scholarly journals Nocardia Endophthalmitis- Prophylactic Prevention with an Innovative Approach

2021 ◽  
Vol 15 (1) ◽  
pp. 258-263
Author(s):  
Atul Kamath ◽  
Aditi Pai ◽  
Jagadeesh K. Reddy
Keyword(s):  
Endothelial Cell ◽  
Poor Prognosis ◽  
Saline Solution ◽  
Corneal Endothelial Cell ◽  
Macular Thickness ◽  
Control Group ◽  
Common Cause ◽  
Aggressive Disease ◽  
Ocular Coherence Tomography ◽  
Corneal Endothelial Cell Density

Background: Nocardia is a common cause of endophthalmitis in southern India. It is an aggressive disease with a poor prognosis. Objective: This study was conducted using an amikacin antibiotic in the drip irrigation of balanced saline solution (BSS) during the surgery to prophylactically study the occurrence of Nocardia endophthalmitis and any subsequent toxic effects of the antibiotics used. Methods: Prospective study period was of 6 months, starting from July to December-2018. Preoperative and postoperative specular counts and macular thickness using Ocular Coherence Tomography (OCT) were compared with any incidence of Nocardia endophthalmitis. A total of 500 patients operated for manual SICS were randomly assigned into 2 groups. The first group of 250 patients received antibiotic amikacin added to the Balanced Saline Solution (BSS) irrigating solution throughout the course of the surgery. The second control group received no antibiotics. Manual SICS was performed on all 500 patients by a single surgeon and was found to be uneventful. Pre- and postoperative corneal endothelial cell density and mean macular thickness using OCT were taken and recorded of all the patients, respectively, and data obtained were statistically compared. Results: No incidence of Nocardia endophthalmitis among the cataract surgeries operated was found. There was no drug-related toxicity to the cornea or macula. Furthermore, no incidence of Nocardia endophthalmitis has been reported since 2018 after using antibiotics. Conclusion: A simple routine of adding amikacin in the drip prophylactically during the course of surgery helped us prevent Nocardia endophthalmitis with no side effects. Also, it will be an innovative technique that is economically feasible and effective in regions where Nocardia endophthalmitis is prevalent.

scholarly journals ROLE OF VITAMIN D IN ENDOTHELIAL CELL OF RETINA

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Dr. Sonpal Jindal ◽  
Dr. Mukesh Kumar Taneja
Keyword(s):  
Vitamin D ◽  
Endothelial Cell ◽  
Vitamin D Deficiency ◽  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Corneal Endothelial Cell ◽  
Control Group ◽  
Study Group ◽  
Vitamin D Levels ◽  
Corneal Endothelial Cell Density

Vitamin D deficiency is a common health problem worldwide. Many parts of the human eye, including the epithelium of the cornea, lens, ciliary body, and retinal pigment epithelium, as well as the corneal endothelium, ganglion cell layer, and retinal photoreceptors, contain vitamin D receptor. Physiological effects of vitamin D From an ocular point of view, the role in macular and retinal health had been advanced, as well as the involvement in corneal inflammatory response, wound healing, and dry eye disease. The most important effect of vitamin D is on, phosphorus, calcium metabolism and on bone mineralization. Recently, it was observed that vitamin D deficiency and insufficiency are related with common cancers, cardiovascular diseases, metabolic syndromes, infectious, and many chronic diseases including autoimmune disease. Benefits of vitamin D may be amplified through synergistic interaction with topical corticosteroids which accelerates improvement in corneal shape and optics, substantially benefiting the control of ocular surface disease and dry eye symptoms. Aqueous humour is the primary source responsible for the feeding of corneal endothelial layer hence endothelial abnormalities can be expected due to accumulated inflammatory cytokines and multiple toxic products in the aqueous humour of the patients with vitamin D deficiency. MATERIAL AND METHODS: Subjects were selected with vitamin D deficiency in the age group of 20–55 years. 50 patients having serum vitamin D levels <15 ng/ml were included in the study. Serum vitamin D levels of <15 ng/ml were included in the control group. Vitamin D levels in tear fluid were measured by direct competitive chemiluminescent enzyme linked immunoassay. A complete ophthalmic evaluation was performed in all participants which includes assessment of visual acuity, anterior segment evaluation and posterior segment evaluation. Specular microscopy was performed on the eyes of the patients with vitamin D deficiency and healthy control group individuals. Corneal endothelial cell density (CD) and central corneal thickness (CCT) values were calculated automatically using the software of the specular microscope.  RESULTS: The study group included 23 male and 27 female subjects while study group included 24 male and 26 female. Mean age of male in study group was 46.4 ± 12.56 and female was 45.6 ± 11.77. In control group mean male age was 48.5 ± 9.25 and female age was 49.56 ± 12.55. In study group Mean Corneal endothelial cell density (CD)  was observed as 2632.89 ± 189.25 cells/mm 2  and Mean central corneal thickness (CCT) was 587.2 ± 25.89 μ. In control group Mean Corneal endothelial cell density (CD) was observed as 2954.97 ± 116.89 cells/mm 2  and Mean central corneal thickness (CCT) was 546.0 ± 36.22 μ. Vitamin D levels of Tears in study group was 8.4 ± 1.7 ng/ml  and in control group it was 16.2 ± 2.3 ng/ml. CONCLUSION: It has been observed that there is statistically significant difference in the corneal endothelial cell density (CD) and central corneal thickness (CCT) in patients with vitamin D deficiency. It was observed that Vitamin D is present in tear fluid and there is significant difference in the levels of vitamin D in study and control group.

scholarly journals Potential Factors of Corneal Endothelial Cells for Progression in Children with Uveitis

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Xu Chen ◽  
Yi Shao ◽  
Shi-Nan Wu ◽  
Shan-Bi Zhou
Keyword(s):  
Endothelial Cells ◽  
Endothelial Cell ◽  
Morphological Changes ◽  
Corneal Endothelial Cell ◽  
Control Group ◽  
Cell Area ◽  
Corneal Endothelial Cells ◽  
Cell Parameters ◽  
Corneal Endothelial Cell Density ◽  
The Difference

Objective. To observe the morphological changes and abnormal structure of corneal endothelial cells in children with uveitis, to analyze the related factors affecting the morphological changes of corneal endothelial cells, and to explore the clinical application of a corneal endothelial microscope in children with uveitis. Methods. The corneal endothelial cells of 70 patients with uveitis were photographed with the Topcon SP-3000 noncontact corneal endothelial microscope, and the corneal endothelial cell density (CD), average cell area (AVE), coefficient of variation of the cell area (CV), and percentage of hexagonal cells (PHC) were measured with the IMAGEnet system. Twenty-eight patients (56 eyes) with monocular uveitis were selected, with the affected eyes (28 eyes) as the experimental group and the contralateral healthy eyes (28 eyes) as the control group. The corneal endothelial cell parameters between the two groups were statistically analyzed. The parameters of corneal endothelial cells in 70 children with uveitis were compared, and the effects of the course of the disease, inflammatory cells in the anterior chamber, and posterior corneal deposition (KP) on the parameters of corneal endothelial cells were analyzed. Results. There are four abnormal forms of the corneal endothelium in children with uveitis: enlarged cell area gap, irregular cell shape, blurred intercellular space, and cell loss. KP showed irregular high reflective white spots in the corneal endothelial microscope images, surrounded by dark areas, and existed in all the eyes with dusty KP found in slit lamp examination and a small number of eyes without obvious KP. Comparing the corneal endothelial cell parameters between the experimental group and the control group, it was found that the corneal endothelial CD and PHC of the former were lower than those of the latter, and the difference was statistically significant ( P < 0.001 and P = 0.018 , respectively). The AVE and CA of the former were higher than those of the latter ( P = 0.013 and P = 0.046 , respectively). The corneal endothelial cell density of the eyes with a course of the disease of more than 1 year was lower than that of the eyes with a course of the disease less than 1 year, the coefficient of variation of the corneal endothelial cell area of the eyes with KP was higher than that of the eyes without KP, and the difference was statistically significant ( P = 0.003 and P = 0.030 , respectively). Conclusion. Corneal endothelial microscopy is one of the important methods for the detection of uveitis with high sensitivity. The change of morphological parameters of corneal endothelial cells is one of the important indexes to assist in the diagnosis of uveitis and can be further promoted in ophthalmological examination.

scholarly journals Myopia, corneal endothelial cell density and morphology in a Japanese population-based cross-sectional study: the JPHC-NEXT Eye Study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Naohiko Aketa ◽  
Miki Uchino ◽  
Motoko Kawashima ◽  
Yuichi Uchino ◽  
Kenya Yuki ◽  
...  
Keyword(s):  
Endothelial Cell ◽  
Cell Density ◽  
Contact Lenses ◽  
Population Based ◽  
Cross Sectional Study ◽  
Corneal Endothelial Cell ◽  
Endothelial Cell Density ◽  
Sectional Study ◽  
Cross Sectional ◽  
Corneal Endothelial Cell Density

AbstractThis population-based cross-sectional study was performed to determine the mean corneal endothelial cell density (ECD), coefficient of variation (CV), and hexagonality (HEX), and their associations with myopia in Japanese adults living in Chikusei city. Of 7109 participants with available data, 5713 (2331 male and 3382 female) participants were eligible for analysis. After assessing the relationship between participant characteristics and spherical equivalent refraction (SER), the association of SER with the abnormal value of ECD (< 2000 cells/mm), CV (≥ 0.40), and HEX (≤ 50%) were determined using the logistic regression models adjusting for potential confounders (age, intraocular pressure, keratometric power, height, and antihypertensive drug use). In male participants, there was no statistically significant relationships between SER and endothelial parameters. In female participants, compared to emmetropia, SER ≤ − 6 D had significantly higher odds ratio (OR) of having the abnormal value of CV (OR = 2.07, 95% confidence interval [CI] 1.39–3.10) and HEX (OR = 2.04, 95% CI 1.29–3.23), adjusted for potential confounders, indicating that the high myopia was associated with the abnormal values of CV and HEX. Further adjustment for contact lenses wear partly attenuated these associations. Association between the SER and ECD was not detected.

scholarly journals 27-gauge trocar-assisted sutureless intraocular lens fixation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tatsuya Jujo ◽  
Jiro Kogo ◽  
Hiroki Sasaki ◽  
Reio Sekine ◽  
Keiji Sato ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Endothelial Cell ◽  
Cell Density ◽  
Intraocular Lens ◽  
Vitreous Hemorrhage ◽  
Corneal Endothelial Cell ◽  
Endothelial Cell Density ◽  
Corneal Endothelial Cell Density ◽  
The Mean ◽  
Iol Fixation

Abstract Backgrounds However there have been numerous investigations of intrascleral intraocular lens (IOL) fixation techniques, there is room for improvement in terms of simplifying complicated techniques and reducing the high levels of skill required. This study aimed to report a novel technique for sutureless intrascleral fixation of the IOL using retinal forceps with a 27-gauge trocar. Methods Nineteen eyes of 18 patients underwent intrascleral fixation of the IOL from July 2018 to September 2019 were enrolled in this study. A 27-gauge trocar formed 3-mm scleral tunnels positioned at 4 and 10 o’clock, 2 mm from the corneal limbus. We used a 3-piece IOL haptic grasped by a 27-gauge retinal forceps and pulled from the 27-gauge trocar. The IOL was fixed by making a flange. Main outcome measures were visual acuity, corneal endothelial cell density, IOL tilt, decentration, predicted error of refraction and complications. Results The 19 eyes were followed up for 1 month. The mean pre- and postoperative logMAR uncorrected visual acuity (UCVA) was 1.06 ± 0.63 and 0.40 ± 0.26, respectively (p < 0.01), while the mean pre- and postoperative logMAR best corrected visual acuity (BCVA) was 0.27 ± 0.51 and 0.06 ± 0.15, respectively (p = 0.09). The mean corneal endothelial cell density was 2406 ± 625 to 2004 ± 759 cells/mm2 at 1 month (p = 0.13). The mean IOL tilt was 3.52 ± 3.00°, and the mean IOL decentration was 0.39 ± 0.39 mm. There was no correlation among IOL tilt, decentration and BCVA (p > 0.05). The mean prediction error of the target refraction was − 0.03 ± 0.93 D. The complications were vitreous hemorrhage (3 eyes), hyphema (1 eye), IOP elevation (1 eye), iris capture of the IOL (1 eye) and hypotony (2 eyes). No IOL dislocation occurred. Conclusions IOL intrascleral fixation with a flange achieved good IOL fixation and visual outcome in the scleral tunnels created with the 27-gauge trocar.

scholarly journals Age-Stratified Analysis of Diabetes and Pseudophakia Effects on Corneal Endothelial Cell Density

Cornea ◽  
2017 ◽  
Vol 36 (3) ◽  
pp. 367-371 ◽  
Author(s):  
Yicheng Chen ◽  
Sean W. Tsao ◽  
Moonseong Heo ◽  
Patrick K. Gore ◽  
Mitchell D. McCarthy ◽  
...  
Keyword(s):  
Endothelial Cell ◽  
Cell Density ◽  
Corneal Endothelial Cell ◽  
Endothelial Cell Density ◽  
Corneal Endothelial Cell Density ◽  
Stratified Analysis

The Effect of Glaucoma Filtering Surgery on Corneal Endothelial Cell Density

1991 ◽  
Vol 22 (5) ◽  
pp. 251-255
Author(s):  
David L Smith ◽  
Gregory L Skuta ◽  
Kim A Lindenmuth ◽  
David C Musch ◽  
Terry J Bergstrom
Keyword(s):  
Endothelial Cell ◽  
Cell Density ◽  
Corneal Endothelial Cell ◽  
Endothelial Cell Density ◽  
Filtering Surgery ◽  
Corneal Endothelial Cell Density

scholarly journals Corneal endothelial cell density loss following glaucoma surgery alone or in combination with cataract surgery: a systematic review protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e050992
Author(s):  
Clarissa E H Fang ◽  
Peng Tee Khaw ◽  
Rashmi G Mathew ◽  
Christin Henein
Keyword(s):  
Endothelial Cell ◽  
Cataract Surgery ◽  
Cell Density ◽  
Systematic Reviews ◽  
Glaucoma Surgery ◽  
Corneal Endothelial Cell ◽  
Endothelial Cell Density ◽  
Controlled Trials ◽  
Surgical Trauma ◽  
Corneal Endothelial Cell Density

ObjectiveWe aim to systematically assess and compare corneal endothelial cell density (ECD) loss in patients with glaucoma following glaucoma surgery and cataract surgery.IntroductionCorneal ECD loss may occur due to intraoperative surgical trauma in glaucoma surgery or postoperatively with chronic endothelial cell trauma or irritation. Corneal oedema and decompensation after aqueous shunt glaucoma surgery has been reported but the long-term ECD loss is still unknown.Inclusion criteriaTrabeculectomy, glaucoma filtration surgery or microinvasive glaucoma surgery in adults with ocular hypertension, primary and secondary open angle glaucoma, normal tension glaucoma and angle-closure glaucoma. Participants with pre-existing corneal disease will be excluded. Glaucoma laser treatments and peripheral iridotomy will be excluded. The outcomes include preoperative and postoperative corneal ECD, percentage change of corneal ECD and adverse events.MethodsWe will conduct an electronic database search for randomised controlled trials, prospective non-randomised studies, observational studies in MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov and The International Prospective Register of Systematic Reviews (PROSPERO). Eligibility criteria will include quantitative articles published after and including the year 2000, written in English and containing data on ECD loss. Two independent reviewers will screen titles and abstracts and extract data from full texts, reporting outcomes according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data extraction of key characteristics will be completed using customised forms. Methodological quality will be assessed using the Joanna Briggs Institute critical appraisal forms.Ethics and disseminationEthics approval is not required for this review, as it will only include published data. Findings will be published in a peer-reviewed journal and disseminated across ophthalmic networks.PROSPERO registration numberPROSPERO CRD42020192303.

scholarly journals Change in corneal endothelial cell density after phacoemulsification in patients with type II diabetes mellitus

2019 ◽  
Vol 35 (5) ◽  
Author(s):  
Muhammad Khalid ◽  
Muhammad Kashif Hanif ◽  
Qamar Ul Islam ◽  
Muhammad Asim Mehboob
Keyword(s):  
Endothelial Cell ◽  
Cell Density ◽  
Type Ii Diabetes Mellitus ◽  
Corneal Endothelial Cell ◽  
Endothelial Cell Density ◽  
Diabetic Patients ◽  
Type Ii ◽  
Significant Difference ◽  
Corneal Endothelial Cell Density ◽  
Study Population

Objective: To compare the mean change in Corneal Endothelial cell Density (CED), from baseline (pre-operative value), two months after phacoemulsification cataract surgery between type II diabetic patients and non-diabetic patients. Methods: This prospective stratified controlled study was conducted at PNS Shifa Hospital, Karachi. 80 eyes of 72 type II diabetic patients and 80 eyes of 77 non diabetic controls, having Nuclear Opalescence (NO) grades 2 and 3 on slit lamp examination underwent phacoemulsification surgery. CED was measured in cells/mm2, of concerned eye of each subject preoperatively and 2 months post operatively using specular microscope. The difference in mean CED change between the two groups after surgery was analyzed. Results: Mean age of study population was 61.41± 6.76 years. Out of study population, 92 (57.5%) were males and 68 (42.5%) were females. There was a statistically significant difference between both groups in terms of mean post-operative CED, mean change in CED and mean frequency change in CED (p <0.05). There was no statistically significant difference between both groups in age, gender, laterality of eyes and mean pre-operative CED, (p >0.05). Difference of pre-operative CED from post-operative CED in each group was statistically significant. Conclusion: There is a significant difference between diabetic population and normal population in terms of corneal endothelial loss after uneventful phacoemulsification cataract surgery. doi: https://doi.org/10.12669/pjms.35.5.596 How to cite this:Khalid M, Hanif MK, Qamar ul Islam, Mehboob MA. Change in corneal endothelial cell density after phacoemulsification in patients with type II diabetes mellitus. Pak J Med Sci. 2019;35(5):---------. doi: https://doi.org/10.12669/pjms.35.5.596 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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