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Deep lamellar

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
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
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
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
Hiroshi Eguchi, Shunji Kusaka, Eiko Arimura-Koike, Kuniko Tachibana, Daishi Tsujioka, Masahiko Fukuda, Yoshikazu Shimomura
There is no report focusing on the visualization of the iris incarceration or the iridocorneal adhesion during keratoplasty by use of microscope-integrated intraoperative optical coherence tomography (MIOCT). The purpose of this study is to report the usefulness of MIOCT for detecting iris incarceration and iridocorneal adhesions during penetrating keratoplasty (PK) and deep anterior lamellar keratoplasty (DALK). MIOCT system was applied both in a patient who underwent PK for corneal leukoma and in a patient who underwent DALK for keratoconus...
August 11, 2016: International Ophthalmology
Bernhard Steger, Elinor Curnow, Robert Cheeseman, Vito Romano, Abigail Kaye, Mark Jones, Stephen Kaye
PURPOSE: To investigate graft survival and rejection following sequential bilateral corneal transplantation. DESIGN: Retrospective cohort study. METHODS: The study included patients with Fuchs endothelial dystrophy (FED), pseudophakic bullous keratopathy (PBK), or keratoconus who had undergone a penetrating keratoplasty (PK), endothelial keratoplasty (EK), or deep anterior lamellar keratoplasty (DALK) between 1999 and 2012. The main cohort included patients who had received a first transplant in both eyes for the same indication and a control cohort patients who had undergone a unilateral first corneal transplant...
October 2016: American Journal of Ophthalmology
Luca Buzzonetti, Roberta Ardia, Sergio Petroni, Gianni Petrocelli, Paola Valente, Rosa Parrilla, Giancarlo Iarossi
PURPOSE: The purpose was to evaluate indications and clinical outcomes in paediatric corneal keratoplasty. METHODS: Fifty-four eyes of 43 patients who underwent corneal keratoplasty from the 1(st) of January 2010 through the 31(st) of December 2013 at the Bambino Gesù Children's Hospital in Rome, Italy, were retrospectively evaluated. To assess the effect of age on graft failure rate, the recipient age was considered as a dichotomous variable (≤5 or >5 years) and a 2X2 table was developed, using the chi-square test for testing the statistical significance...
August 3, 2016: Graefe's Archive for Clinical and Experimental Ophthalmology
Nimrod Miller, Han Shi, Aaron S Zelikovich, Yong-Chao Ma
Spinal muscular atrophy (SMA), the leading genetic cause of infant mortality, predominantly affects high metabolic tissues including motor neurons, skeletal muscles and the heart. Although the genetic cause of SMA has been identified, mechanisms underlying tissue-specific vulnerability are not well understood. To study these mechanisms, we carried out a deep sequencing analysis of the transcriptome of spinal motor neurons in a SMA mouse model, in which we unexpectedly found changes in many genes associated with mitochondrial bioenergetics...
August 3, 2016: Human Molecular Genetics
S L AlTaan, K Termote, M S Elalfy, E Hogan, R Werkmeister, L Schmetterer, S Holland, H S Dua
PurposeTo define optical coherence tomography (OCT) characteristics of type-1, type-2, and mixed big bubbles (BB) seen in deep anterior lamellar keratoplasty.MethodsHuman sclero-corneal discs were obtained from UK (30) and Canada (16) eye banks. Air was injected into corneal stroma until a BB formed. UK samples were fixed in formalin before scanning with Fourier-domain (FD-OCT). One pair of each type of BB was scanned fresh. All BB obtained from Canada were scanned fresh with time-domain (TD-OCT). For each OCT machine used, type-1 BB from which Descemets membrane (DM) was partially peeled, were also scanned...
July 29, 2016: Eye
Suxia Li, Ting Wang, Jiang Bian, Fuhua Wang, Shasha Han, Weiyun Shi
PURPOSE: To evaluate the outcomes of femtosecond laser-assisted deep lamellar keratoplasty (FDLK) in treating advanced keratoconus. METHODS: In the management of keratoconus in advanced stages, 89 patients (94 eyes) received FDLK, and 100 patients (100 eyes) underwent vacuum trephine-assisted deep anterior lamellar keratoplasty (DALK). Visual acuity, corneal curvature, and central corneal thickness were measured. The follow-up duration was 1 year. RESULTS: The best-corrected visual acuity (logMAR) was 0...
October 2016: Cornea
Gloria López-Valverde, Elena Garcia-Martin, José Manuel Larrosa-Povés, Vicente Polo-Llorens, Luis E Pablo-Júlvez
PURPOSE: The purpose of this study is to describe a case of ocular rosacea with a very complex evolution. Rosacea is a chronic dermatological disease that may affect the ocular structures up to 6-72% of all cases. This form is often misdiagnosed, which may lead to long inflammatory processes with important visual consequences for affected patients. Therefore, an early diagnosis and an adequate treatment are important. METHODS: We report the case of a 43-year-old patient who had several relapses of what seemed an episode of acute bacterial conjunctivitis...
January 2016: Case Reports in Ophthalmology
Seema Ramakrishnan, Prabu Baskaran, Romana Fazal, Syed Mohammad Sulaiman, Tiruvengada Krishnan, Rengaraj Venkatesh
Achieving a formed and firm eyeball which is stably fixed in a holding device is a major challenge of surgical wet-lab training. Our innovation, the 'Spring-action Apparatus for Fixation of Eyeball (SAFE)' is a robust, simple and economical device to solve this problem. It consists of a hollow iron cylinder to which a spring-action syringe is attached. The spring-action syringe generates vacuum and enables reliable fixation of a human or animal cadaveric eye on the iron cylinder. The rise in intraocular pressure due to vacuum fixation can be varied as per need or nature of surgery being practised...
October 2016: British Journal of Ophthalmology
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