The Emerging Role of Partial Thickness Keratoplasty In Corneal  Transplantation and Its Use in Fuchs’ Dystrophy

Fungal infection after corneal transplantation is a rare, yet potentially devastating, postoperative complication and has become a growing concern for the transplant surgeon and eye banking community. The Eye Bank Association of America (EBAA) has reported an increasing trend in the rate of postkeratoplasty fungal infections and a reversal in the previously documented predominance of bacterial over fungal infections. Additionally, several studies have confirmed a high correlation between positive corneoscleral donor rim fungal cultures and postoperative infections. Optisol GS (Bausch & Lomb, Irvine, California, USA), the most extensively used corneal storage solution in US eye banks, does not currently contain any antifungal supplementation. Although large randomised control trials evaluating the efficacy and safety of routine antifungal supplementation to corneal storage solution are lacking, several investigative studies have assessed the role of antifungal agents in reducing fungal contamination of donor corneas without causing undue corneal toxicity. This review will present the current epidemiology of postkeratoplasty fungal infections and evidence for obtaining routine fungal rim cultures and antifungal supplementation of storage solution.

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Evaluation of tendoAchilles Lesions by (MRI)

QJM ◽

10.1093/qjmed/hcab106.043 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Maha Mohamed Abd Elraouf ◽

Mennatallah Hatem Shalaby ◽

Mohamed AbdElaziz Yehia Rabeai

Keyword(s):

The Body ◽

Radiology Department ◽

Full Thickness ◽

University Hospitals ◽

Partial Thickness ◽

Careful Clinical Examination ◽

Important Diagnostic Tool ◽

Study Population ◽

Mri Study

Abstract Background: The AT is the largest tendon in the body; it plays an important role in the biomechanics of the lower extremity; despite its strength, the AT is also vulnerable to injury, due to its limited blood supply from musculotendinousa, also it withstands great forces, especially during sporting exercises and it's located superficially. Aim of the Work: To evaluate the role of (MRI) in the diagnosis of AT disorders. Patients and Methods: Type of Study: retrospective and prospective studies. Study Setting The study was conducted in Radiology Department at Ain Shams University Hospitals. Study Period from march 2018 to march 2020. Study Population This study included 40 patients. The patients were referred from either the orthopedic, rheumatology outpatient clinics of Ain Shams hospitals or private clinics to radiology department in Ain Shams University. Results Full thickness tear (30.0%) and Tendenosis (30.0%) were the most frequently detected pathologies followed by partial thickness tear (27.5%) and bursitis ( 22.5%) with significant more risk in male gender and middle age ( >46 years). More than one pathology were found in the same MRI study and this led to development of degenerative theory, that consider almost ruptured AT develop on top of pathological one. Conclusion MRI is a gold standard and important diagnostic tool in the evaluation of AT lesions especially in chronic and complex cases, and who do not respond to conservative measures and provides precious information for surgical intervention in parallel with careful clinical examination. Full thickness tear and partial thickness tear may develop on top of pathological tendon.

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Corneal Transplantation in Advanced Fuchs' Dystrophy

American Journal of Ophthalmology ◽

10.1016/0002-9394(67)92009-0 ◽

1967 ◽

Vol 64 (3) ◽

pp. 433-436 ◽

Cited By ~ 3

Author(s):

A. Hagedoorn

Keyword(s):

Corneal Transplantation ◽

Fuchs Dystrophy

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The role of complement activation in the pathogenesis of Fuchs’ dystrophy

Molecular Immunology ◽

10.1016/j.molimm.2013.11.019 ◽

2014 ◽

Vol 58 (2) ◽

pp. 177-181 ◽

Cited By ~ 3

Author(s):

Ágnes Füst ◽

Dorottya Csuka ◽

László Imre ◽

Mária Bausz ◽

Attila Nagymihály ◽

...

Keyword(s):

Complement Activation ◽

Fuchs Dystrophy

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Corneal Imaging and Densitometry Measurements in Patients with Fuchs' Dystrophy Undergoing Penetrating Keratoplasty and Descemet's Striping Automated Endothelial Keratoplasty

10.21203/rs.3.rs-326343/v1 ◽

2021 ◽

Author(s):

Khaled Alzahrani ◽

Arun Brahma ◽

Fiona Carley ◽

M. Chantal Hillarby

Keyword(s):

Visual Acuity ◽

Penetrating Keratoplasty ◽

Corneal Thickness ◽

Corneal Transplantation ◽

Objective Evaluation ◽

Endothelial Keratoplasty ◽

Evaluation Tool ◽

Corneal Densitometry ◽

Post Surgery ◽

Fuchs Dystrophy

Abstract Aims:In the present study, we used the densitometry software from the Oculus Pentacam to compare postoperative corneal clarity between penetrating keratoplasty (PK) and Descemet's stripping endothelial keratoplasty (DSAEK) in patients with Fuchs' dystrophy.Methods:A retrospective comparative study was carried out at Manchester Royal Eye Hospital. In 28 patients with Fuchs' dystrophy, corneal densitometry measurements were performed 12–18 months after corneal transplantation. The correlations of the densitometry measurements with the best corrected visual acuity (BCVA) and central corneal thickness (CCT) were analysed and compared between eyes that underwent PK and those that underwent DSAEKResults:Corneal densitometry measurements in the 33 eyes showed no significant differences between the PK and DSAEK post-surgery groups. There was no significant correlation between CCT and corneal densitometry measurements in either group (P > 0.05 in both cases). After DSAEK, corneal densitometry measurements were significantly correlated with BCVA in the central (P = 0.01), posterior (P = 0.007), and full-depth (P = 0.008) 0–2 mm zones of the cornea but not in PK group. The postoperative CCT was significantly different between the two groups (P˂0.01).Conclusion:The two types of corneal transplantation resulted in different outcomes in terms of corneal densitometry measurements. Improved visual acuity after DSAEK was found to positively correlate with improvements in corneal clarity. Oculus Pentacam provides an objective evaluation tool to monitor corneal status after surgery.

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