Cornea最新文献_第3页

IF 2.1 3区医学

Cornea Pub Date : 2025-11-01 Epub Date: 2025-08-14 DOI: 10.1097/ICO.0000000000003964

Peter S Hersh, Rita Vought, Steven A Greenstein, John D Gelles

引用次数: 0

Clinical Outcome of Endothelium-Outward Preloaded Descemet Membrane Endothelial Keratoplasty in Long-Term Dextran-Containing Transport Medium Preservation. 长期含右旋糖酐转运介质保存的内皮-外载真皮膜内皮角膜移植术的临床效果。

IF 2.1 3区医学

Cornea Pub Date : 2025-11-01 Epub Date: 2025-01-21 DOI: 10.1097/ICO.0000000000003817

Annekatrin Rickmann, Silke Wahl, André Messias, André M Trouvain, Philipp K Roberts, Karl T Boden, Peter Szurman

{"title":"Clinical Outcome of Endothelium-Outward Preloaded Descemet Membrane Endothelial Keratoplasty in Long-Term Dextran-Containing Transport Medium Preservation.","authors":"Annekatrin Rickmann, Silke Wahl, André Messias, André M Trouvain, Philipp K Roberts, Karl T Boden, Peter Szurman","doi":"10.1097/ICO.0000000000003817","DOIUrl":"10.1097/ICO.0000000000003817","url":null,"abstract":"Purpose: To analyze the clinical outcome of organ-cultured endothelium-outward preloaded DMEK (pDMEK) using the RAPID cartridge.Methods: This prospective study included 80 eyes of 80 patients who received a pDMEK. Best-corrected visual acuity (BCVA), endothelial cell count (ECC), and central corneal thickness were measured preoperatively and 4 to 6 weeks, 3 months, 6 months, and 1 year postoperatively. The difficulty of graft preparation and implantation, rebubbling, and re-DMEK frequency were evaluated.Results: The graft preparation time was 5.3 ± 1.2 minutes on average. After preparation, the ECC before preloading was 2652 ± 180 cells/mm 2 ( P = 0.9, endothelial cell loss [ECL] = 0.8%). After pDMEK, the cornea started to clear up after 1.6 ± 1 day. Compared with the preoperative values, BCVA and central corneal thickness significantly improved during the postoperative course ( P < 0.0001). At the first follow-up examination, the ECL was 43% ( P < 0.0001) and remained stable throughout the follow-up period (all P > 0.5). Rebubbling was necessary in 39/80 patients (48.75%). One patient (1/80, 1.25%) required a re-DMEK after 1 year owing to secondary graft failure with insufficient ECC.Conclusions: The clinical results after endothelium-outward pDMEK showed a significant improvement in BCVA and corneal thickness over the 1-year follow-up period, but the relatively high rebubbling rate and ECL should be taken into account. Therefore, we recommend that further comparative clinical studies should be conducted.","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":"1376-1381"},"PeriodicalIF":2.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001279","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}

引用次数: 0

Letter Regarding: Delayed Late-Onset Severe Progressive Corneal Flattening: A Complication 9 Years After Corneal Collagen Crosslinking. 关于：迟发性迟发性严重进行性角膜扁平化：角膜胶原交联9年后的并发症。

IF 2.1 3区医学

Cornea Pub Date : 2025-11-01 Epub Date: 2025-06-25 DOI: 10.1097/ICO.0000000000003915

Rasik B Vajpayee, Abi Tenen, Colin Chan, Chris Hodge

引用次数: 0

Outcomes Evaluated in Randomized Controlled Trials of Treatments for Dry Eye: A Systematic Review. 干眼症治疗的随机对照试验结果评价：一项系统综述。

IF 2.1 3区医学

Cornea Pub Date : 2025-10-13 DOI: 10.1097/ICO.0000000000004014

Yuhui Wu, Michael X Lin, Daniel Shaughnessy, Riaz Qureshi, Ann-Margret Ervin, Tianjing Li, Esen K Akpek, Ian J Saldanha

{"title":"Outcomes Evaluated in Randomized Controlled Trials of Treatments for Dry Eye: A Systematic Review.","authors":"Yuhui Wu, Michael X Lin, Daniel Shaughnessy, Riaz Qureshi, Ann-Margret Ervin, Tianjing Li, Esen K Akpek, Ian J Saldanha","doi":"10.1097/ICO.0000000000004014","DOIUrl":"https://doi.org/10.1097/ICO.0000000000004014","url":null,"abstract":"Purpose: To initiate the process of core outcome set development for dry eye disease (DED) by conducting a systematic review of all outcomes in randomized controlled trials (RCTs) of treatments for DED. A core outcome set is an agreed-upon minimum set of outcomes that should be measured and reported in all clinical trials in a topic area.Methods: We searched PubMed and Embase from January 1, 2016 to January 3, 2024 for RCTs of treatments for DED. Post hoc, we decided to focus on recent evidence and excluded RCTs published before 2016. Two independent investigators screened titles and abstracts (initially) and full-text articles (subsequently), resolving conflicts through discussion. We refined a previously developed outcome taxonomy for DED. We extracted all outcome domains and measurement instruments used for those domains in the included sample of RCTs.Results: Our searches identified 6477 unique records, and we included 300 RCTs. The most frequently used outcome domains across all RCTs were tear film stability (90.6% of RCTs), overall assessment of ocular symptoms (84.3%), corneal staining score (75.7%), tear production (66.0%), conjunctival staining score (39.7%), visual acuity (35.0%), meibomian gland plugging/clogging grade (27.0%), inferior tear film meniscus height (16.0%), and adverse events (28.0%). There was considerable inconsistency regarding measurement instruments.Conclusions: Variability in outcome measures and instruments used underscores the need for a core outcome set for DED. Our next steps are to begin prioritizing the identified outcomes for a core outcome set for DED.","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298925","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}

引用次数: 0

Autologous Fibrin Glue in Pterygium Surgery as an Alternative to Commercial Fibrin Glue. 自体纤维蛋白胶在翼状胬肉手术中作为市售纤维蛋白胶的替代品。

IF 2.1 3区医学

Cornea Pub Date : 2025-10-01 DOI: 10.1097/ICO.0000000000004012

Márcia Cristina Todo, André Luiz Sita E Souza Bragante, Ananda Lini Vieira da Rocha, Magda Massae Hata Viveiros, Alvio Isao Shiguematsu, Silvana Artioli Schellini

{"title":"Autologous Fibrin Glue in Pterygium Surgery as an Alternative to Commercial Fibrin Glue.","authors":"Márcia Cristina Todo, André Luiz Sita E Souza Bragante, Ananda Lini Vieira da Rocha, Magda Massae Hata Viveiros, Alvio Isao Shiguematsu, Silvana Artioli Schellini","doi":"10.1097/ICO.0000000000004012","DOIUrl":"https://doi.org/10.1097/ICO.0000000000004012","url":null,"abstract":"Purpose: The aim of this study was to evaluate the efficacy and safety of autologous fibrin glue in pterygium surgery, comparing it with commercial fibrin glue in terms of postoperative complications, graft stability, and recurrence rate.Methods: A prospective, randomized, double-blind study was conducted, involving 42 patients with primary pterygium who underwent autologous conjunctival-limbal transplantation. The graft was fixed using autologous fibrin glue (Group 1, G1) or commercial fibrin glue (Group 2, G2). All patients underwent surgery performed by the same surgeon and were reevaluated on postoperative days 7, 30, 90, and 180 by an independent observer, assessing clinical parameters in the preoperative, intraoperative, and postoperative periods.Results: No cases of severe adverse events were reported. Complete graft dehiscence occurred in 1 patient from G1. The G2 group had more cases of subconjunctival hemorrhage (P = 0.0355). Pyogenic granuloma was observed in 1 patient from G2 and 2 patients from G1. There was no significant difference in recurrence rates between the groups (15% in G1 vs. 5% in G2; P = 0.2918). In both groups, graft dimensions tended to decrease slightly in the early postoperative period, followed by stabilization.Conclusions: Autologous fibrin glue demonstrated efficacy and safety comparable to commercial fibrin glue, making it a viable alternative to conjunctival graft fixation in primary pterygium surgery.","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212014","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}

引用次数: 0

Reticular Subepithelial Corneal Deposits in a Patient Receiving Niraparib Therapy. 接受尼拉帕尼治疗的患者网状角膜上皮下沉积。

IF 2.1 3区医学

Cornea Pub Date : 2025-09-29 DOI: 10.1097/ICO.0000000000004001

Sahib Y Tuteja, David Lockington

引用次数: 0

Acanthamoeba Keratitis: Analysis of Risk Factors, Diagnostic Modalities, and Clinical Outcomes at a Tertiary Referral Ophthalmic Unit. 棘阿米巴角膜炎：风险因素分析，诊断方式，和三级转诊眼科的临床结果。

IF 2.1 3区医学

Cornea Pub Date : 2025-09-29 DOI: 10.1097/ICO.0000000000004006

Kirupakaran Arun, Khayam Naderi, Jeremy Hoffman, Su-Yin Koay

{"title":"Acanthamoeba Keratitis: Analysis of Risk Factors, Diagnostic Modalities, and Clinical Outcomes at a Tertiary Referral Ophthalmic Unit.","authors":"Kirupakaran Arun, Khayam Naderi, Jeremy Hoffman, Su-Yin Koay","doi":"10.1097/ICO.0000000000004006","DOIUrl":"https://doi.org/10.1097/ICO.0000000000004006","url":null,"abstract":"Purpose: The aim of this study was to analyze the risk factors, clinical features, and diagnostic tests of Acanthamoeba keratitis and to evaluate clinical outcomes with polyhexanide (PHMB) 0.06% monotherapy.Methods: This study was s retrospective case series of eyes with Acanthamoeba keratitis from January 2020 to April 2023. All patients were investigated with smear microscopy, microbial culture (MC), polymerase chain reaction (PCR), and in vivo confocal microscopy (IVCM) and were commenced on treatment with PHMB 0.06% monotherapy.Results: A total of 149 eyes were included. 93.2% were contact lens (CL) wearers, with the most common risk factor being water exposure to CL (71.2%, 99/139). 6.7% of eyes (10/149) were correctly diagnosed with AK at presentation, with the most common alternative diagnosis being bacterial keratitis (48.3%). The median time from symptom onset to diagnosis was 30 days. When compared with a composite diagnosis reference standard, the sensitivities of IVCM, PCR, and MC were 0.97, 0.49, and 0.13, respectively. Medical treatment success was achieved in 91.9% of eyes (138/149), with a further 2.7% (4/149) requiring surgery to achieve treatment success. The overall treatment failure rate was 4.7% (7/149). Prediagnosis steroid use (P < 0.0002), AK relapse (P < 0.0001), scleritis (P < 0.0001), ring infiltrate at diagnosis (P < 0.02), and delayed diagnosis (P < 0.03) were all poor visual prognostic factors.Conclusions: PHMB 0.06% monotherapy is highly effective in treating Acanthamoeba keratitis, achieving a medical cure in 91.9% of eyes. CL water exposure remains the leading risk factor. While IVCM is the most sensitive diagnostic tool, its limited availability means that clinical judgment in the context of relevant risk factors remains essential for timely diagnosis and treatment.","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211989","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}

引用次数: 0

Influence of Graft Unfolding Time During Descemet Membrane Endothelial Keratoplasty on Postoperative Endothelial Cell Loss and Visual Acuity. 内皮角膜移植术中移植物展开时间对术后内皮细胞损失及视力的影响。

IF 2.1 3区医学

Cornea Pub Date : 2025-09-26 DOI: 10.1097/ICO.0000000000004004

Louise Blöck, Hyeck-Soo Son, Jasper Lind, Maximilian Friedrich, Gerd U Auffarth, Victor A Augustin

{"title":"Influence of Graft Unfolding Time During Descemet Membrane Endothelial Keratoplasty on Postoperative Endothelial Cell Loss and Visual Acuity.","authors":"Louise Blöck, Hyeck-Soo Son, Jasper Lind, Maximilian Friedrich, Gerd U Auffarth, Victor A Augustin","doi":"10.1097/ICO.0000000000004004","DOIUrl":"https://doi.org/10.1097/ICO.0000000000004004","url":null,"abstract":"Purpose: Descemet membrane endothelial keratoplasty (DMEK) is currently the gold standard for Fuchs endothelial corneal dystrophy (FECD). The steps of graft insertion, unfolding, and attachment are known to be challenging. The aim of the study was to explore the influence of graft unfolding time on postoperative visual outcomes and endothelial cell loss (ECL).Methods: In this retrospective single center case series, 117 eyes of 90 patients with FECD were included. Endothelial cell density (ECD) and best-corrected visual acuity (BCVA) were measured preoperatively, 3 months and 1 year after DMEK, and we recorded graft unfolding time during DMEK. To assess the correlation between the outcome parameters and the graft unfolding time, Spearman correlation was performed.Results: Mean ECD of the grafts was 2574.5 (±196.0) cells/mm2 preoperatively and 1642.1 (±531.1)/1585.6 (±478.5) cells/per mm2 at 3 months/1 year postoperatively, respectively, which led to an average ECL of 36.3/38.6%. BCVA preoperatively was 0.40 (±0.26) logMAR, which improved to mean postoperative BCVA of 0.16 (±0.10)/0.13 (±0.09) logMAR 3 months/1 year after DMEK, respectively. The mean graft unfolding time was 03:06 (±02:17) minutes. A significant higher endothelial cell loss at 3 months was found among patients whose graft unfolding time took ≥5 minutes. However, no significant correlations between graft unfolding time and BCVA, ECL, or rebubbling rate were shown.Conclusions: Our analysis showed that the BCVA is not affected by the graft unfolding time, but suggests that prolonged graft unfolding time may have a clinically relevant impact on postoperative ECL. Therefore, it may affect graft survival in the long term.","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212055","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}

引用次数: 0

Development of an Ex Vivo Model of Focal Corneal Desiccation to Investigate the Pathophysiology of Corneal Dellen and Ulcers. 建立局灶性角膜干燥离体模型以研究角膜变浅和溃疡的病理生理。

IF 2.1 3区医学

Cornea Pub Date : 2025-09-25 DOI: 10.1097/ICO.0000000000003995

Arnaud Gaulier, Thara Jaworski, Anais Vautier, Sabine Lefevre, Fanny Chaventre, David Toubeau, Jean-Christophe Sabourin, Éric Gabison, Julie Gueudry, Olivier Boyer, Marc Muraine

{"title":"Development of an Ex Vivo Model of Focal Corneal Desiccation to Investigate the Pathophysiology of Corneal Dellen and Ulcers.","authors":"Arnaud Gaulier, Thara Jaworski, Anais Vautier, Sabine Lefevre, Fanny Chaventre, David Toubeau, Jean-Christophe Sabourin, Éric Gabison, Julie Gueudry, Olivier Boyer, Marc Muraine","doi":"10.1097/ICO.0000000000003995","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003995","url":null,"abstract":"Purpose: To determine the maximum extent of corneal thinning induced solely by dehydration and to establish the threshold at which corneal lysis begins, thereby refining therapeutic indications, with the aim of improving clinical management.Methods: Dehydration was induced in 28 corneas, after 4 ex vivo experimental models. Corneal thickness was regularly measured using swept-source optical coherence tomography (OCT). Histological analysis was performed on 14 of the corneas, with computer-based counting of collagen lamellae. The remaining 14 corneas were rehydrated and remeasured using OCT.Results: Regardless of the model, all corneas exhibited sectoral thinning, clinically resembling corneal dellen. With the most efficient dehydration model, the average minimum pachymetry was 102 ± 30 μm, with minimal values down as low as 49 μm. Computerized histological analysis confirmed that this thinning reflected a greater density of collagen lamellae and not a real loss of collagen. After rehydration, OCT showed a resolution of corneal thinning in all cases.Conclusions: Corneal dellen thinning reflects the compaction of collagen fibers secondary to localized dehydration. Dehydration alone thinned the cornea to an average of 102 μm, and in some cases, it became as low as 49 μm. Above this threshold, corneal rehydration is sufficient to achieve full recovery.","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136235","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}

引用次数: 0

Rates and Risk Factors for Failure After Corneal Collagen Crosslinking for Keratoconus: An IRIS Registry Analysis. 角膜圆锥角膜胶原交联失败的发生率和危险因素：IRIS登记分析。

IF 2.1 3区医学

Cornea Pub Date : 2025-09-25 DOI: 10.1097/ICO.0000000000003970

Bryce Hwang, Binod Acharya, Maurizio Tomaiuolo, Qiang Zhang, Clark Y Chang, Christopher J Rapuano, Leslie Hyman, Zeba A Syed

{"title":"Rates and Risk Factors for Failure After Corneal Collagen Crosslinking for Keratoconus: An IRIS Registry Analysis.","authors":"Bryce Hwang, Binod Acharya, Maurizio Tomaiuolo, Qiang Zhang, Clark Y Chang, Christopher J Rapuano, Leslie Hyman, Zeba A Syed","doi":"10.1097/ICO.0000000000003970","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003970","url":null,"abstract":"Purpose: To investigate rates and risk factors for corneal collagen crosslinking (CXL) failure in patients with progressive keratoconus (KCN) using a large national clinical registry.Methods: Patients with treatment-naïve KCN (International Classification of Diseases [ICD]-9/10: 371.6x/H18.6x) who underwent CXL (Current Procedural Terminology [CPT]: 0402T) between 2016 and 2022 and had at least 6-month follow-up after CXL in the American Academy of Ophthalmology IRIS Registry (Intelligent Research in Sight) were included. The primary outcome was the Kaplan-Meier estimated rate of CXL failure within 3 years, defined as undergoing repeat CXL, penetrating keratoplasty (PK), or deep anterior lamellar keratoplasty (DALK) after initial CXL. Associations between CXL failure and age, sex, race, ethnicity, insurance status, allergic and atopic disease, best recorded visual acuity, and procedure laterality were evaluated using a mixed-effects Cox proportional hazards model.Results: From 2016 to 2022, 11,731 eyes from 8568 patients underwent CXL for KCN. A total of 148 eyes (1.3%) from 143 (1.7%) patients experienced CXL failure, of which 54 eyes (52 patients) underwent PK or DALK. The estimated 3-year and 5-year CXL failure rates were 2.0% (95% confidence interval [CI], 1.5%-2.4%) and 4.5% (95% CI: 3.4%-5.6%), respectively. Multivariable Cox regression demonstrated that age <18 years (hazard ratio [HR]: 2.02; 95% CI, 1.03-3.97; P = 0.04) and unilateral CXL (HR: 1.54; 95% CI, 1.06-2.24; P = 0.02) were associated with higher CXL failure rates.Conclusions: Approximately 1 in 50 eyes with KCN that underwent CXL had repeat treatment or keratoplasty within 3 years in a large national clinical registry. Patients younger than 18 years of age were at greatest risk.","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136271","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}

引用次数: 0