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Arch Soc Esp Oftalmol (Engl Ed) 2022 Jun 22. Epub 2022 Jun 22.

Departamento de Oftalmología (Qvision), Hospital Vithas Vírgen del Mar, Almería, Spain; Hospital Universitario Vírgen de las Nieves, Granada, Spain; Universidad de Sevilla, Departamento de Cirugía, Área de Oftalmología, Sevilla, Spain.

Infectious keratitis (IK) is one of the most common causes of monocular blindness worldwide, especially in developing countries and may account for 5.1%-32.3% of all indications for penetrating keratoplasty (PK). Read More

Stem Cell Reports 2022 Jun 10. Epub 2022 Jun 10.

Department of Ophthalmology, Osaka University Graduate School of Medicine, Suita City, Osaka 565-0871, Japan; Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Suita City, Osaka 565-0871, Japan. Electronic address:

When corneal epithelial stem cells residing in the corneal limbus become dysfunctional, called a limbal stem cell deficiency (LSCD), corneal transparency is decreased, causing severe vision loss. Transplantation of corneal epithelial cell sheets (CEPS) derived from stem cells, including induced pluripotent stem cells, is a promising treatment for LSCD. However, the potential effect of human leukocyte antigen (HLA) concordance on CEPS transplantation has not been addressed. Read More

Front Med (Lausanne) 2022 2;9:831352. Epub 2022 Jun 2.

Singapore National Eye Centre, Singapore, Singapore.

Purpose: Machine learning analysis of factors associated with 10-year graft survival of Descemet stripping automated endothelial keratoplasty (DSAEK) and penetrating keratoplasty (PK) in Asian eyes.

Methods: Prospective study of donor characteristics, clinical outcomes and complications from consecutive patients ( = 1,335) who underwent DSAEK (946 eyes) or PK (389 eyes) for Fuchs' endothelial dystrophy (FED) or bullous keratopathy (BK) were analyzed. Random survival forests (RSF) analysis using the highest variable importance (VIMP) factors were determined to develop the optimal Cox proportional hazards regression model. Read More

Cell Death Discov 2022 Jun 16;8(1):289. Epub 2022 Jun 16.

Aier Eye Hospital of Wuhan University, Wuhan, 430063, P. R. China.

Corneal allograft rejection can be seen in some patients after corneal transplantation. The present study intends to investigate whether JAK2 gene knockout affects corneal allograft rejection through regulation of dendritic cells (DCs)-induced T cell immune tolerance. In order to identify the target gene related to corneal allograft rejection, high-throughput mRNA sequencing and bioinformatics analysis were performed. Read More

Am J Transplant 2022 Jun 15. Epub 2022 Jun 15.

Nantes Université, INSERM, Center for Research in Transplantation and Translational Immunology, UMR 1064, Nantes, France.

Acute rejection (AR) of corneal transplants (CT) has a profound effect on subsequent graft survival but detailed immunological studies in human CT recipients are lacking. In this multi-site, cross-sectional study, clinical details and blood samples were collected from adults with clinically-diagnosed AR of full thickness (FT)-CT (n=35) and posterior lamellar (PL)-CT (n=21) along with Stable CT recipients (n=177) and adults with non-transplanted corneal disease (n=40). For those with AR, additional samples were collected 3 months later. Read More

Acta Ophthalmol 2022 Jun 9. Epub 2022 Jun 9.

Department of Translational Medicine, University of Ferrara, Ferrara, Italy.

Purpose: To evaluate the outcomes of various lamellar keratoplasty techniques performed at our Institution in children aged 14 years or younger over the last decade.

Methods: This single-centre study reviewed 72 eyes that underwent lamellar keratoplasty for various indications. Deep anterior lamellar keratoplasty (DALK) was performed in 19 eyes, mushroom penetrating keratoplasty (PK) in 27 eyes and Descemet stripping automated endothelial keratoplasty (DSAEK) in 25 eyes. Read More

Eur J Ophthalmol 2022 Jun 1:11206721221106314. Epub 2022 Jun 1.

574962Instituto de Cornea, Bogotá, Colombia.

Purpose: To report a case of epithelial downgrowth after penetrating keratoplasty.

Case Description: A 58-year-old man presented with graft rejection in his three-month-old, repeat penetrating keratoplasty. Examination revealed centripetal opacification of the posterior cornea due to deep epithelization. Read More

Indian J Ophthalmol 2022 Jun;70(6):2207

Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India.

Indian J Ophthalmol 2022 Jun;70(6):2206

Cataract, Cornea and Refractive Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Thavalukuppam, Pondicherry, India.

Biomedicines 2022 May 12;10(5). Epub 2022 May 12.

Department of Medicine, Mackay Medical College, New Taipei 252, Taiwan.

Most patients with a corneal injury are administered anti-inflammatory medications and antibiotics, but no other treatments are currently available. Thus, the corneal injury healing is unsatisfactory, affects the vision, and has a risk of blindness in severe cases. Human umbilical mesenchymal stem cells exhibit pluripotent and anti-inflammatory properties and do not cause immunological rejection in the host. Read More

Ann Transl Med 2022 Apr;10(8):482

Department of Ophthalmology, General Hospital of People's Liberation Army, Beijing, China.

Background: Corneal transplantation is the most effective clinical treatment for irreversible corneal endothelial decompensation. However, while visual rehabilitation can be achieved by corneal transplantation, transplant rejection, poor postoperative visual acuity, and lack of suitable donor tissue are currently the greatest obstacles to corneal transplantation. As a result, endothelial cell-based therapy has emerged as an alternative to corneal transplantation treatment. Read More

Graefes Arch Clin Exp Ophthalmol 2022 May 12. Epub 2022 May 12.

Department of Ophthalmology, Gui de Chauliac Hospital, 80 avenue Augustin Fliche, F-34000, Montpellier, France.

Purpose: To assess risk factors of rejection after penetrating keratoplasty (PKP).

Methods: This retrospective monocentric study assessed risk factors for rejection in patients who underwent PKP at Montpellier University Hospital between June 2005 and September 2018. Graft and donor data were obtained from our tissue bank in Montpellier. Read More

Cornea 2022 Apr 21. Epub 2022 Apr 21.

Department of Ophthalmology, Mayo Clinic, Rochester, MN; and.

Purpose: The goal of this study was to compare outcomes of Descemet stripping endothelial keratoplasty (DSEK) in eyes with glaucoma and abnormal anatomy to eyes with Fuchs endothelial corneal dystrophy (FECD).

Methods: In a retrospective interventional series of all cases of DSEK between April 1, 2006, and November 30, 2015, recipient diagnosis, preoperative glaucoma status, concurrent surgical procedures, and graft outcomes were recorded. Graft survival, risk of rejection, and subsequent glaucoma surgery were estimated by using Kaplan-Meier analysis with risk factors determined by proportional hazard models. Read More

Transl Vis Sci Technol 2022 05;11(5)

Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.

Purpose: To assess whether topical application of VEGFR1R2 Trap after corneal transplantation can impair corneal (lymph)angiogenesis and promote murine corneal allograft survival in eyes at high risk of rejection.

Methods: We used the murine model of suture-induced neovascularization and subsequent keratoplasty in eyes at high risk of rejection, which is an established model for local drug application. After transplantation, the mice were treated with either VEGFR1R2 Trap (aflibercept) or human IgG Fc as eye drops for 2 weeks (three times/d). Read More

Sci Rep 2022 05 5;12(1):7331. Epub 2022 May 5.

Department of Ophthalmology, Keimyung University School of Medicine, Dongsan Medical Center, Daegu, Korea.

This study sought to describe the use of deep-frozen donor corneal remnants preserved after keratoplasty procedures for therapeutic or tectonic keratoplasty without subsequent optical keratoplasty. This single-center retrospective consecutive case series analyzed the electronic medical records of patients who had undergone therapeutic or tectonic keratoplasty using deep-frozen donor remains preserved in Optisol-GS, for the past 11 years at Keimyung University Dongsan Medical Center. Fifty-five surgical cases in 46 patients were included. Read More

Indian J Ophthalmol 2022 05;70(5):1817-1818

Department of Cornea and External Diseases of the Eye, Narayana Nethralaya, Bengaluru, Karnataka, India.

A 28-year-old female who underwent an uneventful femtosecond laser enabled keratoplasty (FLEK) in her left eye presented with pain, redness, and blurring of vision in the operated eye two weeks after getting immunized with COVID-19 vector vaccine (ChAdOx1 nCoV19 Vaccine Recombinant COVISHIELD, AstraZeneca). Slit-lamp examination showed donor stromal edema with Descemet's membrane folds and Khodadoust line (KP's on endothelium) with anterior chamber cells and flare. The patient was diagnosed with acute corneal graft rejection and advised hourly topical steroids with cycloplegics and oral steroids. Read More

Front Bioeng Biotechnol 2022 14;10:862969. Epub 2022 Apr 14.

Institute of Ophthalmology, UCL, London, United Kingdom.

Currently corneal transplantation is the main treatment for late-stage keratoconus; however, transplantation procedures are accompanied by significant risk of post-surgical complications; this in addition to supply limitations imposed by a worldwide shortage of human donor corneas, has driven the development of alternative therapies. One such therapy is the use of corneal implants derived from porcine corneas (Xenia, Gebauer Medizintechnik GmbH, Neuhausen, DE). In contrast to human donor tissue, these implants can be produced on demand and due to the processes used pose no risks for host-immune rejection. Read More

Int Med Case Rep J 2022 14;15:201-204. Epub 2022 Apr 14.

Department of Ophthalmology, Rigshospitalet-Glostrup, Glostrup, Denmark.

Purpose: We report a case of acute bilateral Descemet membrane endothelial keratoplasty (DMEK) rejection two weeks following BNT162b2 mRNA COVID-19 vaccine (Pfizer-BioNTech), reflecting on possible changes to the management of patients with DMEK scheduled for COVID-19 vaccination.

Patients And Methods: A 94-year-old woman with Fuchs' endothelial dystrophy who underwent DMEK 24 months earlier (right eye) and 20 months earlier (left eye) demonstrated bilateral graft rejection two weeks after the first dose of COVID-19 vaccine. Standard treatment regimen was followed, and clinical status documented with slit-lamp examination and swept-source optical coherence tomography throughout. Read More

Sci Rep 2022 04 15;12(1):6338. Epub 2022 Apr 15.

Tissue Engineering and Cell Therapy, Singapore Eye Research Institute, Singapore, Singapore.

Following corneal transplantation, there is an initial, rapid decline in corneal endothelial cells (CECs) following surgery. Direct imaging of post-transplantation endothelial cells is only possible weeks after surgery and with a limited field of view. We have developed a labelling approach using 1,1'-dioctadecyl-3,3,3',3'-tetramethylindotricarbocyanine iodide (DIR) dye solution, that enables tracking of labelled CECs in vivo for at least 1 month. Read More

Klin Monbl Augenheilkd 2022 Apr 14. Epub 2022 Apr 14.

Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Germany.

Background: Favorable functional outcomes have been reported after excimer laser-assisted penetrating keratoplasty (EXL PKP). But this technique has not been widely adopted, and there are reports on EXL PKP from only a very limited number of institutions. Some of these results refer to operations carried out with laser systems that are not commercially available. Read More

Clin Ophthalmol 2022 6;16:1055-1067. Epub 2022 Apr 6.

Trefoil Therapeutics, Inc., San Diego, CA, USA.

Purpose: To assess the incremental burden of corneal transplant surgery for US commercially insured patients with Fuchs endothelial corneal dystrophy (FECD) treated with endothelial keratoplasty (EK) compared to controls.

Methods: The study design was retrospective cohort using IBM MarketScan claims (January 2014-September 2019) and included EK-treated (N=1562) and control patients (N=23,485) having ≥12 months' enrollment before and after diagnosis, who were subsequently matched on select characteristics. The index date was the beginning of the pre-operative period (3 months before EK); synthetic EK index was assigned for controls. Read More

Acta Ophthalmol 2022 Apr 11. Epub 2022 Apr 11.

Translational Approach to Epithelial Injury and Repair, CNRS, INSERM, GReD, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Ophthalmology, Université Clermont Auvergne, Clermont-Ferrand, France.

Purpose: To evaluate the efficacy of preventive treatment against allograft rejection after endothelial keratoplasty (EK), we conducted a systematic review and meta-analysis.

Method: PubMed, Cochrane Library, Embase and ScienceDirect databases were searched until May 2021. We computed a random-effect meta-analysis on graft rejection rate stratified by the intervention (i. Read More

Int J Mol Sci 2022 Mar 23;23(7). Epub 2022 Mar 23.

Ophthalmology, School of Medicine, University of North Carolina, Chapel Hill, NC 27599, USA.

The purpose of this paper is to review human leukocyte antigen G (HLA-G) in the eye, its role in immune tolerance, and the potential therapeutic use of AAV gene transfer and expression of HLA-G in various ocular tissues. Several studies are reviewed that demonstrate efficacy in animal models of disease, including intracorneal delivery of AAV-HLA-G to treat corneal inflammation and prevent corneal graft rejection, subconjunctival injection of AAV-HLA-G for ocular graft vs. host disease and potentially dry eye disease, and intravitreal injection of AAV-HLA-G to inhibit uveitis. Read More

Ocul Immunol Inflamm 2022 Apr 11:1-4. Epub 2022 Apr 11.

Department of Ophthalmology, University Hospital of Wales, Cardiff, UK.

Purpose: Multiple cases of corneal graft rejection after various vaccinations have been reported over the past decades. Here we described a case of bilateral cystoid macular edema (CME) and endothelial rejection in a DSAEK patient following influenza and varicella vaccines.

Case Report: A 72-year-old woman with bilateral Fuch's endothelial dystrophy received bilateral DSAEK surgeries. Read More

Front Immunol 2022 24;13:859929. Epub 2022 Mar 24.

Laboratory of Ocular Regenerative Medicine and Immunology, Seoul Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul, South Korea.

Although pig-to-non-human primate (NHP) corneal xenotransplantation has shown long-term graft survival, xenogeneic antigen-related immune responses are still stronger than allogeneic antigen-associated responses. Therefore, there is an unmet need to investigate major rejection pathways in corneal xenotransplantation, even with immunosuppression. This study aimed to identify biomarkers in aqueous humor for predicting rejection and to investigate rejection-related pathways in grafts from NHPs transplanted with porcine corneas following the administration of steroids combined with tacrolimus/rituximab. Read More

Cornea 2022 May;41(5):669-672

University Hospitals of Leicester, United Kingdom; and.

Purpose: The purpose of this study was to report 5 cases of acute corneal graft rejection after COVID-19 vaccination and perform a review of the literature.

Methods: This was a case series and review of literature dated on the October 10, 2021.

Results: We describe 5 cases-2 patients with Descemet stripping automated endothelial keratoplasty (for Fuchs endothelial dystrophy) who presented with acute corneal graft rejection after their first dose of mRNA (BNT162) vaccine. Read More

Cornea 2022 May;41(5):651-653

Department of Ophthalmology Vision Sciences, University of Toronto, Toronto, ON, Canada.

Purpose: The purpose of this study was to report a case of "smoldering" keratolimbal allograft (KLAL) rejection in a patient with subtherapeutic levels of systemic immunosuppression in temporal association with BNT162b2 messenger RNA vaccination for severe acute respiratory syndrome coronavirus 2.

Methods: This was a case report.

Observations: A 72-year-old man presented with circumferential perilimbal engorgement, stagnation, and tortuosity of vessels with mild chemosis in his right eye KLAL segments 1 month after receiving the BNT162b2 messenger RNA vaccine while his tacrolimus trough blood levels were subtherapeutic measuring <2 ng/mL. Read More

PLoS One 2022 5;17(4):e0266072. Epub 2022 Apr 5.

State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao, China.

This study aimed to analyze the factors of rapid attenuation of graft endothelium in the early stage after penetrating keratoplasty (PKP), with a view to guiding patients with PKP to better long-term outcomes. This study included 226 patients who underwent PKP with follow-up time >1 year at the Qingdao Eye Hospital of Shandong First Medical University from January 2018 to June 2020. Medical records were retrospectively studied, and donor factors, patient factors, and surgical factors were comparatively analyzed to clarify those affecting the rapid decay of graft endothelium after PKP. Read More

Ann Palliat Med 2022 Mar;11(3):1112-1120

Department of Medical Equipment, Xijing Hospital, The Fourth Military Medical University, Xi'an, China.

Background: At present, corneal transplantation has become the main surgical method for infectious keratitis. However, the rejection of corneal graft after operation leads to graft opacity, which is an important reason for the failure of transplantation. There is no unified conclusion whether the rejection can be reduced by matching human leucocyte antigen (HLA) before operation. Read More

Acta Biomater 2022 Apr 4. Epub 2022 Apr 4.

Key Laboratory for Corneal Tissue Engineering, College of Marine Life Sciences, Ocean University of China, Qingdao 266003, Shandong Province, China. Electronic address:

Descemet's membrane endothelial keratoplasty (DMEK) may provide fast visual rehabilitation in the therapy of corneal endothelial disorders. However, due to shortage of donated corneas, how to construct a corneal endothelial substitute with powerful functions that can be used for DMEK is still unsolved. Herein, we introduced the method of corneal crosslinking (CXL) and conjugated the components of native Descemet's membrane (DM) to improve the mechanical properties and the biocompatibility of denuded amniotic membrane (dAM), further assessed their effects on cell adhesion, proliferation, YAP translocation, and metabolic activity in human corneal endothelial (HCE) cells. Read More