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

Letter Regarding: Spontaneous Artificial Corneal Endothelial Graft Reattachment: Case Report. 关于：自发性人工角膜内皮移植再植：病例报告。

IF 2.1 3区医学

Cornea Pub Date : 2025-09-17 DOI: 10.1097/ICO.0000000000003968

Natalie di Geronimo, Antonio Moramarco, Vito Romano, Maurizio Mete, Luigi Fontana

引用次数: 0

Letter Regarding: Use of Plasma Rich in Growth Factors for Ocular Surface Disorders: A Systematic Review. 关于：使用富含生长因子的血浆治疗眼表疾病：一项系统综述。

IF 2.1 3区医学

Cornea Pub Date : 2025-09-15 DOI: 10.1097/ICO.0000000000003998

Alejandro Tello

引用次数: 0

A Novel GLA Gene Variant in Fabry Disease: Corneal Verticillata and Multimodal Ocular Imaging Findings. 法布里病中一种新的GLA基因变异：角膜斑疹和多模态眼部成像结果。

IF 2.1 3区医学

Cornea Pub Date : 2025-09-15 DOI: 10.1097/ICO.0000000000003988

Hamed Ghassemi, Amirhossein Hashemi, Ghazal Ghochani, Seyedeh Zahra Seyedi, Kosar Esmaili, Mehdi Aminizade

{"title":"A Novel GLA Gene Variant in Fabry Disease: Corneal Verticillata and Multimodal Ocular Imaging Findings.","authors":"Hamed Ghassemi, Amirhossein Hashemi, Ghazal Ghochani, Seyedeh Zahra Seyedi, Kosar Esmaili, Mehdi Aminizade","doi":"10.1097/ICO.0000000000003988","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003988","url":null,"abstract":"Purpose: To report a case of Fabry disease (FD) in a female patient with a novel heterozygous deletion in the galactosidase A (GLA) gene.Methods: A 35-year-old woman with a prior diagnosis of FD confirmed by genetic testing presented with eye irritation, progressive vision loss, and systemic symptoms. Comprehensive ophthalmologic evaluation included slit-lamp biomicroscopy, fundoscopy, visual field testing, optical coherence tomography (OCT), and OCT angiography (OCTA) of both posterior and anterior segments was performed.Results: Bilateral corneal verticillata was observed on slit-lamp examination. OCT and OCTA of the macula revealed intact retinal structures. Despite normal conjunctival and episcleral vessels on clinical examination, anterior segment OCTA showed mild conjunctival vessel tortuosity. Genetic testing of blood sample identified a novel heterozygous deletion frameshift mutation in the GLA gene (c.816delC, p.Phe273LeufsTer9). Systemic evaluations confirmed multiorgan involvement, including hypertension, renal microalbuminuria, cardiac abnormalities, pulmonary dysfunction, and hyperprolactinemia.Conclusions: Corneal verticillata is a hallmark ocular finding in FD. Anterior segment OCTA can reveal subtle vascular abnormalities not detectable through routine examination. The identification of a novel GLA likely pathogenic variant expands the genetic spectrum of FD.","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145063502","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: Diabetes Endothelial Keratoplasty Study: Methods and Impact on the Use of Corneas From Donors With Diabetes for Descemet Membrane Endothelial Keratoplasty. 关于糖尿病内皮角膜移植术研究：使用糖尿病供体角膜进行视网膜膜内皮角膜移植术的方法和影响。

IF 2.1 3区医学

Cornea Pub Date : 2025-09-12 DOI: 10.1097/ICO.0000000000003996

Alejandro Tello, Laura Sofía Torres-Parada, Virgilio Galvis

引用次数: 0

Concordance Between Clinical and Pathological Diagnosis of Stromal Corneal Dystrophies in a Large Case Series. 大病例系列间质性角膜营养不良的临床与病理诊断的一致性。

IF 2.1 3区医学

Cornea Pub Date : 2025-09-12 DOI: 10.1097/ICO.0000000000003980

Angela Fajardo, Katherine Jara Noel, Acácia Azevedo, Emily Marcotte, Mahshad Darvish, Guillermo Rocha, Miguel Burnier

{"title":"Concordance Between Clinical and Pathological Diagnosis of Stromal Corneal Dystrophies in a Large Case Series.","authors":"Angela Fajardo, Katherine Jara Noel, Acácia Azevedo, Emily Marcotte, Mahshad Darvish, Guillermo Rocha, Miguel Burnier","doi":"10.1097/ICO.0000000000003980","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003980","url":null,"abstract":"Purpose: To assess the frequency and histopathological features of stromal corneal dystrophies. In addition, we sought to evaluate the concordance between the clinical diagnoses provided by ophthalmologists and the pathological reports.Methods: We retrospectively analyzed all cases of stromal corneal dystrophies between 1996 and 2022. Data were collected from pathological reports of corneal buttons obtained from penetrating keratoplasties (PK). Clinical and pathological diagnoses along with demographic information were recorded. Concordance between clinical and pathological diagnoses was assessed using frequency analysis and Cohen kappa coefficient.Results: Histopathological review of 1440 corneal specimens from PK revealed 56 (3.8%) stromal corneal dystrophies in 53 patients. The most common dystrophy found was lattice corneal dystrophy (LCD), present in 30 specimens (53.6%), followed by granular corneal dystrophy type 2 in 14 specimens (25.0%), granular corneal dystrophy type 1 in 7 specimens (12.5%), and macular corneal dystrophy in 5 specimens (8.9%). Concordance between clinical and pathological diagnoses was observed in 37 of 45 cases, resulting in an overall concordance rate of 82.2% with a Cohen kappa coefficient of 0.64.Conclusions: The concordance rate of 82.2% and Cohen kappa coefficient of 0.64 indicate strong agreement between clinical and pathological diagnoses of stromal corneal dystrophies. However, despite ranking as the second most common dystrophy, the absence of clinical diagnoses for granular corneal dystrophy type 2 highlights the critical need to use both Masson Trichrome and Congo red stains when granular or lattice-like deposits are present in the cornea to ensure precise and reliable diagnosis.","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145052175","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

Advancing Understanding of Ligneous Conjunctivitis: Bridging Pathogenesis, Diagnosis, and Therapy. 加深对木质结膜炎的认识：桥接性发病机制、诊断和治疗。

IF 2.1 3区医学

Cornea Pub Date : 2025-09-10 DOI: 10.1097/ICO.0000000000003987

Talia N Shoshany, Andrew Thomson, Amy Shapiro, Amol Sura, Charles Nakar, Henry D Perry

{"title":"Advancing Understanding of Ligneous Conjunctivitis: Bridging Pathogenesis, Diagnosis, and Therapy.","authors":"Talia N Shoshany, Andrew Thomson, Amy Shapiro, Amol Sura, Charles Nakar, Henry D Perry","doi":"10.1097/ICO.0000000000003987","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003987","url":null,"abstract":"Purpose: This review and case report address ligneous conjunctivitis (LC), a rare ocular condition caused by plasminogen deficiency type 1 (PLGD-1), which manifests as wood-like fibrin-rich membranes on the palpebral conjunctiva. The goal is to provide ophthalmologists-often the first physicians to encounter the condition-with a robust understanding of its systemic manifestations and to highlight current therapeutic strategies, with particular emphasis on the administration of intravenous plasminogen concentrate.Methods: We present a clinical LC case alongside a narrative review of published cases, etiology, and treatment approaches.Results: LC initially manifests as erythematous lesions on the palpebral conjunctiva, eventually developing into fibrinous, wood-like membranes. It is typically associated with PLGD-1, a genetic disorder of the plasminogen gene (PLG), which results in impaired fibrinolysis and the formation of fibrin deposits. LC often appears within the first year of life, but patients may experience a prolonged period before diagnosis. PLGD-1 is also associated with the development of mucosal lesions in many other organ systems. Contributing factors include chronic inflammation, allergens, infections, and trauma. There have been many proposed treatment approaches for LC, but the recent approval of intravenous plasma-derived human plasminogen concentrate replacement has been an important advance.Conclusions: LC is an ocular disorder with potential vision- and life-threatening complications. The treatment of LC has historically been challenging; however, recognition of its association with PLGD-1 has led to more effective therapies, particularly intravenous plasminogen concentrate. Early diagnosis and coordinated care between ophthalmologists and other specialists, such as hematologists, are crucial to prevent complications, including vision loss.","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032938","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

Late Dehiscence After Initial Successful EndoArt Implantation. 初步成功植入术后的晚期开裂。

IF 2.1 3区医学

Cornea Pub Date : 2025-09-10 DOI: 10.1097/ICO.0000000000003976

O Ardelean, G Geerling, M Borrelli

{"title":"Late Dehiscence After Initial Successful EndoArt Implantation.","authors":"O Ardelean, G Geerling, M Borrelli","doi":"10.1097/ICO.0000000000003976","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003976","url":null,"abstract":"Purpose: To report a case of late dehiscence of an EndoArt implant and its successful management 10 months after initial implantation.Methods: Case report.Results: A 73-year-old man with a history of multiple failed Descemet membrane endothelial keratoplasty procedures on the right eye underwent EndoArt implantation for bullous keratopathy. The initial surgery was successful with improved visual acuity and a well-attached implant. However, 10 months after implantation, the patient experienced decreased visual acuity because of implant dehiscence in the superior quadrant. A rebubbling procedure using 20% Schwefelhexafluorid (SF6) gas without additional corneal sutures was performed, resulting in successful reattachment of the implant.Conclusions: Although EndoArt dehiscence typically occurs within the first 3 months after implantation, this case demonstrates that late dehiscence can occur even after prolonged implant attachment. Our report highlights the possibility of successful management through rebubbling without additional sutures and emphasizes the importance of extended follow-up for patients with this novel implant.","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033010","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

Recurrent DMEK Failures Related to Intraocular Tutoplast. 复发性DMEK失败与眼内tutopplasty有关。

IF 2.1 3区医学

Cornea Pub Date : 2025-09-10 DOI: 10.1097/ICO.0000000000003994

Soyang Ella Kim, Reem Farwana, Alfonso Vasquez-Perez

{"title":"Recurrent DMEK Failures Related to Intraocular Tutoplast.","authors":"Soyang Ella Kim, Reem Farwana, Alfonso Vasquez-Perez","doi":"10.1097/ICO.0000000000003994","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003994","url":null,"abstract":"Purpose: We report a unique case of recurrent Descemet membrane endothelial keratoplasty (DMEK) failure in a 69-year-old man with a history of pseudophakic bullous keratopathy (PBK) secondary to glaucoma surgeries.Methods: This is a retrospective case report.Results: The initial PAUL glaucoma implant was relocated to the sulcus, and the original sclerostomy was plugged with Tutoplast. The patient subsequently developed PBK and underwent 3 DMEK procedures, each resulting in immediate failure, beginning inferiorly despite uneventful surgery. Subsequent assessment revealed that the Tutoplast was protruding into the anterior chamber and contacting the inferior cornea. This contact was associated with endothelial dysfunction in the transplanted DMEK, leading to complete failure. After removal of the Tutoplast and scleral patch, the patient underwent a fourth DMEK procedure, which has been successful and remains well-functioning after 9 months.Conclusions: This is the first published case highlighting endothelial failure associated with Tutoplast and underscores the importance of thorough preoperative assessment.","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033028","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

Ocular Adverse Events of Antibody Drug Conjugates and Association With Survival From a Real-World Database. 来自真实世界数据库的抗体药物偶联物的眼部不良事件及其与生存的关系。

IF 2.1 3区医学

Cornea Pub Date : 2025-09-10 DOI: 10.1097/ICO.0000000000003997

Samuel H Kim, Rayna F Marshall, Karen M Wai, Ehsan Rahimy, Filippos Vingopoulos, Kapil Mishra, Meghan Berkenstock, Prithvi Mruthyunjaya

{"title":"Ocular Adverse Events of Antibody Drug Conjugates and Association With Survival From a Real-World Database.","authors":"Samuel H Kim, Rayna F Marshall, Karen M Wai, Ehsan Rahimy, Filippos Vingopoulos, Kapil Mishra, Meghan Berkenstock, Prithvi Mruthyunjaya","doi":"10.1097/ICO.0000000000003997","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003997","url":null,"abstract":"Purpose: Ocular adverse events can be black box warning complications for antibody drug conjugates (ADCs), requiring ophthalmologic evaluation. Although extensive management and deescalation protocols are in place, association with overall survival for patients with ocular adverse events are unknown.Methods: Retrospective cohort study with data from deidentified aggregated electronic health records database. Inclusion criteria were prescription of ADCs, no prior recorded ocular symptoms, and the presence of a clinical visit after ADC initiation. Propensity score matching was used to control for demographic factors and cancer diagnoses.Results: A cohort of 14,138 patients with a mean age of 59 years (SD: 20y) was identified. Most common ocular adverse events were dry eyes (2.9%), keratitis or conjunctivitis (2.21%), uveitis (0.23%), and corneal ulcers (0.085%). Belantamab mafodotin had the highest rates of keratitis or conjunctivitis (17.8%). Patients without any ocular adverse events after ADC initiation had an increased risk of death [RR: 1.20, P = 0.0013] within 5 years compared with patients with ocular adverse events. Specifically, patients without keratitis or conjunctivitis after ADC initiation had an increased risk of death [RR: 1.43, P = 0.019] within 1 year.Conclusions: Uveitis and corneal ulcers were exceedingly rare for all ADCs. Patients on ADCs with ocular adverse events, compared with those without, had a decreased risk of death. As ophthalmologic management of patients on ADCs are becoming more prevalent, aggressive management of ocular adverse events may be warranted, when ADCs are effective, as ocular adverse events may portend better survival outcomes.","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074611","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

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