scholarly journals Response to comments on: Glycerol-preserved corneal tissue in emergency corneal transplantation: An alternative for fresh corneal tissue in COVID-19 crisis

2021 ◽  
Vol 69 (1) ◽  
pp. 170
Author(s):  
Neeti Gupta ◽  
Renu Dhasmana ◽  
Amit Maitreya ◽  
Harsh Badahur
Keyword(s):  
Corneal Transplantation ◽  
Corneal Tissue

scholarly journals Total Corneal Transplantation after Trauma

2017 ◽  
Vol 17 (2) ◽  
pp. 37-38
Author(s):  
Elina Silina ◽  
Guna Laganovska
Keyword(s):  
Healthy Donor ◽  
Penetrating Keratoplasty ◽  
Ocular Trauma ◽  
Corneal Transplantation ◽  
Visual Outcome ◽  
Corneal Tissue ◽  
Full Thickness ◽  
Documented Case ◽  
Donor Graft ◽  
Penetrating Ocular Trauma

Abstract The first successful corneal transplantation is known since 1905, performed by Eduard Zirm (2). It has been implemented in order to restore vision in a variety of corneal diseases and after ocular traumas. The traditional technique for corneal transplantation, penetrating keratoplasty (PKP), refers to the full-thickness replacement of corneal tissue with a healthy donor graft (1). Authors report a well-documented case about successfully transplanted cornea after penetrating ocular trauma to improve visual outcome.

scholarly journals Immune Checkpoints Contribute Corneal Immune Privilege: Implications for Dry Eye Associated with Checkpoint Inhibitors

2020 ◽  
Vol 21 (11) ◽  
pp. 3962
Author(s):  
Junko Hori ◽  
Tomoyuki Kunishige ◽  
Yuji Nakano
Keyword(s):  
T Cells ◽  
Regulatory T Cells ◽  
Dry Eye ◽  
Molecular Mechanisms ◽  
Checkpoint Inhibitors ◽  
Corneal Transplantation ◽  
Immune Privilege ◽  
Immune Checkpoints ◽  
Corneal Tissue ◽  
Immunosuppressive Microenvironment

The eye is provided with immune protection against pathogens in a manner that greatly reduces the threat of inflammation-induced vision loss. Immune-mediated inflammation and allograft rejection are greatly reduced in the eye, a phenomenon called ‘immune privilege’. Corneal tissue has inherent immune privilege properties with underlying three mechanisms: (1) anatomical, cellular, and molecular barriers in the cornea; (2) an immunosuppressive microenvironment; and (3) tolerance related to regulatory T cells and anterior chamber-associated immune deviation. This review describes the molecular mechanisms of the immunosuppressive microenvironment and regulatory T cells in the cornea that have been elucidated from animal models of ocular inflammation, especially those involving corneal transplantation, it also provides an update on immune checkpoint molecules in corneal and systemic immune regulation, and its relevance for dry eye associated with checkpoint inhibitor therapy.

scholarly journals Corneal transplantation during the COVID-19 pandemic: An operational guide

2021 ◽  
pp. 112067212110065
Author(s):  
Antonella Franch ◽  
Adriano Fasolo ◽  
Paolo Carraro ◽  
Mosè Favarato ◽  
Federica Birattari ◽  
...  
Keyword(s):  
Corneal Transplantation ◽  
Case Series ◽  
Lamellar Keratoplasty ◽  
Corneal Tissue ◽  
Test Results ◽  
Positive Predicted Value ◽  
Case Series Study ◽  
Anterior Lamellar Keratoplasty ◽  
Exposure Risks ◽  
Series Study

Purpose: To provide an operational guide for corneal transplantation during the COVID-19 pandemic aimed to maintain surgery and avoid spreading of SARS-CoV-2. Methods: Prospective observational case series study in patients requiring corneal graft manage toward separate free and restricted pathways for those COVID-19 negative or positive, respectively. Results: During the national lockdown, 30 consecutive patients underwent endothelial ( n = 16), penetrating ( n = 9), and anterior lamellar keratoplasty ( n = 5). Two patients followed the COVID-19 restricted pathway, as they were considered positive while waiting for test results. Nine patients were hospitalized one night in the hospital. On admission to the hospital before surgery, at surgery, the day after surgery and at 7 and 30 days all patients and health-care personnel showed no symptoms and resulted negative at risks factors/exposure to the SARS-CoV-2 infection and occurrence of COVID-19. Nucleic acid testing resulted not detectable in all patients and SARS-CoV-2 antibodies quantification showed IgG and IgM below the positive predicted value in 29 patients. One patient showed IgM above the cut-off of significance (1.21 and 1.03 preoperative and 1-month postoperative, respectively) that were considered irrelevant because of the absence of symptoms and exposure risks. Conclusions: The concept of donor emergency (i.e. short-term availability of transplant tissues), makes corneal transplantation an always-urgent activity because it is related to the availability of the corneal tissue from a donor. Modest adjustments to ophthalmic clinic and eye surgery organization are required to maintain surgery and care of eye patients in a safe environment.

Trends in the distribution of donor corneal tissue and indications for corneal transplantation: the New Zealand National Eye Bank Study 2000-2009

2011 ◽  
Vol 40 (2) ◽  
pp. 141-147 ◽  
Author(s):  
William J Cunningham ◽  
Nigel H Brookes ◽  
Helen C Twohill ◽  
S Louise Moffatt ◽  
David GC Pendergrast ◽  
...  
Keyword(s):  
New Zealand ◽  
Corneal Transplantation ◽  
Corneal Tissue ◽  
Eye Bank

scholarly journals Prospects and Challenges of Translational Corneal Bioprinting

2020 ◽  
Vol 7 (3) ◽  
pp. 71 ◽  
Author(s):  
Matthias Fuest ◽  
Gary Hin-Fai Yam ◽  
Jodhbir S. Mehta ◽  
Daniela F. Duarte Campos
Keyword(s):  
Tissue Engineering ◽  
Ex Vivo ◽  
Corneal Transplantation ◽  
Human Cornea ◽  
Corneal Tissue ◽  
Full Thickness ◽  
Future Directions ◽  
Spatial Control

Corneal transplantation remains the ultimate treatment option for advanced stromal and endothelial disorders. Corneal tissue engineering has gained increasing interest in recent years, as it can bypass many complications of conventional corneal transplantation. The human cornea is an ideal organ for tissue engineering, as it is avascular and immune-privileged. Mimicking the complex mechanical properties, the surface curvature, and stromal cytoarchitecure of the in vivo corneal tissue remains a great challenge for tissue engineering approaches. For this reason, automated biofabrication strategies, such as bioprinting, may offer additional spatial control during the manufacturing process to generate full-thickness cell-laden 3D corneal constructs. In this review, we discuss recent advances in bioprinting and biomaterials used for in vitro and ex vivo corneal tissue engineering, corneal cell-biomaterial interactions after bioprinting, and future directions of corneal bioprinting aiming at engineering a full-thickness human cornea in the lab.

scholarly journals Conjunctival flap revisited: is it only a temporary solution for difficult corneal diseases?

1970 ◽  
Vol 10 (1) ◽  
pp. 40-45
Author(s):  
MK Sharma ◽  
K Dhakwa ◽  
SKC Rai ◽  
I Kanskai ◽  
AM Bhari ◽  
...  
Keyword(s):  
Herpes Simplex ◽  
Corneal Transplantation ◽  
Complete Healing ◽  
Lamellar Keratoplasty ◽  
Bullous Keratopathy ◽  
Corneal Tissue ◽  
Corneal Ulcers ◽  
Conjunctival Flap ◽  
Neurotrophic Keratitis ◽  
Herpes Simplex Keratitis

Background: The conjunctival flap technique, first described by Gundersen in 1958 has not undergone any major modifications since then, except for some variations depending upon pathology and surgeons’ preferences. Objective: To show the importance of conjunctival (Gundersen) flap in different corneal diseases where keratoplasty is not possible immediately. Methods: Out of total 113 non-healing corneal ulcers of different etiologies, nine patients had undergone total conjunctival flap and the rest of the patients had partial conjunctival flap. Out of 104 partial flaps, 31 patients had bipedicle flap and 73 patients had pedicle conjunctival flap. Diagnoses for Gundersen flap surgery included chronic Non-healing infective keratitis with and without impending perforation(93) (fungal -30, no organisms on culture-42 and bacterial- 21), Neurotrophic keratitis(4),Herpes simplex keratitis(9),Bullous keratopathy(2),Infected nonhealing graft(2),presumed infective perforated keratitis(3)(anterior chamber formed after pad and bandage). Results: Eight flaps retracted due to ulcer necrosis out of which seven cases got perforated with complete healing of ulcer. One case had to be eviscerated due to panophthalmitis. One hundred five cases got cured. Conclusion: Conjunctival flap is the urgent and most reliable remedy (temporary or even permanent in some pathologies) for chronic nonresolving infective and presumed infective keratitis with or without impending perforation, neurotrophic keratitis, chronic herpes simplex keratitis, bullous keratopathy and persistent nonhealing epithelial defects where there are no immediate facilities for corneal transplantation. Conjunctival flap should be familiarized and emphasized as a primary and complementary surgical solution where penetrating keratoplasty or lamellar keratoplasty can’t be immediately performed due to lack of corneal tissue. DOI: http://dx.doi.org/10.3126/hren.v10i1.6006 HREN 2012; 10(1): 40-45

scholarly journals Microsporidial stromal keratitis: an uncommon etiology of bilateral simultaneous corneal infection

2020 ◽  
Vol 17 (3) ◽  
pp. 311-317
Author(s):  
Pragnya R. Donthineni ◽  
Somasheila I. Murthy ◽  
Joveeta Joseph ◽  
Prashant Garg ◽  
Manisha Acharya ◽  
...  
Keyword(s):  
Medical Therapy ◽  
Corneal Transplantation ◽  
Predisposing Factors ◽  
Unusual Presentation ◽  
Corneal Tissue ◽  
Corneal Infection ◽  
Stromal Keratitis ◽  
Corneal Infiltrates ◽  
Possible Cause ◽  
Culture Negative

We report three cases of bilateral microsporidial keratitis, which is an unusual presentation. All three patients presented with bilateral, simultaneous, asymmetrical, deep stromal corneal infiltrates with symptoms ranging from 5 to 12 months. Predisposing factors were noted in two of three patients. Corneal scrapings for microbiology and histopathology of corneal tissue revealed microsporidial spores from both eyes of all patients. There was no response to medical therapy and all underwent bilateral corneal transplantation. Case one additionally had recurrences in the graft and underwent repeat keratoplasties and eventually keratoprosthesis. Microsporidial stromal keratitis is a possible cause of keratitis in cases of very long-standing, indolent, culture-negative, deep stromal corneal infiltrates. So far, this infection has been reported as unilateral; however, we report these cases of bilateral infection, which is rare. Corneal transplantation is the preferred line of management due to lack of response to medical therapy.

scholarly journals Latest Developments in Corneal Surgery

2018 ◽  
Vol 12 (1) ◽  
pp. 17
Author(s):  
Leopoldo Spadea ◽  
Keyword(s):  
Severe Disease ◽  
Corneal Transplantation ◽  
Standard Of Care ◽  
Corneal Tissue ◽  
Conservative Approach ◽  
Corneal Surgery ◽  
Covalent Bonds ◽  
Expert Interview ◽  
University Of Rome ◽  
The University

Keratoconus is a disease characterised by progressive thinning, bulging and distortion of the cornea. Corneal transplantation (keratoplasty), is the standard of care for severe disease, but is associated with risks such as rejection of the transplanted cornea. Collagen cross-linking (CXL) is a relatively new conservative approach to strengthen corneal tissue by reforming new covalent bonds. In an expert interview, Leopoldo Spadea of the University of Rome, Italy, discusses recent advances in keratoplasty and CXL.

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