scholarly journals Analysis of causes and outcomes of corneal transplantation in al-zahra eye hospital in southeast of Iran from 2011-2016

2017 ◽  
Vol 5 (7) ◽  
pp. 2917
Author(s):  
Behrouz Dehghan ◽  
Mohammadnaeem Aminifard ◽  
Zahra Raisi
Keyword(s):  
Transplant Rejection ◽  
Corneal Transplantation ◽  
Organ Transplant ◽  
Corneal Opacity ◽  
Corneal Dystrophy ◽  
Bullous Keratopathy ◽  
Corneal Transplant ◽  
Term Care ◽  
Corneal Scar

Background: Corneal transplantation is known as the most successful and common type of organ transplant, but it calls for more intensive and long-term care. Given the lack of adequate information on this important surgery in this province and the differences between indications and causes of corneal transplantation, the present research was carried out to examine the causes and outcomes of corneal transplant in patients visiting Al-Zahra eye hospital who had received donated cornea in the past five years.Methods: In a retrospective analytical-descriptive study 135 files of 149 eyes that had gone through corneal transplantation were examined. Information on the age, gender, residence, indications, and surgery consequences was extracted and was analyzed in SPSS 19 statistical software with descriptive statistics (percentage, frequency, mean, and standard deviation.Results: The highest transplant indication was keratoconus with a frequency of 39.9% followed by bullous keratopathy, corneal opacity, and transplant rejection with frequencies of 16.1, 12.7, and 10.1%, respectively. Other indications were corneal scar (9.4%), corneal perforation (2.7%), trauma (2.7%), and Fuchs’ corneal dystrophy (1.3%) in the order mentioned. Concerning postoperative complications in this research, 57.7% of the eyes (86 cases) showed no complication. Moreover, complications were mostly related to astigmatism with a frequency of 30.8% (46 cases).Conclusions: In general, the most common indication in this research was keratoconus. Most surgeries were also complication-free and most complications were associated with astigmatism.

scholarly journals Indications for keratoplasty in Nepal: 2005 - 2010

2013 ◽  
Vol 5 (2) ◽  
pp. 207-214 ◽  
Author(s):  
Leena Bajracharya ◽  
R Gurung ◽  
EH DeMarchis ◽  
M Oliva ◽  
S Ruit ◽  
...  
Keyword(s):  
Case Series ◽  
Corneal Opacity ◽  
Corneal Dystrophy ◽  
Bullous Keratopathy ◽  
Infectious Keratitis ◽  
Eye Health ◽  
Corneal Scar ◽  
Recipient Age ◽  
Corneal Opacities ◽  
Corneal Blindness

Introduction: Corneal disease, especially infective keratitis, is one of the major causes of visual impairment and blindness in developing countries. Objective: To find out the current indications for keratoplasty, how these indications have changed over time as well as how they are different from those in other parts of the world. Materials and methods: A retrospective study of a case series of 645 keratoplasty surgeries (589 patients) was conducted at the Tilganga Institute of Ophthalmology from January 2005 to December 2010. Outcome measures: The cases were evaluated in terms of demographic parameters, preoperative diagnosis and the type of surgery performed. Results: The most common indication for surgery was active infectious keratitis (264 eyes, 40.9 %), followed by corneal opacity (173 eyes, 26.8 %), regraft (73 eyes, 11.2 %), bullous keratopathy (58 eyes, 9.0 %), keratoconus (45 eyes, 7.0 %) and corneal dystrophy (11 eyes, 1.7 %). The mean recipient age was 41.7 ± 19.9 years with over a half of the patients between 15 to 49 years of age. More men (64.1 %) underwent keratoplasty than women (35.8 %). 59.8 % of the eyes with infectious keratitis had a perforated corneal ulcer. 49.7 % of corneal opacities were due to previous infectious keratitis. 72 % of regrafts were for endothelial failure of various causes. In older patients (> 50 years), bullous keratopathy was an important indication, after infectious keratitis. Keratoconus and corneal scar were major causes of keratoplasty in children of 14 years or less. Four percent of the patients had keratoplasty in both the eyes. 17.1 % of the patients who had one eye operated on had a blind fellow eye with a vision of less than 3/60. Conclusion: Currently, keratitis, either active or healed, is the major indication for keratoplasty, suggesting that improved primary eye health care is necessary to decrease the prevalence of corneal blindness. Nepal J Ophthalmol 2013; 5(10): 207-214 DOI: http://dx.doi.org/10.3126/nepjoph.v5i2.8730

scholarly journals Corneal transplantation activity in Catalonia, Spain, from 2011 to 2018: Evolution of indications and surgical techniques

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249946
Author(s):  
Noelia Sabater-Cruz ◽  
Marc Figueras-Roca ◽  
Lydia Padró-Pitarch ◽  
Jaume Tort ◽  
Ricardo P. Casaroli-Marano
Keyword(s):  
Corneal Transplantation ◽  
Surgical Techniques ◽  
Annual Reports ◽  
Bullous Keratopathy ◽  
Corneal Transplant ◽  
Endothelial Keratoplasty ◽  
Descemet Membrane Endothelial Keratoplasty ◽  
Eye Bank ◽  
Increasing Trend ◽  
Fuchs Endothelial Dystrophy

Purpose To report corneal transplant activity carried out in Catalonia (Spain) and the evolving indications for keratoplasty over an 8-year period. Methods Annual reports from the Catalan Transplant Organization, Spain, on corneal graft indications and techniques from 2011 to 2018 were reviewed. Results A total of 9457 keratoplasties were performed in Catalonia, from January 2011 to December 2018. The most frequent indications were bullous keratopathy (BK; 20.5%), Fuchs endothelial dystrophy (FED; 17.9%), re-graft (13.7%), and keratoconus (11.3%). Penetrating keratoplasty (PKP) accounted for 63.4% of all performed keratoplasties. Since the introduction of eye bank precut tissue for Descemet stripping automated endothelial keratoplasty (DSAEK) in 2013 and for Descemet membrane endothelial keratoplasty (DMEK) in 2017 the number of endothelial keratoplasties has drastically increased. An increasing trend of posterior lamellar techniques over the total of keratoplasties was found (p<0.001). Endothelial keratoplasties for different endothelial diseases indications (BK, FED, and re-graft), also showed and increasing trend (p<0.001). DMEK is the technique with the highest increase (statistically significantly different from linearity) over other endothelial keratoplasties in FED (p<0.001) but not in BK (p = 0.67) or re-grafts (p = 0.067). Conclusion Endothelial diseases represented the top indication for keratoplasty over the 8-year period. PKP is still the most used technique in Catalonia, but endothelial keratoplasties and especially DMEK showed a significant increasing trend over the last years. This is congruent with the main rationale nowadays for keratoplasties: to customize and transplant as less tissue as possible. Therefore, the availability of precut tissue could have definitely enforced such approach.

Differential effects of primary disease and corneal vascularisation on corneal transplant rejection and survival

2019 ◽  
Vol 104 (5) ◽  
pp. 729-734 ◽  
Author(s):  
Daniel Sibley ◽  
Cathy L Hopkinson ◽  
Stephen J Tuft ◽  
Stephen B Kaye ◽  
Daniel F P Larkin
Keyword(s):  
Cox Regression ◽  
Transplant Rejection ◽  
Bullous Keratopathy ◽  
Corneal Transplant ◽  
Post Transplant ◽  
Weak Evidence ◽  
Previous Infection ◽  
Transplant Failure ◽  
Clinically Significant ◽  
The Uk

AimsTo investigate the relative risk of pretransplant corneal vascularisation on rate of rejection and graft failure within 5 years of surgery when categorised by indication for transplantation.We analysed all adults recorded in the UK transplant registry who had a first cornea transplant for keratoconus (KC), pseudophakic bullous keratopathy (PBK) or previous infection (viral/bacterial/fungal/protozoan) between 1999 and 2017. We analysed the number of quadrants of the recipient cornea vascularised before transplant and type of vascularisation, the interval post-transplant to rejection, if any, and the outcome at 5 years post-transplant. Risk factors for rejection and transplant failure were modelled by multivariable risk-adjusted Cox regression.ResultsCorneal vascularisation was recorded in 10%, 25% and 67% of patients with KC, PBK and infection, respectively. Individuals with PBK had an increased hazard of transplant rejection only when there were more than two quadrants of vascularisation (HR 1.5, p=0.004) when either superficial and/or deep vascularisation was present (HR 1.3 and 1.4, respectively, p=0.004). Individuals who had a transplant for previous infection had an increased hazard of rejection with four quadrants of vascularisation (HR 1.6, p=0.003). There was no risk-adjusted increase in transplant failure associated with vascularisation in any group. There was weak evidence of reduction in risk of rejection and/or failure associated with lamellar compared with penetrating transplantation in KC and PBK in vascularised recipient corneas.ConclusionVascularisation is a risk factor for corneal allograft rejection within 5 years. The indication for transplantation has a clinically significant effect on the magnitude of this risk.

Antibody-Mediated Rejection in Solid Organ Transplant

2016 ◽  
Vol 27 (3) ◽  
pp. 316-323
Author(s):  
Michael Petty
Keyword(s):  
Immune System ◽  
Transplant Rejection ◽  
Organ Transplant ◽  
Solid Organ Transplant ◽  
Solid Organ ◽  
Antibody Mediated Rejection ◽  
End Stage ◽  
Transplanted Organs ◽  
Broad Overview

Within a little more than a decade, the transplant of human organs for end-stage organ disease became a reality. The early barriers to successful long-term graft and patient survival were related to the inability to effectively control the immune system such that it would not attack the donor tissue but would still recognize and destroy invading organisms and cells. As immunosuppressive therapy has been refined and proper matching of donors and recipients has been improved, hyperacute rejection has become a rare occurrence and acute rejection has been markedly controlled. However, antibody-mediated rejection remains an important impediment to increased survival of transplanted organs. This article provides readers with a broad overview of the immune system, discusses mechanisms of transplant rejection, and details prevention, detection, and treatment of antibody-mediated rejection in solid organ transplant.

scholarly journals A 27-Year Report from the Central Eye Bank of Iran

2020 ◽  
Author(s):  
Mohammad Ali Javadi ◽  
Mozhgan Rezaei Kanavi ◽  
Sare Safi
Keyword(s):  
Corneal Transplantation ◽  
Bullous Keratopathy ◽  
Eye Bank ◽  
The Past ◽  
Increasing Trend ◽  
Corneal Transplants ◽  
Corneal Scar ◽  
Common Technique ◽  
The Mean ◽  
Per Capita

Purpose: To report the 27-year statistical data from the Central Eye Bank of Iran (CEBI) and its activity. Methods: All CEBI records regarding procured eyes, tissue utilizations, corneal transplants per capita, and indications for keratoplasty from 1991 to 2017 were analyzed. Results: In total, 115,743 whole eyes were donated during the 27-year period. Out of the 114,169 eyes donated between 1994 and 2017, 95,314 eyes were distributed for transplantation, and 95,057 corneas were actually transplanted. The mean annual rate of corneal transplants per capita was 55.10−6 ± 27.10−6. Although penetrating keratoplasty (PKP, 70%) was the most common technique of corneal transplantation during the study period, it exhibited a decreasing trend between 2006 and 2017 (P = 0.048). It was in contrast to Descemet stripping automated endothelial keratoplasty (DSAEK) that demonstrated an increasing trend during the same period (P < 0.001). Keratoconus (KCN, 39.70%) was the most leading indication for keratoplasty over the last three decades followed by bullous keratopathy (BK, 18.5%), corneal scar and opacities (15.7%), and graft failure (GF, 7.5%), with an increasing trend for BK, GF, and KCN. A majority of scleral tissues (83.7%) were utilized for orbital implant protection. Conclusion: An increasing trend in the number of procured eyes was observed over the past 27 years in Iran. The most leading indications for corneal transplantation were KCN and BK. While PKP was the most common keratoplasty technique, DSAEK showed an increasing trend over the last 12 years.

scholarly journals Characteristics of endothelial corneal transplant rejection following immunisation with SARS-CoV-2 messenger RNA vaccine

2021 ◽  
pp. bjophthalmol-2021-319338
Author(s):  
Maria Phylactou ◽  
Ji-Peng Olivia Li ◽  
Daniel F P Larkin
Keyword(s):  
Graft Rejection ◽  
Messenger Rna ◽  
Transplant Rejection ◽  
Corneal Dystrophy ◽  
Temporal Association ◽  
Corneal Transplant ◽  
First Report ◽  
Corneal Graft Rejection ◽  
Allogeneic Response ◽  
Symptoms And Signs

AimWe 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.MethodsA 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. An 83-year-old woman with bilateral DMEK transplants for FECD 3 and 6 years earlier developed simultaneous acute endothelial rejection in both eyes, 3 weeks post second dose of COVID-19 mRNA vaccine BNT162b2. Rejection in both cases was treated successfully with topical corticosteroids.ConclusionsWe believe this is the first report of temporal association between corneal transplant rejection following immunisation against COVID-19 and the first report of DMEK rejection following any immunisation. We hypothesise that the allogeneic response may have been initiated by the host antibody response following vaccination. Clinicians and patients should be aware of the potential of corneal graft rejection associated with vaccine administration and may wish to consider vaccination in advance of planned non-urgent keratoplasties. Patients should be counselled on the symptoms and signs that require urgent review to allow early treatment of any confirmed rejection episode.

scholarly journals Bilateral posterior lamellar corneal transplant surgery in an infant of 17 weeks old: surgical challenges and the added value of intraoperative optical coherence tomography

2021 ◽  
Author(s):  
Marc Muijzer ◽  
Hester Y. Kroes ◽  
Peter Van Hasselt ◽  
Robert Wisse
Keyword(s):  
Optical Coherence Tomography ◽  
De Novo ◽  
Corneal Transplantation ◽  
Corneal Dystrophy ◽  
Added Value ◽  
De Novo Mutation ◽  
Corneal Transplant ◽  
Optical Coherence ◽  
Posterior Polymorphous Corneal Dystrophy ◽  
Intraoperative Optical Coherence Tomography

To describe the surgical challenges, management, and value of intra-operative optical coherence tomography in a case of a bilateral Descemet Stripping Automated Endothelial Keratoplasty corneal transplantation at 17 weeks of age for the treatment of severe posterior polymorphous corneal dystrophy resulting from a de novo mutation of the OVOL2-gene.

scholarly journals Tips, Tricks, and Guides in Descemet Membrane Endothelial Keratoplasty Learning Curve

2021 ◽  
Vol 2021 ◽  
pp. 1-9 ◽  
Author(s):  
Davide Borroni ◽  
Carlos Rocha de Lossada ◽  
Mohit Parekh ◽  
Kunal Gadhvi ◽  
Chiara Bonzano ◽  
...  
Keyword(s):  
Learning Curve ◽  
Corneal Transplantation ◽  
Lamellar Keratoplasty ◽  
Bullous Keratopathy ◽  
Corneal Transplant ◽  
Tissue Preparation ◽  
Endothelial Keratoplasty ◽  
Descemet Membrane Endothelial Keratoplasty ◽  
Descemet Membrane ◽  
Novice Surgeon

Lamellar keratoplasty is fast becoming the most popular form of corneal transplantation. The adoption of Descemet membrane endothelial keratoplasty (DMEK) in the management of Fuchs endothelial dystrophy and pseudophakic bullous keratopathy is partly responsible for this shift in the paradigm of management of corneal pathology. The learning curve of DMEK, however, has been proven to be much steeper than previous endothelial keratoplasty procedures. To ease the procedure, experts have proposed multiple innovative techniques from tissue preparation to graft unfolding to aid the more novice surgeon. Here, we collate and share tips and tricks from our collective experiences to support the learning curve and outcomes in DMEK for both the novice and more experienced corneal transplant surgeons.

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