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Updated: Jul 12, 2026

Corneal Donor Tissue Preparation for Endothelial Keratoplasty
Published on: June 12, 2012
Unexpected corneal endothelial cell decompensation after intraocular surgery with instruments sterilized by plasma
C A Smith1, J M Khoury, S M Shields
1Department of Ophthalmology and Visual Sciences, Washington University, St. Louis, Missouri, USA. smithc@vision.wustl.edu
Purpose:
Ten cases of unexpected corneal endothelial cell decompensation occurring after routine intraocular surgery using instruments sterilized with a new plasma gas protocol are described.
Design:
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.
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