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41. Does Pregnancy Affect Refractive and Corneal Stability or Corneal Epithelial Remodeling After Myopic LASIK? (Abstract)

Does Pregnancy Affect Refractive and Corneal Stability or Corneal Epithelial Remodeling After Myopic LASIK? To investigate possible refractive changes in pregnant women who have previously undergone myopic laser in situ keratomileusis (LASIK).This prospective study included 64 pregnant women (128 eyes) who had previously undergone bilateral myopic LASIK. Uncorrected distance visual acuity (UDVA), spherical equivalent, corneal keratometry, topography and tomography, and epithelial mapping were (...) the third trimester of the subsequent pregnancy, the average UDVA was 20/18, the residual refractive error was -0.63 ± 1.00 to -0.51 ± 0.82 D, the steepest keratometry value was 40.85 ± 1.89 to 40.88 ± 2.84 D, and the central epithelial thickness was 56.4 ± 3.89 to 57.38 ± 5.04 µm, respectively.In this study, pregnancy did not affect the refractive stability of LASIK. Pregnancy-related changes in refractive error, corneal stability, and total corneal and epithelial thickness in women after LASIK were

2020 Journal of Refractive Surgery

42. Assessment of Corneal Haze After PRK and the Effect of Sutureless Amniotic Membrane Graft by Corneal Densitometry. (Abstract)

Assessment of Corneal Haze After PRK and the Effect of Sutureless Amniotic Membrane Graft by Corneal Densitometry. To assess whether densitometry analysis appropriately monitors the development of haze in myopic patients after photorefractive keratectomy (PRK) when compared to subjective slit-lamp haze grade examinations, and whether sutureless cryo-preserved amniotic membrane reduced postoperative haze development when compared to the standard bandage contact lens.In this retrospective cohort (...) at the Center for Refractive Surgery, Walter Reed National Military Medical Center, a secondary analysis of prospectively collected data was performed. In the prospective study, participants underwent PRK for myopia. Postoperatively, a standard bandage contact lens was applied to the dominant eye and a sutureless cryo-preserved amniotic membrane graft to the nondominant eye. Participants were evaluated at 1, 3, and 6 months postoperatively for haze formation and corneal densitometry using slit-lamp

2020 Journal of Refractive Surgery

43. Individualized Characterization of the Distribution of Collagen Fibril Dispersion Using Optical Aberrations of the Cornea for Biomechanical Models. Full Text available with Trip Pro

Individualized Characterization of the Distribution of Collagen Fibril Dispersion Using Optical Aberrations of the Cornea for Biomechanical Models. The spatial distribution of collagen fibril dispersion has a significant impact on both corneal biomechanical and optical behaviors. The goal of this study was to demonstrate a novel method to characterize collagen fibril dispersion using intraocular pressure (IOP)-induced changes in corneal optical aberrations for individualized finite-element (FE (...) ) modeling.The method was tested through both numerical simulations and ex vivo experiments. Inflation tests were simulated in FE models with three assumed patterns of collagen fibril dispersion and experimentally on three rhesus monkey corneas. Geometry, matrix stiffness, and the IOP-induced changes in wavefront aberrations were measured, and the collagen fibril dispersion was characterized. An individualized corneal model with customized collagen fibril dispersion was developed, and the estimated optical

2020 Investigative Ophthalmology & Visual Science

44. Diurnal Control of Sensory Axon Growth and Shedding in the Mouse Cornea. Full Text available with Trip Pro

axon density were assessed at these four time points using confocal imaging after staining axons in en face whole mount corneas with antibodies against βIII tubulin, GAP43, and L1CAM. In addition, corneal epithelial cell proliferation, thickness, and desquamation were assessed using ki67, LAMP1, Involucrin, and ZO1.Nerve terminal shedding took place between 5:30 AM and 8:30 AM and correlated positively with the timing of apical cell desquamation. After shedding the tips of the nerve terminals (...) Diurnal Control of Sensory Axon Growth and Shedding in the Mouse Cornea. The circadian clock plays an important role in the expression and regulation of various genes and cellular processes in the body. Here, we study diurnal regulation of the growth and shedding of the sensory axons in the mouse cornea.Male and female BALB/cN mice were euthanized 90 minutes before and after the lights are turned on and off; at 5:30 AM, 8:30 AM, 5:30 PM, and 8:30 PM. Nerve terminal growth, shedding and overall

2020 Investigative Ophthalmology & Visual Science

45. CCR2+ migratory macrophages with M1 status are the early-responders in the cornea of HSV-1 infected mice. Full Text available with Trip Pro

CCR2+ migratory macrophages with M1 status are the early-responders in the cornea of HSV-1 infected mice. Complex interactions between HSV-1 and infiltrating immune cells play important roles in establishing localized, acute virus replication as well as chronic latent infection. The extent and duration of initial virus replication are the key determinants of subsequent pathologic inflammatory responses and therefore, the accumulation of immune cell populations at this time point is a key target (...) for prevention. Therefore, we evaluated the role of various immune cell infiltrates between 1 h and 28 days post-infection (PI) using mice infected with virulent HSV-1 strain McKrae without corneal scarification. The effect of corneal scarification on immune cell infiltrates was also determined. We first determined the activation status and origin of macrophage infiltrates as early as 1 h PI. We found a sharp increase in the total macrophage population after 12 h PI, that was primarily due to infiltration

2019 PLoS ONE

46. Glycerine assisted vitreoretinal surgery in edematous cornea. (Abstract)

Glycerine assisted vitreoretinal surgery in edematous cornea. To describe the use of glycerine in improving media clarity in cases with edematous cornea.Retrospective case-series including patients with posterior segment pathologies needing surgical invention and having corneal edema. Each case was studied for the role of topical application of glycerine instead of viscoelastic agents and the course of surgery. The cases were followed up for minimum 3-months duration.Six cases with corneal (...) edema having posterior segment pathology underwent surgery with intraoperative topical application of glycerine. The corneal edema was seen to clear with progression of surgery and was maintained until the end of surgery. Procedures like vitreoretinal surgery, identification of break, internal limiting membrane peeling, intraocular lens explantation, scleral indentation, DSEK graft removal, and subretinal band removal could be performed in these cases.Intraoperative glycerine use during

2020 Retina

47. Pathogenic Role of PPARα Downregulation in Corneal Nerve Degeneration and Impaired Corneal Sensitivity in Diabetes. Full Text available with Trip Pro

and Western blotting, PPARα was downregulated in the corneas of humans with diabetes and diabetic rats. Immunostaining of β-III tubulin demonstrated that corneal nerve fiber metrics were decreased significantly in diabetic rats and mice, which were partially prevented by fenofibrate treatment. As evaluated using a Cochet-Bonnet aesthesiometer, corneal sensitivity was significantly decreased in diabetic mice, which was prevented by fenofibrate. PPARα-/- mice displayed progressive decreases in the corneal (...) nerve fiber density. Consistently, corneal sensitivity was decreased in PPARα-/- mice relative to wild-type mice by 21 months of age. Diabetic mice showed increased incidence of spontaneous corneal epithelial lesion, which was prevented by fenofibrate while exacerbated by PPARα knockout. Western blot analysis revealed significantly altered neurotrophic factor levels in diabetic rat corneas, which were partially restored by fenofibrate treatment. These results indicate that PPARα protects the corneal

2020 Diabetes

48. Role of VIP and Sonic Hedgehog Signaling Pathways in Mediating Epithelial Wound Healing, Sensory Nerve Regeneration, and Their Defects in Diabetic Corneas. (Abstract)

Role of VIP and Sonic Hedgehog Signaling Pathways in Mediating Epithelial Wound Healing, Sensory Nerve Regeneration, and Their Defects in Diabetic Corneas. Diabetic keratopathy, a sight-threatening corneal disease, comprises several symptomatic conditions including delayed epithelial wound healing, recurrent erosions, and sensory nerve (SN) neuropathy. We investigated the role of neuropeptides in mediating corneal wound healing, including epithelial wound closure and SN regeneration (...) . Denervation by resiniferatoxin severely impaired corneal wound healing and markedly upregulated proinflammatory gene expression. Exogenous neuropeptides calcitonin gene-related peptide (CGRP), substance P (SP), and vasoactive intestinal peptide (VIP) partially reversed resiniferatoxin's effects, with VIP specifically inducing interleukin-10 expression. Hence, we focused on VIP and observed that wounding induced VIP and VIP type 1 receptor (VIPR1) expression in normal (NL) corneas, but not corneas from

2020 Diabetes

49. Customised toric intraocular lens implantation in cornea plana. (Abstract)

Customised toric intraocular lens implantation in cornea plana. A 50-year-old woman with cornea plana had reduced visual acuity due to development of lenticular changes. Flat keratometry with high astigmatism, shallow anterior chamber depth and short axial length made it challenging both for intraocular lens (IOL) power calculation and cataract surgery. Surgery was planned for the right eye, as the left eye was densely amblyopic. IOL power required was beyond the commercially available lenses (...) , hence a customised toric IOL was obtained. Phacoemulsification was successfully performed along with-in-the bag implantation of the toric IOL, which resulted in improved visual acuity with satisfactory refractive outcome. Cataract surgery with a customised IOL improved visual acuity in an eye with cornea plana.

2020 Journal of cataract and refractive surgery

50. Corneal higher-order aberrations after crosslinking and intrastromal corneal ring segments for keratoconus. Full Text available with Trip Pro

Corneal higher-order aberrations after crosslinking and intrastromal corneal ring segments for keratoconus. To assess anterior corneal higher-order aberrations (HOAs) after corneal crosslinking (CXL) and intrastromal corneal ring segments (Intacs) used adjunctively.Cornea and refractive surgery practice.Prospective, randomized clinical trial.One hundred fifty-eight eyes of 150 patients were randomized into 2 groups: concurrent, Intacs and CXL during the same session (n = 81), or sequential (...) , Intacs followed by CXL 3 months later (n = 77). Outcomes included changes in total, coma, trefoil, and spherical anterior corneal HOA 6 months after Intacs/CXL. The change in anterior corneal HOAs was correlated with the change in uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and topography indices of maximum keratometry (Kmax), maximum flattening keratometry (Kmaxflat), and inferior-superior (I-S) ratio. A subjective visual function questionnaire was also

2020 Journal of cataract and refractive surgery

51. Factors predicting successful customized excimer laser treatment in irregular corneas. Full Text available with Trip Pro

Factors predicting successful customized excimer laser treatment in irregular corneas. To identify factors associated with a successful wavefront-guided customized treatment (WG-CT) with an excimer laser in highly aberrated corneas.VISSUM Alicante Spain.Retrospective consecutive noncomparative case series.Treatment was performed with the WG-CT Amaris excimer laser using the ORK-CAM software for the calculation of the ablation profile. Eyes of patients with significantly aberrated corneas (...) = .001). In multivariate analysis, posthyperopic treatment eyes were less likely to achieve refractive outcome success (odds ratio = 0.09, P = .02).WG-CT in highly aberrated corneas had a limited refractive predictability. Eyes with preoperative coma-like aberrations are more likely to benefit from a reduction in HOAs. Posthyperopic treatment is associated with a higher rate of refractive surprises.

2020 Journal of cataract and refractive surgery

52. Incidence of corneal transplantation after phacoemulsification in patients with corneal guttata: a registry-based cohort study. Full Text available with Trip Pro

Incidence of corneal transplantation after phacoemulsification in patients with corneal guttata: a registry-based cohort study. To investigate the risk for corneal transplantation after phacoemulsification related to corneal guttata.Forty-nine Swedish cataract surgical units and 7 Swedish cornea transplantation units.Registry-based cohort study.Patient data from the Swedish National Cataract Registry between 2010 and 2012 were linked with data from the Swedish Cornea Transplant Registry between (...) 2010 and September 2017. Data from cataract patients were linked with data from patients who underwent corneal transplantation because of endothelial failure. Triple procedures and other surgical methods for cataract extraction other than phacoemulsification were excluded. If both eyes had surgery, 1 eye was randomly selected from the registry to obtain unrelated samples. The incidence was calculated per 10 000 person years, and Poisson regression analysis was used to investigate the risk

2020 Journal of cataract and refractive surgery

53. Reticular Corneal Edema or Corneal Honeycombing in Eyes Treated With Netarsudil: A Case Series. (Abstract)

Reticular Corneal Edema or Corneal Honeycombing in Eyes Treated With Netarsudil: A Case Series. This is a descriptive case series of 3 patients with uncontrolled intraocular pressure that developed reticular corneal changes after initiating netarsudil (0.02%). In all cases, upon observing reticular corneal edema, netarsudil (0.02%) was stopped followed by disappearance of corneal honeycombing. With the increasing use of this novel glaucoma medication, potentially more rare side effects (...) will be observed. Reticular corneal edema or corneal honeycombing is an ocular examination finding that can rarely occur after initiating netarsudil (0.02%) regardless of prior corneal edema status. In our experience, the reticular changes resolve upon cessation of netarsudil.

2020 Journal of Glaucoma

54. High expression of Matrix Gla Protein in Schnyder corneal dystrophy patients points to an active role of vitamin K in corneal health. (Abstract)

. Availability of MGP seems of vital importance for a healthy cornea and may be related to protection against corneal calcification. Systemic MGP findings reveal a poor vascular VK status in SCD patients and indicate that SCD may lead to cardiovascular consequences.© 2020 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd. (...) High expression of Matrix Gla Protein in Schnyder corneal dystrophy patients points to an active role of vitamin K in corneal health. Schnyder corneal dystrophy (SCD) is a rare autosomal dominant disorder characterized by corneal lipid accumulation and caused by UBIAD1 pathogenic variants. UBIAD1 encodes a vitamin K (VK) biosynthetic enzyme. To assess the corneal and vascular VK status in SCD patients, we focused on matrix Gla protein (MGP), a VK-dependent protein.Conformation-specific

2020 Acta ophthalmologica

55. Cornea Verticillata in classical Fabry disease, first from Sri Lanka: a case report. Full Text available with Trip Pro

Cornea Verticillata in classical Fabry disease, first from Sri Lanka: a case report. Fabry disease is a rare inborn error of metabolism with profound clinical consequences if untreated. It is caused by the deficiency of α galactosidase A enzyme and is the only lysosomal storage disorder with an X linked inheritance. Confirmation requires genetic analysis of Galactosidase Alpha (GLA) Gene, which is often a challenge in resource-poor settings. Despite these technological limitations, specific (...) clinical features in this condition can establish the diagnosis.We report on a 13-year old male who presented with an afebrile convulsion with a background history of chronic burning sensation of hands and feet and anhidrosis for 2 years duration with a similar history of episodic acroparesthesia in the other male sibling. The early clinical diagnosis was based on the history and detection of Cornea Verticillata on eye examination. Biochemical confirmation was established with detection of low α

2020 BMC Pediatrics

56. Effect of 1.8-mm steep-axis clear corneal incision on the posterior corneal astigmatism in candidates for toric IOL implantation. Full Text available with Trip Pro

by Pentacam HR were collected in patients for toric IOL implantation. Surgically induced astigmatism on the posterior cornea (P-SIA) was calculated based on the preoperative and postoperative keratometric data, and the related factors of P-SIA were analyzed.A total of 60 eyes from 56 patients were enrolled. The preoperative anterior, posterior and total corneal astigmatism was 1.58 ± 0.61 D,0.28 ± 0.22 D and 1.70 ± 0.52 D respectively. The postoperative anterior, posterior and total corneal astigmatism (...) Effect of 1.8-mm steep-axis clear corneal incision on the posterior corneal astigmatism in candidates for toric IOL implantation. In the present study, we aimed to analyze the effects of cataract surgery using a 1.8-mm steep-axis clear corneal incision (CCI) on the posterior corneal surfaces based on the keratometry from the rotating Scheimpflug imaging device (Pentacam HR) in candidates for toric intraocular lens (IOL) implantation.Preoperative and at least 1-month postoperative data measured

2020 BMC Ophthalmology

57. Effect of epidermal growth factor ointment on persistent epithelial defects of the cornea. Full Text available with Trip Pro

Effect of epidermal growth factor ointment on persistent epithelial defects of the cornea. Healthy corneal epithelium acts as a barrier against damage to the deeper structures in the eye. Failure in the mechanisms of corneal epithelization can lead to persistent epithelial defects of the cornea (PEDs) and can compromise its function. Epidermal growth factor (EGF) promotes the proliferation, migration, and differentiation of epithelial cells, endothelial cells, and fibroblasts during wound (...) in best-corrected visual acuity (0.9 ± 0.8 to 0.6 ± 0.5 LogMAR) and VAS scores (4.5 ± 1.2 to 2.5 ± 0.7) in 12 eyes (80%). Among these cases, the mean epithelial healing time was 5.5 ± 1.8 weeks. Amniotic membrane transplantation was performed on the remaining 3 (20.0%) patients that did not respond to EGF treatment.EGF ointment could reduce symptoms and promotes corneal epithelialization of refractory PEDs. It may, therefore, be well-tolerated and a potentially beneficial addition in the management

2020 BMC Ophthalmology

58. The diagnosis and phacoemulsification in combination with intraocular lens implantation for an Axenfeld-Rieger syndrome patient with small cornea: a case report. Full Text available with Trip Pro

The diagnosis and phacoemulsification in combination with intraocular lens implantation for an Axenfeld-Rieger syndrome patient with small cornea: a case report. Axenfeld-Rieger syndrome (ARS) is a congenital disease with a series of developmental abnormalities, and no case of ARS with cataract and small cornea has been reported in previous studies. In the present report, we aimed to describe the diagnosis and phacoemulsification of an ARS patient with small cornea.A 58-year-old Han Chinese (...) male patient who was referred to Eye Center of the Second Affiliated Hospital of Zhejiang University Medical College was diagnosed with ARS. Systemic and ophthalmic examination and genetic testing were performed. The slit-lamp microscopic examination of anterior segment showed obvious nuclear cataract, iris lesions, and the abnormal cornea of both eyes with small transversal and longitudinal diameters. ARS with bilateral complicated cataract and small cornea was diagnosed. Microincision

2020 BMC Ophthalmology

59. Three-month Storage of Human Corneas in an Active Storage Machine. Full Text available with Trip Pro

Three-month Storage of Human Corneas in an Active Storage Machine. Corneal storage for the very long term, without degradation, would make it possible to optimize a very limited resource worldwide. We previously demonstrated the superiority, compared to conventional 4-week passive organ culture (OC), of an active storage machine (ASM) that restores intraocular pressure and medium renewal. Here, we investigate eye banking for up to 3 months.In a randomized preclinical trial with 24 paired (...) corneas, 1 was stored in OC and the other in ASM, using the same medium. Assessments were done on the second day and at 3 months: endothelial cell density (ECD in cells/mm), corneal transparency and thickness. At day 86, OC corneas were deswelled in a common hyperosmotic medium, but not the ASM corneas, which had remained thin. In addition, at day 88, viable ECD was measured using a live/dead assay, and endothelial expression of Na/K ATPase, Cox IV, ZO-1, N-CAM, and CD166 was observed.The ASM extended

2020 Transplantation

60. Corneae from body donors in anatomy department: valuable use for clinical transplantation and experimental research. Full Text available with Trip Pro

Corneae from body donors in anatomy department: valuable use for clinical transplantation and experimental research. Explanted corneae are highly needed for the surgical management of patients with severe corneal diseases. The aim of this study was to determine whether the body donors from the Institute of Anatomy are a suitable source of donor corneae.At the Institute of Anatomy at Saarland University Medical Center in Homburg, corneae are prelevated from body donors who had consented (...) in culture medium. The non-transplanted tissues were used for research.Explanted corneae from the Institute of Anatomy are a valuable option in obtaining grafts for corneal transplantation, which is why we are working toward on expanding cooperation with this department.

2020 BMC Ophthalmology

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