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Keratoplasty

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https://www.readbyqxmd.com/read/28932339/penetrating-keratoplasty-for-keratoconus-excimer-versus-femtosecond-laser-trephination
#1
Berthold Seitz, Achim Langenbucher, Tobias Hager, Edgar Janunts, Moatasem El-Husseiny, Nora Szentmáry
BACKGROUND: In case of keratoconus, rigid gas-permeable contact lenses as the correction method of first choice allow for a good visual acuity for quite some time. In a severe stage of the disease with major cone-shaped protrusion of the cornea, even specially designed keratoconus contact lenses are no more tolerated. In case of existing contraindications for intrastromal ring segments, corneal transplantation typically has a very good prognosis. METHODS: In case of advanced keratoconus - especially after corneal hydrops due to rupture of Descemet's membrane - penetrating keratoplasty (PKP) still is the surgical method of first choice...
2017: Open Ophthalmology Journal
https://www.readbyqxmd.com/read/28930381/intraocular-pressure-and-big-bubble-diameter-in-deep-anterior-lamellar-keratoplasty-an-ex-vivo-microscope-integrated-oct-with-heads-up-display-study
#2
Paramjit K Bhullar, Oscar M Carrasco-Zevallos, Alexandria Dandridge, Neel D Pasricha, Brenton Keller, Liangbo Shen, Joseph A Izatt, Cynthia A Toth, Anthony N Kuo
PURPOSE: To investigate the relationship between intraocular pressure (IOP) and big bubble (BB) formation in a model of deep anterior lamellar keratoplasty (DALK). DESIGN: Ex-vivo. METHODS: Corneoscleral buttons from human donors were loaded onto an artificial anterior chamber connected to a column of balanced salt solution. A surgeon-in-training learned to perform DALK via the BB technique using swept-source microscope-integrated optical coherence tomography (SS-MIOCT) with heads-up display (HUD)...
September 2017: Asia-Pacific Journal of Ophthalmology
https://www.readbyqxmd.com/read/28926889/-clinical-research-progress-in-endothelial-keratoplasty
#3
Y Y Zhang, L X Xie
Endothelial keratoplasty (EK) has gradually replaced penetrating keratoplasty (PKP) and has become the main method for the treatment of endothelial dysfunction in developed countries in recent years. EK is safe and effective and can achieve good postoperative vision. The surgical techniques and postoperative effects have been improved continuously along with the development of microsurgical technology and surgical instruments. The EK surgeries mainly include Descemet stripping endothelial keratoplasty (DSEK), Descemet stripping automated endothelial keratoplasty (DSAEK), Descemet membrane endothelial keratoplasty (DMEK) and ultra-thin Descemet stripping automated endothelial keratoplasty (UT-DSAEK), which have different characteristics and advantages compared with PKP...
September 11, 2017: [Zhonghua Yan Ke za Zhi] Chinese Journal of Ophthalmology
https://www.readbyqxmd.com/read/28926886/-keratectomy-combined-with-intrastromal-injection-of-voriconazole-in-treating-fungal-keratitis
#4
S X Li, J Biang, X Li, L T Zhang, W Y Shi
Objective: To investigate the treatment effect of keratectomy combined with intrastromal injection of voriconazole on fungal keratitis. Methods: Retrospective study. Ninety-eight fungal keratitis patients (98 eyes) were treated by keratectomy combined with intrastromal injection of voriconazole in Shandong Eye Hospital from January 2013 to May 2015. The corneal ulcers were mostly located in the paracentral or peripheral cornea, which incompletely blocked the pupil area. Slit lamp and anterior segment optical coherence tomography (AS-OCT) were used for lesion detection...
September 11, 2017: [Zhonghua Yan Ke za Zhi] Chinese Journal of Ophthalmology
https://www.readbyqxmd.com/read/28923582/glaucoma-following-corneal-replacement
#5
REVIEW
Monika Baltaziak, Hall F Chew, Dominik W Podbielski, Iqbal Ike K Ahmed
Glaucoma is a well-known complication following corneal transplantation surgery. Traditional corneal transplantation surgery, specifically penetrating keratoplasty (PK), has been slowly replaced by the advent of new corneal transplantation procedures: primarily lamellar keratoplasties. There has also been an emergence of keratoprosthesis implants for eyes that are high risk of failure with PK. Consequently, there are different rates of glaucoma, pathogenesis, and potential treatment in the form of medical, laser or surgical therapy...
September 16, 2017: Survey of Ophthalmology
https://www.readbyqxmd.com/read/28923499/descemet-membrane-endothelial-keratoplasty-safety-and-outcomes-a-report-by-the-american-academy-of-ophthalmology
#6
Sophie X Deng, W Barry Lee, Kristin M Hammersmith, Anthony N Kuo, Jennifer Y Li, Joanne F Shen, Mitchell P Weikert, Roni M Shtein
PURPOSE: To review the published literature on the safety and outcomes of Descemet membrane endothelial keratoplasty (DMEK) for the surgical treatment of corneal endothelial dysfunction. METHODS: Literature searches were last conducted in the PubMed and the Cochrane Library databases most recently in May 2017. The searches, which were limited to English-language abstracts, yielded 1085 articles. The panel reviewed the abstracts, and 47 were determined to be relevant to this assessment...
September 15, 2017: Ophthalmology
https://www.readbyqxmd.com/read/28914632/stepwise-guided-photorefractive-keratectomy-in-treatment-of-irregular-astigmatism-after-penetrating-keratoplasty-and-deep-anterior-lamellar-keratoplasty
#7
Nir Sorkin, Adi Einan-Lifshitz, Sagi Abelson, Tanguy Boutin, Mahmood Showail, Armand Borovik, Zach Ashkenazy, Clara C Chan, David S Rootman
PURPOSE: To report the outcome of stepwise ablation using topography-guided photorefractive keratectomy to treat irregular astigmatism after either penetrating keratoplasty (PKP) or deep anterior lamellar keratoplasty (DALK). METHODS: This is a retrospective, interventional analysis including patients with irregular astigmatism after either PKP or DALK, who underwent topography-guided photorefractive keratectomy. The entire cohort was analyzed, as well as the PKP and DALK groups separately...
September 12, 2017: Cornea
https://www.readbyqxmd.com/read/28905834/microsporidial-infection-masquerading-as-graft-rejection-post-descemet-s-stripping-automated-endothelial-keratoplasty
#8
Lumbini Devi, N Venkatesh Prajna, Muthiah Srinivasan, Naveen Radhakrishnan, Manoranjan Das
A 51-year-old immunocompetent male with a history of Fuchs' endothelial dystrophy and immature cataract who underwent Descemet's stripping automated endothelial keratoplasty with intraocular lens implantation in both eyes presented with redness and defective vision of 1-day duration in his left eye. Slit lamp examination revealed coarse superficial punctate lesions with graft edema. He was diagnosed with acute graft rejection and treated with topical steroids. Two days later, symptoms worsened in his left eye with the involvement of his right eye showing a similar clinical picture...
September 2017: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/28903964/clinical-profile-of-pythium-keratitis-perioperative-measures-to-reduce-risk-of-recurrence
#9
Shweta Agarwal, Geetha Iyer, Bhaskar Srinivasan, Mamta Agarwal, Shobha Panchalam Sampath Kumar, Lily K Therese
PURPOSE: To report the clinical profile and role of perioperative adjunctive measures to reduce the risk of recurrence in Pythium insidiosum keratitis. METHODS: Retrospective analysis of 10 eyes of 10 patients with P. insidiosum keratitis. Diagnosis was confirmed by PCR DNA sequencing. RESULTS: 7out of 10 patients were from urban locales, and none had any obvious history of injury with vegetative matter and were being treated for fungal keratitis...
September 13, 2017: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/28902856/effect-of-vital-dyes-on-human-corneal-endothelium-and-elasticity-of-descemet-s-membrane
#10
Isabell P Weber, Mrinal Rana, Peter B M Thomas, Ivan B Dimov, Kristian Franze, Madhavan S Rajan
The purpose of this study was to evaluate the effects of vital dyes on human Descemet's membranes (DMs) and endothelia. DMs of 25 human cadaveric corneas with research consent were treated with dyes routinely used in Descemet membrane endothelial keratoplasty (DMEK), 0.05% Trypan blue (TB) or a combination of 0.15% Trypan blue, 0.025% Brilliant blue and 4% Polyethylene glycol (commercial name Membrane Blue Dual; MB). The effects of these two dyes on (i) endothelial cell viability, (ii) DM mechanical properties as assessed by atomic force microscopy, and iii) qualitative DM dye retention were tested for two varying exposure times (one or four minutes)...
2017: PloS One
https://www.readbyqxmd.com/read/28902013/-bubble-in-the-roll-technique-using-the-endoject-dmek-injector-influence-of-the-air-bubble-on-endothelial-cell-loss
#11
Yasemin Akbaba, Julia M Weller, Kathrin Rössler, W John Armitage, Ursula Schlötzer-Schrehardt, Friedrich E Kruse, Theofilos Tourtas
PURPOSE: To evaluate the impact of the air bubble on endothelial cell loss using the "bubble-in-the-roll" technique during Descemet membrane endothelial keratoplasty (DMEK). METHODS: Twenty DMEK grafts not suitable for transplantation were manually prepared from organ-cultured corneoscleral discs and injected into culture media using the Endoject DMEK injector (Medicel AG, Wolfhalden, Switzerland). Based on the injection method, the grafts were divided into 2 groups: In group A (n = 10), a small air bubble was placed inside the graft roll while it was in the injector...
September 8, 2017: Cornea
https://www.readbyqxmd.com/read/28900769/interface-scopulariopsis-gracilis-fungal-keratitis-following-descemet-s-stripping-automated-endothelial-keratoplasty-dsaek-with-a-contaminated-graft
#12
Craig Wilde, Marco Messina, Tara Moshiri, Susan E Snape, Senthil Maharajan
PURPOSE: To report for the first time a case of interface Scopulariopsis gracilis fungal keratitis following Descemet's stripping automated endothelial keratoplasty (DSAEK) with a contaminated graft. METHODS: A 57-year-old man with bilateral keratoconus and previous bilateral penetrating keratoplasties (PK) developed graft failure in association with marked corneal ectasia. He underwent a successful DSAEK. Unfortunately, a contaminated graft was transplanted and the following morning we were contacted by the eye bank to inform us a slow-growing fungus had been detected in the culture plates inoculated with dextran solution used to store the issued corneoscleral button...
September 12, 2017: International Ophthalmology
https://www.readbyqxmd.com/read/28892949/corneal-collagen-cross-linking-for-treatment-of-bacterial-and-herpetic-keratitis
#13
Mohammad Reza Khalili, Hamid Reza Jahadi, Mashaallah Karimi, Masoud Yasemi
INTRODUCTION: Optimal management of infective keratitis is a formidable challenge and subject of ongoing studies. Recently, Collagen Cross-Linking (CXL) of the cornea has been considered to be a new effective therapeutic approach for resistant infectious keratitis. AIM: Aim of the study was to evaluate the effectiveness of CXL with Ultraviolet-A (UV-A) and riboflavin for treatment of the refractory bacterial and Herpes Simplex Virus (HSV) keratitis. MATERIALS AND METHODS: In this prospective interventional study, eight patients with diagnosis of infectious keratitis who were referred to Khalili Hospital eye emergency room, between 2014 and 2015 were included in the study...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28889066/effect-of-lentivirus-mediated-gene-silencing-targeting-toll-like-receptor-2-on-corneal-allograft-transplantation-in-rats
#14
Lang Bai, Weiyi Liang, Minting Chen, Yacouba Cissé, Jing Liu, Yaru Su, Jian Yu, Qiong Liu
AIM: The present work aims to assess the effectiveness of lentiviral vector (LV) mediated Toll-like receptor 2 (TLR2) gene silencing in the survival of transplanted corneal allografts, against immune rejection, in rats. METHODS: LV mediated TLR2 small interference RNA (SiRNA) with enhanced green fluorescent protein (eGFP) [LV-TLR2-siRNA-eGFP] was realised and transfected to both rat corneal epithelial (EC) and stromal cells (SC). Multiplicity of infection (MOI) was optimized for transfection efficiency using flow cytometric (FCM) analysis...
September 7, 2017: Molecular Immunology
https://www.readbyqxmd.com/read/28885609/vitreous-cavity-length-in-keratoconus-implications-for-keratoplasty
#15
M Messina, T Umapathy, V Avadhanam, C Wilde, D G Said, H S Dua
PurposeTo compare axial length (AL) with vitreous cavity length (VCL) in patients with keratoconus and to ascertain whether graft size can be tailored to reduce myopic refractive error in patients with keratoconus undergoing penetrating keratoplasty (PK).Patients and methodsThe AL and VCL were measured prospectively in patients with keratoconus not undergoing PK (Group 1) and in normal phakic, emmetropic individuals (Group 2). A retrospective analysis of these measurements in patients with keratoconus who had undergone PK (Group 3) was also performed...
September 8, 2017: Eye
https://www.readbyqxmd.com/read/28880340/topography-guided-photorefractive-keratectomy-in-the-treatment-of-corneal-scarring
#16
Nir Sorkin, Adi Einan-Lifshitz, Tanguy Boutin, Mahmood Showail, Armand Borovik, Clara C Chan, David S Rootman
PURPOSE: To report the outcome of topography-guided photorefractive keratectomy (TG-PRK) in the treatment of patients with corneal scarring. METHODS: A retrospective, interventional case series including 6 eyes of 6 patients with corneal scarring and irregular astigmatism who underwent TG-PRK. The etiologies for scarring were: infectious corneal ulcers, foreign body trauma, LASIK flap buttonhole, and lamellar keratoplasties performed to correct corneal perforation secondary to corneal melting...
September 1, 2017: Journal of Refractive Surgery
https://www.readbyqxmd.com/read/28875112/bilateral-corneal-perforation-due-to-mrsa-keratitis-in-a-crosslinking-patient
#17
Zackery Oakey, Kevin Thai, Sumit Garg
Introduction: The cornea may become infected and perforated after epithelium-on collagen crosslinking. Case presentation: A healthy 33-year-old male who underwent corneal collagen crosslinking in both eyes developed a purulent keratitis and bilateral corneal perforations, requiring bilateral penetrating keratoplasties. He was exposed to methicillin resistant staphylococcus aureus (MRSA) by a family member with a tracheostomy and was treated with MRSA-directed antibiotics. After prolonged recovery and treatment of his infection, he had acceptable but limited uncorrected visual acuity, with excellent corrected visual acuity...
2017: GMS Ophthalmology Cases
https://www.readbyqxmd.com/read/28872520/descemet-membrane-endothelial-keratoplasty-patch-for-persistent-corneal-hydrops
#18
Elmer Y Tu
PURPOSE: To report successful management of a case of persistent keratoconus-related hydrops with a Descemet membrane endothelial keratoplasty (DMEK) patch graft. METHODS: A case of corneal hydrops persisting for 7 months treated with DMEK was identified. The following information was collected: demographic data, surgical indications, clinical course, diagnostic tests, and clinical outcome. RESULTS: A 55-year-old patient with an established diagnosis of keratoconus was followed for 7 months without improvement in his acute corneal hydrops...
August 31, 2017: Cornea
https://www.readbyqxmd.com/read/28872517/favorable-outcome-in-coccidioides-endophthalmitis-a-combined-medical-and-surgical-treatment-approach
#19
Jennifer J Ling, Derek J Bays, George R Thompson, Ala Moshiri, Mark J Mannis
PURPOSE: To describe a case of Coccidioides endophthalmitis that resulted in a favorable visual outcome after a combined medical and surgical approach. METHODS: A 33-year-old previously healthy woman was referred for evaluation of dyspnea and left-sided vision loss, which began 3 months before, after a trip to Nevada. She was found to have a pulmonary cavitary lesion and fluffy white material in the anterior chamber. An aqueous and vitreous paracentesis grew Coccidioides species...
August 31, 2017: Cornea
https://www.readbyqxmd.com/read/28868034/correction-of-high-astigmatism-after-penetrating-keratoplasty-with-toric-multifocal-intraocular-lens-implantation
#20
Raffaele Nuzzi, Francesca Monteu
After penetrating keratoplasty (PK), high astigmatism is often induced, being frequently about 4-6 dpt. According to the entity and typology of astigmatism, different methods of correction can be used. Selective suture removal, relaxing incisions, wedge resections, compression sutures, photorefractive keratectomy, and laser-assisted in situ keratomileusis can reduce corneal astigmatism and ametropia, but meanwhile they can cause a reduction in the corneal integrity and cause an over- or undercorrection. In case of moderate-to-high regular astigmatisms, the authors propose a toric multifocal intraocular lens (IOL) implantation to preserve the corneal integrity (especially in PK after herpetic corneal leukoma keratitis)...
May 2017: Case Reports in Ophthalmology
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