scholarly journals Corneal hydrops: diagnosis and treatment

2020 ◽  
Vol 13 (2) ◽  
pp. 31-42
Author(s):  
Galina V. Sitnik
Keyword(s):  
Anterior Chamber ◽  
Amniotic Membrane ◽  
Pathological Condition ◽  
Corneal Thickness ◽  
Case Series ◽  
Corneal Edema ◽  
Diagnosis And Treatment ◽  
Lamellar Keratoplasty ◽  
Amniotic Membrane Transplantation ◽  
Corneal Hydrops

Acute corneal hydrops is a pathological condition which clinically presents by marked corneal edema developing due to a break in Descemets membrane. Background. To analyze the results of diagnosis and treatment in patients with acute corneal hydrops. Materials and methods. 42 patients (47 eyes) suffering from acute corneal hydrops were included in the study. This condition appeared on both eyes simultaneously or sequentially in 5 patients. Mean age was 28.7 10.1 years (from 19 to 54 years), 31 men, 11 women. In case of complications or inefficacy of medical therapy surgical procedures were performed: 10% gas (C3F8, SF6) injection into the anterior chamber, amniotic membrane transplantation, partial lamellar keratoplasty, DALK, PKP. Results. Duration of corneal ectasia before acute hydrops occurrence was 12.6 4.6 years. Disease was not diagnosed before in 11.9%. Corneal thickness varied from 692 98 m in focal hydrops to 1200 220 m in total hydrops. Area of edema, height of Descemet detachment and gap between break margins were significantly above in cases of subtotal and total hydrops compared with focal and partial hydrops (2, p 0,001). Injection of 10% gas (C3F8, SF6) in the anterior chamber allowed to significantly accelerating the resolution of this condition in cases of subtotal and total hydrops. Conclusion. Analysis of this case series showed the feasibility of a differentiated approach in the treatment of acute corneal hydrops depending on its severity.

scholarly journals Deep Anterior Lamellar Keratoplasty Following Epikeratophakia: A Novel Two-Stage One-Graft Method To Treat Acute Corneal Hydrops

2021 ◽  
Author(s):  
Chunyu Liu ◽  
Xinyu Huang ◽  
Xin Liu ◽  
Yushan Zhang ◽  
Jiaqi Shen ◽  
...  
Keyword(s):  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Anterior Segment ◽  
Case Series ◽  
Corneal Graft ◽  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Clinical Effects ◽  
Anterior Lamellar Keratoplasty ◽  
Corneal Hydrops

Abstract Purpose To evaluate the clinical effects of deep anterior lamellar keratoplasty (DALK) using a single graft after epikeratophakia for the treatment of acute corneal hydrops. Methods This novel surgical procedure was performed on seven eyes of seven patients between 2019 and 2020. The procedure combines a first-stage surgery of epikeratophakia with intracameral sterile air injection and a second-stage surgery of DALK using the same corneal graft for both procedures. Main outcome measures included pre- and postoperative best-corrected visual acuity (BCVA) and anterior segment optical coherence tomography (AS-OCT) parameters. Corneal transparency, neovascularization and epithelization were observed at the 1-year follow-up. Results Corneal edema resolved rapidly in six of the seven cases. The group mean central corneal thickness was significantly reduced from baseline at 1 day, 1 week, 1 month, and 2 months after the first-stage surgery, respectively (P < 0.0001). At a mean of 2.1±0.7 months after the first-stage surgery, DALK was successfully performed in all cases. Six months later, the central corneal thickness was 611±31 µm and the thickness of the recipient’s residual stroma bed was 20±6 µm at the central corneal area. LogMAR BCVA was improved from 1.74±0.34 at baseline to 0.20±0.11 after DALK (P < 0.0001). No postoperative complications appeared in our case series during one years of observation. Conclusion A novel curative effect was found in the treatment of acute corneal hydrops with epikeratophakia followed by DALK using the same corneal graft.

scholarly journals Intraocular Pressure Changes Following Different Keratoplasty Techniques and Association with Cornea Parameters and anterior Chamber Depth

2021 ◽  
Author(s):  
Gülşah Gümüş ◽  
cigdem altan ◽  
yusuf yildirim ◽  
nilay kandemir besek ◽  
selim genç ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Anterior Chamber ◽  
Corneal Thickness ◽  
Anterior Chamber Depth ◽  
Early Postoperative Period ◽  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Anterior Lamellar Keratoplasty ◽  
The Difference ◽  
Pressure Changes

Abstract Purpose To evaluate early intraocular pressure (IOP) changes following different keratoplasty techniques and to investigate the relationship between corneal thickness (CT), keratometry values, anterior chamber depth (ACD) and IOP changes. Methods We included patients who underwent penetrating keratoplasty (PK), deep anterior lamellar keratoplasty (DALK) and Descemet membrane endothelial keratoplasty (DMEK). ACD, CT, and keratometry measurements were repeated postoperatively at hour 24, week 1, and month 1. IOP measurements were repeated at postoperative hours 6 and 24, week 1, and month 1 by Tono-Pen XL. Results Twenty-two patients underwent PK, 12 patients underwent DALK, and 19 patients underwent DMEK. The difference between the IOP preoperatively and 6 hours postoperatively and between the IOP preoperatively and 24 hours postoperatively were statistically significant in the three types of surgery (p < 0.05 for each). The difference between preoperative and postoperative week 1 IOP was statistically significant only in the PK group (p = 0.023). When the IOP was compared between the three types of surgeries, the IOP at postoperative week 1 in the PK group was significantly higher than the DALK and DMEK groups (p = 0.021). There was no correlation between ACD, corneal thickness, K values, and IOP in any group. Conclusion IOP may increase in all types of keratoplasty during the first hours after surgery, but PK has a risk of high IOP longer in the early postoperative period. PK patients should be followed more carefully during postoperative week 1 to check for an increase in IOP.

scholarly journals Characteristics of New Onset Herpes Simplex Keratitis after Keratoplasty

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Xiaolin Qi ◽  
Miaolin Wang ◽  
Xiaofeng Li ◽  
Yanni Jia ◽  
Suxia Li ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Herpes Simplex ◽  
Amniotic Membrane ◽  
Antiviral Treatment ◽  
Corneal Thickness ◽  
Clinical Manifestations ◽  
Corneal Graft ◽  
Amniotic Membrane Transplantation ◽  
Herpes Simplex Keratitis ◽  
New Onset

Purpose. To observe clinical characteristics and treatment outcomes of new onset herpes simplex keratitis (HSK) after keratoplasty. Methods. Among 1,443 patients (1,443 eyes) who underwent keratoplasty (excluding cases of primary HSK) in Shandong Eye Hospital, 17 patients suffered postoperative HSK. The clinical manifestations, treatment regimens, and prognoses of the patients were evaluated. Results. The incidence of new onset HSK after keratoplasty was 1.18%. Epithelial HSK occurred in 10 eyes, with dendritic epithelial infiltration in 6 eyes and map-like epithelial defects in 4 eyes. Nine eyes had lesions at the junction of the graft and recipient. Stromal necrotic and endothelial HSK occurred in 7 eyes, presenting map-shaped ulcers in the entire corneal graft and recipient (two eyes) or at the graft-recipient junction (five eyes). Confocal microscopy revealed infiltration of a large number of dendritic cells at the junction of the lesion and transparent cornea. All 10 eyes with epithelial lesions and two eyes suffering stromal lesions of ≤1/3 corneal thickness healed after systematic and local antiviral treatment. Best-corrected visual acuity and corneal graft transparency were restored. For stromal HSK with an ulcer of >1/3 corneal thickness, amniotic membrane transplantation was performed, and visual acuity and graft transparency decreased significantly. Conclusion. New onset HSK after keratoplasty primarily resulted in epithelial and stromal lesion, involving both the graft and recipient. Effective treatments included antiviral medications and amniotic membrane transplantation. Delayed treatment may lead to aggravated graft opacification.

scholarly journals Tenonplasty Combined With Amniotic Membrane Transplantation for Patients With Severe Ocular Burns Induced Anterior Segment Necrosis

2020 ◽  
Vol 41 (3) ◽  
pp. 668-673
Author(s):  
Wen-yan Peng ◽  
Li-wen He ◽  
Peng Zeng ◽  
Dong-cui Chen ◽  
Shi-you Zhou
Keyword(s):  
Amniotic Membrane ◽  
Ocular Surface ◽  
Anterior Segment ◽  
Case Series ◽  
Corneal Opacity ◽  
Vascular Supply ◽  
Amniotic Membrane Transplantation ◽  
Final Visit ◽  
Prospective Case Series ◽  
Ocular Burns

Abstract This article describes a novel surgical technique for successful repair of intractable corneoscleral necrosis caused by severe ocular burns. In this prospective case series, 19 eyes of 15 consecutive patients with sectional scleral necrosis and persistent corneal epithelial defects were treated with tenonplasty and amniotic membrane transplantation. The main outcome measure was the stability of the ocular surface after reepithelialization and repair of defects. All patients underwent successful combined surgery involving tenonplasty and amniotic membrane transplantation, in which the conjunctival and corneal surfaces were reconstructed. The interval from injury to surgery was 37.4 ± 24.5 days (3–91 days), and the ocular surfaces became stabilized in 82.2 ± 35.4 days (26–156 days, median 87 days). At the final visit, all cases presented with corneal opacity and neovascularization to various degrees. The best-corrected visual acuity decreased from 2.83 ± 1.02 LogMAR preoperatively to 2.87 ± 1.31 LogMAR postoperatively. The results imply that tenonplasty combined with amniotic membrane transplantation could provide vascular supply to the ischemic sclera, repair defects in the conjunctiva, and promote corneal reepithelialization, thus facilitating ocular surface stabilization after burns.

scholarly journals Еfficacy of Combined Treatment of Epithelial and Endothelial Corneal Dystrophy Using Corneal Crosslinking and Automated Posterior Lamellar Keratoplasty

2019 ◽  
Vol 16 (1S) ◽  
pp. 102-107
Author(s):  
L. R. Marvanova
Keyword(s):  
Surgical Treatment ◽  
Combined Treatment ◽  
Corneal Thickness ◽  
Corneal Edema ◽  
Corneal Dystrophy ◽  
Main Group ◽  
Stage I ◽  
Lamellar Keratoplasty ◽  
Control Group ◽  
Posterior Lamellar Keratoplasty

The purpose: to establish a combined approach to the treatment of patients with epithelial and endothelial cornea dystrophy (EED) based on a comparative study of the results of one-step and two-step methods. Patients and methods. The study included 75 patients (81 eyes) with corneal EED, who underwent surgical treatment at the Ufa Eye Research Institute from 2011 to 2016. The patients were divided into two groups — the main group consisted of 43 (46 eyes, 57 %) patients, who underwent the first stage of the CC before surgical treatment of EED, the second stage after 1–12 months — automated posterior lamellar keratoplasty (APLK). In the control group, isolated APLK was performed in 32 (35 eyes, 43 %) patients. Results. After CC (1–10 days) in the main group an increase in corneal thickness due to edema enhancement in the cornea stroma was observed in patients with stage I–III of the corneal EED. After 3 months, a decrease in corneal thickness was recorded in patients of the main group with I-II stages of the disease (p < 0.05), after 6 months — in all stages of the corneal EED compared with the control group (p < 0.05). According to optical coherence tomography (OCT), a decrease in the total cornea thickness in both зфешутеы groups was noted within 12 months after APLK: in the main group from 667 ± 65 μm initially to 594 ± 31 μm, in the control group, where there was a pronounced corneal edema from 787 ± 56 to 612 ± 67 μm. Conclusion. Corneal cross-linking in patients with I–III stages of corneal EED provides improvement of the cornea, manifested in reducing edema and its thickness. It allows to delay the implementation of the automated posterior lamellar keratoplasty without corneal deterioration in patients with stage I up to 6–12 months, in patients with stage II–III up to 3–6 months.

scholarly journals Preoperative Anatomy Parameters in Implantable Collamer Lenses

2021 ◽  
Author(s):  
Yanzhen Xue ◽  
Yonghong Guo ◽  
Ruibo Zhao
Keyword(s):  
Regression Analysis ◽  
Linear Regression ◽  
Anterior Chamber ◽  
Linear Regression Analysis ◽  
Corneal Thickness ◽  
Intraclass Correlation ◽  
Anterior Segment ◽  
Anterior Chamber Depth ◽  
Case Series ◽  
Significant Difference

Abstract Purpose: To determine patient preoperative anatomical features and the parameters of implantable collamer lenses (ICLs) relevant in explaining vault variability.Setting: Ophthalmology Xi’an Aier Gucheng Eye hospital , Xi’an China.Design: Retrospective case series.Methods:This study comprised 88 eyes of 45 patients implanted with myopic or toric ICLs between May 2021 and August 2021.Pentacam imaging was used for assessing white-to-white (WTW) diameter, central keratometry, anterior chamber depth(ACD), central corneal thickness and vault. Anterior-segment optical coherence tomography（AS-OCT） was used to measure the horizontal anterior chamber angle distance (ATA). Ultrasound biomicroscopy (UBM) was used to measure horizontal and vertical sulcus to sulcus(vSTS). According to different ACD,we divide ACD into shallow group(2.8 to 3.2 mm),medium group(3.2 to 3.5 mm),and deep group(＞3.5mm).Results: Linear regression analysis found significant correlation between WTW diameters and ATA diameters( y= 0.9605x+0.1491,R² = 0.9148),with a coefficient of determinant of 0.9148 (P＜0.01). Linear regression analysis found significant correlation between hSTS and vSTS（y=0.9855x-0.0178,R²=0.1979）,with a coefficient of determinant of 0.1979 (P＜0.01). WTW diameters showed statistically significant difference in shallow and medium ACD (t=-3.28,P＜0.01 ), significant difference in shallow and deep ACD (t=-4.69,P＜0.01 ),there was no correlation in medium and deep ACD(t=-1.41,P＞0.05 ). There was a statistically significant correlation between WTW diameters and hSTS diameters when the ACD was less than 3.5 mm (t=-0.451, P=0.000) (t=1.406, P=0.026),but weak correlation when the ACD was bigger than 3.5 mm(t=1.594, P=0.051). ATA and WTW with a mean difference close to zero(-0.66 mm). Despite the relatively high correlation (intraclass correlation co-efficient =0.689), the range of agreement is quite broad (1.33 mm).Conclusions:ATA measured with AS-OCT can not be used interchangeably with WTW obtained with Pentacam. WTW diameters and hSTS diameters have a statistically significant correlation when the ACD was less than 3.5 mm. WTW, ATA, hSTS and vSTS all should be considered during design the size of lens and regulating the vault after surgery.

scholarly journals AMNIOTIC MEMBRANE TRANSPLANTATION IN OCULAR SURFACE DISORDERS – A CASE SERIES

2016 ◽  
Vol 3 (30) ◽  
pp. 1376-1379
Author(s):  
Umesh Harakuni ◽  
Smita K.S ◽  
Sanya Garg ◽  
Patil S.B ◽  
Shivanand C Bubanale ◽  
...  
Keyword(s):  
Amniotic Membrane ◽  
Ocular Surface ◽  
Case Series ◽  
Amniotic Membrane Transplantation

scholarly journals Clinical and Ultrasound Biomicroscopic Characteristics of Congenital Fibrovascular Pupillary Membrane-Induced Secondary Glaucoma

2021 ◽  
Vol 8 ◽  
Author(s):  
Yingting Zhu ◽  
Lei Fang ◽  
Yimin Zhong ◽  
Julius Oatts ◽  
Ying Han ◽  
...  
Keyword(s):  
Anterior Chamber ◽  
Optic Neuropathy ◽  
Axial Length ◽  
Corneal Thickness ◽  
Anterior Chamber Depth ◽  
Case Series ◽  
Secondary Glaucoma ◽  
Glaucomatous Optic Neuropathy ◽  
Type I ◽  
Type Ii

Purpose: The purpose of this study was to describe and summarize the clinical features of congenital fibrovascular pupillary membrane-induced secondary glaucoma (CFPMSG).Design: Cross-sectional case series.Methods: Eyes of 32 patients with CFPMSG were enrolled. Demographic data, including gender, laterality, age at presentation, and age at onset of glaucoma were collected. Patients underwent comprehensive ophthalmic examinations and ultrasound biomicroscopy (UBM). CFPMSG eyes were classified into three groups based on UBM findings and intergroup analysis was performed using ANOVA.Results: The average age at presentation was 2.4 ± 4.6 months (mean ± SD) and at glaucoma onset was 3.8 ± 4.5 months. Compared to normal fellow eyes, all affected eyes had increased intraocular pressure (IOP), axial length, corneal diameter, and central corneal thickness, and decreased anterior chamber depth (ACD) (all P ≤ 0.001). Twenty-two affected eyes (68.8%) had evidence of glaucomatous optic neuropathy. Based on iris configuration on UBM, eyes were classified as 53% type I (“U” shape), 34% type II (“Y” shape), and 13% type III (no anterior chamber). IOP in types II (33.8 ± 5.9 mmHg) and III (35.2 ± 5.9 mmHg) was significantly higher than in type I eyes (26.5 ± 5.1 mmHg). The ACD was shallower in type II compared to type I (P = 0.045).Conclusion: Congenital fibrovascular pupillary membrane-induced secondary glaucoma is characterized by ocular hypertension, corneal enlargement and edema, axial length elongation, and glaucomatous optic neuropathy. Glaucoma in this condition is secondary to pupillary block and angle-closure. UBM provides important information for the diagnosis and classification of CFPMSG. This novel classification system demonstrated varying levels of severity and may guide on management of this disease.

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