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121. Outcomes of complex Descemet Stripping Endothelial Keratoplasty performed by cornea fellows. (Full text)

Outcomes of complex Descemet Stripping Endothelial Keratoplasty performed by cornea fellows. A major obstacle that academic institutions face is the steep learning curve for cornea fellows initially learning to perform Descemet Stripping Endothelial Keratoplasty (DSEK). The purpose of this study is to evaluate the outcomes of complex DSEK performed by cornea fellow supervised by an attending surgeon at an academic institution.Patients who underwent a complex DSEK procedure performed by a cornea (...) fellow during the years 2009-2013 were included. All the surgeries were supervised by the same cornea attending. All patients had a minimum follow-up of 6 months. Charts were reviewed for demographic data, intraoperative and postoperative complications and clinical outcomes. Corneal graft survival was calculated using the Kaplan-Meier analysis.Fifty-seven eyes of 55 patients (mean age 77.5 ± 8.5 years) were included in the study with a mean follow-up time of 16.4 ± 15.6 months. Previous graft failure

2018 BMC Ophthalmology

122. Functional and Morphologic Alterations in Mechanical, Polymodal, and Cold Sensory Nerve Fibers of the Cornea Following Photorefractive Keratectomy. (Full text)

Functional and Morphologic Alterations in Mechanical, Polymodal, and Cold Sensory Nerve Fibers of the Cornea Following Photorefractive Keratectomy. To define the characteristics and time course of the morphologic and functional changes experienced by corneal sensory nerves after photorefractive keratectomy (PRK).Unilateral corneal excimer laser photoablation was performed in 54 anesthetized 3- to 6-month-old mice; 11 naïve animals served as control. Mice were killed 0, 3, 7, 15, and 30 days (...) after PRK. Excised eyes were placed in a recording chamber superfused at 34°C. Electrical nerve impulse activity of single sensory terminals was recorded with a micropipette applied onto the corneal surface. Spontaneous and stimulus-evoked (cold, heat, mechanical, and chemical stimuli) nerve terminal impulse (NTI) activity was analyzed. Corneas were fixed and stained with anti-β-Tubulin III antibody to measure nerve density and number of epithelial nerve penetration points of regenerating subbasal

2018 Investigative Ophthalmology & Visual Science

123. Biomechanics and Structure of the Cornea: Implications and Association with Corneal Disorders. (PubMed)

Biomechanics and Structure of the Cornea: Implications and Association with Corneal Disorders. Recent studies have shown that alterations in corneal biomechanical properties are associated with corneal pathologies, particularly corneal ectasia. Moreover, these alterations may have implications with regard to the outcomes of therapeutic modalities and corneal refractive surgeries. We address corneal anatomy and its relevance to corneal biomechanical characteristics, as well as ocular

2018 Survey of Ophthalmology

124. Biomechanical assessment of healthy and keratoconic corneas (with/without crosslinking) using dynamic ultrahigh-speed Scheimpflug technology and the relevance of the parameter (A1L-A2L). (PubMed)

Biomechanical assessment of healthy and keratoconic corneas (with/without crosslinking) using dynamic ultrahigh-speed Scheimpflug technology and the relevance of the parameter (A1L-A2L). To examine corneal biomechanics in healthy and keratoconic eyes, with or without crosslinking obtained by ultrahigh-speed Scheimpflug measurements (Corvis ST).One hundred and seventeen eyes were studied in three groups: group 1 (n=39) contained keratoconic eyes without crosslinking. Group 2 (CXL; n=28 (...) ) comprised keratoconic eyes after crosslinking. These were compared with a control group (n=50 matched healthy eyes). In addition, 10 keratoconus patients, before and after CXL treatment, respectively, were examined.The novel parameter A1L-A2L demonstrated highly significant differences between crosslinked corneas and untreated keratoconic or healthy corneas. Velocity during second applanation (A2V) and deformation amplitude (DA) were significantly increased in crosslinked keratoconic eyes both compared

2018 British Journal of Ophthalmology

125. Corneal shape changes of the total and posterior cornea after temporal versus nasal clear corneal incision cataract surgery. (Full text)

Corneal shape changes of the total and posterior cornea after temporal versus nasal clear corneal incision cataract surgery. To compare changes in the shape and astigmatism of the total and posterior cornea between eyes with a nasal clear corneal incision (CCI) and eyes with a temporal CCI in cataract surgery.The left eyes of 100 patients undergoing phacoemulsification were randomly assigned to undergo a 2.4 mm nasal (nasal CCI group) or temporal CCI (temporal CCI group). Corneal astigmatic (...) changes were compared between groups using power vector analysis, and corneal shape changes were compared using videokeratography maps at 2 days, and at 2, 4 and 8 weeks postoperatively.The mean J0 and J45 values of the total cornea were significantly greater in the nasal CCI group than in the temporal CCI group at 2 and 4 weeks postoperatively (p≤0.0392), but did not differ significantly between groups at 2 days and 8 weeks. The videokeratography maps revealed a wedge-shaped flattening in the total

2018 British Journal of Ophthalmology Controlled trial quality: uncertain

126. Differential Expression of Coding and Long Noncoding RNAs in Keratoconus-Affected Corneas. (Full text)

Differential Expression of Coding and Long Noncoding RNAs in Keratoconus-Affected Corneas. Keratoconus (KC) is the most common corneal ectasia. We aimed to determine the differential expression of coding and long noncoding RNAs (lncRNAs) in human corneas affected with KC.From the corneas of 10 KC patients and 8 non-KC healthy controls, 200 ng total RNA was used to prepare sequencing libraries with the SMARTer Stranded RNA-Seq kit after ribosomal RNA depletion, followed by paired-end 50-bp (...) and a false discovery rate ≤ 0.05, we identified 436 coding RNAs and 584 lncRNAs with differential expression in the KC-affected corneas. Pathway analysis indicated the enrichment of genes involved in extracellular matrix, protein binding, glycosaminoglycan binding, and cell migration. Our correlation analysis identified 296 pairs of significant KC-specific correlations containing 117 coding genes enriched in functions related to cell migration/motility, extracellular space, cytokine response, and cell

2018 Investigative Ophthalmology & Visual Science

127. Biomechanical Properties of Human Cornea Tested by Two-Dimensional Extensiometry Ex Vivo in Fellow Eyes: Femtosecond Laser-Assisted LASIK Versus SMILE. (PubMed)

Biomechanical Properties of Human Cornea Tested by Two-Dimensional Extensiometry Ex Vivo in Fellow Eyes: Femtosecond Laser-Assisted LASIK Versus SMILE. To investigate the biomechanical properties of the ex vivo human cornea after flap-based versus cap-based laser refractive surgery in the same donor.In this experimental study, 11 pairs of human corneas unsuitable for transplantation were equally divided into two groups. Corneas from the right eye were treated with femtosecond laser-assisted (...) LASIK (FSLASIK) and corneas from the left eye with small incision lenticule extraction (SMILE). Pachymetry was measured in each eye directly before laser refractive surgery. All corneas were subjected to a refractive correction of -10.00 diopters (D) sphere and -0.75 D cylinder at 0° with a 7-mm zone, using either a 110-μm flap (FS-LASIK) or 130-μm cap (SMILE). For two-dimensional biomechanical measurements, corneoscleral buttons underwent two testing cycles (preconditioning stress-strain curve from

2018 Journal of Refractive Surgery

128. Surgical peripheral iridectomy via a clear-cornea phacoemulsification incision for pupillary block following cataract surgery in acute angle closure. (Full text)

Surgical peripheral iridectomy via a clear-cornea phacoemulsification incision for pupillary block following cataract surgery in acute angle closure. To describe a technique of surgical peripheral iridectomy via a clear-cornea tunnel incision to prevent or treat pupillary block following phacoemulsification.Description of technique and retrospective description results in 20 eyes of 20 patients with acute angle closure with coexisting visually significant cataract undergoing phacoemulsification (...) patients. The incidence of pupillary block in our hospital was 0.09% overall, 0.6% in diabetics and 3.5% in those with diabetic retinopathy.This technique of peripheral iridectomy via the cornea tunnel incision can be safely used during phacoemulsification in eyes at high risk of pupillary block or in the treatment of acute postoperative pupillary-block after cataract surgery. The technique is likely to be especially useful in brown iris, or if a laser is not available.

2018 BMC Ophthalmology

129. Biological Lenticule Implantation for Correction of Hyperopia: An Ex Vivo Study in Human Corneas. (Full text)

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

2018 Journal of Refractive Surgery

130. Inhibition of Soluble Epoxide Hydrolase 2 Ameliorates Diabetic Keratopathy and Impaired Wound Healing in Mouse Corneas. (Full text)

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 (...) the rate of epithelium wound closure and restored hyperglycemia-suppressed STAT3 activation and heme oxygenase-1 (HO-1) expression in the diabetic corneas. Treatment of diabetic corneas with cobalt protoporphyrin, a well-known HO-1 inducer, restored wound-induced HO-1 upregulation and accelerated delayed wound healing. Finally, Ephx2 depletion enhanced sensory innervation and regeneration in diabetic corneas at 1 month after epithelial debridement. Our data suggest that increased sEH activity may

2018 Diabetes

131. Keratan Sulfate Phenotype in the β-1,3-N-Acetylglucosaminyltransferase-7-Null Mouse Cornea. (Full text)

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

132. Evaluation of voriconazole anti-Acanthamoeba polyphaga in vitro activity, rat cornea penetration and efficacy against experimental rat Acanthamoeba keratitis. (Full text)

Evaluation of voriconazole anti-Acanthamoeba polyphaga in vitro activity, rat cornea penetration and efficacy against experimental rat Acanthamoeba keratitis. Acanthamoeba keratitis (AK) is a sight-threatening infectious disease. Its effective and safe medical therapy remains highly debated. Recently, voriconazole, a monotriazole with noted in vitro activity against a large variety of fungi, has been successfully used both topically and systemically to treat human AK cases.To measure anti (...) -Acanthamoeba polyphaga in vitro activity, anti-rat AK efficiency and rat cornea penetration of eye-drop and oral voriconazole.A. polyphaga was maintained in axenic cultures. In vitro, amoebicidal and cysticidal activities of voriconazole were measured using an XTT assay. AK lesions of Sprague Dawley rats were scored from grade 0 to grade 3. For 21 days, from day 7 post-infection, voriconazole (1% solution) eye drops were instilled or voriconazole was administered by gavage (60 mg/kg/day). After killing

2018 Journal of Antimicrobial Chemotherapy

133. Effect of UVA/Riboflavin Collagen Crosslinking on Biomechanics of Artificially Swollen Corneas. (Full text)

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

134. Changes in shape and astigmatism of total, anterior, and posterior cornea after long versus short clear corneal incision cataract surgery. (PubMed)

Changes in shape and astigmatism of total, anterior, and posterior cornea after long versus short clear corneal incision cataract surgery. To compare changes in the shape and astigmatism of the total, anterior, and posterior cornea between eyes with long-length clear corneal incisions (CCIs) and eyes with short-length CCIs in cataract surgery.Hayashi Eye Hospital, Fukuoka, Japan.Prospective case series.Both eyes of patients having phacoemulsification with temporal CCIs were randomized to have (...) a long-length (≥1.75 mm) or short-length (<1.75 mm) CCI. Corneal astigmatic changes were decomposed to vertical/horizontal (Jackson cross-cylinder, axes at 180 degrees and 90 degrees [J0]) and oblique changes (Jackson cross-cylinder, axes at 45 degrees and 135 degrees [J45]) using power vector analysis. Corneal shape changes were assessed using the average of the difference map on videokeratography 2 days and 2, 4, and 8 weeks postoperatively.The mean J0 and J45 values of the total cornea in the 120

2018 Journal of cataract and refractive surgery Controlled trial quality: uncertain

135. Long-term Clinical Outcomes of Phototherapeutic Keratectomy in Corneas With Granular Corneal Dystrophy Type 2 Exacerbated After LASIK. (Full text)

Long-term Clinical Outcomes of Phototherapeutic Keratectomy in Corneas With Granular Corneal Dystrophy Type 2 Exacerbated After LASIK. To investigate the long-term clinical outcomes and recurrence patterns of phototherapeutic keratectomy (PTK) in patients with granular corneal dystrophy type 2 (GCD2) exacerbated after LASIK.Fifty-one patients (76 eyes) with GCD2 exacerbated after LASIK who underwent PTK between January 2007 and February 2017 were included. Participants underwent ophthalmic

2018 Journal of Refractive Surgery

136. Trends in corneal transplantation from 2001 to 2016 in Germany: A report of the DOG-Section Cornea and its Keratoplasty Registry. (Full text)

Trends in corneal transplantation from 2001 to 2016 in Germany: A report of the DOG-Section Cornea and its Keratoplasty Registry. The purpose of this retrospective panel study was to provide an overview of absolute numbers and of trends in the types of and indications for corneal transplantation in Germany from 2001 to 2016.A questionnaire about absolute numbers, types of transplantation, and indications was sent to 111 ophthalmologic departments in Germany, out of which 94 (85%) provided

2018 American Journal of Ophthalmology

137. Aspergillus fumigatus Increased PAR-2 Expression and Elevated Proinflammatory Cytokines Expression Through the Pathway of PAR-2/ERK1/2 in Cornea. (Full text)

Aspergillus fumigatus Increased PAR-2 Expression and Elevated Proinflammatory Cytokines Expression Through the Pathway of PAR-2/ERK1/2 in Cornea. To determine the role of protease-activated receptor-2 (PAR-2) in cornea infected by Aspergillus fumigatus.PAR-2 was tested in normal and infected corneas of C57BL/6 mice. Mice corneas were infected with A. fumigatus with or without pretreatment of PAR-2 antagonist (FSLLRY-NH2). Polymorphonuclear neutrophilic leukocytes (PMNs) were stimulated with 75 (...) % ethanol-killed A. fumigatus with or without pretreatment of FSLLRY-NH2. Disease severity was documented by clinical score and photographs with a slit lamp. PCR, Western blot, and ELISA tested expression of PAR-2, IL-1β, TNF-α, IFN-γ, MIP-2, and p-ERK1/2. PMN infiltration was assessed by myeloperoxidase assay and immunofluorescent staining.PAR-2 expression was significantly elevated by A. fumigatus, whereas the upregulation was significantly inhibited by FSLLRY-NH2 in mice corneas. FSLLRY-NH2 decreased

2018 Investigative Ophthalmology & Visual Science

138. Assessment of Human Corneas Prior to Transplantation Using High-Resolution Two-Photon Imaging. (Full text)

Assessment of Human Corneas Prior to Transplantation Using High-Resolution Two-Photon Imaging. The purpose of this study was to evaluate the feasibility of using two-photon imaging (TPI) to assess the condition of human corneas for transplantation.Human corneas were imaged after different storage times: short-term (STS), medium-term (MTS), and long-term (LTS) storage. A high-resolution, custom-built 5-dimensional multiphoton microscope with 12-fs pulsed laser excitation was used for image (...) acquisition.Optical discrimination between different corneal layers and sublayers based on their morphologic characteristics revealed by two-photon autofluorescence (AF) is possible. Furthermore, all layers were characterized based on AF lifetimes to gain information on metabolic activities of cells. The NAD(P)H free to protein-bound ratio (a1/a2) of epithelial cells increased significantly in both MTS and LTS corneas compared with STS corneas. In endothelial cells, NAD(P)H a1/a2 was significantly increased

2018 Investigative Ophthalmology & Visual Science

139. Colocalization of Galectin-3 With CD147 Is Associated With Increased Gelatinolytic Activity in Ulcerating Human Corneas. (Full text)

Colocalization of Galectin-3 With CD147 Is Associated With Increased Gelatinolytic Activity in Ulcerating Human Corneas. Galectin-3 is a carbohydrate-binding protein known to promote expression of matrix metalloproteinases, a hallmark of ulceration, through interaction with the extracellular matrix metalloproteinase inducer CD147. The aim of this study was to investigate the distribution of galectin-3 in corneas of patients with ulcerative keratitis and to determine its relationship to CD147 (...) and the presence of gelatinolytic activity.This was an observational case series involving donor tissue from 13 patients with active corneal ulceration and 6 control corneas. Fixed-frozen sections of the corneas were processed to localize galectin-3 and CD147 by immunofluorescence microscopy. Gelatinolytic activity was detected by in situ zymography.Tissue from patients with active corneal ulceration showed a greater galectin-3 immunoreactivity in basal epithelia and stroma compared with controls

2018 Investigative Ophthalmology & Visual Science

140. Cornea Preservation Time Study: Methods and Potential Impact on the Cornea Donor Pool in the United States. (Full text)

Cornea Preservation Time Study: Methods and Potential Impact on the Cornea Donor Pool in the United States. The aim of this study was to describe the aims, methods, donor and recipient cohort characteristics, and potential impact of the Cornea Preservation Time Study (CPTS).The CPTS is a randomized clinical trial conducted at 40 clinical sites (70 surgeons) designed to assess the effect of donor cornea preservation time (PT) on graft survival 3 years after Descemet stripping automated (...) endothelial keratoplasty (DSAEK). Eyes undergoing surgery for Fuchs endothelial corneal dystrophy or pseudophakic/aphakic corneal edema were randomized to receive donor corneas stored ≤7 days or 8 to 14 days. Donor and patient characteristics, tissue preparation and surgical parameters, recipient and donor corneal stroma clarity, central corneal thickness, intraocular pressure, complications, and a reading center-determined central endothelial cell density were collected. Surveys were conducted

2015 Cornea Controlled trial quality: uncertain

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