scholarly journals Graft rejection and failure following endothelial keratoplasty (DSAEK) and penetrating keratoplasty for secondary endothelial failure

2014 ◽  
Vol 93 (2) ◽  
pp. 172-177 ◽  
Author(s):  
Iben B. Pedersen ◽  
Anders Ivarsen ◽  
Jesper Hjortdal
Keyword(s):  
Graft Rejection ◽  
Penetrating Keratoplasty ◽  
Endothelial Keratoplasty

scholarly journals Descemet membrane suturing to manage recurrent graft detachment in a patient with Descemet membrane endothelial keratoplasty on failed penetrating keratoplasty

2021 ◽  
Vol 13 ◽  
pp. 251584142110277
Author(s):  
Zahra Ashena ◽  
Thomas Hickman-Casey ◽  
Mayank A. Nanavaty
Keyword(s):  
Visual Acuity ◽  
Penetrating Keratoplasty ◽  
Anterior Segment ◽  
Endothelial Keratoplasty ◽  
Descemet Membrane Endothelial Keratoplasty ◽  
Descemet Membrane ◽  
Ocular Coherence Tomography ◽  
Corrected Visual Acuity ◽  
Intracameral Injection ◽  
History Of

A 65-year-old patient with history of keratoconus, mild cataract and penetrating keratoplasty over 30 years ago developed corneal oedema subsequent of graft failure with best corrected visual acuity (BCVA) of counting fingers. He underwent a successful cataract surgery combined with a 7.25 mm Descemet’s Membrane Endothelial Keratoplasty (DMEK) with Sodium Hexafluoride (SF6) gas. His cornea remained oedematous inferiorly at 4 weeks, despite two subsequent re-bubbling due to persistent DMEK detachment inferiorly. This was managed by three radial full thickness 10-0 nylon sutures placed in the inferior cornea along with intracameral injection of air. Following this, his anterior segment ocular coherence tomography (OCT) confirmed complete attachment of the graft, and the sutures were removed 4 weeks later. Unaided visual acuity was 20/63 and BCVA was 20/32 after 8 months. DMEK suturing can be helpful in persistent DMEK detachments, which is refractory to repeated re-bubbling due to uneven posterior surface of previous PK.

Survey of Rejection Prophylaxis Following Suture Removal in Penetrating Keratoplasty in Germany

2021 ◽  
Author(s):  
Sonja Heinzelmann ◽  
Daniel Böhringer ◽  
Philip Christian Maier ◽  
Berthold Seitz ◽  
Claus Cursiefen ◽  
...  
Keyword(s):  
Graft Rejection ◽  
Graft Failure ◽  
Penetrating Keratoplasty ◽  
Treatment Strategies ◽  
Cost Benefit ◽  
Topical Steroids ◽  
Evidence Based ◽  
Systematic Analysis ◽  
Open Questions ◽  
The Face

Abstract Background Penetrating keratoplasty (PK) gets more and more reserved to cases of increasing complexity. In such cases, ocular comorbidities may limit graft survival following PK. A major cause for graft failure is endothelial graft rejection. Suture removal is a known risk factor for graft rejection. Nevertheless, there is no evidence-based regimen for rejection prophylaxis following suture removal. Therefore, a survey of rejection prophylaxis was conducted at 7 German keratoplasty centres. Objective The aim of the study was documentation of the variability of medicinal aftercare following suture removal in Germany. Methods Seven German keratoplasty centres with the highest numbers for PK were selected. The centres were sent a survey consisting of half-open questions. The centres performed a mean of 140 PK in 2018. The return rate was 100%. The findings were tabulated. Results All centres perform a double-running cross-stitch suture for standard PK, as well as a treatment for rejection prophylaxis with topical steroids after suture removal. There are differences in intensity (1 – 5 times daily) and tapering (2 – 20 weeks) of the topical steroids following suture removal. Two centres additionally use systemic steroids for a few days. Discussion Rejection prophylaxis following PK is currently poorly standardised and not evidence-based. All included centres perform medical aftercare following suture removal. It is assumed that different treatment strategies show different cost-benefit ratios. In the face of the diversity, a systematic analysis is required to develop an optimised regimen for all patients.

Endothelial Keratoplasty Using Donor Tissue Not Suitable for Full-Thickness Penetrating Keratoplasty

Cornea ◽  
2007 ◽  
Vol 26 (5) ◽  
pp. 515-519 ◽  
Author(s):  
Rebecca L Armour ◽  
Paula J Ousley ◽  
Jennifer Wall ◽  
Karen Hoar ◽  
Chris Stoeger ◽  
...  
Keyword(s):  
Penetrating Keratoplasty ◽  
Endothelial Keratoplasty ◽  
Full Thickness ◽  
Donor Tissue

Retrospective Contralateral Study Comparing Descemet Stripping Automated Endothelial Keratoplasty With Penetrating Keratoplasty

Cornea ◽  
2009 ◽  
Vol 28 (5) ◽  
pp. 485-488 ◽  
Author(s):  
Irit Bahar ◽  
Igor Kaiserman ◽  
Eliya Levinger ◽  
Wiwan Sansanayudh ◽  
Allan R Slomovic ◽  
...  
Keyword(s):  
Penetrating Keratoplasty ◽  
Endothelial Keratoplasty

scholarly journals Midterm outcomes of penetrating keratoplasty following allogeneic cultivated limbal epithelial transplantation in patients with bilateral limbal stem cell deficiency

2021 ◽  
Vol 14 (11) ◽  
pp. 1690-1699
Author(s):  
Jun-Fa Xue ◽  
◽  
Ya-Ni Wang ◽  
Chen Chen ◽  
Ru-Fei Yang ◽  
...  
Keyword(s):  
Stem Cell ◽  
Graft Survival ◽  
Graft Rejection ◽  
Ocular Surface ◽  
Penetrating Keratoplasty ◽  
Limbal Stem Cell Deficiency ◽  
Time Interval ◽  
Case Series Study ◽  
Limbal Stem Cell ◽  
Cultivated Limbal Epithelial Transplantation

AIM: To evaluate the midterm outcomes of penetrating keratoplasty (PK) following allogeneic cultivated limbal epithelial transplantation (CLET) for bilateral total limbal stem cell deficiency (LSCD). METHODS: Ten patients (10 eyes) with bilateral LSCD were enrolled in this prospective noncomparative case series study. Each participant underwent PK approximately 6mo after a CLET. Topical tacrolimus, topical and systemic steroids, and oral ciclosporin were administered postoperatively. Best-corrected visual acuity (BCVA), intraocular pressure (IOP), ocular surface grading scores (OSS), corneal graft epithelial rehabilitation, persistent epithelial defect (PED), immunological rejection, and graft survival rate were assessed. RESULTS: The time interval between PK and allogeneic CLET was 6.90±1.29 (6-10)mo. BCVA improved from 2.46±0.32 logMAR preoperatively to 0.77±0.55 logMAR post-PK (P<0.001). Kaplan-Meier analysis of mean graft survival revealed graft survival rates of 100% at 12 and 24mo and 80.0% at 36mo. PEDs appeared in 5 eyes at different periods post-PK, and graft rejection occurred in 4 eyes. The total OSS decreased from 12.4±4.4 before allogeneic CLET to 1.4±1.51 after PK. CONCLUSION: A sequential therapy design of PK following allogeneic CLET can maintain a stable ocular surface with improved BCVA despite the relatively high graft rejection rate.

scholarly journals Pediatric penetrating keratoplasty and graft rejection: experience at the Hospital Infantil de México Federico Gómez

2020 ◽  
Vol 77 (1) ◽  
Author(s):  
Karen Velásquez-Monzón ◽  
Mariana C. Navarro-Peña ◽  
Miguel Klünder-Klünder ◽  
Michael Tsatsos ◽  
Marco A. Ramírez-Ortiz
Keyword(s):  
Graft Rejection ◽  
Penetrating Keratoplasty

scholarly journals Epithelial Downgrowth after Intraocular Surgery Treated with Intracameral 5-Fluorouracil

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Nina Ni ◽  
Marc A. Goldberg ◽  
Ralph C. Eagle ◽  
Christopher J. Rapuano ◽  
Julia A. Haller
Keyword(s):  
Anterior Chamber ◽  
Penetrating Keratoplasty ◽  
Case Reports ◽  
Corneal Edema ◽  
Limited Area ◽  
Endothelial Keratoplasty ◽  
Intraocular Surgery

Purpose. To present the clinical and histopathologic correlation of two cases of epithelial downgrowth (EDG) after prior intraocular surgery.Methods. Observational case reports.Results. We present two cases of EDG occurring after intraocular surgery. In both cases, after two anterior chamber injections of 5-fluorouracil (5FU), the area of EDG initially regressed. In Case 1, a limited area of EDG eventually recurred, and penetrating keratoplasty with cryotherapy was curative. In Case 2, subsequent corneal edema required Descemet-stripping automated endothelial keratoplasty, and the patient remained clinically free of EDG without further treatment.Conclusion. Intracameral 5FU may have a role in the treatment of EDG after intraocular surgery, though its precise utilization and impact remain to be defined.

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