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Lamellar keratoplasty

Antonio Micali, Anna M Roszkowska, Elisa I Postorino, Laura Rania, Emanuela Aragona, Edward Wylegala, Anna Nowinska, Antonio Ieni, Sebastiano Calimeri, Antonina Pisani, Pasquale Aragona, Domenico Puzzolo
PURPOSE: Corneal opacities rarely occur in multiple myeloma (MM). Our study correlates the findings of in vivo confocal microscopy (IVCM), a useful diagnostic tool, with histopathological features of corneal opacities appearing in a patient with MM. METHODS: Case report. RESULTS: A 53-year-old man developed corneal opacities in both eyes, more pronounced in the left eye. After IVCM examination, he underwent penetrating keratoplasty in the left eye, and the button was processed for light and electron microscopy and immunohistochemistry...
October 5, 2016: Cornea
Enrica Sarnicola, Caterina Sarnicola, Francesco Sabatino, Gian M Tosi, Paolo Perri, Vincenzo Sarnicola
PURPOSE: To evaluate outcomes and possible advantages of 2 different techniques of deep anterior lamellar keratoplasty (DALK) in patients with keratoconus: cannula big-bubble DALK and needle big-bubble DALK (Anwar technique). METHODS: This is a retrospective, nonconsecutive, comparative study of 507 eyes affected by keratoconus that underwent DALK between 2002 and 2012. Needle DALK and cannula DALK techniques were performed in 266 eyes and 241 eyes, respectively...
October 5, 2016: Cornea
Yoav Nahum, Irit Bahar, Massimo Busin
PURPOSE: To report the use of Descemet stripping automated endothelial keratoplasty (DSAEK) for treatment of sterile corneal perforations accompanying endothelial decompensation. METHODS: In this multicenter interventional case series, we reviewed the medical records of all tectonic DSAEK surgeries performed at Villa Serena-Villa Igea private Hospitals (Forlì, Italy) and Rabin Medical Center (Petach Tikva, Israel) between January 2014 and March 2016. RESULTS: Three patients with endothelial decompensation and sterile corneal perforation (n = 2) or impending corneal perforation (n = 1) underwent DSAEK between 2014 and 2015 at Villa Igea Hospital, Forlì, Italy, and Rabin Medical Center, Petach Tikva, Israel...
October 5, 2016: Cornea
Yi-Ju Ho, Hung-Chi Chen, Shirley H L Chang, Lung-Kung Yeh, David Hui-Kang Ma
BACKGROUND: Sclerocornea, a congenital corneal pathology characterized by bilateral scleralization of the cornea, which can be found in few cases with posterior fossa malformationshemangiomas-arterial anomalies-cardiac defects-eye abnormalities-sternal cleft and supraumbilical raphe (PHACES) syndrome. Presence of vascularization in peripheral cornea and smaller diameter of recipient cornea correlate to poor outcome of penetrating keratoplasty (PKP) in sclerocornea. Here we report a method to preserve limbus during PKP for small, irregular, and scleralized cornea...
October 2016: Medicine (Baltimore)
Sotiria Palioura, Kathryn Colby
PURPOSE: To evaluate the feasibility of Descemet stripping endothelial keratoplasty using grafts preloaded by an eye bank in a commercially available insertion device. METHODS: In this retrospective case series, a series of 35 eyes in 34 consecutive patients who underwent Descemet stripping endothelial keratoplasty for Fuchs endothelial dystrophy or previously failed full-thickness grafts at a single tertiary care center from March 2013 to March 2014 was included...
October 12, 2016: Cornea
Rachelle N Palchesko, James L Funderburgh, Adam W Feinberg
Basement membranes are protein-rich extracellular matrices (ECM) that are essential for epithelial and endothelial tissue structure and function. Aging and disease cause changes in the physical properties and ECM composition of basement membranes, which has spurred research to develop methods to repair and/or regenerate these tissues. An area of critical clinical need is the cornea, where failure of the endothelium leads to stromal edema and vision loss. Here, an engineered basement membrane (EBM) is developed that consists of a dense layer of collagen IV and/or laminin ≈5-10 nm thick, created using surface-initiated assembly, conformally attached to a collagen I film...
October 10, 2016: Advanced Healthcare Materials
Kaitlyn L Ohden, Susanne Pitz, Jane Ashworth, Augusto Magalhães, Diane R Marinho, Päivi Lindahl, Kristina Teär Fahnehjelm, C Gail Summers
OBJECTIVE: To describe visual outcomes after penetrating keratoplasty and deep anterior lamellar keratoplasty in patients with mucopolysaccharidoses. METHODS: This is a retrospective review of keratoplasty in consecutive patients from Brazil, England, Finland, Germany, Portugal, Sweden and the USA. All patients had corneal clouding due to mucopolysaccharidoses. Preoperative and postoperative visual outcome and ocular comorbidities were identified. Success was arbitrarily defined as any improvement in visual acuity or best-corrected visual acuity better than logarithm of the minimum angle of resolution 0...
September 28, 2016: British Journal of Ophthalmology
Shreesha Kumar Kodavoor, Ramamurthy Dandapani, Ajay Ramesh Kaushik
A 32-year-old female patient underwent deep anterior lamellar keratoplasty (DALK) in both eyes for advanced keratoconus. She developed an infiltrate in the nasal paracentral interface of the left eye. In view of the paracentral location, localized epithelial removal/stromal scraping was done and the infiltrate was removed using forceps and sent for microbiological assay, which revealed fungal filaments. The patient successfully responded to intensive topical antifungal therapy with the maintenance of visual acuity...
August 2016: Indian Journal of Ophthalmology
Xin Liu, Qi Zhou, Xinyu Huang, Zhenxing Liu, Yanlong Bi
The study aimed to evaluate the therapeutic effects of deep anterior lamellar keratoplasty (DALK) using glycerol-cryopreserved corneal tissues (GCCTs) in patients with refractive herpes simplex keratitis (HSK). This article was a retrospective, noncomparative, and interventional case series. Patients with HSK underwent DALK using GCCTs at Shanghai Tongji Hospital from 2012 to 2015. The best spectacle corrected visual acuity, recurrent inflammation, graft status, postoperative central graft thickness, and pre/postoperative complications were detected...
September 2016: Medicine (Baltimore)
Vasilios F Diakonis, Sonia H Yoo, Victor Hernandez, Vardhaman P Kankariya, Florence Cabot, Maria P Fernandez-Jimenez, Sander R Dubovy, Jean-Marie Parel
PURPOSE: To evaluate the feasibility of femtosecond laser-assisted (FA) tunnel creation as a pretreatment for creating a big bubble (BB) to pneumo-dissect the corneal stroma from Descemet membrane. METHODS: Five human cadaver eyes received pretreatment using a femtosecond laser. An intrastromal tunnel, along with a side cut, was achieved using customized femtosecond corneal disruption (custom mask). Before treatment, optical coherence tomography was performed and the intrastromal tunnel was intended to achieve a parallel orientation with respect to the corneal endothelial cell layer (50 µm above the endothelium)...
September 21, 2016: Cornea
Houfa Yin, Peijin Qiu, Fang Wu, Wei Zhang, Wenqi Teng, Zhenwei Qin, Chao Li, Jiaojie Zhou, Zhi Fang, Qiaomei Tang, Qiuli Fu, Jian Ma, Yabo Yang
The scarcity of corneal tissue to treat deep corneal defects and corneal perforations remains a challenge. Currently, small incision lenticule extraction (SMILE)-derived lenticules appear to be a promising alternative for the treatment of these conditions. However, the thickness and toughness of a single piece of lenticule are limited. To overcome these limitations, we constructed a corneal stromal equivalent with SMILE-derived lenticules and fibrin glue. In vitro cell culture revealed that the corneal stromal equivalent could provide a suitable scaffold for the survival and proliferation of corneal epithelial cells, which formed a continuous pluristratified epithelium with the expression of characteristic markers...
2016: Scientific Reports
Emilio Pedrotti, Mattia Passilongo, Adriano Fasolo, Sara Ficial, Stefano Ferrari, Giorgio Marchini
PURPOSE: To compare the refractive outcomes following penetrating keratoplasty and deep anterior lamellar keratoplasty in fellow eyes in patients with keratoconus. METHODS: This is an observational retrospective review of consecutive patients with keratoconus first managed with penetrating keratoplasty in one eye and then with lamellar keratoplasty in the fellow eye, between 2002 and 2007. Data collection was based on patients' hospital records. Information related to assessment before surgery and at 1, 3, 6, 12, 24, and 48 months after keratoplasty were retrieved and considered in the analysis...
September 15, 2016: International Ophthalmology
Bia Z Kim, Jay J Meyer, Nigel H Brookes, S Louise Moffatt, Helen C Twohill, David G Pendergrast, Trevor Sherwin, Charles N J McGhee
AIMS: To report the 25-year longitudinal trends in indications and corneal transplantation techniques in New Zealand. METHODS: Statistical analysis of prospectively acquired New Zealand National Eye Bank (NZNEB) electronic database from 1991 to 2015 inclusive. Subjects were recipients of corneal transplants in 62 centres supplied by the NZNEB. Main outcome measures were indications, recipient age and transplantation techniques. RESULTS: From January 1991 to December 2015, NZNEB supplied tissue for 5574 corneal transplants, increasing annually from 89 (1991) to 290 (2015)...
September 15, 2016: British Journal of Ophthalmology
Anita Ganger, Radhika Tandon, M Vanathi, Pardeep Sagar
PURPOSE: To report a case of post laser in situ keratomileusis (LASIK), nebulomacular corneal opacity following a trauma induced flap dehiscence and was managed with superficial anterior lamellar keratoplasty (SALK). CASE REPORT: A 32-year-old female underwent LASIK 2.5 years back, with a postoperative unaided visual acuity (VA) of 6/6 in both eyes. She was involved in a road traffic accident and sustained blunt trauma to the right eye 5 months before. At the time of presentation, the VA was 1/60 in the right eye...
July 2016: Journal of Ophthalmic & Vision Research
Kuan-I Wu, Hsiao-Sang Chu, Amy Shih-I Pai, Yu-Chih Hou, Szu-Yuan Lin, Wei-Li Chen, Fung-Rong Hu
PURPOSE: To assess the surgical and clinical outcomes of anterior lamellar keratoplasty using anterior corneal buttons from Descemet stripping automated endothelial keratoplasty (DSAEK) donor tissue. METHODS: Retrospective data from 8 patients with unilateral limbal dermoids, treated between February 2011 and January 2016 at National Taiwan University Hospital, were analyzed. Donor corneas for DSAEK were divided into anterior and posterior lamellae using a 350-μm microkeratome...
September 8, 2016: Cornea
Julia M Weller, Ursula Schlötzer-Schrehardt, Friedrich E Kruse, Theofilos Tourtas
PURPOSE: In Descemet membrane endothelial keratoplasty (DMEK), lamellar splitting of the Descemet's membrane (DM) may occur during stripping of host's DM, leaving residual DM on the recipient's DMEK interface. The purpose of this study was to determine the incidence rate of lamellar splitting of DM during DMEK and to describe the ultrastructure of DM in these eyes. DESIGN: Retrospective consecutive case series METHODS: Setting: Institutional, single-center PATIENT POPULATION: 664 eyes with Fuchs endothelial corneal dystrophy (FECD) scheduled for primary DMEK...
September 5, 2016: American Journal of Ophthalmology
Wen-Ya Qiu, Li-Bin Zheng, Fei Pan, Bei-Bei Wang, Yu-Feng Yao
BACKGROUND: Reis-Bücklers corneal dystrophy (RBCD) was consistently reported as a corneal dystrophy only affected Bowman's layer and superficial corneal stroma, and superficial keratectomy was a recommendation surgery for treatment in literatures. The study reported new histopathological and ultrastructural findings in RBCD caused by the Arg124Leu mutation of transforming growth factor induced (TGFBI) gene in a four-generation Chinese pedigree. METHODS: Subjects including eight patients and seven unaffected family members received slit-lamp biomicroscopy and photography...
2016: BMC Ophthalmology
Robert Hoerster, Tisha P Stanzel, Bjoern O Bachmann, Sebastian Siebelmann, Claus Cursiefen
PURPOSE: To investigate the effect of intensified postoperative topical steroid therapy after Descemet membrane endothelial keratoplasty combined with cataract surgery (Triple-DMEK) on postoperative endothelial cell density (ECD). METHODS: This comparative clinical study with historical controls was conducted at a tertiary hospital, specialized in corneal surgery. Patients undergoing DMEK or Triple-DMEK are included prospectively in the Cologne DMEK Database. Until April 2014, first week's postoperative standard therapy for lamellar keratoplasties was prednisolone acetate eye drops 1% applied 5× daily...
November 2016: Cornea
Sunita Chaurasia, Muralidhar Ramappa
AIMS: To study various types of morphological patterns of the air bubble and their relation to a peripheral paracentesis after air injection in corneal stroma in vitro experiment. METHODS: Air was injected into the donor corneas from the endothelial side and pattern was noted. Four different scenarios were created, namely (a) air injection into the deep stroma (n=11), (b) air injection into the superficial stroma (n=3), (c) air injection into the deep stroma after making a peripheral incision internal to the trabecular meshwork region that simulated an anteriorly placed paracentesis incision, with the site of air injection within a clock hour of the peripheral incision (n=7) and (d) air injection into the deep stroma after making a peripheral incision, the site of air injection being 180° away from the peripheral incision site (n=3)...
August 16, 2016: British Journal of Ophthalmology
Olivia S Huang, Jodhbir S Mehta, Hla M Htoon, Donald T Tan, Tina T Wong
PURPOSE: To report the incidence and risk factors of elevated IOP following deep anterior lamellar keratoplasty (DALK). DESIGN: A retrospective case series. METHODS: A retrospective study investigating the 5-year incidence of raised IOP following DALK cases performed from 2004 to 2008 in a tertiary center. Patients with less than 6 months of follow-up were excluded. Elevated IOP was defined as IOP >21 mm Hg. RESULTS: An episode of elevated IOP occurred in 36...
October 2016: American Journal of Ophthalmology
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