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cornea transplantation

Andrew M Williams, Kelly W Muir
There is a severe shortage of donor corneas available worldwide for transplantation, with the number of patients in need of transplant greatly exceeding the number of cornea tissues available. Understanding awareness and attitudes about corneal donation worldwide is a critical step toward addressing this shortage. In this review, awareness of corneal donation and reported willingness to donate are summarized from 55 published studies across 13 countries. In general, many more respondents indicated positive attitudes toward eye donation and willingness to donate their eyes than the number of respondents who have pledged their eyes for donation, suggesting an unrealized potential of additional donors...
2018: Clinical Ophthalmology
Elias Flockerzi, Loay Daas, Ursula Schlötzer-Schrehardt, Annette Zimpfer, Rainer Bohle, Berthold Seitz
PURPOSE: Cystinosis is an autosomal recessive inherited lysosomal storage disease with an incidence of 1:100.000 up to 1:200.000 caused by a gene mutation of a lysosomal transport protein resulting in deposition of cystine in lysosomes in all cells and tissues. In the cornea, crystalline, gold-dust deposition of cystine leads to visual impairment, recurrent erosions, photophobia, epiphora and blepharospasmus. Standard therapy is topical and systemic application of cysteamine which may resolve the accumulated cystine crystals...
June 18, 2018: International Ophthalmology
Priya M Mathews, Kristina Lindsley, Anthony J Aldave, Esen K Akpek
PURPOSE: The purpose of this focused review was to explore the etiologies of corneal blindness worldwide and compare them with the indications and type of keratoplasties (eg, full-thickness penetrating keratoplasty, anterior lamellar keratoplasty, or endothelial keratoplasty) performed. METHODS: A literature search of the articles published in the top 10 journals (based on the Altmetrics score) relevant to corneal transplantation within the past 20 years was performed to determine how the focus within corneal transplantation has changed over time...
June 14, 2018: Cornea
Elyse J McGlumphy, Jordan A Margo, Moulaye Haidara, Clayton H Brown, Caroline K Hoover, Wuqaas M Munir
PURPOSE: Corneal endothelial cell density (ECD) is an important measure for determining suitability for transplantation. Although age has been correlated with ECD, the impact of sex and ethnicity is unclear. METHODS: Corneal donor information from SightLife Eye Bank was collected between 2012 and 2016. Tests of association were adjusted for covariates using linear regression including age, race, and sex. "Unsuitable for transplantation" was a label assigned to specimens with extensive cell dropout, ECD <2000 cells/mm, and poor cell morphology...
June 14, 2018: Cornea
Sebastian Siebelmann, Mario Matthaei, Ludwig M Heindl, Björn O Bachmann, Claus Cursiefen
BACKGROUND: The surgical treatment of corneal dystrophies develops rapidly as the use of lamellar corneal grafting techniques continue. While penetrating keratoplasty was the gold standard for treating a variety of dystrophies a few years ago, the affected layers of the cornea can, nowadays, be selectively replaced or ablated using laser technology. Of particular importance for these methods is optical coherence tomography, which has recently been integrated into surgical microscopes (MI-OCT)...
June 2018: Klinische Monatsblätter Für Augenheilkunde
André Vicente, Berit Byström, Mona Lindström, Ulf Stenevi, Fátima Pedrosa Domellöf
BACKGROUND: To study structural changes in naïve and surgically treated corneas of aniridia patients with advanced aniridia-related keratopathy (ARK). METHODS AND FINDINGS: Two naïve corneal buttons from patients with advanced ARK submitted to penetrating keratoplasty for the first time, one corneal button from an ARK patient that had undergone a keratolimbal allograft (KLAL), two corneal buttons from ARK patients who had previously undergone centered or decentered transplantation and were now retransplanted and two adult healthy donor control corneas were processed for immunohistochemistry...
2018: PloS One
Bogdan Spiru, Sabine Kling, Farhad Hafezi, Walter Sekundo
PURPOSE: To investigate the biomechanical properties of the ex vivo human cornea after flap-based versus cap-based laser refractive surgery in the same donor. METHODS: In this experimental study, 11 pairs of human corneas unsuitable for transplantation were equally divided into two groups. Corneas from the right eye were treated with femtosecond laser-assisted LASIK (FSLASIK) and corneas from the left eye with small incision lenticule extraction (SMILE). Pachymetry was measured in each eye directly before laser refractive surgery...
June 1, 2018: Journal of Refractive Surgery
Nikolaus Luft, Ricarda G Schumann, Martin Dirisamer, Daniel Kook, Jakob Siedlecki, Christian Wertheimer, Siegfried G Priglinger, Wolfgang J Mayer
PURPOSE: To assess the wound healing, inflammation, and tissue ultrastructure in the human corneal stroma after small incision lenticule extraction (SMILE) and femtosecond laser-assisted LASIK (FS-LASIK). METHODS: Sixteen corneoscleral discs of 16 human donors unsuitable for corneal transplantation were obtained from an eye bank. Eight eyes underwent SMILE with -5.00 diopters (D) of myopic correction; in 3 of them the lenticule was not extracted. Further 5 donor corneas were subjected to FS-LASIK with -5...
June 1, 2018: Journal of Refractive Surgery
Monica Lohchab, Gaurav Prakash, Tarun Arora, Prafulla Maharana, Vishal Jhanji, Namrata Sharma, Rasik B Vajpayee
The peripheral corneal thinning disorders are associated with degenerative, autoimmune, or infective causes. Corneal thinning can subsequently affect the visual acuity either by inducing severe astigmatism or by progressive involvement of the central cornea. In addition to this, the integrity of the eye is at risk. Medical management is necessary to adddress the underlying inflammatory or infectious causes; however, most of the cases require surgical intervention for tectonic support or for visual rehabilitation in patients with severe astigmatism...
June 7, 2018: Survey of Ophthalmology
Zekai Cui, Qiaolang Zeng, Shiwei Liu, Yanan Zhang, Deliang Zhu, Yonglong Guo, Mengyuan Xie, Sanjana Mathew, Dongqing Cai, Jun Zhang, Jiansu Chen
The development of functional therapies for corneal repair and regeneration is a pressing issue. Corneal stroma provides the principal functions of the cornea. However, because of the highly organized nature of the stromal matrix, the attempts to reproduce corneal stroma might follow a scar model. Here, we have developed a protocol for the efficient generation of a cell-laden and orthogonal-multilayer tissue-engineered (TE) corneal stroma, which is induced by the mechanical effects of compressed collagen (CC) or stretched compressed collagen (SCC)...
June 5, 2018: Acta Biomaterialia
Manuel A Ramirez-Garcia, Yousuf M Khalifa, Mark R Buckley
Corneal endothelial cell (CEC) loss occurs with surgical anterior segment surgery and corneal transplantation tissue manipulation as well as from contact with synthetic materials like intraocular lenses and tube shunts. While several studies have quantified CEC loss for specific surgical steps, the vulnerability of CECs to isolated, controllable and measurable mechanical forces has not been assessed previously. The purpose of this study was to develop an experimental testing platform where the susceptibility of CECs to controlled mechanical trauma could be measured...
June 5, 2018: Experimental Eye Research
Jeffrey H Stern, Yangzi Tian, James Funderburgh, Graziella Pellegrini, Kang Zhang, Jeffrey L Goldberg, Robin R Ali, Michael Young, Yubing Xie, Sally Temple
Ocular regenerative therapies are on track to revolutionize treatment of numerous blinding disorders, including corneal disease, cataract, glaucoma, retinitis pigmentosa, and age-related macular degeneration. A variety of transplantable products, delivered as cell suspensions or as preformed 3D structures combining cells and natural or artificial substrates, are in the pipeline. Here we review the status of clinical and preclinical studies for stem cell-based repair, covering key eye tissues from front to back, from cornea to retina, and including bioengineering approaches that advance cell product manufacturing...
June 1, 2018: Cell Stem Cell
Yi Qin, Yingnan Zhang, Qingfeng Liang, Xiaolin Xu, Qian Li, Zhiqiang Pan, Antoine Labbé
Purpose: To evaluate the effectiveness of autologous labial salivary gland with labial mucous membrane graft in a rhesus monkey model with severe dry eye. Methods: Eight eyes of eight rhesus monkeys with severe dry eye were included. Four eyes underwent autologous labial salivary gland and mucous membrane graft (group 1) and four eyes served as controls (group 2). The ocular surface was evaluated before and after transplantation surgery (at 1, 4, 8, 12, and 24 weeks)...
May 1, 2018: Investigative Ophthalmology & Visual Science
Rafaella Nascimento E Silva, Lycia Maria Martins Pinho Pedral Sampaio, Aline Silveira Moriyama, Nicolas Cesário Pereira, Mark Lane, Hudson Vergennes da Silva, Adriana Dos Santos Forseto
PURPOSE: Donated corneas are classified as tectonic if there are defects within any layers of the cornea which would prevent a satisfactory visual outcome after transplantation. This study aimed to evaluate whether some tectonic corneas have sufficient endothelial characteristics to allow their use in posterior lamellar keratoplasty, and explored their reclassification for use in this sight-improving procedure. METHODS: A retrospective review of all corneal tissues preserved by the Sorocaba Eye Bank from January to April of 2014 was performed...
April 2018: Arquivos Brasileiros de Oftalmologia
Erika Christina Canarim Martha de Pinho, Fernando Chahud, João-José Lachat, Joaquim José Coutinho-Netto, Sidney Julio Faria E Sousa
RESUMO Objetivo: Estudar o uso da biomembrana de látex e o transplante conjuntival autólogo na cicatrização conjuntival em coelhos. Métodos: Em nove coelhos albinos, neo-zelandeses, machos foram removidas áreas retangulares idênticas, do quadrante supero nasal, adjacente ao limbo, de ambos os olhos. As áreas desnudas da camada esclerótica nos olhos direitos foram recobertas com biomembrana de látex e a dos olhos esquerdos com enxerto conjuntival autólogo. Os animais foram sacrificados em grupos de três, aos 7, 14 e 21 dias após a cirurgia...
April 2018: Arquivos Brasileiros de Oftalmologia
Rachelle N Palchesko, Santiago D Carrasquilla, Adam W Feinberg
Corneal blindness is a major cause of vision loss, estimated to affect over 10 million people worldwide. Once impaired through clouding or shape change, the best treatment option for restoring vision is corneal transplantation using full or partial thickness cadaveric grafts. However, donor corneas are globally limited and face rejection and graft failure, similar to other transplanted organs. Thus, there is a need for viable alternatives to donor corneas in order to increase supply, reduce rejection, and to minimize variability in tissue quality...
May 29, 2018: Advanced Healthcare Materials
Rahul A Sharma, John S Y Park, Yao Wang, Tinghua Zhang, Linda Sharpen, William Dixon, Rookaya Mather
OBJECTIVE: (i) To assess the rate of positive microbiological cultures of corneas prepared by the Eye Bank of Canada (Ontario Division) between January 1, 2012, and December 31, 2013; (ii) to review the microbiology protocols at the 5 major transplant centres in Ontario; and (iii) to assess the incidence of endophthalmitis during the study period. DESIGN: Retrospective chart review. PARTICIPANTS: A total of 4186 consecutive cultured corneal tissues prepared by the Eye Bank from January 1, 2012, to December 31, 2013...
June 2018: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
Qihua Le, C Michael Samson, Sophie X Deng
PURPOSE: To report a case of corneal neovascularization misdiagnosed as total limbal stem cell deficiency (LSCD). METHODS: This is a case report of a 61-year-old woman who has a history of bilateral idiopathic scleritis, keratitis, and uveitis for more than 20 years. She was diagnosed with total LSCD in her left eye based on clinical presentation alone and was confirmed as a candidate for limbal transplantation at several major tertiary eye care centers in the United States...
May 16, 2018: Cornea
David Mingo-Botín, Francisco Arnalich-Montiel, Ana Couceiro de Juan, Sara Ortiz-Toquero
PURPOSE: To assess intrasession repeatability and intersession reproducibility of Pentacam corneal thickness maps in patients with Fuchs endothelial corneal dystrophy (FECD) before and after endothelial transplantation. METHODS: In this observational diagnostic evaluation, 20 healthy subjects along with 81 consecutive patients were examined. Patients were classified into 4 groups: FECD without corneal edema, FECD with corneal edema, Descemet stripping automated endothelial keratoplasty, and Descemet membrane endothelial keratoplasty...
May 16, 2018: Cornea
V Kocaba, O Damour, C Auxenfans, C Burillon
In France, endothelial dysfunction represents approximately one half of the indications for corneal transplants performed each year. However, the use of endothelial keratoplasty is limited by the technical difficulty of the procedure, a shortage of available grafts, and the potential for graft failure or rejection. These limitations are driving researchers to develop new, less invasive, and more effective therapies. Corneal endothelial cell therapy is being explored as a potential therapeutic measure, to avoid the uncertainty associated with grafting...
May 14, 2018: Journal Français D'ophtalmologie
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