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Ophthalmologe 2021 May 7. Epub 2021 May 7.

Zentrum für Augenheilkunde, Medizinische Fakultät und Universitätsklinik Köln, Kerpener Str. 62, 50924, Köln, Deutschland.

Background: The risk of allograft rejection following high-risk keratoplasty increases with the area of corneal neovascularization. Pharmaceutical and physical regression of corneal neovascularization before keratoplasty may offer the potential to reduce the risk of graft rejection after high-risk keratoplasty.

Objective: This article provides a review of the literature on the preconditioning of vascularized high-risk eyes using fine-needle diathermy and corneal cross-linking (preoperative preconditioning by lymphangioregression). Read More

Macromol Biosci 2021 May 6:e2100036. Epub 2021 May 6.

Department of Eye and Vision Science, Institute of Life Course and Medical Science, University of Liverpool, Liverpool, L7 8TX, UK.

A family of poly-ε-lysine hydrogels can be synthesized by crosslinking with bis-carboxylic acids using carbodiimide chemistry. In addition to creating hydrogels using a simple cast method, a fragmented method is used to introduce increased porosity within the hydrogel structure. Both methods have created tunable characteristics ranging in their mechanical properties, transparency, and water content, which is of interest to corneal tissue engineering and can be tailored to specific cellular needs and applications. Read More

Cont Lens Anterior Eye 2021 May 1:101452. Epub 2021 May 1.

Section of Pediatric Ophthalmology, Department of Ophthalmology, Emory University School of Medicine, 1365B Clifton Road, NE, Suite 5400, Atlanta, GA, 30322, United States.

Purpose: To report the use of a custom-designed, scleral contact lens (SL) in the treatment of pediatric patients.

Methods: The medical records of all patients under 15 years of age fitted with SL from March 2018 through February 2020 were retrospectively reviewed. Ophthalmic diagnosis, prior surgical intervention, lens wearing failures, and duration of lens use are reported. Read More

Cornea 2021 Jun;40(6):800-807

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

Purpose: To evaluate the prophylactic effects of immunosuppressants in corneal graft rejection after high-risk penetrating keratoplasty.

Methods: We searched PubMed, Embase, and the Cochrane Library for comparative studies published between 1989 and 2019 that evaluated the efficacy of immunosuppressants for high-risk corneal graft. The primary outcomes were the 1- and 3-year rejection rates. Read More

Cornea 2021 Apr 21. Epub 2021 Apr 21.

Cornea & External Diseases Department, Moorfields Eye Hospital, NHS Foundation Trust, London, United Kingdom; and Department of Health's NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, United Kingdom.

Purpose: We present a technique that preserves good vision in paracentral macroperforations and avoids challenges of tectonic lamellar or penetrating keratoplasty in eyes with poor visual potential.

Method: A wet laboratory was implemented for mini-Descemet stripping endothelial keratoplasty to seal macroperforations ab interno. This included a suture support technique designed to prevent graft herniation. Read More

Br J Ophthalmol 2021 Apr 28. Epub 2021 Apr 28.

Cornea and External Diseases, Moorfields Eye Hospital NHS Foundation Trust, London, UK.

Aim: We report two cases of endothelial corneal allograft rejection following immunisation with SARS-CoV-2 messenger RNA (mRNA) vaccine BNT162b2 and describe the implications for management of transplant recipients postvaccination for COVID-19.

Methods: A 66-year-old woman with Fuchs endothelial corneal dystrophy (FECD) and a unilateral Descemet's membrane endothelial keratoplasty (DMEK) transplant received COVID-19 mRNA vaccine BNT162b2 14 days post-transplant. Seven days later, she presented with symptoms and signs of endothelial graft rejection. Read More

Graefes Arch Clin Exp Ophthalmol 2021 Apr 27. Epub 2021 Apr 27.

Cornea and Ocular Surface Unit, San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy.

Purpose: In cases of corneal opacity with vascularization and peripheral thinning, traditional keratoplasty techniques have several risks and drawbacks. We report the results of a two-step surgical strategy consisting in performing a large diameter tectonic lamellar keratoplasty (TLK) to restore appropriate corneal thickness and an avascular recipient bed, followed by central optical PK within the lamellar graft at a later date.

Methods: This single-institution study analyzes the results of 7 eyes of 7 patients who received PK after large diameter TLK. Read More

Graefes Arch Clin Exp Ophthalmol 2021 Apr 27. Epub 2021 Apr 27.

Department of Eye and Vision Science, University of Liverpool, Liverpool, UK.

Purpose: To report the impact of establishing and maintaining a high intracameral pressure (ICP) of 200 mmHg on UT-DSAEK graft preparation using an artificial anterior chamber pressuriser (ACP) control unit (Moria SA, Antony, France).

Method: Retrospective laboratory and clinical study. Four paired donor corneas were mounted on an artificial anterior chamber and subjected to 70 mmHg ("low") and 200 mmHg ("high") ICP using an ACP system. Read More

Am J Ophthalmol Case Rep 2021 Jun 31;22:101077. Epub 2021 Mar 31.

Department of Ophthalmology, Jena University Hospital, Germany.

Purpose: to report a case of delayed Descemet membrane detachment (DMD) 45 years after penetrating keratoplasty (PK) for keratoconus and its management with a partial descemetorhexis after failed air/gas descemetopexy. A pathomechanism of DMD is proposed based on the anatomic appearance of the DMD and the success of descemetorhexis.

Observations: a 60-year old male presented with acute corneal edema of his left eye 45 years after successful PK for keratoconus. Read More

Front Immunol 2021 7;12:667830. Epub 2021 Apr 7.

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

Macrophages are critical mediators of tissue vascularization both in health and disease. In multiple tissues, macrophages have been identified as important regulators of both blood and lymphatic vessel growth, specifically following tissue injury and in pathological inflammatory responses. In development, macrophages have also been implicated in limiting vascular growth. Read More

Ophthalmologe 2021 Apr 16. Epub 2021 Apr 16.

Zentrum für Augenheilkunde, Medizinische Fakultät, Universitätsklinik Köln, Kerpener Str. 62, 50924, Köln, Deutschland.

Background: Descemet membrane endothelial keratoplasty (DMEK) is considered the gold standard for the treatment of corneal endothelial dysfunction and generally leads to good postoperative results. Recently, studies have also analyzed the outcome of DMEK in so-called high-risk eyes.

Material And Methods: The relevant literature and own data on DMEK for graft failure after penetrating keratoplasty and in vascularized high-risk eyes are presented and discussed. Read More

Int Ophthalmol 2021 Apr 15. Epub 2021 Apr 15.

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

Purpose: To investigate the safety and efficacy of femtosecond laser-assisted penetrating keratoplasty (FLAK) versus conventional penetrating keratoplasty (CPK).

Methods: A literature search of PubMed, Cochrane, Embase, Web of Science, and Clinicaltrials.gov was conducted for comparative studies published from January 2007 to October 2019. Read More

Cornea 2021 Apr 9. Epub 2021 Apr 9.

Department of Biomedical Engineering, Faculty of Life and Medical Sciences, Doshisha University, Kyotanabe, Japan; Department of Cornea and Refractive Surgery, Sankara Nethralaya, Chennai, India. Kowa Company, Ltd, Tokyo, Japan; and School of Optometry, Indiana University, Bloomington, IN.

Purpose: The aim of this study was to investigate the immune cells on corneal endothelium of the graft in patients who underwent penetrating keratoplasty (PK), Descemet-stripping endothelial keratoplasty (DSEK), and Descemet membrane endothelial keratoplasty (DMEK).

Methods: A total of 43 eyes of 43 patients who underwent PK (17 eyes), DSEK (13 eyes), and DMEK (13 eyes) and who did not show any sign of graft rejection were recruited for the study. Patients who underwent cataract surgery (26 eyes) served as controls. Read More

Stem Cell Res Ther 2021 Apr 6;12(1):227. Epub 2021 Apr 6.

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

Background: Systemic administration of mesenchymal stromal cells (MSCs) has been efficacious in many inflammatory disease settings; however, little data are available on the potential immunomodulatory effects following local MSC administration in the context of corneal transplantation. The purpose of this study was to assess the potential of subconjunctival injection of MSCs to promote corneal allograft survival.

Methods: MSCs were isolated from female C57BL/6 (H-2) or Balb/c (H-2) mice and extensively characterized. Read More

Int Immunopharmacol 2021 Apr 3;96:107580. Epub 2021 Apr 3.

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

Corneal lymphangiogenesis induced by macrophages played a critical role in corneal allograft rejection (CGR). However, there are few Food and Drug Administration (FDA)-approved drugs that target lymphangiogenesis. The aim of our study is to evaluate the effects of dimethyl fumarate (DMF) on corneal allograft survival in rats. Read More

Acta Biomater 2021 Mar 27. Epub 2021 Mar 27.

Department of Immunology, Oslo University Hospital and University of Oslo, Oslo, Norway; Centre of Molecular Inflammation Research, and Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway; Research Laboratory, Nordland Hospital, Bodo, Norway; Faculty of Health Sciences, K. G. Jebsen Thrombosis Research and Expertise Center, University of Tromsø, Tromso, Norway.

Inadequate supplies of donor corneas have evoked an escalating interest in corneal xenotransplantation. However, innate immune responses contribute significantly to the mechanism of xenograft rejection. We hypothesized that complement component C5 and TLR co-receptor CD14 inhibition would inhibit porcine cornea induced innate immune responses. Read More

J Glaucoma 2021 Mar;30(3):e108-e113

Department of Ophthalmology, University Medical Center Schleswig-Holstein.

Precis: In eyes with intractable glaucoma, drainage devices provide long-term control of intraocular pressure also after penetrating keratoplasty (PK). There is a high incidence of corneal graft failure.

Purpose: To compare very long-term results of eyes with glaucoma drainage device (GDD) after PK. Read More

Int J Ophthalmol 2021 18;14(3):476-477. Epub 2021 Mar 18.

Department of Sense Organs, Eye Clinic, University "La Sapienza", Rome 00185, Italy.

Front Immunol 2021 2;12:636789. Epub 2021 Mar 2.

Department of Microbiology and Immunology, Miller School of Medicine, University of Miami, Miami, FL, United States.

Corneal transplantation (CT) is the most frequent type of solid organ transplant (SOT) performed worldwide. Unfortunately, immunological rejection is the primary cause of graft failure for CT and therefore advances in immune regulation to induce tolerance remains an unmet medical need. Recently, our work and others in pre-clinical studies found that cyclophosphamide (Cy) administered after ("post-transplant," PTCy) hematopoietic stem cell transplantation (HSCT), i. Read More

Cornea 2021 Apr 1. Epub 2021 Apr 1.

Cornea and Ocular Surface Services, LJ Eye Institute, Ambala City, India.

Purpose: To report our early experiences with Descemet membrane endothelial keratoplasty (DMEK) in congenital hereditary endothelial dystrophy (CHED).

Methods: Retrospective analysis of medical records of eyes with CHED that underwent DMEK between January 1, 2018, and April 30, 2019, and had a minimum of 1-year follow-up.

Results: Three eyes of 2 CHED patients (a 10-year-old girl and a 22-year-old man) were included. Read More

Indian J Ophthalmol 2021 Apr;69(4):985-986

Department of Cornea, Cataract and Refractive Services. Dr Shroff's Charity Eye Hospital, New Delhi, India.

A 32-year-old man with a clear and compact graft following a penetrating keratoplasty 6 years back, developed an episode of acute graft rejection, coinciding with the COVID-19 disease. Subsequent to the infection with the novel coronavirus, he developed symptoms of acute graft rejection concurrent with the development of respiratory distress and peak systemic symptoms. This was the phase of cytokine storm as evidenced by the raised inflammatory markers in his blood tests. Read More

Clin Ophthalmol 2021 2;15:909-921. Epub 2021 Mar 2.

Department of Ophthalmology, Region Västra Götaland, Sahlgrenska University Hospital, Mölndal, Sweden.

Purpose: To compare clinical outcome and complications of Descemet stripping automated keratoplasty (DSAEK) and Descemet membrane endothelial keratoplasty (DMEK).

Methods: This is a retrospective study of the first consecutive cases of DSAEK and DMEK performed by a single surgeon at a tertiary referral centre. Best-corrected visual acuity (BCVA), postoperative complications, rate of rebubbling and regraft were the main outcome measures. Read More

Transplantation 2021 Mar 4. Epub 2021 Mar 4.

Ophthalmology, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal NOVA Medical School | Faculdade de Ciências Médicas - Universidade Nova de Lisboa, Lisbon, Portugal Ophthalmology, Instituto Português de Retina, Lisbon, Portugal Ophthalmology Department, Hospital CUF Cascais, Cascais, Portugal Ophthalmology, Escola Superior de Tecnologia da Saúde de Lisboa do Instituto Politécnico de Lisboa, Lisbon, Portugal Instituto Microcirugía Ocular Barcelona, Barcelona, Spain . Universidad Autónoma de Barcelona, Barcelona, Spain.

Background: We review the literature on the efficacy and safety outcomes of secondary Descemet stripping endothelial keratoplasty (DSEK) and Descemet membrane endothelial keratoplasty (DMEK).

Methods: Literature search of English-written publications up to 27th September 2020 in PubMed database, using the terms "endothelial keratoplasty" in combination with keywords "secondary" or "repeat". In addition, we manually searched the references of the primary articles. Read More

Int Ophthalmol 2021 Mar 24;41(3):957-972. Epub 2021 Feb 24.

Department of Ophthalmology, Collage of Medicine, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.

Objective: To investigate keratoplasty outcomes in a university-based hospital.

Methods: Medical records of all patients undergoing keratoplasty at King Abdulaziz University Hospital, Riyadh, Saudi Arabia, between January 1, 2006, and December 31, 2015, with a minimum follow-up period of three months were reviewed retrospectively. Indications, surgical procedures, complications and outcomes of all surgeries were collected and analyzed. Read More

Int Ophthalmol 2021 May 20;41(5):1965-1979. Epub 2021 Feb 20.

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

Purpose: Femtosecond lasers have revived the possibility of stromal keratophakia or tissue additive keratoplasty, a technique originally introduced by Prof. Jose Ignacio Barraquer in the 1960s. The surgical technique offers a unique solution to treat keratoconus. Read More

Ocul Surf 2021 Apr 16;20:185-194. Epub 2021 Feb 16.

Department of Molecular and Cellular Medicine, Institute for Regenerative Medicine, College of Medicine, Texas A&M University, 1114 TAMU, 206 Olsen Boulevard, College Station, TX, 77845, USA. Electronic address:

Corneal transplantation is a routine procedure for patients with corneal blindness. Despite the streamlining of surgical techniques and deeper understanding of the cellular and molecular pathways mediating rejection, corticosteroids are still the main immunosuppressive regimen in corneal transplantation, and the 15-year survival of corneal transplants remains as low as 50%, which is poorer than that for most solid organ transplants. Recently, mesenchymal stromal cells (MSCs) with unique regenerative and immune-modulating properties have emerged as a promising cell therapy to promote transplant tolerance, minimize the use of immunosuppressants, and prevent chronic rejection. Read More

Jpn J Ophthalmol 2021 Mar 16;65(2):169-183. Epub 2021 Feb 16.

Department of Ophthalmology, Osaka University Graduate School of Medicine, Room E7, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.

Purpose: To conduct a systematic review of clinical research on the use of regenerative medicine for the cornea in human patients.

Methods: A systematic literature search of MEDLINE and the Cochrane Library was performed in May 2020.

Results: Forty-two articles were identified. Read More

Eur J Ophthalmol 2021 Feb 10:1120672121990634. Epub 2021 Feb 10.

UOC Oculistica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

Purpose: To report the surgical outcomes of penetrating keratoplasty (PKP) and sutureless scleral fixation (SSF) using Carlevale Lens (Soleko) combined procedure to solve corneal failure and aphakia in vitrectomized eyes and discuss eventual advantages of this new approach.

Methods: Two patients underwent primary wound repair and pars plana vitrectomy after a penetrating ocular trauma and were referred to the author's clinic. The PKP and SSF-Carlevale lens implantation were performed under retrobulbar anesthesia. Read More

Arq Bras Oftalmol 2021 Feb 3. Epub 2021 Feb 3.

Department of Ophthalmology, General Hospital of Trikala, Greece.

This is a rare case report of acute, paracentral corneal melting and perforation occurring 1 week after an uneventful cataract surgery, with discussions on possible pathogenetic mechanisms. Relevant literature was also reviewed. Herein, a case of an 86-year-old woman with acute, paracentral, and sterile corneal melting and perforation in her left eye at 1 week after an uncomplicated cataract extraction is described. Read More

Sci Rep 2021 Feb 4;11(1):2992. Epub 2021 Feb 4.

Eye Center, Medical Center - Faculty of Medicine, University of Freiburg, Killianstrasse 5, 79106, Freiburg, Germany.

Allogenic transplants of the cornea are prone to rejection, especially in repetitive transplantation and in scarred or highly vascularized recipient sites. Patients with these ailments would particularly benefit from the possibility to use non-immunogenic decellularized tissue scaffolds for transplantation, which may be repopulated by host cells in situ or in vitro. So, the aim of this study was to develop a fast and efficient decellularization method for creating a human corneal extracellular matrix scaffold suitable for repopulation with human cells from the corneal limbus. Read More