ArticleDocumenta ophthalmologica. Advances in ophthalmology2026
Supernormal flicker ERG with postoperative CME after nDSAEK in bullous keratopathy.
Article in Documenta ophthalmologica. Advances in ophthalmology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo report a case of supernormal electroretinogram (ERG) observed after non-Descemet stripping automated endothelial keratoplasty (nDSAEK) in a patient with bullous keratopathy, monitored longitudinally with flicker ERG and OCT.
methodsA woman in her 70s underwent nDSAEK for bullous keratopathy. Postoperative retinal function was evaluated serially using full-field flicker ERG recorded with the RETeval system, together with macular OCT when feasible.
resultsOn postoperative day 4, flicker ERG in the operated eye showed a prolonged implicit time (34.4 ms vs. 31.9 ms) and a markedly increased amplitude (31.4 μV vs. 19.2 μV) compared with the fellow eye. Macular OCT could not be obtained at that time. At the 3-week postoperative visit, OCT revealed cystoid macular edema (CME), and the flicker ERG amplitude was further increased with a slightly shorter implicit time. With topical nepafenac, CME gradually regressed and resolved by 1 year, accompanied by improvement in best-corrected visual acuity to 1.0; the flicker ERG amplitude and implicit time returned to levels comparable to those of the fellow eye.
conclusionsThis case illustrates that transiently increased ERG amplitude accompanied by subtle prolongation of implicit time may occur following nDSAEK and could be associated with postoperative intraocular inflammation and CME. Serial RETeval-based flicker ERG may be useful for monitoring perioperative inflammatory responses after endothelial keratoplasty.
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