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141. Corneal transplant rejection

transplant rejection is the most common cause of transplant failure in the post-operative period. 30% of transplanted corneas experience at least one episode of immune rejection, and a proportion of these lead to eventual transplant failure. The incidence of graft rejection depends on the presence of risk characteristics, e.g. corneal neovascularization Corneal transplant rejection may be reversible or irreversible and can affect both full thickness and lamellar transplants, although rejection may (...) of surgery, but can occur at any time Herpes simplex , bacterial or other infection inflammatory disease (e.g. anterior uveitis) glaucoma subsequent intra-ocular surgery (e.g. cataract surgery, vitrectomy) tear deficiency trauma (chemical, mechanical) Symptoms photophobia redness (may be perilimbal) epiphora blurred vision discomfort or pain Signs Following full-thickness corneal transplantation (Penatrating Keratoplasty, PK), rejection may involve any cellular layer of the cornea (epithelium, stroma

2018 College of Optometrists

142. Survival of corneal nerve/sheath structures in organ-cultured donor corneas. Full Text available with Trip Pro

Survival of corneal nerve/sheath structures in organ-cultured donor corneas. To study the morphology of human corneal nerves in eye bank organ-cultured corneas and in corneal grafts post-transplantation.Thirty-seven organ-cultured corneas were divided into: Group-A, anterior 300-400 μm of 20 corneas used for Descemets stripping endothelial keratoplasty, and Group-B, 17 full-thickness corneas unsuitable for transplantation. Corneas whole mounts were stained for nerves using acetylcholinesterase (...) postoperatively, which remained present in 8 of 10 (80%) corneas at 4-5 weeks and in 9 of 10 (90%) at 7-8 weeks postoperatively. All 5 corneas analysed at 12 weeks showed the same stromal nerves from 1 to 12 weeks postoperatively. Sub-basal nerves were absent in all corneas over the 12-week study period.This study provides further insight into the behaviour of corneal nerves in transplanted corneas. Corneal stromal nerves/nerve-sheaths are preserved in organ-cultured eye bank eyes and persist post

2017 Acta ophthalmologica

143. Biomechanical Strengthening of the Human Cornea Induced by Nanoplatform-Based Transepithelial Riboflavin/UV-A Corneal Cross-Linking. Full Text available with Trip Pro

Biomechanical Strengthening of the Human Cornea Induced by Nanoplatform-Based Transepithelial Riboflavin/UV-A Corneal Cross-Linking. The purpose of this study was to investigate the biomechanical stiffening effect induced by nanoplatform-based transepithelial riboflavin/UV-A cross-linking protocol using atomic force microscopy (AFM).Twelve eye bank donor human sclerocorneal tissues were investigated using a commercial atomic force microscope operated in force spectroscopy mode. Four specimens (...) (P < 0.001). The indentation depth decreased after corneal cross-linking treatments, ranging from an average of 2.4 ± 0.3 μm in untreated samples to an average of 1.2 ± 0.1 μm and 1.8 ± 0.1 μm after nanoplatform-based transepithelial and conventional cross-linking, respectively.The present nanotechnology-based transepithelial riboflavin/UV-A corneal cross-linking was effective to improve the biomechanical strength of the most anterior stroma of the human cornea.

2017 Investigative Ophthalmology & Visual Science

144. A study protocol for a multicentre randomised clinical trial evaluating the safety and feasibility of a bioengineered human allogeneic nanostructured anterior cornea in patients with advanced corneal trophic ulcers refractory to conventional treatment. Full Text available with Trip Pro

A study protocol for a multicentre randomised clinical trial evaluating the safety and feasibility of a bioengineered human allogeneic nanostructured anterior cornea in patients with advanced corneal trophic ulcers refractory to conventional treatment. There is a need to find alternatives to the use of human donor corneas in transplants because of the limited availability of donor organs, the incidence of graft complications, as well as the inability to successfully perform corneal transplant (...) in patients presenting limbal deficiency, neo-vascularized or thin corneas, etc. We have designed a clinical trial to test a nanostructured fibrin-agarose corneal substitute combining allogeneic cells that mimics the anterior human native cornea in terms of optical, mechanical and biological behaviour.This is a phase I-II, randomised, controlled, open-label clinical trial, currently ongoing in ten Spanish hospitals, to evaluate the safety and feasibility, as well as clinical efficacy evidence

2017 BMJ open Controlled trial quality: uncertain

145. Outcomes of iontophoretic corneal collagen crosslinking in keratoconic eyes with very thin corneas. Full Text available with Trip Pro

Outcomes of iontophoretic corneal collagen crosslinking in keratoconic eyes with very thin corneas. The purpose of this retrospective study was to report the results of iontophoretic corneal collagen crosslinking (I-CXL) with riboflavin and ultraviolet A irradiation in patients affected by keratoconus, each with thinnest pachymetry values of <400 μ (with epithelium) and not treatable using standard epithelium-off technique.Fifteen eyes of 15 patients affected by progressive keratoconus (...) and with thinnest pachymetry values <400 μ underwent I-CXL. The uncorrected (UDVA) and corrected (CDVA) distance visual acuity, maximum and minimum keratometry (K max and K min) readings, corneal thickness at the thinnest point (CTTP), endothelial cell density (ECD), and intraocular pressure (IOP) were assessed before I-CXL, at 1, 3, 6, and 12 months postoperatively.The mean UDVA and CDVA significantly increased 12 months after I-CXL (P = .002 for both comparisons). The K max readings significantly decreased

2017 Medicine

146. The Effects of Distance Between the Corneal Apex and the Inner and Outer Corneal Wound Edges on Corneal Astigmatism After Cataract Surgery. (Abstract)

, the mean change in anterior, posterior, and total corneal astigmatism at 1 week and anterior astigmatism at 1 month were statistically significantly greater in the inner incision close group than in the inner incision far group. In the outer incision distance group, the mean change in anterior corneal astigmatism at 1 week was statistically significantly greater in the close group than in the far group. Surgically induced astigmatism (SIA) of the posterior cornea showed a statistically significant (...) The Effects of Distance Between the Corneal Apex and the Inner and Outer Corneal Wound Edges on Corneal Astigmatism After Cataract Surgery. To compare the effects of the distance from the inner and outer corneal incision wounds to the corneal apex on the changes in corneal astigmatism after cataract surgery.Seventy-two eyes with anterior corneal astigmatism less than 2.50 diopters (D) were evaluated. The distance between the incision wound and the corneal apex was measured using the Pentacam

2017 Journal of Refractive Surgery

147. Colony Stimulating Factor-1 Receptor Expressing Cells Infiltrating the Cornea Control Corneal Nerve Degeneration in Response to HSV-1 Infection. Full Text available with Trip Pro

Colony Stimulating Factor-1 Receptor Expressing Cells Infiltrating the Cornea Control Corneal Nerve Degeneration in Response to HSV-1 Infection. Herpes simplex virus type-1 (HSV-1) is a leading cause of neurotrophic keratitis, characterized by decreased or absent corneal sensation due to damage to the sensory corneal innervation. We previously reported the elicited immune response to infection contributes to the mechanism of corneal nerve regression/damage during acute HSV-1 infection. Our aim (...) and harvested for FC, nerve structure by immunohistochemistry, viral content by plaque assay, soluble factor content by suspension array, and activation of signaling pathways by Western blot analysis. C57BL6 mice were used to compare to the MAFIA mouse model.MAFIA mice treated with AP20187 had efficient depletion of CD45+CD11b+GFP+ cells in the tissues analyzed. The reduction of CD45+CD11b+GFP+ cells recruited to the infected corneas of AP20187-treated mice correlated with preservation of corneal nerve

2017 Investigative Ophthalmology & Visual Science

148. Corneal Endothelial Cell Integrity in Precut Human Donor Corneas Enhanced by Autocrine Vasoactive Intestinal Peptide Full Text available with Trip Pro

Corneal Endothelial Cell Integrity in Precut Human Donor Corneas Enhanced by Autocrine Vasoactive Intestinal Peptide To demonstrate that vasoactive intestinal peptide (VIP), a corneal endothelial (CE) cell autocrine factor, maintains the integrity of corneal endothelium in human donor corneoscleral explants precut for endothelial keratoplasty.Twelve paired human donor corneoscleral explants used as control versus VIP-treated explants (10 nM, 30 minutes, 37°C) were shipped (4°C) to the Lions Eye (...) ). After 6 days in culture, the damage in whole CE discs decreased from 20.0% (control) to 5.5% (VIP treated).VIP treatment before precut enhanced the preservation of corneal endothelium.

2017 Cornea

149. High-resolution wavefront-guided surface ablation with corneal cross-linking in ectatic corneas: a pilot study Full Text available with Trip Pro

High-resolution wavefront-guided surface ablation with corneal cross-linking in ectatic corneas: a pilot study A preliminary study to evaluate the outcomes of high-resolution wavefront-guided (HRWG) photorefractive keratectomy (PRK) with simultaneous corneal cross-linking (CXL) in ectasia eyes.Sixteen eyes of 11 patients (mean age 31.9±9.8 years; range: 15-48 years) with keratoconus or post-laser-assisted in situ keratomileusis ectasia underwent HRWG PRK with simultaneous CXL. Manifest

2017 Clinical ophthalmology (Auckland, N.Z.)

150. Improving the success rate of human corneal endothelial cell cultures from single donor corneas with stabilization medium Full Text available with Trip Pro

Improving the success rate of human corneal endothelial cell cultures from single donor corneas with stabilization medium Main objective of this study was to improve the success rate of human corneal endothelial cell (hCEC) cultures from single donor corneas. We could show that the use of stabilization medium prior to cell isolation may have a positive effect on the success rate of hCEC cultures from single research-grade donor corneas by allowing growth of otherwise possibly not successful (...) cultures and by improving their proliferative rate. hCEC were obtained from corneo-scleral rims of 7 discarded human research-grade cornea pairs. The Descemet membrane-endothelium (DM-EC) sheets of each pair were assigned to 2 experimental conditions: (1) immediate cell isolation after peeling, and (2) storage of the DM-EC sheet in a growth factor-depleted culture medium (i.e. stabilization medium) for up to 6 days prior to cell isolation. hCEC isolated by enzymatic digestion were then induced

2017 Cell and tissue banking

151. Transient Ingrowth of Lymphatic Vessels into the Physiologically Avascular Cornea Regulates Corneal Edema and Transparency Full Text available with Trip Pro

Transient Ingrowth of Lymphatic Vessels into the Physiologically Avascular Cornea Regulates Corneal Edema and Transparency Lymphangiogenesis is essential for fluid homeostasis in vascularized tissues. In the normally avascular cornea, however, pathological lymphangiogenesis mediates diseases like corneal transplant rejection, dry eye disease, and allergy. So far, a physiological role for lymphangiogenesis in a primarily avascular site such as the cornea has not been described. Using a mouse (...) model of perforating corneal injury that causes acute and severe fluid accumulation in the cornea, we show that lymphatics transiently and selectively invade the cornea and regulate the resolution of corneal edema. Pharmacological blockade of lymphangiogenesis via VEGFR-3 inhibition results in increased corneal thickness due to delayed drainage of corneal edema and a trend towards prolonged corneal opacification. Notably, lymphatics are also detectable in the cornea of a patient with acute edema due

2017 Scientific reports

152. The role of corneal stroma: A potential nutritional source for the cornea Full Text available with Trip Pro

The role of corneal stroma: A potential nutritional source for the cornea Corneal stroma plays a pivotal role in normal visual function. Anatomically, it is located between the outer epithelium and the inner endothelium and is the thickest layer of the cornea. Keratocytes in the stroma produce a variety of cellular products, including growth factors/cytokines, extracellular matrix (ECM) components, and kinases. These products support normal corneal development and homeostasis.

2017 Journal of nature and science

153. Corneal Cross-Linking with Riboflavin and UV-A in the Mouse Cornea in Vivo: Morphological, Biochemical, and Physiological Analysis Full Text available with Trip Pro

Corneal Cross-Linking with Riboflavin and UV-A in the Mouse Cornea in Vivo: Morphological, Biochemical, and Physiological Analysis To morphologically, biochemically, and physiologically characterize corneal cross-linking with riboflavin and UV-A light (CXL) in a newly established in vivo murine model.C57BL/6 wild-type mice (N = 67) were treated with various CXL protocols, with modification of the following parameters: total energy (fluence) used, duration of UV-A irradiation, continuous versus (...) irradiation inhibited neovascularization, but favored scar formation. Changes in the speed of enzymatic digestion suggest that CXL in mice, when compared to humans, requires less UV-A energy than the difference in corneal thickness between the species would suggest.We demonstrated the in vivo response of very strong and very weak CXL and identified the best suited range of UV fluence in murine corneas. The presented murine CXL model may be helpful in future research addressing cellular and molecular

2017 Translational vision science & technology

154. Cultured corneas show dendritic spread and restrict herpes simplex virus infection that is not observed with cultured corneal cells Full Text available with Trip Pro

Cultured corneas show dendritic spread and restrict herpes simplex virus infection that is not observed with cultured corneal cells Herpes simplex virus-1 (HSV-1) causes life-long morbidities in humans. While fever blisters are more common, occasionally the cornea is infected resulting in vision loss. A very intriguing aspect of HSV-1 corneal infection is that the virus spread is normally restricted to only a small fraction of cells on the corneal surface that connect with each other (...) in a dendritic fashion. Here, to develop a comprehensive understanding of the susceptibility of human corneal epithelial (HCE) cells to HSV-1 infection, we infected HCE cells at three different dosages of HSV-1 and measured the outcomes in terms of viral entry, gene and protein expression, viral replication and cytokine induction. In cultured cells, infectivity and cytokine induction were observed even at the minimum viral dosage tested, while a more pronounced dose-restricted infectivity was seen in ex vivo

2017 Scientific reports

155. Corneal biomechanical data and biometric parameters measured with Scheimpflug-based devices on normal corneas Full Text available with Trip Pro

Corneal biomechanical data and biometric parameters measured with Scheimpflug-based devices on normal corneas To analyze the correlations between ocular biomechanical and biometric data of the eye, measured by Scheimpflug-based devices on healthy subjects.Three consecutive measurements were carried out using the corneal visualization Scheimpflug technology (CorVis ST) device on healthy eyes and the 10 device-specific parameters were recorded. Pentacam HR-derived parameters (corneal curvature (...) ) data of lower-order aberrations, and posterior RMS of higher-order aberrations and spherical aberration of the posterior cornea. Anterior chamber depth showed a significant relationship, but there were no significant correlations between corneal volume, anterior chamber volume, mean chamber angle or AL and the 10 specific CorVis ST parameters.CorVis ST-generated parameters are influenced by corneal curvature radii, some corneal RMS data, but corneal volume, anterior chamber volume, chamber angle

2017 International journal of ophthalmology

156. The use of WaveLight® Contoura to create a uniform cornea: the LYRA Protocol. Part 1: the effect of higher-order corneal aberrations on refractive astigmatism Full Text available with Trip Pro

The use of WaveLight® Contoura to create a uniform cornea: the LYRA Protocol. Part 1: the effect of higher-order corneal aberrations on refractive astigmatism To demonstrate how higher-order corneal aberrations can cancel out, modify, or induce lower-order corneal astigmatism.Six representative eyes are presented that show different scenarios in which higher-order aberrations interacting with corneal astigmatism can affect the manifest refraction. WaveLight® Contoura ablation maps showing (...) the higher-order aberrations are shown, as are results of correction with full measured correction using the LYRA (Layer Yolked Reduction of Astigmatism) Protocol.Higher-order corneal aberrations such as trefoil, quadrafoil, and coma can create ovalization of the central cornea, which can interact with the ovalization caused by lower-order astigmatism to either induce, cancel out, or modify the manifest refraction. Contoura processing successfully determines the linkage of these interactions resulting

2017 Clinical ophthalmology (Auckland, N.Z.)

157. Thinner Corneas Appear to Have More Striking Effects of Corneal Collagen Crosslinking in Patients with Progressive Keratoconus Full Text available with Trip Pro

Thinner Corneas Appear to Have More Striking Effects of Corneal Collagen Crosslinking in Patients with Progressive Keratoconus Purpose. To analyze the outcomes and difference after UVA/riboflavin corneal collagen crosslinking (CXL) in four different corneal thickness groups of patients with progressive keratoconus. Methods. Retrospective study. Eyes with progressive keratoconus after CXL were divided into 4 subgroups as follows: group 1, thinnest corneal thickness (TCT) ≤ 400 µm; group 2, 400 (...)  µm < TCT ≤ 450 µm; group 3, 450 µm < TCT ≤ 500 µm; group 4, TCT ≥ 500 µm. Baseline, 6-month, and 12-month visual acuity, corneal topography, TCT, and endothelial cell density were evaluated. Results. The analysis included 123 eyes of 101 patients. At 6 and 12 months after CXL, there was a mean improvement about visual acuity and keratometry values in all patients. There was a reduction in the change of maximum keratometry (Kmax) with the increase of TCT. After 1 year of treatment, it was 3.04

2017 Journal of ophthalmology

158. Ascorbic Acid Promotes the Stemness of Corneal Epithelial Stem/Progenitor Cells and Accelerates Epithelial Wound Healing in the Cornea Full Text available with Trip Pro

Ascorbic Acid Promotes the Stemness of Corneal Epithelial Stem/Progenitor Cells and Accelerates Epithelial Wound Healing in the Cornea High concentration of ascorbic acid (vitamin C) has been found in corneal epithelium of various species. However, the specific functions and mechanisms of ascorbic acid in the repair of corneal epithelium are not clear. In this study, it was found that ascorbic acid accelerates corneal epithelial wound healing in vivo in mouse. In addition, ascorbic acid (...) enhanced the stemness of cultured mouse corneal epithelial stem/progenitor cells (TKE2) in vitro, as shown by elevated clone formation ability and increased expression of stemness markers (especially p63 and SOX2). The contribution of ascorbic acid on the stemness enhancement was not dependent on the promotion of Akt phosphorylation, as concluded by using Akt inhibitor, nor was the stemness found to be dependent on the regulation of oxidative stress, as seen by the use of two other antioxidants (GMEE

2017 Stem cells translational medicine

159. Differential Gene Transcription of Extracellular Matrix Components in Response to In Vivo Corneal Crosslinking (CXL) in Rabbit Corneas Full Text available with Trip Pro

Differential Gene Transcription of Extracellular Matrix Components in Response to In Vivo Corneal Crosslinking (CXL) in Rabbit Corneas We studied changes in gene transcription after corneal crosslinking (CXL) in the rabbit cornea in vivo and identified potential molecular signaling pathways.A total of 15 corneas of eight male New-Zealand-White rabbits were de-epithelialized and equally divided into five groups. Group 1 served as an untreated control. Groups 2 to 5 were soaked with 0.1 (...) % riboflavin for 20 minutes, which in Groups 3 to 5 was followed by UV-A irradiation at a fluence of 5.4 J/cm2. Ultraviolet A (UVA) irradiation was delivered at 3 mW/cm2 for 30 minutes (Group 3, standard CXL protocol), 9 mW/cm2 for 10 minutes (Group 4, accelerated), and 18 mW/cm2 for 5 minutes (Group 5, accelerated). At 1 week after treatment, corneal buttons were obtained; mRNA was extracted and subjected to cDNA sequencing (RNA-seq).A total of 297 differentially transcribed genes were identified after

2017 Translational vision science & technology

160. Use of glycerol-preserved corneas for corneal transplants Full Text available with Trip Pro

Use of glycerol-preserved corneas for corneal transplants This study was carried out to see the results of glycerol-preserved cornea (GPC) in emergency situation when fresh corneal tissue was not available. The aim was to study the outcome of corneal transplantation using GPC.This was a retrospective study. The medical records of all the patients were reviewed, who underwent keratoplasty using "GPC" during the period from October 2011 to December 2015. The indication of keratoplasty, duration (...) of preservation of the GPC, and its outcome were analyzed. Descriptive statistics were applied.Out of the 222 penetrating keratoplasty (PKP) performed over the study period, the GPC was used in 34 patients (males = 31, 91.2%) aged 15-74 years. Therapeutic keratoplasty was performed in all cases in this cohort except one in which tectonic keratoplasty was done. The primary indication of PKP (91.2%) was infectious keratitis. Of these, 20 (64.5%) patients presented with perforated corneal ulcers. Post-PKP

2017 Indian journal of ophthalmology

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