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Corneal graft rejection

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https://www.readbyqxmd.com/read/28505675/-anti-lymph-angiogenic-strategies-to-improve-corneal-graft-survival
#1
Felix Bock, Claus Cursiefen
Corneal transplantation (keratoplasty) is the most frequently performed form of transplantation worldwide. A rejection reaction against the transplant is the main complication occurring after transplantation in an already vascularized, so-called "high-risk" recipient eye. Our group has shown that clinically invisible lymphatic vessels play a crucial role in the induction of a rejection reaction against the corneal graft, and that anti-(lymph)angiogenic therapies in the mouse model of keratoplasty can significantly improve transplant survival...
May 2017: Klinische Monatsblätter Für Augenheilkunde
https://www.readbyqxmd.com/read/28505034/pediatric-corneal-transplants
#2
Danielle Trief, Maria C Marquezan, Christopher J Rapuano, Christina R Prescott
PURPOSE OF REVIEW: Pediatric keratoplasty poses unique challenges in clinical and surgical management. However, successful transplantation can afford a child vision in an otherwise poorly seeing eye. This review will provide an update on recent advances in pediatric keratoplasty. RECENT FINDINGS: Although children who receive corneal transplants remain at increased risk of rejection, infection, and graft dehiscence compared with adult corneal transplant recipients, new surgical techniques, and advances in clinical management have led to better outcomes...
May 12, 2017: Current Opinion in Ophthalmology
https://www.readbyqxmd.com/read/28495906/emergency-corneal-grafting-in-the-uk-a-6-year-analysis-of-the-uk-transplant-registry
#3
Parwez Hossain, Abdo Karim Tourkmani, Dimitri Kazakos, Mark Jones, David Anderson
BACKGROUND: Corneal graft (CG) surgery is the most common and successful tissue transplant worldwide. A small and important group of patients are operated in emergency situations, typically to save a perforated eye. Our knowledge of the indications and outcomes of emergency corneal graft (eCG) is limited. METHODS: Retrospective, multifactorial analysis of all CGs registered by the UK Transplant Service from April 1999 to March 2005. RESULTS: A total of 12 976 CGs were performed...
May 11, 2017: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/28457284/corneal-surgery-in-the-flying-eye-hospital-characteristics-and-visual-outcome
#4
Javed Hussain Farooqui, Emile Sharifi, Ahmed Gomaa
OBJECTIVE: The Flying Eye Hospital (FEH) of ORBIS International is a capacity-building platform that trains ophthalmologists throughout the developing world on-board a fully functional eye hospital based in an airplane and in the local hospitals of developing countries. Corneal blindness (CB) is the second leading cause of blindness in most developing countries. Treatment of existing global CB requires effective eye banking and surgeons trained in corneal transplant. ORBIS International has programs that addressed both those needs...
April 2017: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
https://www.readbyqxmd.com/read/28435226/inhibition-of-lymphangiogenesis-in-vitro-and-in-vivo-by-the-multikinase-inhibitor-nintedanib
#5
Tong Lin, Lan Gong
PURPOSE: To investigate the feasibility of nintedanib, a novel triple angiokinase inhibitor, for inhibiting lymphatic endothelial cell (LEC)-induced lymphangiogenesis in vitro and inflammatory corneal lymphangiogenesis in vivo. MATERIALS AND METHODS: Methylthiazolyldiphenyl-tetrazolium bromide (MTT) test, transwell system, and tube-formation assay were used to evaluate the effects of nintedanib on the proliferation, migration, and tube formation of LECs stimulated by vascular endothelial growth factor-C (VEGF-C), basic fibroblast growth factor (bFGF), or platelet-derived growth factor-BB (PDGF-BB)...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28429535/a-cross-circulated-bicephalic-model-of-head-transplantation
#6
Peng-Wei Li, Xin Zhao, Yun-Long Zhao, Bing-Jian Wang, Yang Song, Zi-Long Shen, Hong-Jun Jiang, Hai Jin, Sergio Canavero, Xiao-Ping Ren
AIMS: A successful cephalosomatic anastomosis ("head transplant") requires, among others, the ability to control long-term immune rejection and avoidance of ischemic events during the head transference phase. We developed a bicephalic model of head transplantation to study these aspects. METHODS AND RESULTS: The thoracic aorta and superior vena cava of a donor rat were anastomosed with the carotid artery and extracorporeal veins of a recipient rat by vascular grafts...
April 21, 2017: CNS Neuroscience & Therapeutics
https://www.readbyqxmd.com/read/28428556/treatment-of-donor-corneal-tissue-with-immunomodulatory-cytokines-a-novel-strategy-to-promote-graft-survival-in-high-risk-corneal-transplantation
#7
Maryam Tahvildari, Parisa Emami-Naeini, Masahiro Omoto, Alireza Mashaghi, Sunil K Chauhan, Reza Dana
Antigen-presenting cells (APCs) play an important role in transplant rejection and tolerance. In high-risk corneal transplantation, where the graft bed is inflamed and vascularized, immature APCs in the donor corneal stroma quickly mature and migrate to lymphoid tissues to sensitize host T cells. In this study, using a mouse model of corneal transplantation, we investigated whether enrichment of tolerogenic APCs (tolAPCs) in donor corneas can enhance graft survival in corneal allograft recipients with inflamed graft beds...
April 20, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28410548/two-year-clinical-outcome-of-500-consecutive-cases-undergoing-descemet-membrane-endothelial-keratoplasty
#8
Jorge Peraza-Nieves, Lamis Baydoun, Isabel Dapena, Abbas Ilyas, Laurence E Frank, Salvatore Luceri, Lisanne Ham, Silke Oellerich, Gerrit R J Melles
PURPOSE: To evaluate the clinical outcome of 500 consecutive cases up to 2 years after Descemet membrane endothelial keratoplasty (DMEK) and to assess which parameters may have influenced the clinical outcome. METHODS: From a group of 500 eyes (393 patients), which underwent DMEK for Fuchs endothelial corneal dystrophy (FECD), bullous keratopathy, failed corneal transplants and other indications, clinical outcomes [best-corrected visual acuity (BCVA), central endothelial cell density (ECD), and central corneal thickness] were evaluated before, and at 6, 12, and 24 months after DMEK and postoperative complications were documented...
June 2017: Cornea
https://www.readbyqxmd.com/read/28410359/intraoperative-s-stamp-enabled-rescue-of-3-inverted-descemet-membrane-endothelial-keratoplasty-grafts
#9
Peter B Veldman, Zachary M Mayko, Michael D Straiko, Mark A Terry
PURPOSE: To report the clinical outcomes of 3 Descemet membrane endothelial keratoplasty (DMEK) grafts, in which an upside down DMEK graft orientation was discovered after SF6 gas insufflation of the anterior chamber and the orientation was then corrected intraoperatively. METHODS: A total of 371 consecutive DMEK cases using an S-stamp were analyzed and found to include 3 cases in which the DMEK graft was initially elevated with SF6 gas in an upside down orientation, as demonstrated intraoperatively by the S-stamp...
June 2017: Cornea
https://www.readbyqxmd.com/read/28393447/anti-cd40-antibody-mediated-costimulation-blockade-promotes-long-term-survival-of-deep-lamellar-porcine-corneal-grafts-in-non-human-primates
#10
Jaeyoung Kim, Dong Hyun Kim, Hyuk Jin Choi, Hyun Ju Lee, Hee Jung Kang, Chung-Gyu Park, Eung-Soo Hwang, Mee Kum Kim, Won Ryang Wee
BACKGROUND: Corneal xenotransplantation is an effective solution for the shortage of human donor corneas, and the porcine cornea may be a suitable candidate for the donor cornea because of its optical similarity with humans. However, it is necessary to administer additional immunosuppressants to overcome antigenic differences. We aimed to investigate the feasibility of porcine corneas with anti-CD40 antibody-mediated costimulation blockade in a clinically applicable pig-to-non-human primate corneal xenotransplantation model...
April 10, 2017: Xenotransplantation
https://www.readbyqxmd.com/read/28380101/the-outcome-of-penetrating-keratoplasty-for-corneal-scarring-due-to-herpes-simplex-keratitis
#11
Yesim Altay, Sema Tamer, Abdullah Sencer Kaya, Ozgur Balta, Ayse Burcu, Firdevs Ornek
Purpose: To determine the outcomes of penetrating keratoplasty (PK) for treatment of corneal scarring caused by Herpes simplex virus (HSV) keratitis, and whether the corneal scar type affects treatment outcome. Methods: A retrospective analysis of patients who underwent PK for HSV-related corneal scarring between January 2008 and July 2011 was performed. The patients were categorized into two groups. Group 1 consisted of patients with a quiescent herpetic corneal scar and group 2 consisted of patients who developed a corneal descemetocele or perforation secondary to persistent epithelial defects with no active stromal inflammation...
January 2017: Arquivos Brasileiros de Oftalmologia
https://www.readbyqxmd.com/read/28380096/visual-rehabilitation-using-mini-scleral-contact-lenses-after-penetrating-keratoplasty
#12
Guilherme Andrade do Nascimento Rocha, Patrícia Oliveira Braga Miziara, Ana Clara Vieira de Castro, Arthur Andrade do Nascimento Rocha
Purpose: To report the visual rehabilitation outcomes and complications of patients fitted with mini-scleral rigid gas-permeable (RGP) contact lenses (mini-SCLs) after penetrating keratoplasty. Methods: We retrospectively reviewed 27 eyes (21 patients) that were fitted with mini-SCLs between October 2013 and December 2014. We analyzed demographic data, previous corneal disorders, visual outcomes, interval from keratoplasty to contact lens fitting, topographic and specular microscope data, fitted contact lens parameters, and complications...
January 2017: Arquivos Brasileiros de Oftalmologia
https://www.readbyqxmd.com/read/28374268/the-challenging-management-of-pediatric-corneal-transplantation-an-overview-of-surgical-and-clinical-experiences
#13
REVIEW
Antonio Di Zazzo, Stefano Bonini, Salvatore Crugliano, Michele Fortunato
PURPOSE: Pediatric keratoplasty is an immense challenge because of the technical complexity of the procedure and the high risk of rejection in young graft recipients. Our aim is to describe the major indications and appropriate timing of corneal transplantation intervention, including a report of our experience and surgical tips, in conjunction with the current literature. METHODS: Review of the literature on indications for keratoplasty in pediatric patients classified as: congenital, traumatic and acquired non-traumatic opacities...
April 3, 2017: Japanese Journal of Ophthalmology
https://www.readbyqxmd.com/read/28336058/large-9-mm-deep-anterior-lamellar-keratoplasty-with-clearance-of-a-6-mm-optical-zone-optimizes-outcomes-of-keratoconus-surgery
#14
Massimo Busin, Pia Leon, Yoav Nahum, Vincenzo Scorcia
PURPOSE: To evaluate the outcomes of a 9-mm deep anterior lamellar keratoplasty (DALK) with removal of the deep stroma limited to the central 6-mm optical zone. DESIGN: Prospective, noncomparative, interventional case series. PARTICIPANTS: A total of 80 consecutive keratoconic eyes without deep stromal scarring, with at least 1 postoperative examination 1 month after complete suture removal. INTERVENTION: A standardized DALK was performed, including (1) deep trephination of the recipient bed 450 to 550 μm in depth and 9 mm in diameter; (2) pneumatic dissection; (3) debulking of approximately 80% of the anterior stroma; (4) removal of the deep stroma (bubble roof) from a central 6-mm optical zone; and (5) transplantation of a 9-mm anterior corneal lamella cut by microkeratome-assisted dissection (400-μm head) and sutured with a double running 10-0 nylon suture...
March 20, 2017: Ophthalmology
https://www.readbyqxmd.com/read/28328727/strategies-for-deep-anterior-lamellar-keratoplasty-after-hydrops-in-keratoconus
#15
Matthias Fuest, Jodhbir S Mehta
Corneal hydrops affects approximately 2.5% of keratoconus (KC) cases, predominantly young males approximately 25 years of age with steep cones. Often, patients are left with a vision-reducing corneal scar frequently necessitating surgical treatment. Penetrating keratoplasty (PK) has worse survival outcomes in hydrops than in general KC cases. Deep anterior lamellar keratoplasty (DALK) is a nonpenetrating technique believed to achieve equal or better outcomes in visual acuity, graft survival, endothelial rejection rates, and endothelial cell survival in comparison with PK, while maintaining globe integrity and the patients' Descemet membrane (DM) and endothelium...
March 21, 2017: Eye & Contact Lens
https://www.readbyqxmd.com/read/28318723/pan-european-survey-of-the-topical-ocular-use-of-cyclosporine-a
#16
A Labbé, C Baudouin, D Ismail, M Amrane, J-S Garrigue, A Leonardi, F C Figueiredo, G Van Setten, M Labetoulle
OBJECTIVE: To assess medical practices surrounding the use of topical ocular cyclosporine A across European Union nations. METHODS: Key stakeholders (ophthalmologists, hospital pharmacists, regulatory health authorities) from European Union member states were interviewed by telephone using a semi-structured, open-ended questionnaire. Ophthalmologists responded to questions about practice patterns of cyclosporine A use (prescription frequency, indication, dosage), pharmacists about cyclosporine A formulations (composition, manufacturing process, quality control, distribution), and the regulatory authorities about market authorization and pharmacovigilance for various cyclosporine A products...
March 2017: Journal Français D'ophtalmologie
https://www.readbyqxmd.com/read/28299010/systemic-immunomodulatory-strategies-in-high-risk-corneal-transplantation
#17
REVIEW
Tulio B Abud, Antonio Di Zazzo, Ahmad Kheirkhah, Reza Dana
The cornea is the most commonly transplanted tissue in the body. Although corneal grafts generally have high success rates, transplantation onto inflamed and vascularized host beds, or so-called high-risk corneal transplantation, has a high rate of graft rejection. The management of this high-risk corneal transplantation is challenging and involves numerous measures. One of the key measures to prevent graft rejection in these cases is the use of systemic immunosuppressive agents. In this article, we will review the systemic immunosuppressive agents most commonly used for high-risk corneal transplantation, which include corticosteroids, cysclosporine A, tacrolimus, mycophenolate mofetil, and rapamycin...
January 2017: Journal of Ophthalmic & Vision Research
https://www.readbyqxmd.com/read/28259779/in-vivo-characteristics-of-corneal-endothelium-descemet-s-membrane-complex-for-the-diagnosis-of-corneal-graft-rejection
#18
Mohamed Abou Shousha, Sonia H Yoo, Mohamed S Sayed, Sean Edelstein, Matthew Council, Ravi S Shah, Joshua Abernathy, Zachary Schmitz, Patrick Stuart, Rocio Bentivegna, Maria P Fernandez, Christopher Smith, Xiaotang Yin, George J Harocopos, Sander R Dubovy, William J Feuer, Jianhua Wang, Victor L Perez
PURPOSE: To evaluate the utility of Endothelial/Descemet's membrane complex (En/DM) characteristics in diagnosing corneal graft rejection. DESIGN: Diagnostic reliability study. METHODS: 139 eyes (96 corneal grafts post penetrating keratoplasty or Descemet's stripping automated endothelial keratoplasty: 40 clear, 23 actively rejecting, 24 rejected and 9 non-immunological failed grafts, along with 43 age-matched control eyes) were imaged using high-definition optical coherence tomography...
March 1, 2017: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/28257425/corneal-stromal-stem-cells-reduce-corneal-scarring-by-mediating-neutrophil-infiltration-after-wounding
#19
Andrew J Hertsenberg, Golnar Shojaati, Martha L Funderburgh, Mary M Mann, Yiqin Du, James L Funderburgh
Corneal scarring limits vision for millions of individuals worldwide. Corneal transplantation (keratoplasty) is the standard of care for corneal opacity; however, it bears the risk of graft rejection and infection and is not universally available. Stem cell therapy holds promise as an alternative to keratoplasty. Stem cells from human corneal stroma (CSSC) induce regeneration of transparent corneal tissue in a mouse wound-healing model. In this study we investigated the mechanism by which CSSC prevent deposition of fibrotic tissue...
2017: PloS One
https://www.readbyqxmd.com/read/28251080/clinical-results-of-non-descemet-stripping-endothelial-keratoplasty
#20
Tao Zhang, Shao-Wei Li, Tie-Hong Chen, Jing-Liang He, Yan-Wei Kang, Fang-Qi Lyu, Jian-Hua Ning, Chang Liu
AIM: To investigate the impact of non-Descemet stripping endothelial keratoplasty (non-DSEK) on graft rejection rate, and its overall procedural effectiveness in patients. METHODS: Non-DSEK was performed on 65 eyes of 64 patients, and the procedural outcomes, including rejection episodes, failure and dislocation of the grafts, best corrected visual acuity (BCVA), endothelial cell density (ECD), and other complications, were analyzed retrospectively. RESULTS: Of the 65 eyes, 63 recovered from bullous keratopathy with a clear cornea...
2017: International Journal of Ophthalmology
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