Reappraisal of the suitability of corneas from bacteremic donors for use in corneal transplants

2018 ◽  
Vol 103 (8) ◽  
pp. 1030-1034 ◽  
Author(s):  
Hsiao-Sang Chu ◽  
Chun-Ting Lai ◽  
Yu-Chih Hou ◽  
Hsin-Yu Liu ◽  
I-Jong Wang ◽  
...  
Keyword(s):  
Endothelial Cell ◽  
Microbial Contamination ◽  
Infectious Complications ◽  
Corneal Transplant ◽  
Bacterial Strains ◽  
Corneal Transplants ◽  
Utility Rate ◽  
Corneal Donation ◽  
Cell Densities ◽  
Work Up

BackgroundThis study examined whether corneas from bacteremic donors could be used for corneal transplant.MethodsCorneas donated to the National Eye Bank of Taiwan between 1 January 2014 and 30 June 2017 were included in this study. All the corneas had corneoscleral rim cultures during the retrieval process and were hypothermic preserved in the Optisol-GS storage medium. A microbial work-up flow chart was used for the sterility check of all grafts. Bacteremic donors were defined as those whose last blood culture before corneal donation was positive. The microbial contamination rates, the endothelial cell densities, the tissue utility rates and early complications after transplants were compared between the corneas from bacteremic versus non-bacteremic donors.Results697 corneas from 356 donors were analysed, 70 of which were from bacteremic donors. The microbial contamination rates of the corneas from bacteremic and non-bacteremic donors (7.1% vs 9.1%)(p=0.30) were close. None of the contaminated corneas grew the same bacterial strains as those from their blood cultures. The corneas from bacteremic donors and non-bacteremic donors have similar endothelial cell densities (2931±297 cells/mm2 vs 2903 ± 470 cells/mm2) (p=0.63). Corneas from bacteremic and non-bacteremic donors shared a similar utility rate (98.6% vs 99.4%)(p=0.41). None of the corneas caused infectious complications after transplants.ConclusionOur study showed that corneas from bacteremic and non-bacteremic donors have equally low contamination rates and are of the same quality in terms of endothelial cell density and safety.

scholarly journals Awareness and Attitudes toward Corneal Donations among Applicants and Staff of a Driver, Vehicle and Licensing Authority (DVLA) in Ghana

2019 ◽  
Author(s):  
Seth Lartey ◽  
ELLEN KONADU ANTWI-ADJEI ◽  
Solomon Agyapong ◽  
Abdul-Kabir Mohammed ◽  
Derrick N.O. Mensah ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Corneal Transplant ◽  
Cross Sectional ◽  
Willingness To Donate ◽  
Drivers License ◽  
Study Population ◽  
Good Potential ◽  
Potential Mode ◽  
Corneal Donation ◽  
Age Range

Abstract Background: Corneal transplantations are surgeries performed for irreparable corneal diseases and damage. However, there is a gap between the number of potential recipients and the number of donor corneas available. The main aim of the study was to determine the awareness and attitudes toward corneal donation among applicants and staff of DVLA, Kumasi-Ghana. Methods: A descriptive cross-sectional study was conducted. 100 participants were selected using convenient sampling method. A structured questionnaire was used to elicit responses from participants concerning awareness and attitudes toward corneal transplant. Results: The mean ± SD age of the participants was 32.05 ± 11.48years and age range, 18-67years. Males were 66% whilst females constituted 34%. 32.7% of the participants were aware of corneal donation. Majority of the participants were Christians (83.1%) and Singles (63%). Television was the source of information with the highest preponderance (49.4%). 67.3% were willing to donate their corneas after death. 63.9% were willing to indicate their donor statuses on drivers’ license form which had a significant association with willingness to donate cornea after death (p<0.05, ᵪ 2 = 12.187). Conclusion: There is a poor level of awareness (32.7%) of transplant and donation amongst the study population but a good level of willingness to donate organs (67%). Consent via driving license would seem to be a good potential mode of obtaining consent to supplement the harvesting of adequate tissues for transplant if adequate awareness is created.

scholarly journals Awareness and Attitudes toward Corneal Transplants among Applicants and Staff of a Driver, Vehicle and Licensing Authority (DVLA) in Ghana

2019 ◽  
Author(s):  
Seth Lartey ◽  
ELLEN KONADU ANTWI-ADJEI ◽  
Solomon Agyapong ◽  
Abdul-Kabir Mohammed ◽  
Derrick N.O. Mensah ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Corneal Transplant ◽  
Cross Sectional ◽  
Willingness To Donate ◽  
Corneal Transplants ◽  
Drivers License ◽  
Study Population ◽  
Good Potential ◽  
Potential Mode ◽  
Age Range

Abstract Introduction: Corneal transplantations are surgeries performed for irreparable corneal diseases and damage. However, there is a gap between the number of potential recipients and the number of donor corneas available. The main aim of the study was to determine the awareness and attitudes towards corneal transplants among applicants and staff of DVLA, Kumasi-Ghana. Materials and Methods: A descriptive cross-sectional study was conducted. 100 participants were selected using convenient sampling method. A structured questionnaire was used to elicit responses from participants concerning awareness and attitudes toward corneal transplant. Results: The mean ± SD age of the participants was 32.05 ± 11.48years and age range, 18-67years. Males were 66% whilst females constituted 34%. 32.7% of the participants were aware of corneal transplant. Majority of the participants were Christians (83.1%) and Singles (63%). Television was the source of information with the highest preponderance (49.4%). 67.3% were willing to donate their corneas after death. 63.9% were willing to indicate their donor statuses on drivers’ license form which had a significant association with willingness to donate cornea after death (p<0.05, ᵪ2= 12.187). Conclusion: There is a poor level of awareness (32.7%) of transplant donation amongst the study population but and a good level of willingness to donate organs (67%). Consent via driving license would seem to be a good potential mode of obtaining consent to supplement the harvesting of adequate tissues for transplant if adequate awareness is created. Keywords: Knowledge, Willingness, Unwillingness, Cornea, DVLA

scholarly journals Antibiotic prophylaxis of acute postoperative endophthalmitis

2021 ◽  
Vol 21 (4) ◽  
pp. 220-226
Author(s):  
V.P. Nikolaenko ◽  
◽  
D.F. Belov ◽  
◽  
Keyword(s):  
Antibiotic Prophylaxis ◽  
Povidone Iodine ◽  
Legal Aspects ◽  
Infectious Complications ◽  
Published Data ◽  
Antibacterial Prophylaxis ◽  
Postoperative Endophthalmitis ◽  
Bacterial Strains ◽  
Routes Of Administration ◽  
Causative Agents

This paper reviews current aspects of antibacterial prophylaxis of acute endophthalmitis, a dangerous complication of cataract surgery. The lack of a common standard for preventing phaco infectious complications, a growing number of resistant bacterial strains, and legal aspects of the lack of some antibiotic formulations and routes of their administration with established efficacy in Russia account for the importance of this issue. The authors provide a list of primary causative agents of endophthalmitis and specify their antimicrobial susceptibility, highlight the importance of using antiseptics to prevent endophthalmitis, and describe in detail routes of administration of antibiotics, including conventional ones (subconjunctival injections, topical use) and whose actively promoted (intracameral, transzonular). In conclusion, the authors suggested a rational antimicrobial preventive algorithm for endophthalmitis after phaco based on the analysis of recent Russian and foreign published data and adapted to the Russian health care system. Keywords: phacoemulsification, endophthalmitis, antiseptic, antibiotic, prophylaxis, antibacterial resistance, fluoroquinolones, aminoglycosides, povidone-iodine, intracameral administration. For citation: Nikolaenko V.P., Belov D.F. Antibiotic prophylaxis of acute postoperative endophthalmitis. Russian Journal of Clinical Ophthalmology. 2021;21(4):220–226 (in Russ.). DOI: 10.32364/2311-7729-2021-21-4-220-226.

Endothelial Keratoplasty: The Influence of Preoperative Donor Endothelial Cell Densities on Dislocation, Primary Graft Failure, and 1-Year Cell Counts

Cornea ◽  
2008 ◽  
Vol 27 (10) ◽  
pp. 1131-1137 ◽  
Author(s):  
Mark A Terry ◽  
Neda Shamie ◽  
Edwin S Chen ◽  
Karen L Hoar ◽  
Paul M Phillips ◽  
...  
Keyword(s):  
Endothelial Cell ◽  
Graft Failure ◽  
Endothelial Keratoplasty ◽  
Cell Counts ◽  
Primary Graft Failure ◽  
Cell Densities

Visualization of the posterior surface of the lens nucleus with triamcinolone acetonide in phacoemulsification

2020 ◽  
pp. 112067212097735
Author(s):  
Tadashi Mizuguchi ◽  
Masayuki Horiguchi ◽  
Atsuhiro Tanikawa
Keyword(s):  
Intraocular Pressure ◽  
Endothelial Cell ◽  
Triamcinolone Acetonide ◽  
Corneal Endothelial Cell ◽  
Posterior Surface ◽  
Evaluation Technique ◽  
Novel Technique ◽  
Corneal Endothelial Cell Density ◽  
Cell Densities ◽  
Phaco Time

Purpose: We report a novel technique for visualizing the posterior surface of the lens nucleus during phacoemulsification. Surgical Technique: Hydro-dissection was performed using a solution of 20 mg triamcinolone acetonide powder without preservatives mixed with 3 ml BSS-plus, and triamcinolone acetonide was clearly identifiable underneath the posterior surface of the lens nucleus. Using a phaco-tip, the nucleus was shaved to the level of the triamcinolone acetonide and could be easily divided. The remnant triamcinolone acetonide was aspirated as much as possible from the lens cortex with an infusion/aspiration tip. Subjects and Evaluation Technique: Twenty-eight eyes in 28 patients with cataracts were enrolled in this study. Triamcinolone acetonide-assisted phacoemulsification was performed in 13 eyes in 13 patients (triamcinolone acetonide-phacoemulsification group), and normal phacoemulsification was performed in 15 eyes in 15 patients (phacoemulsification group). Intraocular pressure was measured in all patients pre-operatively, 1 day after, and 1 week after surgery. Corneal endothelial cell density was measured pre-operatively and 1 month after surgery. The time of surgical phacoemulsification (surgical phaco time) was measured from the video of the surgery. Results: Surgery was successively performed in all eyes. Pre-operative and post-operative intraocular pressures and cell densities did not significantly differ between the two groups. Surgical phaco time was shorter in the triamcinolone acetonide-phacoemulsification group than in the phacoemulsification group (157.1 ± 51.7 s vs 225.3 ± 45.1 s; p = 0.006). Conclusion: The triamcinolone acetonide-assisted phacoemulsification procedure is safe and useful for visualizing the posterior surface of the lens nucleus and facilitates removal of the lens nucleus by phacoemulsification.

scholarly journals Knowledge, Attitude and Awareness towards Corneal Donation in Aseer Region, Saudi Arabia

2021 ◽  
Vol 20 (11) ◽  
Author(s):  
Abdulrahman Mohammed Al-Amri ◽  
Faisal Misfer Alqahtani ◽  
Hassan Abdullah Alqahtani ◽  
Mansour Salem Alqahtani ◽  
Mohammed Moshabbab Alqahtani ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Corneal Transplantation ◽  
Knowledge Score ◽  
Corneal Dystrophy ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Corneal Transplants ◽  
Level Of Knowledge ◽  
Corneal Donation ◽  
Sight Restoration

Background: Corneal transplantation is the mainstay procedure performed for sight restoration in patients with corneal blindness, which can be caused by infection, corneal dystrophy, degenerative disorders such as keratoconus or traumatic causes. Most corneal transplants in Saudi Arabia are performed using imported corneas. Aims: To determine the level of knowledge and awareness and the factors affecting corneal donation in Aseer region, Saudi Arabia. Subjects and Methods: A descriptive cross-sectional approach was used targeting the population of Aseer region aged 18 years and above. The data were collected using electronic self-administered questionnaire. The tool covered the participants’ biodemographic data, knowledge related questions and willingness of corneal donation and factors affecting such attitudes. Results: Of the 641 participants, 66.1% were males, 47.6% were in the age group 20 – 30 years and 19.2% claimed to have enough knowledge about corneal donation. The mean knowledge score (SD) was 2.13 (1.757) out of 8. Regarding participants’ attitude, 26.7% were willing to donate their own cornea. The willingness was significantly associated with good level of knowledge (p = 0.008). Females were more inclined to donate their corneas than males (30.9% vs 24.5%, p = 0.025). Conclusion: The study revealed a low level of knowledge of corneal donation in Aseer region, Saudi Arabia. Approximately one quarter of the participants reported willingness of corneal donation. Lack of knowledge was the main barrier, as it was reported by almost two thirds. Key words: Cornea, Donation, Awareness, Penetrating Keratoplasty, Saudi Arabia

scholarly journals Epi-off-lenticule-on corneal collagen cross-linking in thin keratoconic corneas

2020 ◽  
Vol 40 (12) ◽  
pp. 3403-3412
Author(s):  
Carlo Cagini ◽  
F. Riccitelli ◽  
M. Messina ◽  
F. Piccinelli ◽  
G. Torroni ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Endothelial Cell ◽  
Cell Density ◽  
Corneal Thickness ◽  
Endothelial Cell Density ◽  
Cross Linking ◽  
Corneal Transplant ◽  
Collagen Cross Linking ◽  
Corneal Collagen

Abstract Purpose To evaluate the safety and efficacy of corneal collagen cross-linking (CXL) performed on overlaying a corneal lenticule to thin recipient corneas of progressive keratoconus (KC) patients. Methods In this study were enrolled eyes of patients affected by progressive KC with a minimum corneal thickness less than 400 µm, after overlaying a lenticule of human corneal stroma prepared with the femtosecond laser. The lenticules used were 100 µm thick and of 8.5 mm diameter in all the cases. Both the host cornea and the lenticules were subjected to epithelial debridement. CXL was carried out according to the standard protocol. Visual acuity, refraction, slit-lamp examination, endothelial cell density, pachymetry and keratometry, anterior segment tomography (AS-OCT) and confocal microscopy were evaluated preoperatively and at 1, 3, 6 and 12 months postoperatively. Results CXL was performed in 10 eyes of 8 patients (main age 23), corneal thickness range 379–414 µm, mean 387.6 µm. One patient was lost at follow-up. In all other cases, visual acuity and the endothelial cell density remained stable over a 12-month follow-up. Preoperative mean K1 and mean K2 were 46.91 ± 1.9 and 50.75 ± 2.93, respectively, and at 12 months mean K1 was 47.36 ± 2.66 and mean K2 50.53 ± 3.35. The AS-OCT clearly showed a demarcation line in all patients at 1, 3 (mean depth 283 µm and 267 µm, respectively) and in some cases at 6 months. Reduced keratocyte density and stromal oedema were observed immediately up to 1 month after treatment, while a slight subepithelial haze was present at 1-month and completely disappeared by 6 months. Conclusion This new technique seems to offer a therapeutic opportunity for young patients suffering from progressive KC with very thin corneas, in which the standard treatment is not indicate, and delay or avoid the need for a corneal transplant.

scholarly journals MULTIDRUG-RESISTANT AND EXTREMELY DRUG-RESISTANT BACTERIA: ARE WE FACING THE END OF THE ANTIBIOTIC ERA?

2016 ◽  
Vol 7 (1) ◽  
Author(s):  
G.M. Rossolini
Keyword(s):  
Antibiotic Resistance ◽  
Bacterial Infections ◽  
Multidrug Resistant ◽  
Modern Medicine ◽  
Infectious Complications ◽  
Future Perspective ◽  
Resistant Bacteria ◽  
Bacterial Strains ◽  
Public Health Agencies ◽  
Drug Resistant Bacteria

Antibiotics are one of the most significant advancements of modern medicine. They have changed the prognosis of several bacterial infections, and made possible advanced medical practices associated with a high risk of infectious complications. Unfortunately, antibiotics are affected by the phenomenon of antibiotic resistance, which jeopardizes their efficacy. In recent years, antibiotic discovery and development has been lagging, due to a lower appeal of this sector for the pharmaceutical industry, while antibiotic resistance has continued to evolve with the eventual emergence and dissemination of bacterial strains which are resistant to most available antibiotics and pose a major challenge to antimicrobial chemotherapy. This worrisome scenario, indicated as the “antibiotic resistance crisis”, has been acknowledged by Scientific Societies and Public Health Agencies, and is now gathering an increasing attention from the Media and Governments. This article reviews the antibiotic-resistant pathogens which currently pose major problems in terms of clinical and epidemiological impact, and briefly discuss future perspective in this field.

scholarly journals Lymphatic vessels identified in failed corneal transplants with neovascularisation

2018 ◽  
Vol 103 (3) ◽  
pp. 421-427 ◽  
Author(s):  
Michael Adam Diamond ◽  
Sze Wah Samuel Chan ◽  
Xun Zhou ◽  
Yelena Glinka ◽  
Eileen Girard ◽  
...  
Keyword(s):  
In Situ Hybridisation ◽  
Lymphatic Vessels ◽  
Immunoperoxidase Staining ◽  
Corneal Transplant ◽  
Fluorescence In Situ Hybridisation ◽  
Consistent Finding ◽  
Fish Samples ◽  
Corneal Transplants ◽  
Transplant Failure ◽  
Negative Controls

BackgroundCorneal transplant failure with neovascularisation is a leading indication for full-thickness grafts in patients. Lymphangiogenesis is implicated in the pathology of graft failure, and here we systematically evaluate failed human corneal transplants with neovascularisation for the presence of lymphatic vessels.MethodsNine failed grafts with neovascularisation, based on H&E staining with subsequent immunoperoxidase staining for CD31, a blood vessel marker, were selected. Lymphatics were investigated by immunohistochemical and immunofluorescence approaches using podoplanin as a lymphatic marker. In two of nine cases, fluorescence in situ hybridisation (FISH) was used for detection of lymphatic mRNAs including podoplanin, VEGFR-3 and LYVE-1. All immunofluorescence and FISH samples were compared with positive and negative controls and visualised by confocal microscopy.ResultsCorneal neovascularisation was established in all cases by H&E and further confirmed by CD31 immunoreactive profiles. Immunohistochemistry for the podoplanin antibody was positive in all cases and showed morphologies ranging from distinct luminal structures to elongated profiles. Simultaneous immunofluorescence using CD31 and podoplanin showed lymphatic vessels distinct from blood vessels. Podoplanin immunofluorescence was noted in seven of nine cases and revealed clear lumina of varying sizes, in addition to lumen-like and elongated profiles. The presence of lymphatic mRNA was confirmed by FISH studies using a combination of at least two of podoplanin, VEGFR-3 and LYVE-1 mRNAs.ConclusionsThe consistent finding of lymphatic vessels in failed grafts with neovascularisation implicates them in the pathogenesis of corneal transplant failure, and points to the lymphatics as a potential new therapeutic target.

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