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Feature developments in artificial corneal devices: a review.

Corneal disease ranks as the fifth leading cause of global blindness, affecting more than 10 million individuals. Donor corneal transplantation, keratoplasty, remains the mainstay of addressing loss of corneal clarity. Historically, full-thickness penetrating keratoplasty (PK) has been one of the most successful and widely performed transplant procedures, although predominantly available in developed countries. The landscape for corneal transplantation has changed dramatically over the last two decades with the emergence of partial-thickness transplantation techniques and corneal cross-linking

Prevalence and Severity of Corneal Guttata After Descemet Membrane Endothelial Keratoplasty.

PURPOSE: The postoperative occurrence of corneal guttae (CG) in patients after Descemet membrane endothelial keratoplasty (DMEK) can lead to a significant reduction in visual acuity (VA) with the subsequent need for repeat DMEK. Therefore, the aim of this study was to analyze the prevalence and clinical significance of CG in transplanted corneas after DMEK. METHODS: The prevalence and progression of CG after DMEK of 1657 patients were examined using endothelial specular microscopy images. The severity grade of CG was classified into 3 grades (G1 <40%, G2 40-80%, G3 >80%). Central corneal thic

Expression Profiling of ADAMTS (L) Superfamily of Genes in Various Human Eye Tissues.

BACKGROUND: A disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS) is a superfamily of extracellular proteinases found in both mammals and invertebrates. Although there is some evidence about the role of ADAMTSs in ocular diseases such as glaucoma and ectopia lentis, but there is little information about the expression patterns of ADAMTS-1-20 and ADAMTS-like (ADAMTSL-1-6 and PAPLN) genes in human ocular tissues. This study aimed to evaluate the expression profiling of ADAMTS(L) superfamily of genes in different ocular tissues based on age. METHODS: In 2019, nine human donated

Mendelian Randomization Implicates Bidirectional Association between Myopia and Primary Open-Angle Glaucoma or Intraocular Pressure.

PURPOSE: Observational studies suggest that myopic eyes carry a greater risk of primary open-angle glaucoma (POAG); however, the evidence for this association is inconsistent. This may be the result of confounding factors that arise from myopia that complicate clinical tests for glaucoma. This study used Mendelian randomization (MR) analysis to determine genetic causal associations among myopia, glaucoma, and glaucoma-related traits that overcome the effects of external confounders. DESIGN: Bidirectional genetic associations between myopia and refractive spherical equivalent (RSE), POAG, and

Comparative activity of antimicrobials against Pseudomonas aeruginosa, Achromobacter xylosoxidans and Stenotrophomonas maltophilia keratitis isolates.

BACKGROUND/AIMS: Achromobacter xylosoxidans and Stenotrophomonas maltophilia are emerging corneal pathogens, which are closely related to Pseudomonas aeruginosa, and have intrinsic resistance to many commonly available antimicrobials. The purpose of this study is to compare the in vitro efficacy of 12 antimicrobial agents against A. xylosoxidans, S. maltophilia and P. aeruginosa isolates recovered from clinical cases of keratitis. METHODS: Recovered corneal isolates (n=58) were identified and extracted from the Microbiology Data Bank of the Bascom Palmer Eye Institute. Comparative in vitro mi

Effect of collagen cross-linking in stromal fibril organization in edematous human corneas.

PURPOSE: To assess structural stromal modifications after riboflavin and UV-A exposure in edematous human corneas. METHOD: Fourteen eyes with corneal edema were enrolled in the study. In the cross-linking (CXL) group, 7 corneal buttons were obtained from 6 patients who underwent penetrating keratoplasty (PK) 7-90 days after the CXL treatment. The control group was composed of 7 corneal buttons with bullous keratopathy. After the PK, stromal modifications were investigated using immunofluorescence in all corneal grafts. All patients had at least 3 months of corneal edema and were in the eye ba

Infectious keratitis after photorefractive keratectomy in the United States army and navy.

PURPOSE: To review the incidence, culture results, clinical course, management, and visual outcomes of infectious keratitis after photorefractive keratectomy (PRK) at 6 Army and Navy refractive surgery centers. DESIGN: Retrospective study. PARTICIPANTS: Twelve thousand six hundred sixty-eight Navy and Army sailors and service members. METHODS: Army and Navy refractive surgery data banks were searched for cases of infectious keratitis. A retrospective chart review and query of the surgeons involved in the care of those patients thus identified provided data regarding preoperative preparation

Positive donor rim culture in penetrating keratoplasty.

A 3-year retrospective study on the risk factors of positive donor rim cultures in penetrating keratoplasty was performed. One thousand and ninety-seven consecutive donor rim cultures were reviewed from the period between June 1990 and October 1993 to determine the rate of culture positivity. The sex, age, diabetes status, use of respirator at time of death, cause of death, harvesting technique, storage time, and corneal storage medium utilized for the donors with positive donor rim culture were compared to those for 100 randomly selected culture negative donor controls. Logistic analysis was

Oxidative injury to blood vessels and glia of the pre-laminar optic nerve head in human glaucoma.

Glaucoma is a leading cause of irreversible world blindness. Oxidative damage and vascular injury have been implicated in the pathogenesis of this disease. The purpose of this study was to determine in human primary open angle glaucoma whether oxidative injury occurs in pre-laminar optic nerve blood vessels and glial cells. Following IRB approval, sections from post-mortem primary open angle glaucoma eyes (n=5) with mean age of 77 +/- 9 yrs (+/-SD) were compared to normal control eyes (n=4) with mean age 70 +/- 9 yrs (Eye Bank of Canada). Immunostaining with nitrotyrosine, a footprint for pero

Retention of the Pre-Descemet's Layer Reduces Endothelial Graft Scrolling: Digital Morphometric Analysis of Precut Endothelial Grafts.

Purpose: To evaluate the biomechanical impact of the Pre-Descemet's Layer (PDL) on central graft width (CGW) and Scrolling Score (SS) using … analysis represents a reproducible approach for preoperative characterization of graft behavior in eye banks.

Descemet's membrane endothelial keratoplasty: surgical outcomes and endothelial cell count modelling from a UK centre.

PURPOSE: To report surgical outcomes and endothelial cell density (ECD) trends up to 2 years post-operatively in the first cohort of eyes undergoing Descemet's membrane endothelial keratoplasty (DMEK) for low-to-moderate risk indications at our UK centre. Tight corneal sutures were used to ensure high intraoperative pressure from intracameral air for 10-min and to maintain a good post-operative air fill. Outcomes were compared to a prior series at our unit of similar eyes having Descemet's stripping endothelial keratoplasty (DSEK). METHODS: Retrospective, interventional series. Inclusions: al

Historical Review and Update of Surgical Treatment for Corneal Endothelial Diseases.

The cornea remains in a state of deturgescence, maintained by endothelial cell Na+/K+ ATPase and by tight junctions between endothelial cell … the results of a new procedure, Descemet's membrane endothelial keratoplasty (DMEK). Recently, some eye banks have experimented with the preparation of DMEK/Descemet's membrane automated endothelial keratoplasty donor tissue that may help the surgeon avoid the risk of tissue loss during the stromal separation step. Recently, the authors described a new bima …

Multiparametric grading of glaucoma severity by histopathology can enable post-mortem substratification of disease state.

Neurodegeneration in glaucoma patients is clinically identified through longitudinal assessment of structure-function changes, including intraocular pressure, cup-to-disc ratios from fundus images, and optical coherence tomography imaging of the retinal nerve fiber layer. Use of human post-mortem ocular tissue for basic research is rising in the glaucoma field, yet there are challenges in assessing disease stage and severity, since tissue donations with informed consent are often unaccompanied by detailed pre-mortem clinical information. Further, the interpretation of disease severity based so

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… *p < 0.05, **p < 0.01, ***p < 0.001, ****p < 0.0001, One-way Analysis of variance (ANOVA) followed by Tukey’s multiple comparison test Discussion Researchers often use post-mortem eyes obtained from eye banks to identify biomarkers and new therapeutic targets. … It is challenging to obtain donor globes from eye banks with a rich set of longitudinal imaging and functional measurements, at least in the United States, and potentially in other localities. …

Differential expression profiles of MAPT (TAU) gene isoforms in dry age-related macular degeneration.

Age-related macular degeneration (AMD) is a neurodegenerative retinal disorder that typically emerges later in life and is the primary cause of central visual loss. The microtubule-associated protein Tau (MAPT) gene produces six significant splice variants in neural cells, which are differentiated by the exclusion or inclusion of exon 10, resulting in expression of 3R and 4R isoforms. Changes in Tau expression and the ratio of 4R-3R isoforms have been observed in various neurodegenerative diseases; however, the expression of Tau mRNA in AMD remains unexplored. This study represents the first i

Endogenous fluorescence can differentiate the keratoconic cornea.

The purpose of the study was to investigate the endogenous fluorescence of the keratoconic cornea in order to analyze changes in the spectra due to the keratoconic stroma abnormalities. Twenty-two corneal buttons obtained from patients with keratoconus (KC, N = 22) at the time of penetrating keratoplasty were used. As a reference, twelve normal corneas (N = 12): ten from the Eye Bank and two from enucleated eyes due to choroidal melanoma were used. The fluorescence excitation/emission matrices (EEM) in the ranges of 250-400/260-600 nm were recorded. Healthy cornea, keratoconic cornea and scler

Diagnostic efficacy of polymerase chain reaction in granulomatous uveitis.

SETTING: The granulomatous uveitis, multifocal choroiditis and periphlebitis have been suspected to be of tubercular origin but no definitive reports about detection of etiological agents have been documented in the literature. Conventional bacteriological methods are not generally helpful in diagnosing ocular tuberculosis due to difficulty with potential morbidity associated with obtaining the biopsy material from the eye. Thus, the diagnosis of ocular tuberculosis is most often presumptive. OBJECTIVE: We evaluated the role of polymerase chain reaction (PCR) for detection of Mycobacterium tu

Impact of COVID-19 Pandemic on Infectious Keratitis Outcomes: A Retrospective Multicenter Study in Tertiary Eye Hospitals of South India.

PURPOSE: The purpose of this study was to report the adverse effects of the COVID-19 pandemic on the clinical outcomes of infectious keratitis in South India. METHODS: Two hundred fifty-eight patients presented with infectious keratitis at 6 tertiary care centers when strict travel restrictions were in place from March 24 to May 31, 2020. Case records were collected retrospectively and analyzed for demographics, type of initial treatment, length of delay in presentation, microbiological diagnosis, clinical course, and final treatment outcome. RESULTS: The mean age of the patients was 49.2 ye

Utility of a Model to Predict Endothelial Cell Density of Donor Corneas to Determine Suitability for Transplantation.

IMPORTANCE: The geographic distribution of pediatric ophthalmological care has not been reported on since 2007; understanding this distribution could shed light on potential avenues to increase access, which is a necessary first step in addressing the pediatric ophthalmological needs of underserved areas. OBJECTIVE: To analyze the number and location (ie, geographic distribution) of pediatric ophthalmologists in relation to US population demographic characteristics. DESIGN, SETTING, AND PARTICIPANTS: In this cross-sectional study, public databases from the American Academy of Ophthalmology a

Optimizing Corneal Transplant Safety: The Impact of Mandatory Prion Protein Testing on Iatrogenic Creutzfeldt-Jakob Disease Prevention in the Czech Republic.

PURPOSE: The purpose of this study was to assess the effectiveness of legally mandated testing for pathogenic prion proteins in corneal tissue donors in the Czech Republic, considering its impact on safety, financial, and temporal costs. METHODS: Between January 2007 and December 2023, standardized brain regions were collected from all corneal tissue donors in the Czech Republic. Tissue samples were tested for the presence of pathogenic prion proteins by the Czech Reference Laboratory for Human Prion Diseases. The testing used a Western blot analysis, using 2 distinct monoclonal anti-PrP anti

Did Collagen Cross-Linking Reduce the Requirement for Corneal Transplantation in Keratoconus? The Canadian Experience.

PURPOSE: To investigate the relationship between corneal collagen cross-linking (CXL) and the number of corneal transplants required for the treatment of keratoconus (KCN) in 2 major Canadian provinces. METHODS: This is a retrospective review of all corneal transplantation performed in Ontario and British Columbia over an 18-year period (1998-2016). Data were collected at the Eye Bank of Canada-Ontario/British Columbia Divisions. The primary outcome was to determine the change in proportion and absolute number of corneal transplants required for treatment of KCN since the introduction of CXL