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high risk cornea graft

Vito Romano, Mario Cruciani, Luigi Conti, Luigi Fontana
BACKGROUND: Pterygium, a growth of the conjunctiva over the cornea, is a progressive disease leading in advanced stages to visual impairment, restriction of ocular motility, chronic inflammation and cosmetic concerns. Surgical removal is the treatment of choice, but recurrence can be a problem. Currently the best surgical option in terms of recurrence is conjunctival autograft. To date the most common surgical methods of attaching conjunctival autografts to the sclera are through suturing or fibrin glue...
December 2, 2016: Cochrane Database of Systematic Reviews
Jesse M Vislisel, Kenneth M Goins, Michael D Wagoner, Gregory A Schmidt, Benjamin T Aldrich, Jessica M Skeie, Cynthia R Reed, M Bridget Zimmerman, Mark A Greiner
PURPOSE: To determine the incidence of positive corneoscleral donor rim fungal cultures after keratoplasty and to report clinical outcomes of grafts with culture-positive donor rims. DESIGN: Retrospective cohort study. PARTICIPANTS: Consecutive donor corneas and keratoplasty recipients at a single tertiary referral center over 20 years. METHODS: Patient charts were reviewed to determine the incidence of positive donor rim fungal cultures and clinical outcomes of all grafts using contaminated tissue...
November 3, 2016: Ophthalmology
Antonio Di Zazzo, Maryam Tahvildari, Brinda Subbarayal, Jia Yin, Thomas H Dohlman, Takenori Inomata, Alireza Mashaghi, Sunil K Chauhan, Reza Dana
BACKGROUND: Corneal neovascularization increases the risk of T cell mediated allograft rejection. Here, we investigate whether T cells promote angiogenesis in transplantation. METHODS: Conventional effector T cells were collected from draining lymph nodes (DLNs) of allogeneic or syngeneic corneal transplanted BALB/c mice. T cells were either cocultured with vascular endothelial cells (VECs) to assess VEC proliferation or used in a Mixed Lymphocyte Reaction assay...
August 3, 2016: Transplantation
D Pahor, A Pahor
Purpose: To present the surgical management of perforated corneal ulcer using PRECLUDE® Pericardial Membrane, composed of expanded polytetrafluoroethylene (e-PTFE; GORE-TEX®), as an alternative surgical procedure in patients at high risk of graft rejections and to evaluate side effects for a prolonged period. Patients and Methods: The study included all patients who were admitted to our department and underwent surgical repair of perforated corneal ulcer with the e-PTFE membrane between 2010 and 2015. In total, 8 patients (8 eyes) were enrolled...
July 6, 2016: Klinische Monatsblätter Für Augenheilkunde
Jeanie D Ling, Viraj Mehta, Cherie Fathy, Yuna Rapoport, Matthew M Zhang, Anthony Daniels, Sahar Kohanim
Corneal transplantation is a common type of tissue transplantation that aims to improve vision or relieve pain. Given the immune privilege of the cornea, the primary graft often has a high success rate, approaching 90%. Despite the good overall outcome of corneal transplantation in various studies, the individual graft survival rate varies, depending on the preoperative diagnosis and donor and recipient factors. Race and ethnicity have been shown to be important in other types of organ transplantation. The aim of this study was to review the available ophthalmic literature regarding any differences in rates and outcomes of corneal transplantation based on ethnicity and race...
2016: Seminars in Ophthalmology
Lucia Kuffova, Jared E Knickelbein, Tian Yu, Carlos Medina, Guillermo Amescua, Alexander M Rowe, Robert L Hendricks, John V Forrester
PURPOSE: The "high-risk phenotype" of corneal graft recipients is considered to be related to preexisting vascularization such as that associated with herpes simplex virus-1 (HSV-1) keratitis (HSK). The purpose of this study was to investigate the immunologic mechanisms underlying accelerated corneal graft rejection using a mouse model of HSK. METHODS: Herpes simplex virus type 1 keratitis was induced in BALB/c mice. Syngeneic and allogeneic (C57BL/6 mice) corneal grafts were performed in mice with HSK at different times after infection...
April 2016: Investigative Ophthalmology & Visual Science
Tian Yu, Vijayalakshmi Rajendran, May Griffith, John V Forrester, Lucia Kuffová
Corneal transplantation is the most common surgical procedure amongst solid organ transplants with a high survival rate of 86% at 1-year post-grafting. This high success rate has been attributed to the immune privilege of the eye. However, mechanisms originally thought to promote immune privilege, such as the lack of antigen presenting cells and vessels in the cornea, are challenged by recent studies. Nevertheless, the immunological and physiological features of the cornea promoting a relatively weak alloimmune response is likely responsible for the high survival rate in "low-risk" settings...
March 24, 2016: World Journal of Transplantation
Shveta Bali, Richard Filek, Francie Si, William Hodge
Cornea transplantation has a high success rate and typically only requires topical immunomodulation. However, in high-risk cases, systemic immunosuppression can be used. We conducted a systematic review on the efficacy and side effects of systemic immunosuppression for high-risk cornea transplantation. The study population was 18 years old or older with a high-risk transplant (two or more clock hours of cornea vascularization or a previous failed graft or a graft needed because of herpes simplex keratitis)...
April 2016: Journal of Clinical Medicine Research
Yang Liu, Huilin Lv, Li Ren, Guanhua Xue, Yingjun Wang
Cornea disease is the second cause of blindness and keratoplasty is the most commonly performed option for visual rehabilitation of patients with corneal blindness. However, the clinical treatment has been drastically limited due to a severe shortage of high-quality donor corneas. Although collagen film with outstanding biocompatibility has promising application in corneal tissue engineering, the moisturizing properties of collagen-based materials must be further improved to satisfy the requirements of clinical applications...
2016: Journal of Biomaterials Science. Polymer Edition
D Hos, J Dörrie, N Schaft, F Bock, M Notara, F E Kruse, S Krautwald, C Cursiefen, B O Bachmann
The chemokine receptor CCR7 is essential for migration of mature dendritic cells (DCs) to the regional lymph nodes, and it has been shown that blocking of CCR7 improves graft survival after high-risk corneal transplantation in vascularized recipient corneas. However, it is so far unknown whether blocking of CCR7 reduces migration of DCs from the avascular cornea to the draining lymph nodes and whether this leads to improved graft survival also in the low-risk setting of corneal transplantation, which accounts for the majority of perforating transplantations performed...
May 2016: Experimental Eye Research
Maria Gema Fornés, Maria Angustias Jiménez, Marcela Eisman, Jose Luis Gómez Villagrán, Rafael Villalba
Careful donor selection and implementation of tests of appropriate sensitivity and specificity are of paramount importance for minimizing the risk of transmitting infectious diseases from donors to corneal allograft recipients. Reported cases of viral transmission with corneal grafts are very unusual. Nevertheless potential virus transmission through the engraftment cannot be ruled out. According to European Guideline 2006/17/EC, screening for antibodies for Hepatitis B core antigen (anti HBc) is mandatory, and when this test is positive, some criteria must be established before using corneas...
June 2016: Cell and Tissue Banking
Nadia Zakaria, Sorcha Ní Dhubhghaill, Michiel Taal, Zwi Berneman, Carina Koppen, Marie-José Tassignon
PURPOSE: Cultivated limbal epithelial stem cell transplantation (CLET) is a surgical approach reserved for severe stem cell deficiency and anterior segment pathology. The recipient cornea typically displays a highly vascularized pannus that must be dissected before graft placement. Extensive pannus dissection, however, can result in corneal thinning and increase the risk of ectasia and ultimately, of perforation. We aimed to examine the value of anterior segment optical coherence tomography (AS-OCT) intraoperatively during pannus resection and long-term postoperative follow-up of CLET surgery...
November 2015: Asia-Pacific Journal of Ophthalmology
Oliver Treacy, Gerry Fahy, Thomas Ritter, Lisa O'Flynn
Corneal transplantation is the most frequently performed transplant procedure in humans. Human leukocyte antigen matching, while imperative for other types of organ transplants, is usually not performed before cornea transplantation. With the use of topical steroid immunosuppressants, which are subsequently tailed off to almost zero, most corneal transplants will not be rejected in recipients with low risk of graft rejection. This phenomenon has been described as immune privilege by Medawar many years ago. However, this immune privilege is relative and can be easily eroded, e...
2016: Methods in Molecular Biology
M Kauss Hornecker, S Charles Weber, M-L Brandely Piat, M Darrodes, K Jomaa, F Chast
INTRODUCTION: The University Hospitals Paris Centre Pharmacy compounds three concentrations of cyclosporine eye drops: 20mg/mL (=2%); 5mg/mL (=0.5%) and 0.5mg/mL (=0.05%). Cyclosporine A 2% drops were developed in 1995 to prevent the rejection of high-risk cornea transplants after failure of topical steroids. The other concentrations of eye drops were developed for the treatment of various immune or inflammatory diseases of the cornea, conjunctiva and uvea. These eye drops are dispensed with a physician's prescription to hospitalized or ambulatory patients...
October 2015: Journal Français D'ophtalmologie
Minawaer Abudou, Taixiang Wu, Jennifer R Evans, Xueyi Chen
BACKGROUND: Penetrating keratoplasty is a corneal transplantation procedure in which a full-thickness cornea from the host is replaced by a graft from a donor. The use of various immunosuppressants to prevent graft rejection, the most common cause of graft failure in the late postoperative period, is increasing. OBJECTIVES: To assess the effectiveness of immunosuppressants in the prophylaxis of corneal allograft rejection after high- and normal-risk keratoplasty...
August 27, 2015: Cochrane Database of Systematic Reviews
Reziwan Maimaitiming, Xin Yang, Kelala Wupuer, Nan Ye, Na Kong, Baoyu Gu, Yuanyuan Fan, Lan Shao, Zhiqiang Pan
BACKGROUND: To explore the causes of corneal allograft rejection in Xinjiang Uygur patients and the factors that affect rejection through a retrospective clinical analysis. METHODS: A retrospective analysis of 126 Uygur cases from January 2010 to November 2014 in which corneal transplantation had been performed at the Xinjiang Urumqi ENT hospital. Of the treated patients, 85 eyes belonged to male patients and 41 eyes belonged to female patients. Patients were aged 10-77 years (mean age 46...
2015: International Journal of Clinical and Experimental Medicine
Qin Qin, Yunjie Shi, Qingqing Zhao, Dan Luo, Yuan Chen, Jing Wu, Min Zhao
BACKGROUND: Corneal graft rejection is the major cause of corneal failures. Previous studies have shown that the CD25 monoclonal antibody can inhibit corneal graft rejection during the acute phase of rejection in rat models. In the current study, we evaluated the safety and efficacy of the topical Entranster™ vector in rat corneal applications and further investigated the effects of CD25siRNA gene transfer on high-risk rat corneal graft rejection. METHODS: Fluorescence detection, clinical assessment, hematoxylin and eosin (HE), terminal deoxynucleotidyl transferase biotin-dUTP nick end labelling (TUNEL) and CD11b assays were used to evaluate the safety and efficacy of CD25siRNA gene transfer in normal SD rat corneas...
October 2015: Graefe's Archive for Clinical and Experimental Ophthalmology
Siamak Zarei-Ghanavati, Carolina Betancurt, Alma Michelle Mas, Jianhua Wang, Victor L Perez
PURPOSE: To evaluate the anterior keratoprosthesis-cornea interface in eyes with Boston type I keratoprosthesis (Kpro). METHODS: In a prospective non-interventional study, patients with Boston type I Kpro underwent ultra-high resolution optical coherence tomography (UHR-OCT) evaluation. The images were used to measure and describe characteristics of the anterior keratoprosthesis-cornea interface, epithelial interaction at the keratoprosthesis edge and the keratoprosthesis-cornea interface gap...
January 2015: Journal of Ophthalmic & Vision Research
Oleksiy Buznyk, Nataliya Pasyechnikova, M Mirazul Islam, Stanislav Iakymenko, Per Fagerholm, May Griffith
Corneas with severe pathologies have a high risk of rejection when conventionally grafted with human donor tissues. In this early observational study, we grafted bioengineered corneal implants made from recombinant human collagen and synthetic phosphorylcholine polymer into three patients for whom donor cornea transplantation carried a high risk of transplant failure. These patients suffered from corneal ulcers and recurrent erosions preoperatively. The implants provided relief from pain and discomfort, restored corneal integrity by promoting endogenous regeneration of corneal tissues, and improved vision in two of three patients...
October 2015: Clinical and Translational Science
Jorge L Alio, Ahmed A Abdelghany, Sabat K Abu-Mustafa, G Zein
PURPOSE: To report the outcomes of a new model of epidescemetic keratoprosthesis (Kpro) implanted without total corneal trephination. METHODS: Patients were considered for implantation with the new Kpro model (KeraKlear) if they were at high risk of failure with standard penetrating keratoplasty (PK) or showed conditions with a poor prognosis following PK such as severe chemical injury. We used femtosecond laser to create the surgical planes adequate for the purpose of the Kpro implantation, and the Kpro was implanted intralamellar in 11 eyes and epidescemetical in 4 eyes...
November 2015: British Journal of Ophthalmology
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