title: Corneal endothelium self-healing mathematical model after inadvertent descemetorhexis.
abstract: An 85-year-old man presented with an unusual complication of cataract surgery. During injection of an ophthalmic viscosurgical device, Descemet membrane was accidentally dissected and removed during the capsulorhexis. Early postoperative visual acuity was counting fingers as a result of massive corneal edema. Using a mathematical model of the endothelium, we evaluated the corneal endothelial cell self-healing capacity from the periphery by calculating the theoretical endothelial cell density (ECD) after corneal endothelial cell redistribution. The calculated theoretical ECD was 1592 cells/mm(2). At 22 months, the corrected distance visual acuity improved to 20/25. The central ECD was 549 cells/mm(2), 516 cells/mm(2), 987 cells/mm(2), and 1344 cells/mm(2) at 5, 8, 16, and 22 months, respectively. The originality of this case is based on the mathematical simulation of the corneal endothelial cell's spontaneous self-healing process, deferring keratoplasty.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: From the Ophthalmology Department (Jullienne, Manoli, Thuret, Gain), University Hospital, Corneal Graft Biology (Jullienne, Tiffet, He, Thuret, Gain), Engineering and Imaging Laboratory, EA2521, Federative Institute of Research in Sciences and Health Engineering, Health & Innovation Pole, Jean Monnet University, Ecole Nationale Supérieure des Mines de Saint-Etienne (Rannou), Eye Bank of Saint-Etienne (Thuret, Gain), Auvergne-Loire Blood Centre, Saint-Etienne, and the Institut Universitaire de France (Thuret), Paris, France.
authors.forename: Rémy
authors.initials: R
authors.lastname: Jullienne
authors.affiliation: From the Ophthalmology Department (Jullienne, Manoli, Thuret, Gain), University Hospital, Corneal Graft Biology (Jullienne, Tiffet, He, Thuret, Gain), Engineering and Imaging Laboratory, EA2521, Federative Institute of Research in Sciences and Health Engineering, Health & Innovation Pole, Jean Monnet University, Ecole Nationale Supérieure des Mines de Saint-Etienne (Rannou), Eye Bank of Saint-Etienne (Thuret, Gain), Auvergne-Loire Blood Centre, Saint-Etienne, and the Institut Universitaire de France (Thuret), Paris, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Manoli
authors.affiliation: From the Ophthalmology Department (Jullienne, Manoli, Thuret, Gain), University Hospital, Corneal Graft Biology (Jullienne, Tiffet, He, Thuret, Gain), Engineering and Imaging Laboratory, EA2521, Federative Institute of Research in Sciences and Health Engineering, Health & Innovation Pole, Jean Monnet University, Ecole Nationale Supérieure des Mines de Saint-Etienne (Rannou), Eye Bank of Saint-Etienne (Thuret, Gain), Auvergne-Loire Blood Centre, Saint-Etienne, and the Institut Universitaire de France (Thuret), Paris, France.
authors.forename: Théophile
authors.initials: T
authors.lastname: Tiffet
authors.affiliation: From the Ophthalmology Department (Jullienne, Manoli, Thuret, Gain), University Hospital, Corneal Graft Biology (Jullienne, Tiffet, He, Thuret, Gain), Engineering and Imaging Laboratory, EA2521, Federative Institute of Research in Sciences and Health Engineering, Health & Innovation Pole, Jean Monnet University, Ecole Nationale Supérieure des Mines de Saint-Etienne (Rannou), Eye Bank of Saint-Etienne (Thuret, Gain), Auvergne-Loire Blood Centre, Saint-Etienne, and the Institut Universitaire de France (Thuret), Paris, France.
authors.forename: Zhiguo
authors.initials: Z
authors.lastname: He
authors.affiliation: From the Ophthalmology Department (Jullienne, Manoli, Thuret, Gain), University Hospital, Corneal Graft Biology (Jullienne, Tiffet, He, Thuret, Gain), Engineering and Imaging Laboratory, EA2521, Federative Institute of Research in Sciences and Health Engineering, Health & Innovation Pole, Jean Monnet University, Ecole Nationale Supérieure des Mines de Saint-Etienne (Rannou), Eye Bank of Saint-Etienne (Thuret, Gain), Auvergne-Loire Blood Centre, Saint-Etienne, and the Institut Universitaire de France (Thuret), Paris, France.
authors.forename: Klervi
authors.initials: K
authors.lastname: Rannou
authors.affiliation: From the Ophthalmology Department (Jullienne, Manoli, Thuret, Gain), University Hospital, Corneal Graft Biology (Jullienne, Tiffet, He, Thuret, Gain), Engineering and Imaging Laboratory, EA2521, Federative Institute of Research in Sciences and Health Engineering, Health & Innovation Pole, Jean Monnet University, Ecole Nationale Supérieure des Mines de Saint-Etienne (Rannou), Eye Bank of Saint-Etienne (Thuret, Gain), Auvergne-Loire Blood Centre, Saint-Etienne, and the Institut Universitaire de France (Thuret), Paris, France. Electronic address: gilles.thuret@univ-st-etienne.fr.
authors.forename: Gilles
authors.initials: G
authors.lastname: Thuret
authors.affiliation: From the Ophthalmology Department (Jullienne, Manoli, Thuret, Gain), University Hospital, Corneal Graft Biology (Jullienne, Tiffet, He, Thuret, Gain), Engineering and Imaging Laboratory, EA2521, Federative Institute of Research in Sciences and Health Engineering, Health & Innovation Pole, Jean Monnet University, Ecole Nationale Supérieure des Mines de Saint-Etienne (Rannou), Eye Bank of Saint-Etienne (Thuret, Gain), Auvergne-Loire Blood Centre, Saint-Etienne, and the Institut Universitaire de France (Thuret), Paris, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Gain
mesh_terms: D000369:Aged, 80 and over; D019923:Capsulorhexis; D002452:Cell Count; D015715:Corneal Edema / Q000209:etiology* / Q000503:physiopathology; D055954:Corneal Endothelial Cell Loss / Q000209:etiology* / Q000503:physiopathology; D003886:Descemet Membrane / Q000293:injuries*; D004728:Endothelium, Corneal / Q000473:pathology; D006801:Humans; D007431:Intraoperative Complications; D019654:Lens Implantation, Intraocular; D008297:Male; D008962:Models, Theoretical; D018918:Phacoemulsification / Q000009:adverse effects*; D066167:Slit Lamp; D041623:Tomography, Optical Coherence; D055675:Viscosupplements / Q000008:administration & dosage; D014792:Visual Acuity; D014945:Wound Healing / Q000502:physiology*
chemical_list: D055675:Viscosupplements