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Ritika Mukhija, Noopur Gupta, Anita Ganger, Seema Kashyap, Nishat Hussain, Murugesan Vanathi, Radhika Tandon
PURPOSE: To report an unusual case of isolated Acremonium eumycetoma presenting as a protuberant mass over the cornea. METHODS: Case report and literature review. RESULTS: A 55-year-old male patient referred to our center with a case of perforated corneal ulcer with uveal tissue prolapse was examined in the casualty department and found to have central melt, approximately 8 mm, along with suspected uveal tissue prolapse. A provisional diagnosis of sloughed corneal ulcer with uveal prolapse was made along with differential diagnoses of fungal ball and infected foreign body granuloma...
September 18, 2018: Cornea
Andrew Walkden, Catherine Fullwood, Shi Zhuan Tan, Leon Au, Malcolm Armstrong, Arun K Brahma, Jaya D Chidambaram, Fiona Carley
PURPOSE: Microbial keratitis (MK) is a major cause of corneal blindness worldwide. Variations in season and temperature can affect MK incidence due to specific causative organisms; however, few studies have examined these factors in the UK. METHODS: Retrospective review of all corneal scrapes from patients with MK presenting to Manchester Royal Eye Hospital, UK, between January 2004 and December 2015. Manchester's monthly temperature data were obtained from Met Office UK...
September 18, 2018: Cornea
Naoki Okumura, Keitaro Kobayashi, Naoya Ishida, Takato Kagami, Satoru Hiwa, Tomoyuki Hiroyasu, Noriko Koizumi
PURPOSE: To develop software to evaluate the fibroblastic morphological changes in cultured human corneal endothelial cells (HCECs) as a quality control measure for use in tissue engineering therapy. METHODS: Software was designed to recognize cell borders, to approximate cell shape as an ellipse, and to calculate the aspect ratio of the ellipse as an indicator of severity of the fibroblastic morphological change. Using the designed software, 60 phase contrast images of polygonal HCECs and 60 phase contrast images of fibroblastic HCECs were analyzed...
September 18, 2018: Cornea
Anand Pasari, Marianne O Price, Matthew T Feng, Francis W Price
PURPOSE: To evaluate outcomes and graft survival of Descemet membrane endothelial keratoplasty (DMEK) for failed penetrating keratoplasty (PK). METHODS: Ninety-three DMEK procedures performed in 84 eyes of 77 patients with failed PK were retrospectively reviewed. The main outcomes were corrected distance visual acuity and graft survival assessed with Kaplan-Meier survival analysis and proportional hazards modeling taking follow-up into consideration. RESULTS: Sixty-nine eyes had 1 previous failed PK, 13 had 2, 1 had 3, and 1 had 4...
September 14, 2018: Cornea
Nilufer Yesilirmak, Priyanka Chhadva, Florence Cabot, Anat Galor, Sonia H Yoo
PURPOSE: To study outcomes after surgical removal of epithelial ingrowth (EI) in post-laser in situ keratomileusis patients, specifically comparing visual results and recurrence rates between 2 different EI management techniques. METHODS: In this retrospective chart review of 67 eyes of 54 patients who underwent surgical treatment for EI after laser in situ keratomileusis between July 1999 and July 2014 at the Bascom Palmer Eye Institute, Miami, FL, surgical techniques, recurrence rates, visual acuity (VA), and refractive error were assessed...
September 14, 2018: Cornea
Hayyam Kiratli, Figen B Aygün, Gökhan Gedikoğlu
PURPOSE: To report a patient who developed unilateral corneal stromal infiltration while undergoing systemic chemotherapy for multinodal peripheral T-cell lymphoma not otherwise specified. METHODS: Clinical, imaging, and immunohistopathological features of a 40-year-old woman who presented with a stromal haze in the right cornea were reviewed. RESULTS: At initial presentation, her visual acuity in the right eye was 20/40. Slit-lamp examination showed stromal infiltration located mainly in the inferotemporal peripheral cornea without epithelial or limbal involvement...
September 14, 2018: Cornea
Rohit Dhakal, Ashik Mohamed, Sunita Chaurasia, Muralidhar Ramappa, Subhadra Jalali
PURPOSE: To evaluate the relationship between endothelial cell density (ECD) and mean corneal diameter (MCD) in eyes with uveal coloboma associated with microcornea. METHODS: Corneal endothelial cell imaging was performed using specular microscopy on 22 eyes of 18 subjects diagnosed with uveal coloboma associated with microcornea. The MCD was noted as the average of horizontal and vertical corneal diameters, which were measured using the ruler tool of the slit-lamp biomicroscope and Castroviejo calipers...
September 14, 2018: Cornea
Kazutaka Kamiya, Masahide Takahashi, Akihito Igarashi, Nobuyuki Shoji
PURPOSE: To compare the rate of central island (CI) and visual acuity after phototherapeutic keratectomy (PTK) with and without the CI program. METHODS: This retrospective study comprised 147 eyes of 89 consecutive patients (mean age ± SD, 71.1 ± 9.6 years) undergoing PTK with and without the anti-CI program [photorefractive keratectomy (PRK) mode and PTK mode] using the VISX Star S4 excimer laser system (Johnson & Johnson Vision, Santa Ana, US) for treatment of band keratopathy (BK) or granular corneal dystrophy (GCD)...
September 14, 2018: Cornea
Hamza Zafar, Shi Zhuan Tan, Andrew Walkden, Catherine Fullwood, Leon Au, Arun Brahma, Fiona Carley
PURPOSE: Changing trends of infective keratitis have been identified worldwide. The aim of this study was to define the clinical associations, characteristics, and outcomes of patients with culture-proven Moraxella keratitis from a large tertiary corneal unit in the United Kingdom. METHODS: Patients with confirmed Moraxella isolates presenting between January 2004 and November 2016 were analyzed. Patient-related factors were examined, including patient demographics, date of presentation, clinical presentation, predisposing factors, best-corrected visual acuity (BCVA), treatment plans, and clinical outcomes...
September 14, 2018: Cornea
Marshall J Huang, Steven Kane, Deepinder K Dhaliwal
PURPOSE: To compare the visual outcomes and associated morbidity of patients with Fuchs endothelial corneal dystrophy who were treated with either Descemet membrane endothelial keratoplasty (DMEK) or descemetorhexis without endothelial keratoplasty (DWEK). METHODS: This is a retrospective comparative cohort study of 27 eyes with mild to moderate Fuchs dystrophy (with corneal guttae/edema limited to the central cornea with relatively clear periphery) that were treated at the University of Pittsburgh Medical Center from 2015 to 2017 with either DMEK (n = 15) or DWEK (n = 12)...
September 14, 2018: Cornea
Olena Al-Shymali, Alejandra E Rodriguez, Maria A Amesty, Jorge L Alio
PURPOSE: To report the use of different superficial keratopigmentation (KTP) techniques for restoring or enhancing cosmetic appearance of eyes impaired for several reasons. METHODS: This is a retrospective, consecutive, noncomparative interventional series of cases, in which 136 cosmetically disabled eyes (due to different corneal abnormalities) of 130 patients were included. A total of 222 procedures of superficial manual KTP and superficial automated KTP were performed...
September 14, 2018: Cornea
Mark A P Fajgenbaum, Emma J Hollick
PURPOSE: High intraocular pressure (IOP) is common in association with intracameral air and gas tamponade after Descemet membrane endothelial keratoplasty (DMEK); yet its influence on endothelial cell survival is unknown. Our aim was to determine the effect of high IOP measured 2 hours after DMEK on 1-month endothelial cell density (ECD). The influence of other potentially relevant factors was also investigated. METHODS: Retrospective, consecutive series. Inclusions: low-to-moderate risk DMEK surgery alone or combined with phacoemulsification...
September 14, 2018: Cornea
Hideaki Yokogawa, Akira Kobayashi, Tetsuhiko Okuda, Natsuko Mori, Toshinori Masaki, Kazuhisa Sugiyama
PURPOSE: To restore vision in complex eyes with coexisting anterior and posterior segment problems, combined corneal transplantation (penetrating keratoplasty [PK] or Descemet-stripping automated endothelial keratoplasty [DSAEK]), pars plana vitrectomy (PPV), and/or flanged intrascleral intraocular lens (IOL) fixation, designated vitreocorneal surgery are performed. In this study, we evaluated the usefulness of vitreocorneal surgery for eyes with complex comorbidities. METHODS: Thirteen consecutive eyes in 13 patients with coexisting corneal pathology (ie, corneal scarring, bullous keratoplasty, corneal laceration) and posterior segment pathology (ie, aphakia without capsular support, retinal detachment, intravitreal foreign body) underwent vitreocorneal surgery...
September 13, 2018: Cornea
Alvin L Young, Di Cao, Wai Kit Chu, Tsz Kin Ng, Yolanda W Y Yip, Vishal Jhanji, Chi Pui Pang
Pterygium is a fibrovascular subepithelial growth of degenerative tissue over the limbus. It is a common condition worldwide that is especially prevalent in tropical countries within the "pterygium belt." Its exact etiology remains to be elucidated; however, it is strongly associated with exposure to ultraviolet light. The high expression levels of tumor protein p53 (TP53) observed in laboratory studies of pterygium seem to contradict the fast-growing nature of its clinical behavior, and TP53 mutations have been suggested...
September 13, 2018: Cornea
Caleb L Shumway, Sahil Aggarwal, Marjan Farid, Hannah Muniz-Castro, Allison Jarstad, Sumit Garg, Sanjay Kedhar, Matthew Wade
PURPOSE: To compare the effect of 3 common suturing techniques on eyes that received femtosecond laser-enabled penetrating keratoplasty (FLEK) with a zig-zag configuration at the Gavin Herbert Eye Institute, University of California- Irvine, California. METHODS: This is a retrospective chart review of a series of 319 eyes of 286 patients who underwent FLEK with a zig-zag configuration. One hundred fifty-seven eyes had running sutures, 136 eyes had simple interrupted sutures, and 26 eyes had combined sutures (single running and simple interrupted)...
September 12, 2018: Cornea
Gilda Cennamo, Daniela Montorio, Salvatore Del Prete, Antonio Del Prete, Giovanni Cennamo
PURPOSE: To measure corneal epithelial thickness (CET) in patients with glaucoma using anterior-segment optical coherence tomography and to evaluate CET changes in relation to corneal epithelial microvilli analyzed by scanning electron microscopy (SEM). METHODS: Twenty-two eyes (16 patients) being treated with preservative-containing topical medications and 12 normal eyes underwent anterior-segment optical coherence tomography imaging using RTVue-100. The CET maps generated corresponded to a 6-mm diameter area of cornea that was divided into 17 sectors...
September 12, 2018: Cornea
Motokazu Tsujikawa
Gelatinous drop-like corneal dystrophy (GDLD; OMIM: 204870) is an autosomal recessive Mendelian-inherited disease. Subepithelial amyloid deposition results in severe visual impairment. Its pathogenesis remains unknown. Identification of the responsible gene is a useful approach to investigating the pathogenesis of genetic diseases. Such an identification is also necessary for the creation of genetic models. For this purpose, our group performed positional cloning using homozygosity mapping. The results revealed that GDLD maps to the short arm of chromosome 1...
September 10, 2018: Cornea
Saurabh Ghosh, Borja Salvador-Culla, Ajay Kotagiri, Sreekumari Pushpoth, Adrian Tey, Zoë K Johnson, Francisco C Figueiredo
PURPOSE: To analyze the incidence, nature, outcomes, and complications of acute chemical eye injuries, including the incidence of limbal stem cell deficiency (LSCD) and to compare the 2 main classifications for ocular chemical injuries: Roper-Hall (RH) and Dua. METHODS: This is a prospective, consecutive, interventional single-center study between April and October 2009 of all new patients with acute chemical eye injury presenting to the Royal Victoria Infirmary eye emergency department (EED)...
September 7, 2018: Cornea
Jong Suk Song, In Ho Woo, Youngsub Eom, Hyo Myung Kim
Punctal plugs are an effective treatment option for patients with aqueous-deficient dry eye refractory to topical medications. However, punctal plugs are not commonly used in clinical practice mainly because of various misconceptions, rather than clinical complications. We analyzed previous studies and present 5 misconceptions related to punctal plugs. The first and most important misconception is that ocular surface inflammation should be sufficiently controlled before punctal plug insertion. However, it is unclear how ocular surface inflammation can be sufficiently controlled in patients refractory to conventional topical medications...
September 6, 2018: Cornea
Minako Ito, Mana Iizuka-Koga, Makoto Ando, Akihiko Yoshimura
Regulatory T cells (Tregs) are essential for the maintenance of immune homeostasis. Studies of Treg are not only necessary for understanding the mechanism of immune homeostasis but also extremely useful for the development of treatments of various immune diseases. Forkhead box P3 (Foxp3) was identified as the master gene responsible for the immune-suppressing activity of Tregs. The promoter region and several intronic enhancers, designated conserved noncoding sequence (CNS) 0, 1, 2, and 3, at the Foxp3 gene locus have important roles in Foxp3 expression and Treg development...
September 6, 2018: Cornea
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