Journal of EuCornea最新文献

{"title":"Corneal epithelial restoration after penetrating keratoplasty in repeated failed cultivated limbal stem cell grafts","authors":"Joséphine Behaegel ,&nbsp;Carina Koppen ,&nbsp;Veerle Van Gerwen ,&nbsp;Marie-José Tassignon ,&nbsp;Sorcha Ní Dhubhghaill","doi":"10.1016/j.xjec.2019.03.001","DOIUrl":"https://doi.org/10.1016/j.xjec.2019.03.001","url":null,"abstract":"<div><h3>Purpose</h3><p>To report a case of corneal epithelial restoration after penetrating keratoplasty following multiple complications in repeated failed cultivated stem cell grafts.</p></div><div><h3>Methods</h3><p>This is a case report of a 62-year old patient who was treated for unilateral severe limbal stem cell deficiency after a chemical burn of the right eye.</p></div><div><h3>Results</h3><p>Two attempts to reconstruct the ocular surface using autologous cultivated limbal stem cell grafts (CLET) failed, and were complicated by perforations requiring two emergency penetrating keratoplasties. While the first donor cornea revascularised quickly, the corneal epithelium of the second remained transparent, avascular and stable until one year postoperatively. In vivo confocal microscopic examination confirmed presence of a healthy corneal epithelial phenotype.</p></div><div><h3>Conclusions</h3><p>Occurrence of serious adverse events are related to an inadequate epithelial homeostasis following CLET. The mechanisms of action of limbal stem cell transplantation are still poorly understood and the corneal epithelial integrity may be maintained without limbal input.</p></div>","PeriodicalId":100782,"journal":{"name":"Journal of EuCornea","volume":"2 ","pages":"Pages 6-9"},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.xjec.2019.03.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72241789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single arcuate keratotomy based on front axial curvature and front elevation topographic maps to improve post-keratoplasty astigmatism","authors":"K. Tu","doi":"10.1016/J.XJEC.2019.03.002","DOIUrl":"https://doi.org/10.1016/J.XJEC.2019.03.002","url":null,"abstract":"","PeriodicalId":100782,"journal":{"name":"Journal of EuCornea","volume":"197 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77390361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Descemet membrane endothelial keratoplasty after penetrating keratoplasty","authors":"Jose L. Güell ,&nbsp;Merce Morral ,&nbsp;Miriam Barbany ,&nbsp;Oscar Gris ,&nbsp;Daniel Elies ,&nbsp;Felicidad Manero","doi":"10.1016/j.xjec.2019.03.003","DOIUrl":"10.1016/j.xjec.2019.03.003","url":null,"abstract":"<div><h3>Purpose</h3><p>To describe visual and clinical outcomes of descemet membrane endothelial keratoplasty (DMEK) for late endothelial failure after penetrating keratoplasty (PK).</p></div><div><h3>Methods</h3><p>Retrospective, observational study of patients who consecutively received DMEK to treat PK graft failure. Intraoperative complications were recorded. Our previously described DMEK surgical technique was used except that host descemet membrane was not stripped in any of the eyes. Corrected distance visual acuity (CDVA), and endothelial cell density (ECD) were evaluated before surgery and at regular intervals up to 24 months after the surgery.</p></div><div><h3>Results</h3><p>Twenty-six eyes of 26 patients were included. Mean host age was 58.50 ± 12.50 years old. Mean donor age was 65.30 ± 10.49. Mean follow up after DMEK was 23.08 ± 10.27 (range 6 months–48 months). Seventeen (65.38%) eyes reached at least the 24-month follow up time point. At last follow up, 24 eyes (92.31%) presented with clear corneas. Twenty-four months postoperatively, mean Snellen CDVA in decimal fraction was 0.75 ± 0.03 (range 0.6–0.80) and mean central endothelial cell density was 1480.41 ± 320.56 cells/mm² (range, 591–1950 cells/mm²). Mean cell loss at 6 months was 27.67 ± 16.03%. Three (11.53%) eyes had significant graft detachment that required re-bubbling. No episodes of immunological graft rejection were documented.</p></div><div><h3>Conclusions</h3><p>Our experience shows that DMEK is a useful technique to treat endothelial graft failure following PK. Compared to repeat PK, DMEK-specific surgical complications and postsurgical management should be expected.</p></div>","PeriodicalId":100782,"journal":{"name":"Journal of EuCornea","volume":"2 ","pages":"Pages 10-13"},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.xjec.2019.03.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88933860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single arcuate keratotomy based on front axial curvature and front elevation topographic maps to improve post-keratoplasty astigmatism","authors":"Kyaw L. Tu","doi":"10.1016/j.xjec.2019.03.002","DOIUrl":"https://doi.org/10.1016/j.xjec.2019.03.002","url":null,"abstract":"<div><h3>Purpose</h3><p>To describe using single arcuate keratotomy (SAK) and compression sutures (CS) to improve two cases of post-keratoplasty irregular astigmatism.</p></div><div><h3>Patients and methods</h3><p>Patient A. A 26 year-old female with keratoconus developed left acute hydrops and underwent a penetrating keratoplasty. She subsequently developed cataract in that eye and uncorrected visual acuity (UCVA) was counting fingers. Patient B. A 57 year-old man had left penetrating keratoplasty for keratoconus 30 years previously. UCVA was 0.96 LogMAR. He could not achieve good vision with spectacles and found it increasingly difficult to tolerate contact lenses. Both patients had irregular graft astigmatism and underwent SAK and CS based on front axial curvature and front elevation topographic maps. Patient A had incisional refractive surgery combined with cataract removal and lens implantation.</p></div><div><h3>Results</h3><p>Patient A at 6 months postoperative (4 months post-removal of CS) visit attained visual acuity of 0.50 LogMAR unaided, improving to 0.10 LogMAR with −4.50DS/+7DC × 45°. Keratometric surgical effect (KSE) was +2.54DS/−4.69DC × 27° and the percentage reduction in astigmatic error was 57.8%. Patient B at 4 months postoperative (6 weeks post-removal of CS) visit attained unaided visual acuity of 0.42 LogMAR and 0.10 LogMAR with +0.50DS/−6.00DC × 175°. KSE was −4.94DS/10.27DC × 13° and the percentage reduction in astigmatic error was 65.3%.</p></div><div><h3>Conclusion</h3><p>Single arcuate keratotomy with compression sutures based on front axial curvature and front elevation topographic maps can be a safe and effective treatment for post-keratoplasty irregular astigmatism.</p></div>","PeriodicalId":100782,"journal":{"name":"Journal of EuCornea","volume":"2 ","pages":"Pages 14-17"},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.xjec.2019.03.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72241790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unilateral astigmatic changes associated with pressure induced stromal keratitis after bilateral laser in situ keratomileusis: A case report","authors":"Arpita K. Bhasin MD/PhD,&nbsp;Soroosh Behshad MD, MPH","doi":"10.1016/j.xjec.2019.04.003","DOIUrl":"https://doi.org/10.1016/j.xjec.2019.04.003","url":null,"abstract":"<div><h3>Purpose</h3><p>To describe a patient with unilateral astigmatic changes associated with stromal edema secondary to increased intraocular pressure after LASIK.</p></div><div><h3>Method</h3><p>Case report and review of the literature.</p></div><div><h3>Results</h3><p>We report a case of unilateral astigmatic changes associated with increased intraocular pressure (IOP) immediately following bilateral LASIK. After treatment with two IOP lowering medications and early cessation of steroids, the topographic and manifest astigmatism gradually resolved with improvement in visual acuity.</p></div><div><h3>Conclusion</h3><p>Pressure induced stromal keratitis (PISK) can have an asymmetric presentation that may manifest with an increase in corneal curvature. Corneal topography changes are not typically reported with PISK. Therefore, we wish to bring light to topographical changes as a tool to help aid in early diagnosis of PISK.</p></div>","PeriodicalId":100782,"journal":{"name":"Journal of EuCornea","volume":"2 ","pages":"Pages 24-26"},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.xjec.2019.04.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72241791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Topography-guided ablation for the treatment of irregular astigmatism","authors":"S. Kwitko, Felipe P. Cabral, B. S. Araújo, Y. P. Jung","doi":"10.1016/J.XJEC.2019.04.001","DOIUrl":"https://doi.org/10.1016/J.XJEC.2019.04.001","url":null,"abstract":"","PeriodicalId":100782,"journal":{"name":"Journal of EuCornea","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74375738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimization and histological validation of DMEK graft preparation with specific instruments","authors":"Javier Cabrerizo ,&nbsp;Clara Rodriguez-Aierbe ,&nbsp;Klavs Højgaard-Olsen ,&nbsp;Maria Christiansen-Kyhn ,&nbsp;Mark Alberti ,&nbsp;Jesus Garrido-Fierro","doi":"10.1016/j.xjec.2018.07.001","DOIUrl":"10.1016/j.xjec.2018.07.001","url":null,"abstract":"<div><h3>Purpose</h3><p>To assess the learning curve and technique standardization of Descemet membrane endothelial keratoplasty (DMEK) preparation with a purpose-specific instruments at The Basque Transfusion and Human Tissue Centre.</p></div><div><h3>Methods</h3><p>Twenty corneas not eligible for transplantation from 18 donors were prepared by an eye bank technician without previous surgical experience. The technique was monitored and standardized and three differentiated steps were characterized: “cleaning”, “stripping” and “pulling”. Preparation time, number of tears at every stage of the technique and donor demographics were measured. Tissue damage was catagorized into five graft morphological types. To evaluate microscopic tissue damage, electron microscopy images were taken from three pre-specified areas of the donor cornea: graft periphery, trabecular meshwork and denuded stroma.</p></div><div><h3>Results</h3><p>Viable grafts resulted in 14 out of the 20 preparations. A positive trend was found between graft usability and the experience of the operator. Small peripheral round tears were the most common findings overall and in the viable grafts subset. Radial and round tears occurred most frequently during the stripping and the cleaning phase, respectively. Univariate analyses showed no correlation between preparation time, donor age and gender and culture medium.</p></div><div><h3>Conclusion</h3><p>DMEK preparation with a purpose-specific instruments may have a relatively short learning curve, suggesting feasibility for eye bank technicians without previous surgical experience.</p></div>","PeriodicalId":100782,"journal":{"name":"Journal of EuCornea","volume":"1 2","pages":"Pages 23-30"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.xjec.2018.07.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86268728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare case of Histoplasma Keratitis in an immunocompetent patient","authors":"Ashish Nagpal ,&nbsp;Dhwni Shahanand ,&nbsp;Jinkal Shah ,&nbsp;Bhavini Shah","doi":"10.1016/j.xjec.2018.07.002","DOIUrl":"10.1016/j.xjec.2018.07.002","url":null,"abstract":"<div><h3>Purpose</h3><p>To report an unusual case of isolated Histoplasma Keratitis in a healthy immune competent patient in a tertiary eye care centre in Western India.</p></div><div><h3>Methods</h3><p>A 50 year old patient diagnosed with microbial keratitis was investigated microbiologically and was proven to have Histoplasma Keratitis on the culture of the corneal scrapping. The patient was successfully treated with topical antifungals leading to resolution of keratitis.</p></div><div><h3>Results</h3><p>A 50 year old immune-competent patient with a central corneal infiltrate underwent corneal scrapping and the sample was sent for microbiology and culture. The culture growth showed growth of Histoplasma Capsulatum and was treated with topical Amphotericin B (0.15%) and natamycin (5%). The lesion resolved in 20 days to leave behind a faint nebular scar. No other ocular or systemic associations of Histoplasmosis were found on further investigation.</p></div><div><h3>Conclusion</h3><p>This is the second case report on Histoplasma Keratitis and the first one reported in an immune-competent patient in Indian subcontinent, to the best of our knowledge. Mycotic corneal infections being very common in India (temperate climate), it is imperative to do a detailed microbiological work-up of a patient with microbial keratitis. Isolated Histoplasma Keratitis can occur in immune-competent individuals. These patients respond very well to topical Amphotericin B (0.15%) and recover completely.</p></div>","PeriodicalId":100782,"journal":{"name":"Journal of EuCornea","volume":"1 2","pages":"Pages 31-33"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.xjec.2018.07.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73844207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of chitosan and chitosan N-acetylcysteine solutions on conjunctival epithelial cells","authors":"Nadine Schuerer ,&nbsp;Elisabeth Stein ,&nbsp;Aleksandra Inic-Kanada ,&nbsp;Ehsan Ghasemian ,&nbsp;Marijana Stojanovic ,&nbsp;Jacqueline Montanaro ,&nbsp;Nora Bintner ,&nbsp;Christine Hohenadl ,&nbsp;Robert Sachsenhofer ,&nbsp;Talin Barisani-Asenbauer","doi":"10.1016/j.xjec.2018.04.002","DOIUrl":"10.1016/j.xjec.2018.04.002","url":null,"abstract":"<div><h3>Aim of the study</h3><p>Chitosan, a partially deacetylated polysaccharide derived from chitin, and chitosan-N-acetylcysteine (C-NAC), a thiolated chitosan, both show enhanced retention times on the ocular surface when compared to other polymers commonly used in eye drops. To evaluate these compounds as adjuvants for ocular drug delivery or uptake of topically administered conjunctival vaccines, biochemical characteristics of both polymers were investigated <em>in vitro</em> and <em>in vivo</em>.</p></div><div><h3>Methods</h3><p>Human conjunctival epithelial (HCjE) cells were used to investigate biocompatibility of buffered chitosan and C-NAC containing formulations. Cellular uptake was studied using fluorescein-isothiocyanate (FITC)-labelled polymers. Transepithelial electrical resistance (TEER) measurements were performed to determine effects of chitosan on tight junctions of stratified HCjE cells <em>in vitro</em>. <em>In vivo</em> uptake of topically applied chitosan into conjunctival epithelial cells was investigated in guinea pigs.</p></div><div><h3>Results</h3><p>Minimal effects on cell viability were seen with both compounds after application for 30 min in a concentration of 0.1%. <em>In vitro</em> uptake into HCjE cells was only observed with the chitosan containing solution. An effect on tight junctions was demonstrated by significantly (<em>P</em> &lt; .05) decreasing TEER levels 60 min after incubation with chitosan. <em>In vivo</em>, FITC-labelled chitosan was detected within guinea pig conjunctival epithelial cells 120 min after topical administration. No adverse effects were observed.</p></div><div><h3>Conclusions</h3><p>Results demonstrated that chitosan is taken up into conjunctival epithelial cells <em>in vitro</em> and <em>in vivo</em>, therefore fulfilling some of the requirements of an adjuvant for conjunctival mucosal vaccines. C-NAC is also well tolerated but not taken up by cells, making it a good candidate for ocular formulations supposed to persist on the ocular surface for an extended period of time.</p></div>","PeriodicalId":100782,"journal":{"name":"Journal of EuCornea","volume":"1 1","pages":"Pages 12-18"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.xjec.2018.04.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83139999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bursting and Booming Bubbles","authors":"Harminder S Dua MD, FRCOphth., PhD.","doi":"10.1016/j.xjec.2018.06.001","DOIUrl":"10.1016/j.xjec.2018.06.001","url":null,"abstract":"","PeriodicalId":100782,"journal":{"name":"Journal of EuCornea","volume":"1 1","pages":"Pages 1-2"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.xjec.2018.06.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87253845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}