Cornea最新文献

{"title":"A Manual Technique for Corneal Allogeneic Intrastromal Ring Segments Without a Femtosecond Laser.","authors":"Takahiko Hayashi, Yusuke Hara, Chihiro Sunouchi, Kentaro Yuda, Takashi Kojima, Naoko Kato, Brendan Cronin, Satoru Yamagami","doi":"10.1097/ICO.0000000000003853","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003853","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the outcomes of corneal allogeneic intrastromal ring segments (CAIRS) using a simplified manual technique for treating keratoconus.</p><p><strong>Methods: </strong>This prospective case series included 5 eyes from 5 patients with keratoconus (4 males, 1 female, mean age 32.5 ± 10.6 years) treated with manual CAIRS. Surgeries were performed under local anesthesia by a single surgeon. An intrastromal pocket for donor tissue implantation was manually created using a spatula, and donor corneas were prepared using a Jacobs CAIRS trephine. Corneal parameters, including higher-order aberrations, coma, and spherical aberrations at a 6 mm diameter, were measured using optical coherence tomography (CASIA SS-1000, Tomey, Japan). Anterior and posterior corneal indices, subjective refractive power, cylinder, spherical equivalent, best-corrected visual acuity (BCVA; logarithm of the minimum angle of resolution [logMAR]), and central corneal thickness. Intra- and postoperative complications were also analyzed.</p><p><strong>Results: </strong>Over a mean follow-up of 6.4 ± 2.9 months, no complications occurred. BCVA improved from 0.74 ± 0.44 logMAR preoperatively to 0.19 ± 0.66 logMAR (P = 0.043). The maximum keratometry (Kmax) value decreased from 63.6 ± 8.3D preoperatively to 59.6 ± 6.8D postoperatively (P = 0.043). Spherical equivalent improved from -11.2 ± 5.8D to -5.3 ± 3.1D (P = 0.043), and astigmatism reduced from -5.0 ± 3.4D to -3.3 ± 2.9D. Total corneal higher-order aberrations decreased from 5.6 ± 1.6D to 4.2 ± 1.6D postoperatively (P = 0.043).</p><p><strong>Conclusions: </strong>Manual CAIRS is an effective treatment when a femtosecond laser is not available.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662965","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":"Cornea Classic: Nichols, Nichols, and Mitchell, \"The Lack of Association Between Signs and Symptoms in Patients With Dry Eye Disease\" (2004).","authors":"Karla Zadnik","doi":"10.1097/ICO.0000000000003857","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003857","url":null,"abstract":"<p><strong>Abstract: </strong>Like all important areas of vision research, the field of dry eye has matured in the past 20 years. At the time this paper, currently the sixth most cited paper ever published in Cornea, was written by current leaders in the field, Kelly Nichols and Jason Nichols, their results challenged much of the accepted dogma. In a relevant small sample of clinic-based patients diagnosed with dry eye, they established the absence of important correlations between the patients' reported symptoms and diagnostic signs of dry eye, summarizing dry eye as a symptom-based disease.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662971","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":"Processing Methods Affect Biological Properties of Amniotic Membrane Sheet Products.","authors":"Yuan Zhang, Allison Helman, Olivia G Mead, Sean Tighe, Yingting Zhu, Scheffer C G Tseng","doi":"10.1097/ICO.0000000000003849","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003849","url":null,"abstract":"<p><strong>Abstract: </strong>Amniotic membrane (AM) is widely used in ophthalmology because of its antiinflammatory, antiscarring, and wound healing promoting properties, which are due in part to a key matrix component, heavy chain-hyaluronan/pentraxin3. Herein, we assess various processing methods used to manufacture AM sheet products and their effect on the biological properties of AM mediated by heavy chain-hyaluronan/pentraxin3.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656320","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":"Implantation of Opposing Dual Corneal Allogeneic Intrastromal Ring Segments With Topography-Guidance: A Novel Method for Improved Corneal Reshaping.","authors":"Dilan Colak, Burcu Yakut, Ugur Tunc, Aylin Kilic","doi":"10.1097/ICO.0000000000003833","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003833","url":null,"abstract":"<p><strong>Purpose: </strong>To present the outcomes of topography-guided opposing dual-segment KeraNatural implantation in patients with keratoconus with symmetrical corneal cones.</p><p><strong>Methods: </strong>This study evaluated 6 eyes from 5 patients who had undergone dual allogeneic intrastromal ring segment (corneal allogeneic intrastromal ring segment) opposite horizontal implantation surgery based on topographic cone location with a follow-up period ranging from 6 months to 3 years. Preoperative and postoperative measurements, including visual acuity, refractive, topographic keratometric values, and central corneal thickness, were analyzed.</p><p><strong>Results: </strong>Corrected distance visual acuity increased from 0.93 ± 0.58 preoperatively to 0.33 ± 0.14 postoperatively and Kmax decreased from 57.87 ± 1.87 to 55.47 ± 1.62 diopters. No significant complications were reported during the follow-up period.</p><p><strong>Conclusions: </strong>This study investigates the outcomes of dual KeraNatural implantation in patients with keratoconus with symmetrical cones. The findings from this study may yield enhanced outcomes, necessitating additional exploration and possible implementation as a new standard in keratoconus surgery.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656310","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":"Timeframe to Keratoplasty After Ocular Surface Stem Cell Transplantation.","authors":"Daniel Peretz, Kian M Madjedi, Edward J Holland","doi":"10.1097/ICO.0000000000003860","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003860","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study is to report the actual time delay between ocular surface stem cell transplantation (OSST) and keratoplasty at a high-volume center for limbal stem cell deficiency (LSCD). Understanding expected timelines and reasons for any delays or deferrals can allow for more accurate expectation-setting discussions with prospective patients.</p><p><strong>Methods: </strong>A retrospective chart review was performed on all patients having undergone OSST between January 2013 and December 2022. Charts were reviewed to determine whether the need for keratoplasty was specified at the time of OSST planning. Parameters for these cases were then collected including underlying diagnoses, type of OSST performed, and time delay between OSST and keratoplasty (if performed). Results were then aggregated, and subgroup analysis was conducted.</p><p><strong>Results: </strong>A total of 219 eyes were included, of which, 128 eyes had initial intent for keratoplasty. Of these, 48% had keratoplasty within 6 months of OSST, 17% between 6 and 24 months, 5% beyond 2 years, and, interestingly, 30% had no subsequent keratoplasty. Most eyes with no eventual keratoplasty experienced unanticipated stromal clearing after OSST obviating the need for keratoplasty.</p><p><strong>Conclusions: </strong>This is the first study to report realized time delay between OSST and keratoplasty at a large LSCD practice. Prospective patients can be counselled that 76% of compliant cases with initial intent for keratoplasty either had keratoplasty within 6 months or exhibited unanticipated stromal clearing after OSST alone. Patients with congenital aniridia or contact lens-related LSCD are more likely to have unanticipated stromal clearing.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656351","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: Optical Coherence Tomography Angiography in Patients With the Boston Keratoprosthesis Type 1.","authors":"David Mikhail, Daniel Milad, Mona Harissi-Dagher","doi":"10.1097/ICO.0000000000003872","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003872","url":null,"abstract":"","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656315","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":"Anterior Stromal Melt With Corneal Allogeneic Intrastromal Ring Segments in a Patient With Severe Atopy.","authors":"Shady T Awwad, Karen E Asfar, Jeremiah Gendy, Soosan Jacob, Jad F Assaf","doi":"10.1097/ICO.0000000000003851","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003851","url":null,"abstract":"<p><strong>Purpose: </strong>To report the first case of anterior stromal melt after insertion of a corneal allogeneic intrastromal ring segment (CAIRS) in a patient with severe atopy.</p><p><strong>Methods: </strong>A 27-year-old woman with keratoconus, severe atopy, and giant upper tarsal conjunctival papillae underwent uneventful insertion of a CAIRS in her right eye. 4 months later, she presented with severe exacerbation of her atopy, necessitating anti-IgE monoclonal antibody therapy initiation.</p><p><strong>Results: </strong>Slit-lamp examination revealed thinning of the corneal stroma overlying the CAIRS over a 30-degree sector, also documented by optical coherence tomography. There was a resolution of the giant conjunctival papillae. The patient was started on topical cyclosporine and a tapering loteprednol regimen, along with the anti-IgE treatment. The last follow-up showed stability in visual acuity, stromal thickness, and topographic parameters, which remained better than preoperatively.</p><p><strong>Conclusions: </strong>Anterior stromal melt, commonly seen with synthetic segments, can rarely develop after CAIRS implantation, in specific circumstances, such as severe inflammation and atopy. Prompt systemic and topical management can potentially stop progression and retain the implanted segment.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647545","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":"Application of Anterior Segment Optical Coherence Tomography in Detecting Kayser-Fleischer Rings in Wilson Disease.","authors":"Bingjie Shi, Yi Chen","doi":"10.1097/ICO.0000000000003843","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003843","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the presentation of Kayser-Fleischer (KF) rings in the cornea using anterior segment optical coherence tomography (AS-OCT) in patients with Wilson disease (WD).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the clinical data from 31 patients (62 eyes) who were diagnosed with WD, were positive for KF rings, and who were admitted to our hospital between August 2020 and December 2022. All patients underwent slit-lamp and AS-OCT examinations, with the KF ring width measured on AS-OCT grayscale images.</p><p><strong>Results: </strong>On AS-OCT, the KF ring appeared as a high-reflective band at the level of Descemet membrane. The color band on AS-OCT displayed the ring in shades of yellow-green, yellow, or orange. The width of the KF ring was measured accurately using AS-OCT.</p><p><strong>Conclusions: </strong>AS-OCT, when combined with slit-lamp examination, provides a reliable method for evaluating KF rings in patients with WD. The grayscale measurements obtained via AS-OCT offer precise quantification of the corneal KF ring width.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662969","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":"Comparative Outcomes of Single Versus Multiple Cyanoacrylate Tissue Adhesive Applications in the Management of Corneal Thinning and Perforation.","authors":"Ryan S Huang, Manokamna Agarwal, Michael Mimouni, David S Rootman, Clara C Chan","doi":"10.1097/ICO.0000000000003859","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003859","url":null,"abstract":"<p><strong>Purpose: </strong>To compare outcomes between patients treated with a single cyanoacrylate tissue adhesive (CTA) patch for corneal thinning or perforation and those requiring multiple CTA applications.</p><p><strong>Methods: </strong>We conducted a single-center, comparative cohort study of patients with corneal thinning or perforation treated with either a single or multiple CTA applications in Toronto, Canada, between 2006 and 2024. Primary outcomes were the need for penetrating keratoplasty (PKP) and the best-corrected visual acuity (BCVA) at final follow-up. Associations between the number of CTA applications with baseline characteristics, perforation characteristics, and final outcomes were analyzed using univariable and multivariable logistic regression models.</p><p><strong>Results: </strong>Overall, 189 patients (median age 69.0 years; 42% female) were included, with 116 (61%) in the single CTA group and 73 (39%) in the multiple-application group (mean 2.3 ± 0.6), over a median follow-up of 4.4 months. Baseline characteristics were similar between groups. Central and paracentral corneal defects were more likely to require multiple glue applications than peripheral defects (OR = 2.92, 95% CI, 1.31-6.51, P = 0.009). No difference was observed in final BCVA between groups (median: 2.0 logarithm of the minimum angle of resolution [single] vs. 2.0 logarithm of the minimum angle of resolution [multiple]; P = 0.838). Patients receiving multiple CTA applications (48%, n = 35/73) were more likely to require PKP (OR = 2.70, 95% CI, 1.42-5.15, P = 0.003) than those treated with a single glue patch (26%, n = 30/116).</p><p><strong>Conclusions: </strong>Multiple CTA applications were more frequently needed for central/paracentral defects and were associated with a greater likelihood of PKP. Given no significant difference in final BCVA, a conservative, stepwise management approach can be pursued without compromising long-term visual outcomes, allowing flexibility in surgical planning.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623972","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":"Concurrent Descemet Stripping Only With Excision of Iris Pigment Epithelial Cysts.","authors":"Andrea C Santiago-Leon, Sadegh Ghafarian, Charissa H Tan, Sander R Dubovy, Zelia M Correa, Ellen H Koo","doi":"10.1097/ICO.0000000000003852","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003852","url":null,"abstract":"<p><strong>Purpose: </strong>To describe a case of bilateral large iris pigment epithelial (IPE) cysts causing corneal endothelial dysfunction that was successfully managed with a surgical cyst excision combined with Descemet stripping only (DSO) procedure followed by postoperative rho kinase inhibitor (ROCK-I) administration.</p><p><strong>Methods: </strong>Case report.</p><p><strong>Results: </strong>A 27-year-old woman presented with bilateral large IPE cysts adhering to the corneal endothelium, causing endothelial dysfunction with overlying corneal edema. Ultrasound biomicroscopy of both eyes revealed multiple thick-walled cysts, with points of adhesion to the pupillary margin, occupying the central part of the anterior chamber and adhering anteriorly to the corneal endothelium. Baseline pachymetry measurements were 631 μm in the right eye and 980 μm in the left. Following surgical excision, cystic lesions are removed from the posterior aspect of the cornea, in a similar fashion to the DSO technique. Pathology confirmed the presence of iris epithelium and Descemet membrane without evidence of malignancy. Topical netarsudil 0.02% was administered postoperatively, resulting in significant improvement in vision, complete resolution of corneal edema, reduction in corneal pachymetry, and a significant increase in central endothelial cell count at 6 months postoperatively, without recurrence of cysts.</p><p><strong>Conclusions: </strong>DSO combined with cyst excision, followed by topical ROCK-I administration, is a viable approach for the management of corneal decompensation associated with IPE cysts that are adherent to the endothelium. We herein demonstrate complete clearance of corneal edema and excellent visual outcomes without cyst recurrence, potentially avoiding the need for endothelial keratoplasty.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623452","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}