Corneal Transplant

A 55-year-old nurse was referred with a 5-month history of right eye corneal abscess. The initial injury occurred when doing lawn work. The infection worsened despite multiple antibiotic, antiviral, and steroid treatments. Visual acuity was limited to hand motion. On examination, there was keratitis, ocular hypertension, and a secondary cataract. Corneal scrapings grew a filamentous fungus, identified as Metarhizium anisopliae (MA). Despite intensive antifungal treatment with topical, intravitreous, and systemic voriconazole, purulent corneal melting and scleritis with endophthalmitis rapidly appeared...

PURPOSE: To evaluate and compare the attitudes of ophthalmologists and gynecologists in suggesting appropriate approach to pregnancy in different ocular conditions. METHODS: Specialty-specific questionnaires on delivery mode and abortion indications for ophthalmic patients (refractive, vascular, oncologic, retinal, glaucoma, postoperation, posttrauma, and infectious) were designed and distributed among physician staff of Farabi Eye Hospital and Yas Women Hospital in Tehran...

An 87-year-old woman presented 1 month after uneventful cataract surgery with ipsilateral corneal edema. She was diagnosed with pseudophakic bullous keratopathy and scheduled for endothelial transplantation. However, a few days later, she presented with bilateral corneal edema, dilated pupils and further reduction of visual acuity. Neuro-Ophthalmic evaluation disclosed a bilateral ocular ischemic syndrome causing complete visual loss. Temporal artery biopsy was consistent with GCA. Corneal decompensation should be considered as a rare presentation of GCA, that ophthalmologists should suspect in any case of unilateral or bilateral ocular ischemic syndrome...

PURPOSE: Common polymorphic variants upstream of Zinc finger protein gene 469 (ZNF469) have been associated with central corneal thickness. Rare ZNF469 variants have been shown in keratoconus patients. The aim of the current study was to investigate the frequency of ZNF 469 gene variants in rapidly progressive advance keratoconus patients who underwent corneal transplant surgery by the age of 30, compared to their frequency in the normal Turkish population. METHODS: A search in a patient database was performed to identify patients with a rapidly progressive keratoconus requiring corneal transplant surgery by the age of 30 in at least one eye...

Tissue-engineered human anterior hemi-cornea (TE-aHC) is a promising equivalent for treating anterior lamellar keratopathy to surmount the severe shortage of donated corneas. This study was intended to construct a functional TE-aHC with nontransfected human corneal stromal (ntHCS) and epithelial (ntHCEP) cells using acellular porcine corneal stromata (aPCS) as a carrier scaffold, and evaluate its biological functions in a dog model. To construct a TE-aHC, ntHCS cells were injected into an aPCS scaffold and cultured for 3 days; then, ntHCEP cells were inoculated onto the Bowman's membrane of the scaffold and cultured for 5 days under air-liquid interface condition...

BACKGROUND: Conjunctival flaps are a widely used treatment for numerous corneal ulcers that are caused by microorganismal infections. However, whether it can be performed on immune-mediated corneal ulcers is controversial. CASE PRESENTATION: We present two cases of Mooren's ulcer that were treated using conjunctival flap in an attempt to prevent further corneal perforation at their local hospital. A rapid acceleration in ulcer progression was observed after a conjunctival flap was applied...

Objective: clinically characterizing cornea transplant patients and their distribution according to indicated and post-operative conditions of cornea transplantation, as well as estimating the average waiting time. Method: a cross-sectional, descriptive and analytical study performed for all cornea transplants performed at a reference service (n=258). Data were analyzed using Statistical Package for the Social Sciences, version 20.0. Results: the main indicator for cornea transplant was keratoconus...

To evaluate the impact of death-to-preservation time (DPT) on effective utilisation of donor corneas. In a prospective observational study conducted at our tertiary eye centre, donated corneas received over a 15-month period from November 2011 to January 2013 were evaluated. Donor age, donor refrigeration (done or not), DPT, endothelial cell density (ECD), corneal grading, clinical utilisation and surgical outcome after graft transplantation were noted. To analyse the impact of different DPT on donor cornea transplantation, primary outcome measures (corneal grading and endothelial cell density) and secondary outcome measures (primary graft failure and graft infection) were analysed...

PURPOSE: It was the aim of this investigation to elucidate the functional effects of CTG18.1 trinucleotide repeat expansion and the polymorphism rs613872 in the transcription factor 4 (TCF4) in corneas of patients affected by Fuchs' endothelial corneal dystrophy (FECD). METHODS: Sixty-one unrelated German patients with FECD and 113 unaffected controls were investigated and genotyped for the CTG18.1 locus by triplet primed PCR (TP-PCR) and the rs613872 polymorphism via Sanger sequencing and by employing genomic DNA from peripheral blood leucocytes...

BACKGROUND: The consequences of a corneal transplant are evaluated and classified by care providers, but understanding and interpretation of the results varies between patients, and creates different views for them and influences their lives in different ways while these influences are largely unknown. AIM: This study aimed to explore understanding of new life in patients after corneal transplantation. METHODS: This qualitative study was conducted using a hermeneutic phenomenological approach in Tehran in 2016...

Objective: To identify the primary disease spectrum and trends of surgical procedure of keratoplasty patients. Methods: Retrospective case series study. To review all patients who underwent keratoplasty at Department of ophthalmology in Tongji Hospital from January 1, 2012 to December 31, 2015. The data collected included age, sex, birthplace, and primary corneal disease and associated surgical procedures. Then the data were compared with similar papers domestic and foreign. Results: A total of 315 keratoplasties were performed during this 4-year period...

PURPOSE: To analyze demographic, clinical, and keratometric outcomes of the second eye in keratoconic patients when the first eye has already been grafted, initially and finally at 12 years. METHODS: Retrospective analysis of initial and 12 years visual and keratometric outcomes of the second eye in keratoconic patients when the first one has already been grafted. RESULTS: A total of 107 patients were included: 66 patients were analyzed at the beginning of the follow-up and at 12 years...

PURPOSE: Our purpose was to describe the clinical course, and individualized management approaches, of patients with migration of a dexamethasone implant into the anterior chamber. METHODS: This was a retrospective review of four patients with seven episodes of anterior chamber migration of a dexamethasone implant. RESULTS: After 924 intravitreal dexamethasone injections, anterior migration of the implant occurred in four eyes of four patients (0...

The management of severe keratoconus requires corneal transplantation, for which the gold standard is deep anterior lamellar keratoplasty (DALK), preserving the healthy Descemet's membrane and endothelium. The safety and reproducibility of corneal cuts have been improved by the evolution of femtosecond lasers in refractive surgery, and femtosecond laser in DALK would seem to provide the same advantages over the manual method. In our retrospective study, we compare functional and anatomical results of femtosecond-assisted DALK versus manual trephination DALK in patients with keratoconus in stage 4 of the Krumeich classification...

With insufficient options to meet the clinical demand for cornea transplants, one emerging area of emphasis is on cornea tissue engineering. In the present study, the goal was to combine the corneal stroma and epithelium into one co-culture system, in order to monitor both human corneal stromal stem cell (hCSSC) and human corneal epithelial cell (hCE) growth and differentiation into keratocytes and differentiated epithelium in these 3D tissue systems in vitro. Co-culture conditions were first optimized, including the medium, air/liquid interface culture, and surface topography and chemistry of biomaterial scaffold films based on silk protein...

BACKGROUND AND AIMS: Many studies of corneal transplantation focus on graft failure or rejection as endpoints, or report visual outcomes at one postoperative time point. We aimed to study the stability of visual outcomes between 2 and 5 years following corneal transplantation. METHODS: All patients with keratoconus (868) or Fuchs endothelial dystrophy (FED) (569) receiving their first corneal transplant for visual purposes in the UK between January 2003 and December 2009 were included...

PURPOSE OF REVIEW: To provide a concise review of the oculoplastic manifestations of ocular graft versus host disease (GVHD), and to discuss their management. RECENT FINDINGS: Ocular GVHD occurs as a common immune-mediated complication of hematopoietic stem cell transplantation that presents as a Stevens-Johnson-like syndrome in the acute phase or a Sjögren-like syndrome in the chronic phase. Cicatricial conjunctivitis may be underreported in ocular GVHD. The spectrum of oculoplastic manifestations includes GVHD of the skin, cicatricial entropion, nasolacrimal duct obstruction, and lacrimal gland dysfunction...

Due to rising demand worldwide it is becoming increasingly more difficult to satisfy the needs for human corneal transplants. At this point transplantation is the only possible cure for endothelial diseases, such as Fuchs endothelial dystrophy. In this article we present descemetectomy, a circumscribed removal of Descemet's membrane (DMx) without subsequent transplantation, as new possible treatment option on the basis of a clinical case.

PURPOSE: The aims of this study were to investigate the incidence of positive donor tissue cultures before transfer to preservation medium (Optisol™-GS) for penetrating keratoplasty, to verify the efficacy of antibiotics contained in Optisol™-GS by examining the drug susceptibility and to assess the relationship between the results of our microbial assessments as well as donor factors and the incidence of contamination. METHODS: We conducted a retrospective, cross-sectional study using Juntendo Eye Bank records for all corneal transplantations...

Background Eyes with severe corneal opacifications and insufficient prognosis for high-risk corneal transplantation can be considered for the implantation of a Boston-keratoprosthesis. Since 2013, this technique of "artificial" corneal replacement is provided to high-risk eyes at the Department of Ophthalmology, University of Cologne and for 9 years at the University of Salzburg. In the meantime, a type I Boston keratoprosthesis (BI-KPro) has been implanted in 24 eyes in Cologne and in 28 eyes in Salzburg. Methods In this article, results and complications according to BI-KPro are discussed, both from the literature in PubMed, as well as from our own experiences...