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J Biomed Mater Res A 2019 Apr 22. Epub 2019 Apr 22.

Department of Ophthalmology, RWTH Aachen University Hospital, Aachen, Germany.

Corneal transplantation is the treatment of choice for patients with advanced corneal diseases. However, the outcome may be affected by graft rejection, high associated costs, surgical expertise and most importantly the worldwide donor shortage. In recent years, bioprinting has emerged as an alternative method for fabricating tissue equivalents using autologous cells with architecture resembling the native tissue. Read More

Taiwan J Ophthalmol 2019 Jan-Mar;9(1):18-26

Cornea Services, Devers Eye Institute, Portland, OR, USA.

With the success of Descemet's stripping automated endothelial keratoplasty (DSAEK) technique providing better outcomes in visual prognosis and theoretically lower rejection rate than penetrating keratoplasty, DSAEK dominated the realm of endothelial keratoplasty for the past decade. However, Descemet's membrane endothelial keratoplasty (DMEK) has become more and more popular worldwide due to its even lower rejection rate, faster visual recovery, better visual outcome, and lower long-term endothelial loss. In this article, we demonstrate the techniques and nuances of DMEK surgery in detail for corneal specialists who are beginning their DMEK surgeries. Read More

J Refract Surg 2019 Apr;35(4):239-246

Purpose: To describe 2-year results of deep intrastromal arcuate keratotomy with in situ keratomileusis (DIAKIK) for the treatment of high astigmatism after keratoplasty.

Methods: This prospective study included 20 eyes from 20 patients presenting with high astigmatism after keratoplasty. All were treated by two-step femtosecond laser surgery, with two intrastromal arcuate keratotomies and a corneal flap, followed a few months later by excimer photoablation after reopening of the flap. Read More

Xenotransplantation 2019 Apr 14:e12515. Epub 2019 Apr 14.

Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea.

We investigated the predictive biomarkers for graft rejection in pig-to-non-human primate (NHP) full-thickness corneal xenotransplantation (n = 34). The graft score (0-12) was calculated based on opacity, edema, and vascularization. Scores ≥ 6 were defined as rejection. Read More

Eur J Pharm Sci 2019 May 27;133:104-114. Epub 2019 Mar 27.

GDHPPCLab, School of Chemistry, Sun Yat-Sen University, 510275, China; Key Lab for Polymer Composite and Functional Materials of Ministry of Education, School of Chemistry, Sun Yat-Sen University, Guangzhou 510275, China. Electronic address:

This study aimed to develop a stable and biodegradable tacrolimus loaded nanocarrier that enhanced tacrolimus corneal penetration and delivered in a sustained manner, thus to create a promising treatment to prevent immune rejection after corneal allografts. Spherical tacrolimus loaded methoxy poly (ethylene glycol)-block-poly (D,L)-lactic-co-glycolic acid (mPEG-b-PLGA) micelles with a mean diameter of 81.3 ± 1. Read More

Cornea 2019 Mar 19. Epub 2019 Mar 19.

Department of Ophthalmology, Peking University Third Hospital, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China.

Purpose: This article explores the application of optical coherence tomography angiography (OCTA) in assessing corneal neovascularization (CoNV) and investigates the features of CoNV in eyes with corneal transplantation.

Methods: A pilot, case series, observational study was conducted to enroll patients who underwent corneal transplantation including penetrating keratoplasty (PKP) and deep lamellar keratoplasty (DLKP) with or without additional keratolimbal allograft transplantation. All patients were followed with a series of ophthalmologic examinations including slit-lamp photography and were then imaged with the anterior segment OCTA. Read More

Invest Ophthalmol Vis Sci 2019 Mar;60(4):1050-1062

College of Optometry, University of Houston, Houston, Texas, United States.

Purpose: We recently reported that the glycosaminoglycan hyaluronan (HA), which promotes inflammatory angiogenesis in other vascular beds, is an abundant component of the limbal extracellular matrix. Consequently, we have explored the possibility that HA contributes to lymphangiogenesis in the inflamed cornea.

Methods: To study the role of HA on lymphangiogenesis, we used mice lacking the hyaluronan synthases and injury models that induce lymphangiogenesis. Read More

Drug Deliv 2019 Dec;26(1):290-299

a State Key Laboratory of Ophthalmology , Zhongshan Ophthalmic Center, Sun Yat-sen University , Guangzhou , China.

Tacrolimus has been widely applied to prevent organ rejection after transplantation. However, the conventional pharmaceutical formulation of tacrolimus limits its applications in ocular therapy due to its hydrophobicity and low corneal penetrability. We optimized tacrolimus-loaded methoxy poly (ethylene glycol-block-poly (d, l)-lactic-co-glycolic acid) nanoparticles (TAC-NPs) by simple and effective nanotechnology as a drug delivery system for corneal graft rejection to overcome these drawbacks. Read More

Ulus Travma Acil Cerrahi Derg 2019 Mar;25(2):172-176

Department of Ophthalmology, Ankara Numune Training and Research Hospital, Ankara-Turkey.

Background: To evaluate the results of penetrating keratoplasty (PK) due to trauma-related corneal scarring.

Methods: We evaluated 24 eyes of 24 patients who underwent PK due to trauma-related scarring of the cornea between May 2010 and June 2016. The postoperative visual acuity, graft transparency, and complications were evaluated. Read More

Cornea 2019 Mar 12. Epub 2019 Mar 12.

State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong Academy of Medical Sciences, Qingdao, China.

Purpose: To detect early growth of blood and lymphatic vessels in the mouse cornea and iris after penetrating keratoplasty.

Methods: Penetrating keratoplasty was performed with C57BL/6 mice as donors and BALB/c mice as recipients. Graft transparency and neovascularization were examined by slit-lamp microscopy. Read More

Int J Pharm 2019 May 13;562:1-10. Epub 2019 Mar 13.

GDHPPCLab, School of Chemistry, Sun Yat-Sen University, 510275, China; Key Lab for Polymer Composite and Functional Materials of Ministry of Education, School of Chemistry, Sun Yat-Sen University, Guangzhou 510275, China. Electronic address:

FK506 (tacrolimus) is an effective immunosuppressant, but its poor water solubility and low bioavailability impose barriers to ocular drug delivery. The nanomicelles (NMs) formulations comprised of amino-terminated poly(ethylene glycol-block-poly(D,L)-lactic acid) (NH-PEG-b-PLA) and hydroxypropyl methylcellulose (HPMC) were developed to increase the penetration of hydrophobic drugs in the eye and enhance the drug bioavailability for ocular disorder therapy. Spherical FK506/NH-PEG-b-PLA/HPMC NMs with mean diameter of 101. Read More

Biomed Pharmacother 2019 May 8;113:108558. Epub 2019 Mar 8.

State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, PR China. Electronic address:

Immune rejection is a critical complication that results in the graft failure after corneal transplantation. Thus, there remains a need for new therapies for allograft rejection. AICAR (aminoimidazole-4-carboxamide ribonucleoside) is an, as adenosine monophosphate-activated protein kinase (AMPK) activator and a purine nucleoside with a wide range of metabolic effects, including activation of AMPK. Read More

Vestn Oftalmol 2019;135(1):98-103

S. Fyodorov Eye Microsurgery Federal State Institution, 59A Beskudnikovsky Blvd., Moscow, Russian Federation, 127486.

Nowadays, endothelial keratoplasty has become an alternative to penetrating keratoplasty (PKP) in the management of corneal endothelial dysfunction. Descemet membrane endothelial keratoplasty (DMEK) is a relatively new corneal transplantation surgery technique suited for patients with endothelial insufficiency, an increasing number of surgeons are learning the graft preparation technique and the surgery itself after seeing its excellent postoperative visual outcomes and faster rehabilitation of patients. DMEK has significant advantages in comparison with automated and manual Descemet Stripping Endothelial Keratoplasty (DSAEK/DSEK) and PKP including lower risk of immunologic graft rejection (1-2%), lower cost of the procedure, and it does not require expensive equipment such as a microkeratome or a femtosecond laser device. Read More

Eye Contact Lens 2019 Feb 27. Epub 2019 Feb 27.

Department of Ophthalmology (T.D.O.), Havener Eye Institute, The Ohio State University Wexner Medical Center, Columbus, OH; and Department of Ophthalmology (T.F.M.), West Virginia University Eye Institute, West Virginia University, Morgantown, WV.

Purpose: The purpose of this study was to examine the outcomes of conjunctival flaps performed at our institution.

Methods: The medical records of all patients who underwent a total or partial conjunctival flap surgery over the course of a 6-year period from 2010 to 2015 were reviewed to identify the ocular diagnoses and perform a retrospective review of the preoperative and postoperative course.

Results: Thirty-five patients received a conjunctival flap during the 6-year period, 20 partial flaps and 15 total flaps. Read More

Int J Ophthalmol 2019 18;12(2):324-332. Epub 2019 Feb 18.

Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Science Key Laboratory, Beijing 100730, China.

Donor cornea shortage is a primary hurdle in the development of corneal transplantation. Of all species, porcine corneas are the ideal transplantation material for humans. However, the xenoimmune rejection induced by porcine corneal xenotransplantation compromises surgical efficacy. Read More

Cureus 2018 Dec 17;10(12):e3744. Epub 2018 Dec 17.

Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, MYS.

Purpose To describe the demographics, indications, clinical outcomes and survival rate of penetrating keratoplasty in Malaysian children living in a suburban area, and discuss the literature on paediatric penetrating keratoplasty. Methodology A retrospective review of medical records was performed on children younger than 17 years of age who had undergone penetrating keratoplasty in Hospital Universiti Sains Malaysia from January 2008 to December 2017. We recorded demographic data, presenting visual acuity, indications, final visual acuity, and graft survival at 12 months into the postoperative period. Read More

Am J Ophthalmol 2019 Feb 18. Epub 2019 Feb 18.

Ocular Surface Imaging Center, Cornea and Refractive Surgery Service, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, MA; Center for Translational Ocular Immunology, and Cornea Service, New England Eye Center, Department of Ophthalmology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA. Electronic address:

Purpose: Diagnosis of graft rejection is based on patient symptoms and on clinical signs by the slit-lamp biomicroscopy. The purpose of this study is to investigate whether laser in vivo confocal microscopy (IVCM) can aid in the diagnosis of corneal graft rejection by detecting cellular corneal changes that take place after transplantation.

Design: Prospective case-control study. Read More

Am J Ophthalmol 2019 Feb 4. Epub 2019 Feb 4.

Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Purpose: To evaluate the effect of keratoconus severity on the visual and refractive outcomes and complications after deep anterior lamellar keratoplasty (DALK).

Design: Consecutive interventional case series.

Methods: This study enrolled 227 keratoconus-affected eyes that underwent DALK. Read More

J Med Case Rep 2019 Feb 6;13(1):31. Epub 2019 Feb 6.

Department of Ophthalmology, University Hospital of Tübingen, Elfriede-Aulhorn-Str. 7, 72076, Tübingen, Germany.

Background: We report the first histopathologically proven occurrence of a retrocorneal membrane after Descemet's membrane endothelial keratoplasty.

Case Presentation: A white Caucasian 76-year-old woman received penetrating keratoplasty on her right eye 2 years after Descemet's membrane endothelial keratoplasty surgery with combined cataract extraction and intraocular lens implantation for Fuchs' endothelial corneal dystrophy due to an allograft rejection with ensuing graft failure. Her preoperative vision was counting fingers (20/2000) caused by immunological debris, corneal edema, and secondary membrane formation. Read More

Arq Bras Oftalmol 2019 Mar-Apr;82(2):152-154

Department of Ophthalmology and Visual Sciences, Universidade Federal de São Paulo, São Paulo, SP, Brazil.

We describe here a case of a 21-year-old woman who presented with low visual acuity, pain, and hyperemia in the left eye for 45 days. Her eye had extensive corneal infiltrate, with melting and a central perforation that was glued with cyanoacrylate, but with Seidel (+). She underwent tectonic corneal transplantation, and anterior chamber lavage with subconjunctival infiltration with voriconazole, as well as intracameral injections of amphotericin B. Read More

Am J Ophthalmol 2019 Feb 2. Epub 2019 Feb 2.

Department of Corneal and External Eye Diseases, Moorfields Eye Hospital, London EC1V 2PD, United Kingdom. Electronic address:

Purpose: To examine clinical outcomes in deep anterior lamellar keratoplasty (DALK) for keratoconus using contemporary techniques in a multi-surgeon public healthcare setting.

Design: Consecutive, retrospective case series.

Setting: Moorfields Eye Hospital, London STUDY POPULATION: Consecutive cases of keratoconus treated with non-laser assisted DALK from September 1, 2012, to September 31, 2016. Read More

Cornea 2019 Apr;38(4):515-522

Clinica degli Occhi Sarnicola, Grosseto, Italy.

Deep anterior lamellar keratoplasty (DALK) is the ideal surgery for corneal stromal diseases with a healthy endothelium. This technique offers substantial advantages compared with penetrating keratoplasty, primarily the avoidance of endothelial rejection and longer graft survival. Several DALK techniques have been described and classified into 2 categories, descemetic DALK (dDALK) and predescemetic DALK (pdDALK) depending on whether Descemet membrane-endothelium was thought to be exposed or minimal residual stroma was left behind. Read More

Medicine (Baltimore) 2019 Jan;98(3):e14191

Department of Ophthalmology and Visual Science, Daejeon St. Mary's Hospital.

Rationale: To report a case of herpes simplex virus (HSV) linear endotheliitis in a 57-year-old male who had underwent keratoplasty 10 years ago. The characteristic linear keratic precipitates (KPs) resembled the Khodadoust line in graft rejection. The differential diagnosis is essential, because the treatment regimen is different between HSV linear endotheliitis and graft rejection. Read More

Eye (Lond) 2019 Jan 8. Epub 2019 Jan 8.

External Disease Service, Moorfields Eye Hospital, London, United Kingdom.

Background: Cytomegalovirus (CMV) endotheliitis is a significant cause for acute corneal allograft rejection in East Asian populations, where there is a high CMV seroprevalence. To determine how frequently CMV is associated with corneal graft failure in the UK, we looked for the presence of CMV DNA in grafts that had failed and had been removed at repeat keratoplasty. We also looked for CMV DNA in corneal rims discarded after corneal transplantation. Read More

Cornea 2019 Feb;38(2):177-182

Department of Ophthalmology, Loyola University Medical Center, Maywood, IL.

Purpose: Descemet stripping endothelial keratoplasty (DSEK), currently the most common procedure for managing corneal endothelial dysfunction, may be repeated following DSEK failure from a variety of causes. This multicenter study reports the risk factors and outcomes of repeat DSEK.

Methods: This was an institutional review board-approved multicenter retrospective chart review of patients who underwent repeat DSEK. Read More

Cornea 2019 Apr;38(4):413-418

Corneal and External Eye Disease Department, Singapore National Eye Centre, Singapore.

Purpose: To describe 4 cases of cytomegalovirus (CMV) corneal endotheliitis occurring after Descemet membrane endothelial keratoplasty (DMEK).

Methods: This is a retrospective, interventional case series. Case records of 4 patients (one eye each) diagnosed with CMV corneal endotheliitis after DMEK were reviewed retrospectively. Read More

Ther Adv Ophthalmol 2018 Jan-Dec;10:2515841418815802. Epub 2018 Dec 7.

Ophthalmic Research Center, Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran 16666, Iran.

A transparent cornea is essential for the formation of a clear image on the retina. The human cornea is arranged into well-organized layers, and each layer plays a significant role in maintaining the transparency and viability of the tissue. The endothelium has both barrier and pump functions, which are important for the maintenance of corneal clarity. Read More

Ther Adv Ophthalmol 2018 Jan-Dec;10:2515841418814187. Epub 2018 Dec 3.

Department of Ophthalmology, Bascom Palmer Eye Institute, 900 NW 17th Street, Miami, FL 33136, USA.

Purpose: This study compared the effectiveness of endothelial/Descemet's membrane complex thickness obtained using high-definition anterior segment optical coherence tomography with endothelial cell density obtained using confocal microscopy as diagnostic tools in predicting corneal transplant rejection.

Methods: This observational, prospective, cross-sectional study evaluated penetrating keratoplasty grafts. Slit lamp examination organized the grafts into healthy or rejecting grafts. Read More

Clin Ophthalmol 2018 14;12:2315-2322. Epub 2018 Nov 14.

Department of Ophthalmology, Japan Community Health Care Organization Hoshigaoka Medical Center, Hirakata, Osaka 573-8511, Japan.

Background: Deep anterior lamellar keratoplasty (DALK) is indicated to correct high astigmatism in patients with keratoconus (KC) and no evidence of Descemet's membrane rupture. However, some patients with KC experience graft rejection-like inflammatory reactions within 2 months (usually in the first week) after DALK. The aim of this study was to identify the characteristics and influencing factors of these reactions by reviewing the records of patients who underwent DALK or penetrating keratoplasty (PKP) for KC or other corneal problems. Read More

Zhonghua Yan Ke Za Zhi 2018 Dec;54(12):881-882

Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.

An artificial cornea is a lamellar porcine corneal implant. Artificial corneas may be beneficial for the shortage of cornea donors and eye banks. It is necessary to grasp the indications of artificial corneal transplantation and pay attention to its perioperative treatment to reduce relapse and rejection, so as to achieve the best postoperative effect. Read More

Am J Ophthalmol 2019 Mar 28;199:150-158. Epub 2018 Nov 28.

Netherlands Institute for Innovative Ocular Surgery (NIIOS), Rotterdam, Netherlands; Melles Cornea Clinic Rotterdam, Rotterdam, Netherlands; Amnitrans EyeBank Rotterdam, Rotterdam, Netherlands; NIIOS-USA, San Diego, California, USA. Electronic address:

Purpose: To evaluate the feasibility and clinical outcomes of Descemet membrane endothelial keratoplasty (DMEK) in eyes with a glaucoma drainage device (GDD).

Design: Retrospective, interventional case series.

Methods: Clinical outcomes of 23 DMEK procedures for bullous keratopathy (52%), failed previous transplant (39%), or Fuchs endothelial corneal dystrophy (9%) in 20 eyes (19 patients) with a GDD were retrospectively analyzed at 2 tertiary referral centers. Read More

Front Immunol 2018 20;9:2666. Epub 2018 Nov 20.

Regenerative Medicine Institute, School of Medicine, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland.

High-risk cornea transplant recipients represent a patient population with significant un-met medical need for more effective therapies to prevent immunological graft rejection due to heightened anti-donor immune response. In this study, a rat model of pre-existing anti-donor immunity was developed in which corneal allografts were rejected earlier than in non-pre-sensitized recipients. In this model, third-party (non-donor, non-recipient strain) allogeneic mesenchymal stromal cells (allo-MSC) were administered intravenously 7 and 1 days prior to transplantation. Read More

J AAPOS 2019 Feb 27;23(1):28.e1-28.e5. Epub 2018 Nov 27.

Royal Victorian Eye and Ear Hospital, Melbourne, Australia.

Purpose: To report outcomes of femtosecond-assisted single-piece mushroom keratoplasty for the treatment of full-thickness corneal disease in pediatric patients with healthy endothelium.

Methods: Femtosecond-assisted mushroom keratoplasty was performed in 8 eyes of 8 patients (age range, 8-17 years) with central full-thickness corneal opacity. The single-piece mushroom-shaped graft consisted of a large anterior portion (9 mm in diameter; 250 μm in thickness) and a small posterior portion (6-6. Read More

Cornea 2019 Mar;38(3):268-274

Department of Ophthalmology, Tokyo Dental College, Ichikawa General Hospital, Chiba, Japan.

Purpose: To evaluate the effect of iris damage on endothelial cell loss in the early phase after penetrating keratoplasty (PKP).

Methods: This prospective consecutive study included 74 patients who underwent PKP without graft rejection during the follow-up period. Endothelial cell density (ECD) was measured using specular microscopy at 1, 3, 6, and 12 months after PKP. Read More

Semin Ophthalmol 2018 Nov 29:1-8. Epub 2018 Nov 29.

a Department of Ophthalmology , Bozyaka Training and Research Hospital , İzmir , Turkey.

Purpose: To investigate the impact of donor and recipient factors on graft survival in penetrating keratoplasty (PK).

Material And Methods: This retrospective study included 365 eyes that underwent PK using corneas from 231 donors between June 2010 and June 2015. Patients were divided into three groups (group 1: primary endothelial diseases; group 2: iatrogenic endothelial disorders; and group 3: other pathologies with a healthy endothelium) according to PK indications. Read More

Cornea 2019 Feb;38(2):194-197

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

Purpose: To report the outcome of deep anterior lamellar keratoplasty (DALK) and success rates of the big-bubble (BB) technique or manual dissection after a failed use of the BB technique in eyes that underwent prior radial keratotomy (RK).

Methods: A retrospective chart review of patients who underwent DALK after RK at Toronto Western Hospital, Canada, between 1999 and 2017 was performed. Demographic characteristics, success rates of the BB technique and manual dissection, intraoperative and postoperative complications, and best spectacle-corrected visual acuity before and after corneal transplant were analyzed. Read More

Curr Mol Med 2018 ;18(6):365-375

State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University. Guangzhou 510060, China.

Background: In our previous study, both allogeneic and xenogeneic smallincision femtosecond laser-assisted intrastromal keratoplasty were demonstrated to be safe and effective surgeries. Glycerol-dehydrated corneal lamellae could serve as alternative xenogeneic inlay grafts. However, these xenogeneic lamellae have not been explored in lamellar keratoplasty (LK). Read More

Am J Ophthalmol 2019 Mar 1;199:9-18. Epub 2018 Nov 1.

Singapore National Eye Centre, Singapore; Singapore Eye Research Institute, Singapore; Ophthalmology Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. Electronic address:

Purpose: To report the incidence and outcomes of intraoperative Descemet membrane (DM) perforations during deep anterior lamellar keratoplasty (DALK).

Design: Retrospective, consecutive, interventional case series.

Methods: A retrospective audit of all DALK cases performed from 2004 to 2015 in a tertiary center, with and without intraoperative DM perforations. Read More

Invest Ophthalmol Vis Sci 2018 Oct;59(12):5277-5284

Eye Center, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.

Purpose: Corneal vascularization significantly increases the risk for graft rejection after keratoplasty. Semaphorin 3F (Sema3F) is a known modulator of physiologic avascularity in the outer retina. The aim of this study was to investigate whether Sema3F is involved in maintaining corneal avascularity and can reduce the risk for corneal graft rejection. Read More

Br J Ophthalmol 2018 Oct 24. Epub 2018 Oct 24.

NIHR Moorfields Clinical Research Facility, Moorfields Eye Hospital, London, UK

Aims: To prospectively evaluate the changes in corneal leucocyte density with in vivo confocal microscopy (IVCM) following transplantation and to determine if leucocyte density post-transplant is an indicator of graft rejection risk.

Methods: IVCM imaging of cornea pre-transplant and post-transplant at 1  week, 1, 3 and 12 months. The changes in leucocyte density associated with diagnosis, vascularisation, type of keratoplasty, topical steroid and immunosuppression treatment, allograft rejection and failure within 4 years post-transplant were analysed. Read More

Front Immunol 2018 8;9:2283. Epub 2018 Oct 8.

State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong Academy of Medical Sciences, Qingdao, China.

Allograft rejection is the major cause of corneal allograft failure. Rapamycin (RAPA) has been reported as an effective and novel immunosuppressive agent for patients undergoing corneal transplantation. However, its high water insolubility and low bioavailability have strongly constrained its clinical application. Read More

Cornea 2019 Feb;38(2):166-172

Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands.

Purpose: To study the influence of different intraoperative air tamponade times on graft adherence after Descemet membrane endothelial keratoplasty (DMEK).

Methods: In this interventional case series, we evaluated 117 eyes with Fuchs endothelial corneal dystrophy (FECD) that underwent DMEK using intraoperative air tamponade times of 60 minutes (group I; n = 39), 45 minutes (group II; n = 39), or 30 minutes (group III; n = 39). At 1 and 6 months postoperatively, graft adherence status, endothelial cell density, central pachymetry, and postoperative complications were recorded. Read More

Cornea 2019 Feb;38(2):162-165

Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands.

Purpose: To present 4 cases of postoperative repositioning of inverted grafts after Descemet membrane endothelial keratoplasty (DMEK).

Methods: Retrospective case reports of 4 patients presenting with subtotal to total graft detachment after DMEK, most probably owing to upside-down graft positioning. Graft repositioning was performed 1 to 14 days after initial DMEK surgery. Read More

Can J Ophthalmol 2018 10 7;53(5):510-517. Epub 2018 May 7.

Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ont.

Objective: To report and analyze the clinical outcomes of the first 250 cases of Descemet membrane endothelial keratoplasty (DMEK).

Methods: A retrospective case series was conducted on the first 250 DMEK cases. The cohort included eyes with previous trabeculectomy, pre-existing glaucoma drainage device, and previous vitrectomy. Read More

Cornea 2019 Feb;38(2):173-176

Vitreo-Retinal Service, Moorfields Eye Hospital, London, United Kingdom.

Purpose: To present our experience of Descemet stripping endothelial keratoplasty (DMEK) graft luxation into the vitreous cavity in 2 cases.

Methods: DMEK was performed in 2 patients with aphakic bullous keratopathy. The indications for keratoplasty were endothelial failure caused by chronic intermediate uveitis and glaucoma in 1 case and decompensated previous penetrating keratoplasty in the other. Read More

Cornea 2019 Feb;38(2):157-161

Department of Ophthalmology, University of Muenster Medical Center, Muenster, Germany.

Purpose: To evaluate a deep learning-based method to automatically detect graft detachment (GD) after Descemet membrane endothelial keratoplasty (DMEK) in anterior segment optical coherence tomography (AS-OCT).

Methods: In this study, a total of 1172 AS-OCT images (609: attached graft; 563: detached graft) were used to train and test a deep convolutional neural network to automatically detect GD after DMEK surgery in AS-OCT images. GD was defined as a not completely attached graft. Read More

Cornea 2019 Jan;38(1):105-109

Department of Cornea and Refractive Services, Sadguru Seva Sang Trust, Chitrakoot, Madhya Pradesh, India.

Purpose: To evaluate a new surgical technique ("prick and print") for harvesting shaped donor corneal grafts in cases with perforated peripheral ulcerative keratitis (PUK).

Methods: We conducted a retrospective case series at a tertiary center. Medical records of 13 patients with perforated PUK, who underwent tectonic eccentric keratoplasty using the stenciling-based prick and print technique during the past 1 year, were reviewed. Read More

Cornea 2019 Jan;38(1):24-29

Department of Ophthalmology, Eye Clinic Sulzbach, Knappschaft Hospital Saar, Sulzbach/Saar, Germany.

Purpose: To compare the clinical outcome after Descemet membrane endothelial keratoplasty (DMEK) either as precut or conventional Descemet membrane graft preparation under standard European eye bank organ culture conditions.

Methods: This was a prospective pilot study of patients receiving either precut or conventional DMEK. Graft preparation was performed using the liquid bubble technique. Read More

Cornea 2019 Jan;38(1):42-49

Department of Ophthalmology, Gavin Herbert Eye Institute, University of California, Irvine, Irvine, CA.

Purpose: To report long-term visual and astigmatism outcomes in cases of zig-zag femtosecond laser-enabled penetrating keratoplasty (FLEK).

Methods: Retrospective review. Three hundred thirty-five eyes of 287 patients underwent (FLEK) with a zig-zag incision pattern. Read More