Long-term topical bevacizumab for prevention of corneal graft rejections

2020 ◽  
pp. 112067212093950
Author(s):  
Hua-Hsuan Kuo ◽  
Elizabeth P Shen
Keyword(s):  
Graft Rejection ◽  
Corneal Transplantation ◽  
Case Series ◽  
Corneal Neovascularization ◽  
Corneal Graft ◽  
Retrospective Case ◽  
Efficient Treatment ◽  
Corneal Graft Rejection ◽  
Donor Graft

Purpose: To evaluate the safety and efficacy of 1% topical bevacizumab (10 mg/mL) on newly formed corneal neovascularization (NV) after penetrating keratoplasty (PK). Methods: This is a retrospective case series reporting three eyes (three patients) of with newly formed corneal NV after corneal transplantation. All eyes had pre-existing corneal NVs and were high risk corneal graft rejection cases. One percent topical bevacizumab was started immediately after corneal NV formation post-PK. Topical bevacizumab was kept at twice weekly throughout the follow-up period. Results: Regression of corneal NV without donor graft invasion was noted in all three patients (100%). Duration of topical bevacizumab use was 13 to 36 months. All three corneal grafts (100%) remained clear and no signs of graft rejection were noted for the period of observation. There were no associated systemic or ocular adverse effects. Conclusion: Long-term use of topical 1% bevacizumab may be a safe and efficient treatment for corneal NVs and prevention of graft rejections after corneal transplantation.

scholarly journals Role of pre-transplant corneal injective anti VEGF treatment in high risk transplantation corneas

2021 ◽  
Author(s):  
Romina Fasciani ◽  
Emanuele crincoli ◽  
Luigi Mosca ◽  
Laura Guccione ◽  
Alice Caristia ◽  
...  
Keyword(s):  
High Risk ◽  
Graft Rejection ◽  
Graft Failure ◽  
Corneal Transplantation ◽  
Corneal Neovascularization ◽  
Control Group ◽  
Preoperative Treatment ◽  
Group 5

Abstract Background In “high-risk” corneal graft recipients, like those with neovascularization of the cornea, the failure rate can exceed 35% at three years, the main cause being graft rejection. The main purpose of the study is to demonstrate the efficacy of pre-transplant Bevacizumab corneal injection in long term lowering of the prevalence of graft failure and rejection in high risk corneal transplantations. Methods This retrospective single-centre case-control study analyzed 37 eyes with significant corneal neovascularization and eligible for corneal transplantation at baseline. One group (BT group) included patients who were treated with a 3 months preoperative cycle of subconjunctival and/or intrastromal 5 mg/0.2 ml Bevacizumab injected at the limbus with a 27 G needle. The control group (NT group) didn’t receive the preoperative treatment. The main outcome was the prevalence of graft failures and rejections during the follow up period. Secondary outcomes included the prevalence of adverse events and the prevalence of patients who avoided corneal transplantation due to the treatment. Results BT group included 24 eyes with a follow up duration of 61.2 ± 24 months. Eight patients (33.3%) avoided transplant surgery after the injection. In the BT group 5 cases of graft failure (20.8%), 1 of which due to graft rejection (4%), occurred during the follow up. The NT group registered 6 cases (46.1%) of immune rejection of the graft and no additional graft failures from other causes. Conclusions Pre-transplant bevacizumab corneal injections are a safe and effective method to prevent graft rejection in neovascularized corneas.

Survival of the fittest: phacoemulsification outcomes in four corneal transplants by Dr Ramon Castroviejo

2020 ◽  
pp. bjophthalmol-2020-316435
Author(s):  
Jovany Jeomar Franco ◽  
Jose Luis Reyes Luis ◽  
Salma Rahim ◽  
Stephen Greenstein ◽  
Roberto Pineda
Keyword(s):  
Corneal Thickness ◽  
Corneal Transplantation ◽  
Case Series ◽  
Long Term Results ◽  
Retrospective Case ◽  
Term Survival ◽  
Corneal Transplants ◽  
Long Term Follow Up

AimTo evaluate and report the outcomes following phacoemulsification on four eyes, 45 years or more after corneal transplantation.MethodsA retrospective case series of four eyes in three patients (P1, P2, P3), undergoing phacoemulsification at least 45 years after corneal transplantation by Dr Ramon Castroviejo. Corneal graft survival outcome measures included central corneal thickness (CCT), best-corrected visual acuity (BCVA), corneal clarity and endothelial cell count (ECC).ResultsPhacoemulsification was successfully completed in all four cases with no instances of graft failure during the postoperative follow-up period, which ranged from 17 months to 76 months. At the conclusion of the follow-up period, all four grafts remained clear, and BCVA remained better than or similar to preoperative values. Long-term follow-up revealed no meaningful changes in CCT after phacoemulsification. All but one case experienced a decrease in ECC, with ECC values in the four cases ranging from 538 cells/mm2 to 1436 cells/mm2 at the conclusion of postoperative follow-up.ConclusionLimited data have been published on the long-term survival of corneal grafts after intraocular surgery, especially for extremely ‘mature’ corneal transplants. This case series demonstrates that with appropriate preoperative, intraoperative and postoperative measures, successful phacoemulsification can be performed in these cases with excellent long-term results.

scholarly journals Risk of Corneal Graft Rejection After High-risk Keratoplasty Following Fine-needle Vessel Coagulation of Corneal Neovascularization Combined With Bevacizumab

2019 ◽  
Vol 5 (5) ◽  
pp. e452 ◽  
Author(s):  
Deniz Hos ◽  
Viet Nhat Hung Le ◽  
Martin Hellmich ◽  
Sebastian Siebelmann ◽  
Sigrid Roters ◽  
...  
Keyword(s):  
High Risk ◽  
Graft Rejection ◽  
Corneal Neovascularization ◽  
Corneal Graft ◽  
Fine Needle ◽  
Corneal Graft Rejection

scholarly journals Histomorphological view of the cornea investigated by laser confocal microscopy in keratoplasty

2022 ◽  
pp. 110-117
Author(s):  
D. A. Krakhmaleva ◽  
Z. V. Surnina ◽  
S. A. Malzhoen ◽  
A. A. Gamidov
Keyword(s):  
Confocal Microscopy ◽  
Immune Cells ◽  
Graft Rejection ◽  
Penetrating Keratoplasty ◽  
Corneal Transplantation ◽  
Corneal Graft ◽  
Rejection Reaction ◽  
Corneal Graft Rejection

Introduction. Corneal transplantation is the most successful and commonly performed allotransplantation procedure as compared with other organs and tissues. Over 100,000 corneal transplantations are performed worldwide every year.Purpose. This study investigated whether in vivo confocal microscopy (IVCM) can aid in the diagnosis of a graft rejection reaction by detecting changes in cellular structures and density of immune cells after penetrating keratoplasty.Materials and methods. The study included thirty-four eyes of 34 patients who underwent penetrating keratoplasty (7 eyes with corneal graft rejection, 27 without rejection). The average age of patients is 51.1 ± 13.6 years (from 23 to 76 years). The follow-up period ranged from 12 to 36 months (24.5 ± 4.84 months). Follow-up was performed at 1, 3, 6, 12 months and annually after PKP. To study the morphology of the cornea all patients underwent IVCM to assess the basal epithelium, subbasal layer, stroma and endothelium. Immune cells were identified and evaluated for the shape, length of the processes and their density.Results. Patients with corneal graft rejection demonstrated significant accumulation of corneal dendritic-like immune cells compared to patients with non-rejected grafts. In addition, the cells acquired a more mature morphology (grade 2–3). The density of dendritic cells (DC) was 809.17 ± 342.19 (p < 0.001). A positive correlation was found between DC density and graft rejection (p < 0.001). As well the patients showed signs of endothelial failure with low endothelial cell density and pleomorphism, increased light scattering and hyperreflectivity of the stroma.Conclusions. In a complex of diagnostic measures, confocal microscopy may provide a valuable clinical adjunctive tool in diagnosis and management of early corneal graft rejection.

scholarly journals Recurrent contracted sockets treated with personalized, three-dimensionally printed conformers and buccal grafts

2021 ◽  
pp. 112067212110000
Author(s):  
Annabel LW Groot ◽  
Jelmer S Remmers ◽  
Roel JHM Kloos ◽  
Peerooz Saeed ◽  
Dyonne T Hartong
Keyword(s):  
Three Dimensional ◽  
Case Series ◽  
Secondary Outcome ◽  
Retrospective Case ◽  
Upper Eyelid ◽  
Ocular Prosthesis ◽  
Buccal Mucosal Graft ◽  
Custom Made ◽  
3D Printed

Purpose: Recurrent contracted sockets are complex situations where previous surgeries have failed, disabling the wear of an ocular prosthesis. A combined method of surgery and long-term fixation using custom-made, three-dimensional (3D) printed conformers is evaluated. Methods: Retrospective case series of nine patients with recurrent excessive socket contraction and inability to wear a prosthesis, caused by chemical burns ( n = 3), fireworks ( n = 3), trauma ( n = 2) and enucleation and radiotherapy at childhood due to optic nerve glioma ( n = 1) with three average previous socket surgeries (range 2–6). Treatment consisted of a buccal mucosal graft and personalized 3D-printed conformer designed to be fixated to the periosteum and tarsal plates for minimal 2 months. Primary outcome was the retention of an ocular prosthesis. Secondary outcome was the need for additional surgeries. Results: Outcomes were measured at final follow-up between 7 and 36 months postoperatively (mean 20 months). Eight cases were able to wear an ocular prosthesis after 2 months. Three cases initially treated for only the upper or only the lower fornix needed subsequent surgery for the opposite fornix for functional reasons. Two cases had later surgery for cosmetic improvement of upper eyelid position. Despite pre-existing lid abnormalities (scar, entropion, lash deficiency), cosmetic outcome was judged highly acceptable in six cases because of symmetric contour and volume, and reasonably acceptable in the remaining two. Conclusions: Buccal mucosal transplant fixated with a personalized 3D-designed conformer enables retention of a well-fitted ocular prosthesis in previously failed socket surgeries. Initial treatment of both upper and lower fornices is recommended to avoid subsequent surgeries for functional reasons.

Corneal Graft Rejection after Yellow Fever Vaccine: A Case Report

2021 ◽  
pp. 1-4
Author(s):  
Roberto Vignapiano ◽  
Lidia Vicchio ◽  
Eleonora Favuzza ◽  
Michela Cennamo ◽  
Rita Mencucci
Keyword(s):  
Case Report ◽  
Yellow Fever ◽  
Graft Rejection ◽  
Corneal Graft ◽  
Yellow Fever Vaccine ◽  
Corneal Graft Rejection

CORNEAL GRAFT REJECTION PROBABLY MEDIATED BY ANTIBODIES

2009 ◽  
Vol 59 (1) ◽  
pp. 119-125 ◽  
Author(s):  
NIELS EHLERS ◽  
THOMAS OLSEN ◽  
HANS ERIK JOHNSEN
Keyword(s):  
Graft Rejection ◽  
Corneal Graft ◽  
Corneal Graft Rejection

Long-Term Stability After Regenerative Treatment of Infrabony Defects: A Retrospective Case Series

2017 ◽  
Vol 88 (6) ◽  
pp. 536-542 ◽  
Author(s):  
Katrin Nickles ◽  
Bettina Dannewitz ◽  
Kerstin Gallenbach ◽  
Tatjana Ramich ◽  
Susanne Scharf ◽  
...  
Keyword(s):  
Case Series ◽  
Retrospective Case ◽  
Term Stability ◽  
Long Term Stability ◽  
Retrospective Case Series ◽  
Infrabony Defects

scholarly journals Urinary and sexual functions after surgical treatment of penile fracture concomitant with complete urethral disruption

2014 ◽  
Vol 86 (1) ◽  
pp. 15 ◽  
Author(s):  
Ali Abdel Raheem ◽  
Hassan El-Tatawy ◽  
Ahmed Eissa ◽  
Abdel Hamid Elbahnasy ◽  
Mohamed Elbendary
Keyword(s):  
Case Series ◽  
Surgical Reconstruction ◽  
Urethral Injury ◽  
Penile Curvature ◽  
Retrospective Case ◽  
Penile Fracture ◽  
Case Series Study ◽  
Long Term Follow Up

Objectives: Penile fracture with concomitant complete urethral disruption is an uncommon urologic disorder. Data about the treatment and outcome measurements of this condition are scarce in the literature. The aim of the present study is to evaluate the long term urinary and sexual functions of patients with penile fracture associated with complete urethral injury after immediate surgical reconstruction. Patients and methods: Twelve patients met our inclusion criteria and were included in this retrospective case series study; however, one was lost during follow-up. Patient's medical records were reviewed and all patients were interviewed for clinical evaluation. Urinary function was assessed by history, uroflometry and retrograde urethrography, while, sexual function was assessed by questionnaire (Sexual Health Inventory for Men) and penile Doppler for patients with erectile dysfunction. Results: Patients’ mean age was 32.3 ± 7.5 years (range 21-43) and the mean follow-up period was 72.6 ± 45.4 months (range 14-187). Vigorous sexual intercourse was the main cause in 91% of our patients. No serious long term complications was found. Only 1 patient (9%) suffered from anterior urethral stricture, 1 patient (9%) complained of weak erection, 3 patients (27%) had a palpable fibrosis and 2 patients (18%) reported a slight penile curvature during erection. Ninety one percent of all our patients maintained their normal urinary and sexual functions. Conclusion: On the long term follow-up, most of the patients maintained their normal erectile and voiding functions with no harmful long-term complications. We advocate immediate surgical intervention and reconstruction of both corpora cavernous and urethra as a first line treatment for those patients.

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