IF 1.9 3区医学

Cornea Pub Date : 2025-03-07 DOI: 10.1097/ICO.0000000000003850

Cameron B Reinisch, Albert Y Cheung, Robert J Porter, Enrica Sarnicola, Robert Folberg, Medi Eslani, Edward J Holland

{"title":"Sludging: A Postoperative Clinical Finding After Ocular Surface Stem Cell Transplantation.","authors":"Cameron B Reinisch, Albert Y Cheung, Robert J Porter, Enrica Sarnicola, Robert Folberg, Medi Eslani, Edward J Holland","doi":"10.1097/ICO.0000000000003850","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003850","url":null,"abstract":"Purpose: The objective of this study was to describe a postoperative clinical finding coined \"sludging.\" Sludging is defined as a noninflammatory vascular phenomenon observed following ocular surface stem cell transplantation (OSST) characterized by dilated blood vessels localized to the graft. Also, the aim of our study was to identify associated risk factors and the impact on OSST graft outcomes.Methods: A total of 261 eyes of 196 patients who underwent OSST to treat severe limbal stem cell deficiency from 2006 to 2016 were included in this retrospective review. Clinical characteristics were collected, including patient and donor demographics as well as clinical outcomes.Results: The clinical features of sludging include painless dilation of blood vessels localized on the graft, with an absence of inflammation, limbal injection, and corneal epithelial abnormalities. The overall prevalence of sludging was 77 of 261 eyes (29.5%), and the mean time of appearance after OSST was 1.31 ± 1.48 years. Sludging resolved in 54 of 77 eyes (70.1%) after 0.93 ± 1.04 years. Sludging was most commonly seen after keratolimbal allograft (KLAL) (43.4%) as compared with living-related conjunctival limbal allograft (13.5%, P = 0.00012). The presence of sludging was associated with higher rates of both future graft rejection (P = 0.0012) and graft failure (P = 0.0053). There were no significant donor characteristics associated with developing sludging among KLAL recipients.Conclusions: Sludging is a noninflammatory postoperative clinical finding following OSST, particularly KLAL. Prompt recognition of sludging is critical to differentiate from acute graft rejection as the management and prognosis is different.","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603076","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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IF 1.9 3区医学

Cornea Pub Date : 2025-03-07 DOI: 10.1097/ICO.0000000000003840

Oliver Dorado Cortez, Philippe Gain, Gilles Thuret

引用次数: 0

Sterile Keratolysis Following Porcine Collagen Implant in Advanced Keratoconus. 猪胶原植入术治疗晚期圆锥角膜的无菌角膜溶解。

IF 1.9 3区医学

Cornea Pub Date : 2025-03-05 DOI: 10.1097/ICO.0000000000003854

Rashmi Deshmukh, Pravin Krishna Vaddavalli

引用次数: 0

Ocular Manifestations in Congenital Cutis Laxa: A Case Series. 先天性皮肤松弛症的眼部表现：一个病例系列。

IF 1.9 3区医学

Cornea Pub Date : 2025-03-05 DOI: 10.1097/ICO.0000000000003845

Arnaud Van Slycken, Aude Beyens, Bert Callewaert, Elke O Kreps

{"title":"Ocular Manifestations in Congenital Cutis Laxa: A Case Series.","authors":"Arnaud Van Slycken, Aude Beyens, Bert Callewaert, Elke O Kreps","doi":"10.1097/ICO.0000000000003845","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003845","url":null,"abstract":"Purpose: Congenital cutis laxa (CL) syndromes encompass a diverse group of inherited connective tissue disorders characterized by redundant, wrinkled, and inelastic skin, often with systemic involvement. Ocular involvement in CL has sporadically been reported albeit without systematic, comprehensive ocular assessment. The purpose of this study was to evaluate the ocular phenotype in an established cohort of patients with CL with a particular emphasis on corneal involvement.Methods: A prospective cross-sectional study was conducted at Ghent University Hospital, Belgium, involving 13 genetically confirmed patients with CL. Ophthalmic evaluations included autorefraction, slit-lamp biomicroscopy, corneal tomography, ocular biometry, spectral-domain optical coherence tomography, and fundoscopy.Results: A total of 13 patients (26 eyes), 4 males (30%) and 9 females (69%), were assessed including 5 with ELN-related CL, 1 individual with FBLN5-related CL, 2 with LTBP4-related CL, 4 with ATP6V0A2-related CL, and 1 with PYCR1-related CL. Six patients (46%) were emmetropic, 5 (38%) myopic, and 2 (15%) hyperopic. Reduced corrected visual acuity was detected solely in patients with the ATP6V0A2 subtype. Three (23.1%) cases of keratoconus were detected in the cohort. All 4 patients with ATP6V0A2-related CL had prominent corneal tomographic abnormalities, with either high-grade astigmatism or pronounced corneal flattening and thinning.Conclusions: A high rate of corneal geometry change was detected in this heterogeneous cohort of patients with CL, including a high rate of corneal ectasia. These findings highlight the impact of elastic fiber disassembly on corneal homeostasis and indicate a need for ocular assessment including corneal imaging in patients with CL.","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566345","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

Long-Term Efficacy and Safety of Fluorometholone 0.1% Use After Descemet Membrane Endothelial Keratoplasty. Descemet 膜内皮角膜移植术后使用 0.1% 氟米龙的长期疗效和安全性。

IF 1.9 3区医学

Cornea Pub Date : 2025-03-05 DOI: 10.1097/ICO.0000000000003846

Neeti Gupta, Francis W Price, Marianne O Price

{"title":"Long-Term Efficacy and Safety of Fluorometholone 0.1% Use After Descemet Membrane Endothelial Keratoplasty.","authors":"Neeti Gupta, Francis W Price, Marianne O Price","doi":"10.1097/ICO.0000000000003846","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003846","url":null,"abstract":"Purpose: To assess rates of steroid-induced ocular hypertension, de novo glaucoma, and rejection episodes with long term, off-label use of fluorometholone 0.1% after Descemet membrane endothelial keratoplasty (DMEK) in patients without preexisting glaucoma.Methods: We retrospectively reviewed records of 250 patients without previous glaucoma, who underwent DMEK between 2015 and 2019, used prednisolone acetate 1% for 2 months, and then switched to fluorometholone 0.1%, used indefinitely. Subjects with prior penetrating keratoplasty or <5-year follow-up were excluded. Main outcomes were rates of postoperative steroid-induced ocular hypertension, glaucoma, and rejection episodes, assessed with Kaplan-Meier analysis, taking follow-up into consideration.Results: The indications for DMEK were Fuchs dystrophy (94%), failed endothelial keratoplasty (4%), and secondary corneal edema (2%). The median patient age was 67 years (range 35-89 years), and median follow-up was 7 years (range 5-9 years). The cumulative rate of steroid-induced ocular hypertension was 2% at 1 year, 5% at 5 years, and 7% at 8 years. The cumulative rate of glaucoma was 2% at 1 year, 4% at 5 years, and 4% at 8 years; all cases of de novo glaucoma were managed medically and did not require surgical intervention. The cumulative rate of definite rejection episodes was 1% at 1 year, 1% at 5 years, and 2% at 8 years.Conclusions: Long-term use of fluorometholone 0.1% after DMEK results in low rates of steroid induced ocular hypertension, de novo glaucoma, and immunologic rejection in patients without prior glaucoma.","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566205","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

Escalón: A Prospective Randomized Trial of Corneal Endothelial Cell Therapy in Subjects With Corneal Edema. Escalón：角膜内皮细胞治疗角膜水肿的前瞻性随机试验。

IF 1.9 3区医学

Cornea Pub Date : 2025-03-03 DOI: 10.1097/ICO.0000000000003844

Edward J Holland, Elizabeth Yeu, Matthew Giegengack, John Berdahl, Eris Jordan, Rodrigo Quesada, Gabriel Quesada, Shigeru Kinoshita, Chie Sotozono, Munetoyo Toda, Morio Ueno, Arnaud Lacoste, Xin Qu, Frada Berenshteyn, Nysha Blender, Michael H Goldstein

{"title":"Escalón: A Prospective Randomized Trial of Corneal Endothelial Cell Therapy in Subjects With Corneal Edema.","authors":"Edward J Holland, Elizabeth Yeu, Matthew Giegengack, John Berdahl, Eris Jordan, Rodrigo Quesada, Gabriel Quesada, Shigeru Kinoshita, Chie Sotozono, Munetoyo Toda, Morio Ueno, Arnaud Lacoste, Xin Qu, Frada Berenshteyn, Nysha Blender, Michael H Goldstein","doi":"10.1097/ICO.0000000000003844","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003844","url":null,"abstract":"Purpose: Escalón is a prospective, randomized, double-masked, parallel-group trial designed to evaluate the safety and efficacy of cultured human corneal endothelial cells (CECs) and the Rho-associated protein kinase (ROCK) inhibitor Y-27632 for treating corneal edema secondary to endothelial dysfunction.Methods: Eligible eyes with bullous keratopathy (N = 18) or Fuchs dystrophy (N = 4) were randomized to receive endothelial polishing and a single intracameral injection containing 1 x 106 CECs and 10, 20, or 100 μM Y-27632. The primary outcome was safety based on incidence and severity of ocular and nonocular treatment-emergent adverse events (TEAEs). Efficacy outcomes included changes from baseline in central corneal thickness (CCT) and best-corrected visual acuity (BCVA) at all time points up to month 12.Results: Twenty-two eyes received treatment. Data from all study groups were pooled, as no clinically meaningful differences existed between groups. Study eyes experienced no serious TEAEs. Common study eye TEAEs included posterior capsule opacification (72.7%), pupillary disorders/dyscoria (27.3%), and transient intraocular pressure elevations (22.7%). Mean CCT improved from 697.0 μm at baseline to 571.2 μm at month 12. Mean BCVA improved from 0.995 logMAR at baseline to 0.330 logMAR at month 12. The proportion of all subjects with a ≥ 0.3 LogMAR improvement in BCVA was 88.9% at month 12.Conclusions: The study demonstrated that transplantation of cultured CECs with Y-27632 was safe and efficacious across all evaluated doses of Y-27632. No clinically meaningful dose response was seen for Y-27632. This innovative therapeutic approach represents a promising option for treating corneal edema arising from corneal endothelial dysfunction.","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540468","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

Delayed Late-Onset Severe Progressive Corneal Flattening: A Complication 9 Years After Corneal Collagen Crosslinking. 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 1.9 3区医学

Cornea Pub Date : 2025-03-03 DOI: 10.1097/ICO.0000000000003839

Giulia Firmani, Christopher Ashton, Scott Hau, Romesh I Angunawela

引用次数: 0

Conjunctival Neuroma After Corneal Neurotization in a Patient With Neurotrophic Keratopathy. 神经营养性角膜病变患者角膜神经化后结膜神经瘤1例报告。

IF 1.9 3区医学

Cornea Pub Date : 2025-03-01 DOI: 10.1097/ICO.0000000000003780

Alex de O C Camacho, Sara Alzanki, Mohammed Al Enazi, Nora Cherifi, Romain Cayrol, Akram Rahal, Isabelle Hardy, Isabelle Brunette, Michèle Mabon

{"title":"Conjunctival Neuroma After Corneal Neurotization in a Patient With Neurotrophic Keratopathy.","authors":"Alex de O C Camacho, Sara Alzanki, Mohammed Al Enazi, Nora Cherifi, Romain Cayrol, Akram Rahal, Isabelle Hardy, Isabelle Brunette, Michèle Mabon","doi":"10.1097/ICO.0000000000003780","DOIUrl":"10.1097/ICO.0000000000003780","url":null,"abstract":"Purpose: To report a rare case of conjunctival neuroma after a successful corneal neurotization surgery.Methods: The clinical file and histopathology slides of this patient who underwent surgical corneal neurotization for a neurotrophic keratopathy in the right eye were reviewed.Results: A 70-year-old man with a history of severe herpetic (varicella zoster) neurotrophic keratopathy and keratouveitis in the right eye developed a corneal perforation, which required tectonic keratoplasty (May 2020). Corneal neurotization was performed 1 year later without complication, using the ipsilateral supraorbital and supratrochlear nerves to reinnervate the right cornea (April 2021), followed by repeat penetrating keratoplasty (September 2021). Three months later, a superonasal conjunctival mass was observed with a contiguous corneal delle and melt at the corneal-host junction. In vivo confocal microscopy showed numerous nerve fibers within the conjunctival mass, suggesting a diagnosis of conjunctival neuroma. The mass was surgically debulked, and the diagnosis was confirmed by histopathology and immunohistochemistry. The delle and corneal melt were successfully treated with an amniotic membrane.Conclusions: To the best of our knowledge, this is the first case of confirmed conjunctival neuroma reported after corneal neurotization. Confocal microscopy, histopathology, and immunohistochemistry have proven to be highly useful tools for the prompt recognition and accurate diagnosis necessary for the proper management of this rare complication.","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":"368-370"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806098","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: Intracameral Enoxaparin for Descemet Membrane Endothelial Keratoplasty: A Pilot Safety Study. 关于：用于 Descemet 膜内皮角膜移植术的鞘内依诺肝素：安全性试验研究。

IF 1.9 3区医学

Cornea Pub Date : 2025-03-01 Epub Date: 2024-10-30 DOI: 10.1097/ICO.0000000000003743

Mohammad H Dastjerdi

引用次数: 0

Bowman Layer Transplantation With Stromal Inclusion Using Femtosecond Laser: 3-Year Results. 使用飞秒激光进行带有基质包涵的鲍曼层移植：3 年结果

IF 1.9 3区医学

Cornea Pub Date : 2025-03-01 Epub Date: 2024-07-10 DOI: 10.1097/ICO.0000000000003620

Aranza Guadalupe Estrada-Mata, Mónica Benedetti Sandner, Gonzalo García de Oteyza, Diana Karla Gutiérrez-García, Areli Nishimura-Crespo, Carlos Enrique De la Torre González, Guillermo De Wit Carter, Ana Mercedes García-Albisua

{"title":"Bowman Layer Transplantation With Stromal Inclusion Using Femtosecond Laser: 3-Year Results.","authors":"Aranza Guadalupe Estrada-Mata, Mónica Benedetti Sandner, Gonzalo García de Oteyza, Diana Karla Gutiérrez-García, Areli Nishimura-Crespo, Carlos Enrique De la Torre González, Guillermo De Wit Carter, Ana Mercedes García-Albisua","doi":"10.1097/ICO.0000000000003620","DOIUrl":"10.1097/ICO.0000000000003620","url":null,"abstract":"Purpose: The aim of this study was to evaluate the 3-year clinical results of Bowman layer with stromal inclusion (Bowman layer) transplantation using femtosecond laser for patients with advanced keratoconus.Methods: This single-center retrospective study included 7 eyes of 7 patients diagnosed with progressive keratoconus who underwent Bowman layer transplantation with stromal inclusion between 2018 and 2020. Follow-up was carried out from the date of surgery until 36 months later. Bowman layer grafts were positioned into a mid-stromal pocket performed by a femtosecond laser and patients were evaluated up to 3 years after surgery.Results: Corneal flattening of 5.49 D ( P = 0.0020) in Kmax was observed, increased in corneal pachymetry, and an improvement best-corrected visual acuity measured in logarithm of minimum angle of resolution (LogMAR) from 0.89 to 0.60 and tolerance to contact lens from 42% of the patients to 100% of them. Stabilization of the cornea was achieved in 100% with no further progression of the keratoconus; all surgical procedures were uneventful, and no complications were observed during the 3 years of follow-up.Conclusions: Bowman layer transplantation with stromal inclusion flattened the cornea improving best-corrected visual acuity and contact lens tolerance and stabilized keratoconus in 100% of the patients during 3 years of follow-up and may be a feasible option in patients with advanced and progressive KC to delay or avoid the need for PK or DALK.","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":"332-336"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141579218","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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