AB028. Corneal endothelium decompensation in patients with chronic hypotony after glaucoma surgery
Bibliographic record
Abstract
Background: To describe and discuss four cases of corneal endothelial decompensation secondary to chronic hypotony after glaucoma surgery. Methods: A retrospective case review was undertaken for four4 patients over a 20-year period from a single glaucoma surgeon. These data were collected from the clinical records of each subject included in the study: (I) patient demographic characteristics; (II) past ocular history and indication for surgery; (III) ocular vitals; (IV) complications from glaucoma surgery; (V) corneal exam and pathology and the indication for corneal transplant; (VI) surgical interventions during the period of follow-up. Results: Four patients sustained chronic hypotony (range, 3–18 years) after glaucoma surgery. In most of these eyes during relative hypotony, long thin vertical folds were often noted in the superficial cornea (possibly involving Bowman’s layer and the epithelium), leading to fluorescein pooling. They subsequently developed marked corneal pathologies including stromal edema, diminished endothelial density, microcyst formation, corneal erosion, Descemet folds, superficial punctate keratitis and bullous keratopathy. Three of them received Descemet stripping automated endothelial keratoplasty (DSAEK) and regained functional vision. Conclusions: This case series demonstrates a unique clinical entity in which corneal endothelial demise developed in the context of chronic hypotony. The mechanism underlying this entity, which we term “chronic hypotony corneal endotheliopathy (CHCE)”, remains unclear. We hypothesize that it can be due to a combination of tectonic instability and energy disturbance of the cornea. In clinical practice, it is important to monitor endothelial cell count in patients with persistent hypotony, especially those who had procedures such as glaucoma surgery that can precipitate endothelial injury.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".