Cornea最新文献

{"title":"Letter Regarding: Comment on \"Descemet Membrane Endothelial Keratoplasty with and Without Graft Deswelling: A Prospective Clinical Study\".","authors":"Qinling Jiang, Lin Mou","doi":"10.1097/ICO.0000000000003912","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003912","url":null,"abstract":"","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atypical Endophthalmitis Following Artificial Corneal Endothelial Implantation.","authors":"Beatrice Cesaro, Mariantonia Ferrara, Francesco Morescalchi, Nicola Bergamaschi, Federico Gandolfo, Francesco Semeraro, Vito Romano","doi":"10.1097/ICO.0000000000003916","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003916","url":null,"abstract":"<p><strong>Purpose: </strong>EndoArt is an artificial endothelial layer device for the management of chronic corneal edema in cases with multiple corneal failed transplants, aiming to restore corneal deturgescence and optical clarity. However, postoperative complications, such as endophthalmitis, remain a significant risk. We report the first case of EndoArt-associated endophthalmitis, although a direct causual link remains uncertain.</p><p><strong>Case description: </strong>A 75-year-old woman presented with increasing floaters in the left eye 7 months after EndoArt implantation for corneal endothelial dysfunction following multiple graft failures. At presentation, the best-corrected visual acuity (BCVA) was counting fingers, without ocular pain. Slitlamp examination showed noninjected conjunctiva and well-positioned corneal implant with mild corneal edema. B-scan ultrasonography revealed mild vitreous haze, flat retina. Six weeks before, a corneal transfixing single suture was removed. Right eye was unremarkable. The following day, BCVA in the left eye worsened with the appearance of stromal infiltrate, anterior chamber fibrin, and hypopyon, increased vitreous opacification and vitreous strands, leading to diagnosis of endophthalmitis. The patient underwent prompt vitrectomy, revealing purulent vitreous infiltration and hemorrhagic chorioretinitis. The EndoArt was not removed, as not directly involved in the infection. Staphylococcus epidermidis was identified in the aqueous and vitreous humors. Postoperative local and systemic antibiotics led to a gradual resolution of inflammation. At 2-month follow-up, the BCVA improved to 20/400.</p><p><strong>Discussion: </strong>This case describes the atypical clinical appearance and the rapid progression of endophthalmitis in a patient with EndoArt. Prompt vitrectomy and a conservative approach, with EndoArt retention, led to infection resolution and preserved corneal clarity.</p><p><strong>Conclusions: </strong>Vigilance, early diagnosis, and a tailored surgical approach are crucial to improving outcomes after artificial corneal endothelial implantation. Here the artifcial corneal endothelium implantation may have helped preserve cornea clarity during endophthalmitis, enably timely vitrectomy and contribuiting to a favorable outcome.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Efficacy of Corneal Crosslinking Combined With Phototherapeutic Keratectomy With or Without Topography-Guided Photorefractive Keratectomy.","authors":"Pedro Gil, João Quadrado Gil, Margarida Dias, Telmo Cortinhal, Nuno Alves, Andreia Rosa, Joaquim Murta","doi":"10.1097/ICO.0000000000003921","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003921","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the visual, refractive, and tomographic outcomes between transepithelial phototherapeutic keratectomy (PTK) with corneal crosslinking (CXL) and topography-guided photorefractive keratectomy (TG-PRK) with PTK and CXL.</p><p><strong>Methods: </strong>Longitudinal retrospective case-control study. Patients with progressive keratoconus submitted to either PTK-CXL or PTK and TG-PRK plus CXL (PRK-CXL) protocols were included, depending on baseline pachymetry and corrected distance visual acuity (CDVA). Minimum follow-up of 12 months up to 3 years.</p><p><strong>Results: </strong>A total of 120 eyes from 120 patients were included, 51.7% (n = 62) in the PTK-CXL and 48.3% (n = 58) in the PRK-CXL groups. Baseline characteristics were similar between groups, except for logMAR CDVA (PTK-CXL: 0.36 ± 0.24; PRK-CXL: 0.47 ± 0.21; P = 0.025) and thinnest pachymetry (PTK-CXL: 436.58 ± 37.09 μm; PRK-CXL: 460.83 ± 21.90; P = 0.002). LogMAR CDVA significantly improved, with no differences between groups across all time points. But the mean improvement between the last follow-up and baseline was higher in the PRK-CXL group (PTK-CXL: -0.12 ± 0.19; PRK-CXL: -0.24 ± 0.22; P = 0.015). Maximum keratometry remained stable in the PTK-CXL (baseline: 60.82 ± 6.94D; 1 year: 60.82 ± 8.05; P = 0.993) but flattened in the PRK-CXL groups (baseline: 59.05 ± 5.97; 1 year: 54.45 ± 5.88; P < 0.001). Total and higher-order aberrations improved in both groups, but spherical aberration and coma only improved after PRK-CXL. All tomographic features remained stable across the follow-up.</p><p><strong>Conclusions: </strong>PTK-CXL and TG-PRK plus CXL protocols are safe and effective both at arresting the disease progression and providing visual improvement. The latter brings further corneal flattening, greater visual improvement, and less corneal aberrations. For patients with progressive keratoconus with adequate corneal thickness, we recommend combined TG-PRK plus CXL, with the PTK-CXL protocol reserved for patients with better visual acuity or thinner corneas.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply.","authors":"Gowri Pratinya Kolipaka, Sirisha Senthil","doi":"10.1097/ICO.0000000000003900","DOIUrl":"10.1097/ICO.0000000000003900","url":null,"abstract":"","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a Mentoring Program in Cornea: Findings from a Qualitative Study of Participants.","authors":"Parma E Montufar Wright, Patrice M Hicks, Elise V Mike, Mikhayla L Armstrong, Osama Ahmed, Bennie Jeng, Stephanie Marioneaux, Fasika Woreta, Maria A Woodward","doi":"10.1097/ICO.0000000000003901","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003901","url":null,"abstract":"<p><strong>Purpose: </strong>A cornea mentorship program aims to increase the number of underrepresented in medicine physicians pursuing cornea fellowships in ophthalmology. This study evaluates participant demographics, career facilitators and barriers, and the program's impact.</p><p><strong>Methods: </strong>Participants from the 2022 and 2023 cornea mentorship program cohorts completed an anonymous survey assessing demographics, motivations for participation, and mentorship in ophthalmology. They were also invited to participate in semistructured interviews exploring barriers and facilitators to a career in ophthalmology. Survey responses were analyzed using descriptive statistics, whereas interview transcripts were examined for thematic content, classifying sentiments as facilitators or barriers.</p><p><strong>Results: </strong>Of 12 participants, 10 completed the survey and 7 were interviewed. Four main themes emerged: 1) institution-home institution/residency program; 2) mentoring-aspects of mentorship; 3) personal-traits, support systems, and identities; 4) programs-extracurricular ophthalmology programs. Among 133 quotes, personal life was the most frequently cited barrier (35 citations, 26%) hindering participants' pathways to medical school and an ophthalmology career, whereas mentoring was the leading facilitator (29 citations, 22%) supporting their progress. Programs were solely cited as facilitators (16 citations, 12%). Notably, 100% of participants who graduated from residency are cornea fellows.</p><p><strong>Conclusions: </strong>Participants reported personal life as the most frequent barrier and mentoring as the most frequent facilitator to a career in medicine. Mentorship and pathway programs were crucial to success. The cornea mentorship program effectively encouraged underrepresented in medicine residents to pursue cornea fellowships, underscoring the need for continued diversity initiatives in ophthalmology.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retroprosthetic Membrane Is Associated With Subsequent Development of de Novo Angle Closure in Eyes With Boston Keratoprosthesis.","authors":"Faris I Karas, Andrea C Arteaga, Carmen Somavilla, Imane Tarib, Maria S Cortina","doi":"10.1097/ICO.0000000000003907","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003907","url":null,"abstract":"<p><strong>Purpose: </strong>Boston keratoprosthesis (KPro) is a widely used treatment for corneal diseases unsuitable for traditional keratoplasty. Postoperative complications, notably retroprosthetic membrane (RPM) formation and secondary glaucoma, significantly affect patient outcomes. Anterior segment optical coherence tomography (AS-OCT) enables precise visualization of KPro-related complications, such as angle closure and RPM formation. This study aimed to investigate the association between RPM formation and de novo angle closure in eyes with Boston KPro.</p><p><strong>Methods: </strong>A retrospective analysis of patients who underwent Boston KPro type 1 implantation was conducted. Patients with preoperative angles documented by AS-OCT and a minimum 1-year follow-up with serial AS-OCT imaging were included. Demographic data, surgical details, visual acuity, intraocular pressure, and complications were recorded. The presence of RPM and angle closure was assessed clinically and via AS-OCT.</p><p><strong>Results: </strong>This study included 18 eyes from 18 patients who underwent KPro implantation with a follow-up period averaging 4.7 years. Preoperative visual acuity was poor (20/400 or worse) in all eyes, with an improvement in 78% of cases to 20/200 or better postoperatively. Complications included angle closure in 61% of eyes, with a significant association between retroprosthetic membrane (RPM) formation and angle closure (P = 0.0012). De novo glaucoma developed in 4 eyes, primarily associated with RPM and angle closure, and was managed medically.</p><p><strong>Conclusions: </strong>This study highlights a significant association between RPM formation and de novo angle closure in eyes with Boston KPro. Our study findings strongly suggest that RPM formation plays a role in inducing angle closure, contributing to glaucoma development, and is the first study to provide AS-OCT evidence of potential causality. Understanding these associations can improve patient care and outcomes after KPro implantation. Strategies aimed at reducing RPM formation could potentially mitigate other KPro-related complications, including angle closure and de novo glaucoma.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter Regarding: Cyanoacrylate Glue Patch for Corneal Melting in Keratoprosthesis.","authors":"David Mikhail, Daniel Milad, Mona Harissi-Dagher","doi":"10.1097/ICO.0000000000003908","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003908","url":null,"abstract":"","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of Graft Donor Age in Descemet Membrane Endothelial Keratoplasty.","authors":"Alexander Wolf, Maria Della Volpe Waizel, Warda Darwisch, André M Trouvain, Karl T Boden, Berthold Seitz, Fabian N Fries, Annekatrin Rickmann","doi":"10.1097/ICO.0000000000003906","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003906","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate differences between 3 donor age groups in their influence on complication rates during preparation or implantation and on the postoperative outcome of Descemet membrane endothelial keratoplasty (DMEK).</p><p><strong>Methods: </strong>Retrospective comparison of 2067 eyes (1374 patients) undergoing DMEK, divided into 3 subgroups [1: <50 years (n = 63); 2: 50 to 80 years (n = 1607), 3: >80 years (n = 397)]. The data of visual acuity, central corneal thickness, and endothelial cell count, intra- and postoperative complications were collected.</p><p><strong>Results: </strong>Although transplants from group 1 were significantly more likely to have severe double roll forming than the older donors (P <0.001), this fact had no significant influence on intraoperative complications (P = 0.26), postoperative endothelial cell count (P = 0.28), or the rebubbling rate (P = 0.35). The rebubbling rate and transplant flip rate were found to be highest in group 3, although these findings did not attain statistical significance. Furthermore, this did not result in a higher repeat keratoplasty rate, as this was comparable in the 3 groups. Although visual acuity and central corneal thickness were comparable across the 3 groups, endothelial cell count differed significantly over time. At the initial follow-up, endothelial cell loss was 33% to 35% in all groups. However, subsequent clinical courses revealed a substantial variation, with group 3 displaying the highest endothelial cell loss after 2 years (P = 0.026).</p><p><strong>Conclusions: </strong>The use of younger donor corneas <50 years and older donor corneas >80 years seems to be suitable for DMEK surgery after liquid-bubble preparation under organ culture conditions and should not be categorically excluded to counteract the global donor shortage.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous Artificial Corneal Endothelial Graft Reattachment: Case Report.","authors":"Mechleb Nicole, Gatinel Damien, Saad Alain","doi":"10.1097/ICO.0000000000003905","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003905","url":null,"abstract":"<p><strong>Purpose: </strong>EndoArt, a synthetic endothelial substitute for corneal edema, often requires multiple rebubbling procedures because of high detachment rates. This study reports 2 cases of spontaneous EndoArt reattachment, suggesting a potential alternative management approach.</p><p><strong>Methods: </strong>Two patients with endothelial dysfunction underwent EndoArt implantation. Both experienced partial detachment postoperatively. Although rebubbling was considered, a conservative approach was taken, leading to spontaneous reattachment. Serial anterior segment optical coherence tomography (AS-OCT) monitored graft adherence and corneal thickness.</p><p><strong>Results: </strong>Spontaneous reattachment occurred within 2 to 6 weeks, accompanied by progressive corneal thinning and clarity improvement. No further intervention was required, and reattachment remained stable for 6 to 8 months. These cases challenge the notion that all EndoArt detachments necessitate immediate rebubbling.</p><p><strong>Conclusions: </strong>This is the first report of spontaneous EndoArt reattachment. Although rebubbling remains standard practice, observation may be a viable option in select cases, reducing the need for additional procedures. Further studies are needed to refine management strategies and improve outcomes.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Ex Vivo Model to Study Early Changes in Keratoconus.","authors":"Pritpal Kaur, Loren Moon, Deepti Sharma, Jiangxia Wang, Akrit Sodhi, Ian Pitha, Charles Eberhart, Uri Soiberman","doi":"10.1097/ICO.0000000000003903","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003903","url":null,"abstract":"<p><strong>Purpose: </strong>To develop an ex vivo model for keratoconus that simulates eye rubbing, a hallmark characteristic of patients with this disease.</p><p><strong>Methods: </strong>Uniaxial stretch (3% strain, 6 h) was applied to human stromal caps placed in stretch chambers, followed by hematoxylin and eosin staining and evaluation of Bowman layer (BL) breaks in stretched corneas compared with unstretched controls. The impact of mechanical strain on corneal epithelium was also assessed by applying similar cyclical strain to mouse eyes, and changes in basal epithelium morphology were examined using F-actin immunostaining. In addition, Wnt10a and Col12a1 mRNA levels were analyzed in full-thickness epithelium.</p><p><strong>Results: </strong>Human corneas subjected to mechanical strain showed a significantly higher number of BL breaks compared with unstretched controls (2.0 ± 1 vs. 0.4 ± 0.53, P = 0.003). In mouse corneas, mechanical strain increased the basal epithelial cell width by 15% (7.16 ± 1.67 vs. 8.25 ± 1.82 μm, P < 0.001), while reducing the apical cell height by 8% (7.88 ± 1.93 vs. 7.30 ± 1.72, P = 0.025). Wnt10a and Col12a1 mRNA levels were reduced in stretched mouse epithelium compared with unstretched controls (67%, P = 0.0312; 65%, P = 0.0312, respectively).</p><p><strong>Conclusions: </strong>Eye rubbing is a well-known risk factor for the development and progression of keratoconus. By simulating eye rubbing using our ex vivo cyclical mechanical strain model reproduces changes that occur in early keratoconus. Specifically, this model recapitulates at least 3 elements of the keratoconus phenotype (BL breaks, enlargement of the basal epithelium, and reduction in transcript levels of Wnt10a and Col12a1), which makes it a valuable tool for the development of targeted drug therapies for progressive keratoconus.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}