despite resolution of corneal edema.


CONCLUSIONS
Toxic corneal endothelial cell destruction syndrome was associated with the introduction of plasma gas sterilization protocols.
Department of Ophthalmology and Visual Sciences, Washington University, St. Louis, Missouri, USA. smithc@vision.wustl.edu
C A
CA
Smith
J M
JM
Khoury
S M
SM
Shields
G J
GJ
Roper
R E
RE
Duffy
H F
HF
Edelhauser
A J
AJ
Lubniewski
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003300:Copper / Q000009:adverse effects*; D015715:Corneal Edema / Q000139:chemically induced* / Q000473:pathology; D004728:Endothelium, Corneal / Q000187:drug effects* / Q000473:pathology; D004866:Equipment Contamination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000295:instrumentation; D011681:Pupil Disorders / Q000139:chemically induced / Q000473:pathology; D012189:Retrospective Studies; D013242:Sterilization / Q000295:instrumentation / Q000379:methods; D013577:Syndrome; D014792:Visual Acuity; D015032:Zinc / Q000009:adverse effects*
D003300:Copper; D015032:Zinc