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181. 3D Functional Corneal Stromal Tissue Equivalent Based on Corneal Stromal Stem Cells and Multi-Layered Silk Film Architecture. Full Text available with Trip Pro

3D Functional Corneal Stromal Tissue Equivalent Based on Corneal Stromal Stem Cells and Multi-Layered Silk Film Architecture. The worldwide need for human cornea equivalents continues to grow. Few clinical options are limited to allogenic and synthetic material replacements. We hypothesized that tissue engineered human cornea systems based on mechanically robust, patterned, porous, thin, optically clear silk protein films, in combination with human corneal stromal stem cells (hCSSCs), would (...) generate 3D functional corneal stroma tissue equivalents, in comparison to previously developed 2D approaches. Silk film contact guidance was used to control the alignment and distribution of hCSSCs on RGD-treated single porous silk films, which were then stacked in an orthogonally, multi-layered architecture and cultured for 9 weeks. These systems were compared similar systems generated with human corneal fibroblasts (hCFs). Both cell types were viable and preferentially aligned along the biomaterial

2017 PLoS ONE

182. Calculations of actual corneal astigmatism using total corneal refractive power before and after myopic keratorefractive surgery. Full Text available with Trip Pro

Calculations of actual corneal astigmatism using total corneal refractive power before and after myopic keratorefractive surgery. To calculate actual corneal astigmatism using the total corneal refractive astigmatism for the 4-mm apex zone of the Pentacam (TCRP4astig) and keratometric astigmatism (Kastig) before and after photorefractive keratectomy or laser in situ keratomileusis.Uncomplicated 56 eyes after more than 6 months from the surgery were recruited by chart review. Various corneal (...) ) and Kastig was strongly correlated with the difference between TCRP4astig and Kastig. TCRP4astig was different from Kastig in magnitude rather than meridian before and after surgery; the preoperative difference was due to the posterior cornea only; however, the postoperative difference was observed in both anterior and posterior parts. For arithmetic adjustment, 0.28 D and 0.27 D were subtracted from the preoperative and postoperative magnitudes of Kastig, respectively. For coefficient adjustment

2017 PLoS ONE

183. Corneal Nerve Fractal Dimension: A Novel Corneal Nerve Metric for the Diagnosis of Diabetic Sensorimotor Polyneuropathy. Full Text available with Trip Pro

Corneal Nerve Fractal Dimension: A Novel Corneal Nerve Metric for the Diagnosis of Diabetic Sensorimotor Polyneuropathy. Corneal confocal microscopy (CCM), an in vivo ophthalmic imaging modality, is a noninvasive and objective imaging biomarker for identifying small nerve fiber damage. We have evaluated the diagnostic performance of previously established CCM parameters to a novel automated measure of corneal nerve complexity called the corneal nerve fiber fractal dimension (ACNFrD).A total (...) of 176 subjects (84 controls and 92 patients with type 1 diabetes) with and without diabetic sensorimotor polyneuropathy (DSPN) underwent CCM. Fractal dimension analysis was performed on CCM images using purpose-built corneal nerve analysis software, and compared with previously established manual and automated corneal nerve fiber measurements.Manual and automated subbasal corneal nerve fiber density (CNFD) (P < 0.0001), length (CNFL) (P < 0.0001), branch density (CNBD) (P < 0.05), and ACNFrD (P

2018 Investigative Ophthalmology & Visual Science

184. Changes in Corneal Biomechanical Properties With Different Corneal Cross-linking Irradiances. (Abstract)

Changes in Corneal Biomechanical Properties With Different Corneal Cross-linking Irradiances. To evaluate whether different corneal cross-linking (CXL) irradiances, all with the same delivered total energy, achieve similar increases in corneal material stiffness.One hundred twenty-six healthy white Japanese rabbits were randomly divided into seven groups (n = 18 each). After removing the epithelium of the left corneas, six groups were exposed to riboflavin (0.22% concentration by volume (...) ) and ultraviolet-A (370 nm) at different CXL irradiations, all with the same total dose (5.4 J/cm2), ranging from 3 mW/cm2 for 30 minutes to 90 mW/cm2 for 1 minute. The left corneas of the seventh group were exposed to riboflavin without irradiation. Twelve corneas of each group were prepared for inflation testing, where they were subjected to internal hydrostatic pressure simulating intraocular pressure, whereas the other six specimens were processed for electron microscopy measurements of fibril diameter

2018 Journal of Refractive Surgery

185. Pathophysiology of Corneal Scarring in Persistent Epithelial Defects After PRK and Other Corneal Injuries. Full Text available with Trip Pro

Pathophysiology of Corneal Scarring in Persistent Epithelial Defects After PRK and Other Corneal Injuries. To analyze corneal persistent epithelial defects that occurred at 3 to 4 weeks after -4.50 diopter (D) photorefractive keratectomy (PRK) in rabbits and apply this pathophysiology to the treatment of persistent epithelial defects that occur after any corneal manipulations or diseases.Two of 168 corneas that had -4.50 D PRK to study epithelial basement membrane regeneration developed (...) or for up to 0.3 mm behind the leading edge of the epithelium, although epithelial basement membrane had normally regenerated in other areas of the zone ablated by an excimer laser where the epithelium healed promptly.A persistent epithelial defect in the cornea results in the development of myofibroblasts and disordered extracellular matrix produced by these cells that together cause opacity within, and a short distance beyond, the persistent epithelial defect. Clinicians should treat persistent

2018 Journal of Refractive Surgery

186. New intraocular pressure measurement method using reflected pneumatic pressure from cornea deformed by air puff of ring-type nozzle. Full Text available with Trip Pro

New intraocular pressure measurement method using reflected pneumatic pressure from cornea deformed by air puff of ring-type nozzle. In this study, a non-contact type intraocular pressure (IOP) measuring system using reflected pneumatic pressure is proposed to overcome the disadvantages of existing measurement systems. A ring-type nozzle, a key component in the proposed system, is designed via computational fluid analysis. It predicts the reflected pneumatic pressure based on the nozzle exit (...) the measurement distance is short and eye pressure is low. The cornea of an artificial eye is significantly deformed at a low IOP, and the applied pneumatic pressure is more concentrated in front of the ring-type nozzle because of the deformed cornea. Thus, the reflected pneumatic pressure at a low IOP has more inflows into the pressure sensor inserted inside the nozzle. The sensitivity of the output based on the IOP at measurement distances between 3-5 mm is -0.0027, -0.0022, -0.0018, -0.0015, and -0.0012

2017 PLoS ONE

187. Effect of UVA/Riboflavin Collagen Crosslinking on Biomechanics of Artificially Swollen Corneas. Full Text available with Trip Pro

Effect of UVA/Riboflavin Collagen Crosslinking on Biomechanics of Artificially Swollen Corneas. The purpose of this study was to characterize the relation between corneal hydration and stiffening effects of the UVA/riboflavin collagen crosslinking treatment and to investigate how artificially swelling the cornea prior to this treatment procedure affects tensile property improvement.Porcine corneas were collagen crosslinked in vitro at different hydration levels using a number of hypoosmolar (...) (hydration) prior to collagen crosslinking treatment.Collagen crosslinking with either a hypoosmolar or isoosmolar solution significantly increased corneal tensile modulus (P < 0.05). Corneas that were swollen prior to crosslinking showed significantly softer tensile properties compared with those that were crosslinked at lower hydration (P < 0.05). Although the degree of tensile property improvement was hydration dependent, the stiffness of samples crosslinked at higher hydration was not significantly

2018 Investigative Ophthalmology & Visual Science

188. Easy xeno-free and feeder-free method for isolating and growing limbal stromal and epithelial stem cells of the human cornea. Full Text available with Trip Pro

Easy xeno-free and feeder-free method for isolating and growing limbal stromal and epithelial stem cells of the human cornea. Epithelial and stromal stem cells are required to maintain corneal transparency. The aim of the study was to develop a new method to isolate and grow both corneal stromal (SSC) and epithelial limbal (LSC) stem cells from small human limbal biopsies under culture conditions in accordance with safety requirements mandatory for clinical use in humans. Superficial limbal

2017 PLoS ONE

189. Corneal transplant follow-up study II (CTFS II): a prospective clinical trial to determine the influence of HLA class II matching on corneal transplant rejection: baseline donor and recipient characteristics. Full Text available with Trip Pro

Corneal transplant follow-up study II (CTFS II): a prospective clinical trial to determine the influence of HLA class II matching on corneal transplant rejection: baseline donor and recipient characteristics. To describe a study to determine the influence of HLA class II matching on allograft rejection of high-risk, full-thickness corneal transplants.A prospective, longitudinal, clinical trial (ISRCTN25094892) with a primary outcome measure of time to first clinically determined rejection (...) episode. Tissue typing used DNA-based techniques. Corneas were allocated to patients with ≤2 human leucocyte antigen (HLA) class I antigen mismatches by cohort minimisation to achieve 0, 1 or 2 HLA class II (HLA-DR) antigen mismatches. Transplants were to be followed up at 6 months and then annually on the anniversary of surgery for 5 years. Power calculations estimated a sample size of 856 transplants to detect a 0.1 difference in probability of rejection at 1 year between HLA class II matched

2018 British Journal of Ophthalmology

190. Corneal Neurotization Improves Ocular Surface Health in a Novel Rat Model of Neurotrophic Keratopathy and Corneal Neurotization. Full Text available with Trip Pro

Corneal Neurotization Improves Ocular Surface Health in a Novel Rat Model of Neurotrophic Keratopathy and Corneal Neurotization. Corneal neurotization is a novel surgical procedure to reinnervate the cornea in patients with neurotrophic keratopathy (NK). We developed a rat model of NK and corneal neurotization to further investigate corneal neurotization as a treatment to improve maintenance and healing of the corneal epithelium.Thy1-GFP+ Sprague Dawley rats were used to develop the model (...) . Corneal denervation was performed via stereotactic electrocautery of the ophthalmomaxillary branch of the trigeminal nerve. Corneal neurotization was performed by guiding donor sensory axons from the contralateral infraorbital nerve into the cornea via two nerve grafts. Corneal imaging, including nerve density measurements and retrograde labeling were performed to validate the model. In vivo assays of corneal maintenance and repair were used to examine whether treatment with corneal neurotization

2018 Investigative Ophthalmology & Visual Science

191. Effect of dexamethasone intravitreal implant (Ozurdex®) on corneal endothelium in retinal vein occlusion patients : Corneal endothelium after dexamethasone implant injection. Full Text available with Trip Pro

Effect of dexamethasone intravitreal implant (Ozurdex®) on corneal endothelium in retinal vein occlusion patients : Corneal endothelium after dexamethasone implant injection. To assess corneal endothelial cell changes after intravitreal dexamethasone (DEX) implant (Ozurdex®) injection in patients with macular edema secondary to retinal vein occlusion (RVO).Twenty-two eyes of 22 patients were assessed prospectively after intravitreal 0.7 mg DEX implant injection. Twenty-two eyes of 22 healthy (...) volunteers served as control group. Corneal endothelial cell parameters including endothelial cell density (ECD), coefficient of variation of cell size (CV), percentage of hexagonality (Hex) and central corneal thickness (CCT) were analyzed before and 1 and 3 months after injection by specular microscopy. The results of the study were compared statistically.There were 17 (77.3%) patients with branch RVO and 5 (22.7%) patients with central RVO. Mean intraocular pressure (IOP) was 14.73 mmHg before

2018 BMC Ophthalmology

192. TSLP Protects Corneas From Pseudomonas aeruginosa Infection by Regulating Dendritic Cells and IL-23-IL-17 Pathway. Full Text available with Trip Pro

TSLP Protects Corneas From Pseudomonas aeruginosa Infection by Regulating Dendritic Cells and IL-23-IL-17 Pathway. We sought to determine the role of epithelium-produced thymic stromal lymphopoietin (TSLP) and its underlying mechanisms in corneal innate immune defense against Pseudomonas (P.) aeruginosa keratitis.The expression of TSLP and TSLPR in cultured human corneal epithelial cells (HCECs) and mouse corneas was determined by PCR, Western, and/or ELISA. Cellular localization of TSLP (...) receptor (TSLPR) was determined by whole mount confocal microscopy. TSLP-TSLPR signaling was downregulated by neutralizing antibodies and/or small interfering (si)RNA; their effects on the severity of P. aeruginosa-keratitis and cytokine expression were assessed using clinical scoring, bacterial counting, PMN infiltration, and real-time PCR. The role of dendritic cells (DCs) in corneal innate immunity was determined by local DC depletion using CD11c-DTR mice.P. aeruginosa-infection induced

2018 Investigative Ophthalmology & Visual Science

193. Optimization of femtosecond lasers using porcine and human donor corneas before in vivo use. (Abstract)

Optimization of femtosecond lasers using porcine and human donor corneas before in vivo use. To demonstrate a safe and effective method of optimizing a femtosecond laser upon installation or for a new procedure before use on patients. In this case, specifically for optimizing settings for intrastromal corneal pocket creation for the presbyopic small-aperture corneal inlay (Kamra) and deep laser in situ keratomileusis (LASIK) flaps for the presbyopic hydrogel corneal inlay (Raindrop).Keil LASIK (...) pockets for the small-aperture corneal inlay. Further adjustment of settings to 14.0 mm/s pocket at 110% energy was still necessary to optimize pockets. No change in settings was necessary when creating deeper corneal LASIK flaps (ie, the same settings could be used for flaps of 110 μm or 180 μm).After settings were optimized for porcine corneas, further optimization was necessary before successful corneal incisions could be created in vivo for corneal pockets. No further optimization was required

2018 Journal of cataract and refractive surgery

194. Visualization of corneal vascularization in peripheral hypertrophic subepithelial corneal opacification with OCT angiography. Full Text available with Trip Pro

Visualization of corneal vascularization in peripheral hypertrophic subepithelial corneal opacification with OCT angiography. The major goal of this study was to test the hypothesis that in patients with peripheral hypertrophic subepithelial corneal opacification (PHSCO), visualization of corneal vessels is better with optical coherence tomography angiography (OCTA) than with conventional slit lamp microphotography.Patients with PHSCO were included in this prospective study. The corneal (...) coherence tomography angiography allows better visualization of corneal neovascularization than slit lamp photography in patients with PHSCO. Corneal opacifications were found predominantly nasally, which was reflected by a local enlargement of corneal thickness.© 2018 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

2018 Acta ophthalmologica

195. UV-light crosslinking regresses mature corneal blood and lymphatic vessels and promotes subsequent high-risk corneal transplant survival. Full Text available with Trip Pro

UV-light crosslinking regresses mature corneal blood and lymphatic vessels and promotes subsequent high-risk corneal transplant survival. Immunologic graft rejection is the main complication after corneal transplant into pathologically prevascularized so-called high-risk eyes. The aim of this study was to evaluate whether ultraviolet (UV) light crosslinking can regress pathologic corneal blood and lymphatic vessels and thereby improve subsequent graft survival. Using the murine model of suture (...) -induced corneal neovascularization, we found that corneal crosslinking with UVA light and riboflavin regressed both preexisting blood and lymphatic vessels significantly via induction of apoptosis in vascular endothelial cells. In addition, macrophages and CD45+ cell counts were significantly reduced. Consistently, corneal crosslinking reduced keratocyte density and corneal thickness without affecting corneal nonvascular endothelial cells, iris, and lens depending on the crosslinking duration

2018 American Journal of Transplantation

196. Biological Lenticule Implantation for Correction of Hyperopia: An Ex Vivo Study in Human Corneas. Full Text available with Trip Pro

Biological Lenticule Implantation for Correction of Hyperopia: An Ex Vivo Study in Human Corneas. To evaluate changes in corneal tomography after stromal lenticule implantation ex vivo, with respect to the dependency of the lenticule thickness and implantation depth on the corneal curvature and the postoperative biomechanical strength at increased chamber pressure.Twenty-eight human donor corneas underwent pocket implantation of refractive stromal lenticules. Four groups were created (...) by the combination of two implantation depths (110 and 160 µm) and two lenticule thicknesses (95 µm = 4.00 diopters [D], 150 µm = 8.00 D). Sagittal keratometry and total corneal refractive power (TCRP4mm,apex,zone) were obtained for the front and back curvature with Pentacam HR (Oculus Optikgeräte GmbH, Wetzlar, Germany) at chamber pressures of 15 and 40 mm Hg.The anterior curvature steepening was comparable between the 4.00 D and 8.00 D groups (P > .141), but more pronounced with 110 µm implantation depth (P

2018 Journal of Refractive Surgery

197. Effects of whole globe enucleation versus in situ corneoscleral excision on donor cornea tissue quality: a systematic review protocol

Effects of whole globe enucleation versus in situ corneoscleral excision on donor cornea tissue quality: a systematic review protocol Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record

2020 PROSPERO

198. Two-year follow-up of corneal cross-linking and refractive surface ablation in patients with asymmetric corneal topography. (Abstract)

groups in spherical aberration and coma after adjustment for multiple comparisons.Non-simultaneous CXL followed by PRK may be performed safely, and refractive results over a 2-year follow-up are highly similar in virgin and previously cross-linked corneas. Despite using mitomycin C, corneal haze can be significantly higher in the first year after PRK in eyes pretreated with CXL.© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2019. All rights reserved (...) Two-year follow-up of corneal cross-linking and refractive surface ablation in patients with asymmetric corneal topography. To evaluate the safety and efficacy of corneal cross-linking (CXL) followed by photorefractive keratectomy (PRK) for refractive correction in patients with bilateral asymmetric topography.Forty-four patients (88 eyes) were enrolled in this prospective randomised clinical trial. CXL with subsequent PRK after 6 months was performed in one eye (study group), and PRK alone

2018 British Journal of Ophthalmology Controlled trial quality: uncertain

199. Keratan Sulfate Phenotype in the β-1,3-N-Acetylglucosaminyltransferase-7-Null Mouse Cornea. Full Text available with Trip Pro

Keratan Sulfate Phenotype in the β-1,3-N-Acetylglucosaminyltransferase-7-Null Mouse Cornea. Synthesis of keratan sulfate (KS) relies on coordinated action of multiple enzymes, including the N-acetylglucosamine-transferring enzyme, β-1,3-N-acetylglucosaminyltransferase-7 (β3GnT7). A mouse model deficient in β3GnT7 was developed to explore structural changes in KS and the extracellular matrix (ECM; i.e., the corneal stroma), elucidate the KS biosynthesis mechanism, and understand its role (...) in corneal organization.A knockout vector for the β3GnT7-encoding gene, B3gnt7, was created to develop heterozygous- (htz) and homozygous-null (null) knockouts. Epithelial, stromal, and whole cornea thicknesses were measured from each group. Proteoglycans were stained with cupromeronic blue for visualization by electron microscopy, and Western blot analyses were conducted on the KS core protein, lumican. Corneal sections were labelled fluorescently for KS and chondroitin sulfate/dermatan sulfate (CS/DS

2018 Investigative Ophthalmology & Visual Science

200. Inhibition of Soluble Epoxide Hydrolase 2 Ameliorates Diabetic Keratopathy and Impaired Wound Healing in Mouse Corneas. Full Text available with Trip Pro

Inhibition of Soluble Epoxide Hydrolase 2 Ameliorates Diabetic Keratopathy and Impaired Wound Healing in Mouse Corneas. EPHX2 (encoding soluble epoxide hydrolase [sEH]) converts biologically active epoxyeicosatrienoic acids (EETs), anti-inflammatory and profibrinolytic effectors, into the less biologically active metabolites, dihydroxyeicostrienoic acids. We sought to characterize the expression and the function of EPHX2 in diabetic corneas and during wound healing. The expression of EPHX2 (...) at both mRNA and protein levels, as well as sEH enzymatic activity, was markedly upregulated in the tissues/cells, including corneal epithelial cells as well as the retina of human type 2 and mouse type 1 (streptozotocin [STZ] induced) and/or type 2 diabetes. Ephx2 depletion had no detectable effects on STZ-induced hyperglycemia but prevented the development of tear deficiency. Ephx2-/- mice showed an acceleration of hyperglycemia-delayed epithelium wound healing. Moreover, inhibition of sEH increased

2018 Diabetes

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