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Sample records for experimental corneal scars

  1. Improvement in corneal scarring following bacterial keratitis.

    Science.gov (United States)

    McClintic, S M; Srinivasan, M; Mascarenhas, J; Greninger, D A; Acharya, N R; Lietman, T M; Keenan, J D

    2013-03-01

    Bacterial keratitis results in corneal scarring and subsequent visual impairment. The long-term evolution of corneal scars has not been well described. In this case series, we identified patients who had improvement in corneal scarring and visual acuity from a clinical trial for bacterial keratitis. We searched the records of the Steroids for Corneal Ulcers Trial (SCUT) for patients who had improvement in vision between the 3-month and 12-month visits and reviewed their clinical photographs. Of the 500 patients enrolled in SCUT, five patients with large central corneal scars due to bacterial keratitis are presented. All experienced improvement in rigid contact lens-corrected visual acuity from months 3 to 12. All patients also had marked improvement in corneal opacity during the same time period. None of the patients opted to have penetrating keratoplasty. Corneal scars may continue to improve even many months after a bacterial corneal ulcer has healed. The corneal remodeling can be accompanied by considerable improvement in visual acuity, such that corneal transplantation may not be necessary.

  2. Minimising Corneal Scarring from the use of Harmful Traditional Eye ...

    African Journals Online (AJOL)

    Corneal scarring is the fourth largest cause of blindness globally, and a much more prominent factor in developing countries. Blindness from corneal scarring is largely a preventable phenomenon, and is capable of causing significant morbidity that can last for a lifetime. A significant proportion of these cases are caused by ...

  3. Ipsilateral Rotational Autokeratoplasty for the Management of Traumatic Corneal Scar

    OpenAIRE

    Alime Günes; Tahir Kansu Bozkurt; Cihan Unlu; Betül Ilkay Sezgin Akcay; Hüseyin Bayramlar

    2012-01-01

    A 40-years-old male patient with a corneal scar secondary to perforating eye injury had undergone ipsilateral rotational autokeratoplasty in our clinics. The corneal scar involved the pupillary area. The patient had a preoperative visual acuity of counting fingers. The patient's cornea was trephined with a 0.5 mm temporal decentration. The 8.0 mm autograft was rotated approximately 180° to relocate the scar to the temporal aspect of the cornea. The final position of the corneal scar was tempo...

  4. Ipsilateral rotational autokeratoplasty for the management of traumatic corneal scar.

    Science.gov (United States)

    Günes, Alime; Kansu Bozkurt, Tahir; Unlu, Cihan; Sezgin Akcay, Betül Ilkay; Bayramlar, Hüseyin

    2012-01-01

    A 40-years-old male patient with a corneal scar secondary to perforating eye injury had undergone ipsilateral rotational autokeratoplasty in our clinics. The corneal scar involved the pupillary area. The patient had a preoperative visual acuity of counting fingers. The patient's cornea was trephined with a 0.5 mm temporal decentration. The 8.0 mm autograft was rotated approximately 180° to relocate the scar to the temporal aspect of the cornea. The final position of the corneal scar was temporal of the visual axis and central area was clear. The visual acuity at 1-, 3-, and 6-months followups was better than the first visual acuity in the patient. Ipsilateral rotational autokeratoplasty has many advantages over conventional keratoplasty. There is no risk of immunological rejection of the graft, postoperative corticosteroids are not needed as frequently, and donor cornea is not required. A rotational autograft can be a powerful alternative to conventional keratoplasty for some patients with traumatic corneal scars.

  5. Ipsilateral Rotational Autokeratoplasty for the Management of Traumatic Corneal Scar

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    Alime Günes

    2012-01-01

    Full Text Available A 40-years-old male patient with a corneal scar secondary to perforating eye injury had undergone ipsilateral rotational autokeratoplasty in our clinics. The corneal scar involved the pupillary area. The patient had a preoperative visual acuity of counting fingers. The patient’s cornea was trephined with a 0.5 mm temporal decentration. The 8.0 mm autograft was rotated approximately 180° to relocate the scar to the temporal aspect of the cornea. The final position of the corneal scar was temporal of the visual axis and central area was clear. The visual acuity at 1-, 3-, and 6-months followups was better than the first visual acuity in the patient. Ipsilateral rotational autokeratoplasty has many advantages over conventional keratoplasty. There is no risk of immunological rejection of the graft, postoperative corticosteroids are not needed as frequently, and donor cornea is not required. A rotational autograft can be a powerful alternative to conventional keratoplasty for some patients with traumatic corneal scars.

  6. Effects of Corneal Scars and Their Treatment With Rigid Contact Lenses on Quality of Vision

    NARCIS (Netherlands)

    de Jong, Bram; van der Meulen, Ivanka J E; van Vliet, Johannes M J; Lapid-Gortzak, Ruth; Nieuwendaal, Carla P; van den Berg, Thomas J T P

    OBJECTIVES: To study the effects of corneal scars and the treatment of these scars with rigid gas-permeable (RGP) contact lenses on quality of vision including straylight. Visual effects were related to scar characteristics such as size and grade. METHODS: Straylight and best-corrected visual acuity

  7. Customized toric intraocular lens implantation for correction of extreme corneal astigmatism due to corneal scarring

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    R Bassily

    2010-03-01

    Full Text Available R Bassily, J LuckOphthalmology Department, Royal United Hospital, Combe Park, Bath, UKAbstract: A 76-year-old woman presented with decreased visual function due to cataract formation. Twenty-five years prior she developed right sided corneal ulceration that left her with 10.8 diopters (D of irregular astigmatism at 71.8° (steep axis. Her uncorrected visual acuity was 6/24 and could only ever wear a balanced lens due to the high cylindrical error. Cataract surgery was planned with a custom designed toric intraocular lens (IOL with +16.0 D sphere inserted via a wound at the steep axis of corneal astigmatism. Postoperative refraction was -0.75/+1.50 × 177° with a visual acuity of 6/9 that has remained unchanged at six-week follow-up with no IOL rotation. This case demonstrates the value of high power toric IOLs for the correction of pathological corneal astigmatism.Keywords: intraocular lens, corneal ulceration, visual acuity, scarring

  8. Hypocellular scar formation or aberrant fibrosis induced by an intrastromal corneal ring: a case report

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    Ramkumar Hema L

    2011-08-01

    Full Text Available Abstract Introduction Intrastromal corneal rings or segments are approved for the treatment of myopia and astigmatism associated with keratoconus. We describe a clinicopathological case of intrastromal corneal rings. For the first time, the molecular pathological findings of intrastromal corneal rings in the cornea are illustrated. Case presentation A 47-year-old African-American man with a history of keratoconus and failure in using a Rigid Gas Permeable contact lens received an intrastromal corneal ring implant in his left eye. Due to complications, penetrating keratoplasty was performed. The intrastromal corneal ring channels were surrounded by a dense acellular (channel haze and/or hypocellular (acidophilic densification collagen scar and slightly edematous keratocytes. Mild macrophage infiltration was found near the inner aspect of the intrastromal corneal rings. Molecular analyses of the microdissected cells surrounding the intrastromal corneal ring channels and central corneal stroma revealed 10 times lower relative expression of IP-10/CXCL10 mRNA and two times higher CCL5 mRNA in the cells surrounding the intrastromal corneal ring, as compared to the central corneal stroma. IP-10/CXCL10 is a fibrotic and angiostatic chemokine produced by macrophages, endothelial cells and fibroblasts. Conclusion An intrastromal corneal ring implant can induce hypocellular scar formation and mild inflammation, which may result from aberrant release of fibrosis-related chemokines.

  9. Bitoric rigid gas permeable contact lens fitting for the management of a corneal scar caused by herpes zoster ophthalmicus.

    Science.gov (United States)

    de Juan, Victoria; Martín, Raúl; Rodríguez, Guadalupe

    2012-03-01

    Empirical fitting of a bitoric rigid gas permeable contact lens for the management of a scarred irregular cornea caused by herpes zoster ophthalmicus is described. Two corneal scars, which affect the pupil axis, caused an irregular cornea and produced low visual acuity and anisometropia. Two contact lenses were necessary to complete the fitting. Visual acuity improved from 0.2 to 1.0. The rigid gas permeable lenses can be a good alternative in the management of patients with irregular corneas caused by herpes zoster ophthalmicus. © 2011 The Authors. Clinical and Experimental Optometry © 2011 Optometrists Association Australia.

  10. Activation of JNK signaling mediates connective tissue growth factor expression and scar formation in corneal wound healing.

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    Long Shi

    Full Text Available Connective Tissue Growth Factor (CTGF and Transforming growth factor-β1 (TGF-β1 are key growth factors in regulating corneal scarring. Although CTGF was induced by TGF-β1 and mediated many of fibroproliferative effects of TGF-β1, the signaling pathway for CTGF production in corneal scarring remains to be clarified. In the present study, we firstly investigated the effects of c-Jun N-terminal kinase (JNK on CTGF expression induce by TGF-β1 in Telomerase-immortalized human cornea stroma fibroblasts (THSF. Then, we created penetrating corneal wound model and determined the effect of JNK in the pathogenesis of corneal scarring. TGF-β1 activated MAPK pathways in THSF cells. JNK inhibitor significantly inhibited CTGF, fibronectin and collagen I expression induced by TGF-β1 in THSF. In corneal wound healing, the JNK inhibitor significantly inhibited CTGF expression, markedly improved the architecture of corneal stroma and reduced corneal scar formation, but did not have a measurable impact on corneal wound healing in vivo. Our results indicate that JNK mediates the expression of CTGF and corneal scarring in corneal wound healing, and might be considered as specific targets of drug therapy for corneal scarring.

  11. Control of Scar Tissue Formation in the Cornea: Strategies in Clinical and Corneal Tissue Engineering

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    Samantha L. Wilson

    2012-09-01

    Full Text Available Corneal structure is highly organized and unified in architecture with structural and functional integration which mediates transparency and vision. Disease and injury are the second most common cause of blindness affecting over 10 million people worldwide. Ninety percent of blindness is permanent due to scarring and vascularization. Scarring caused via fibrotic cellular responses, heals the tissue, but fails to restore transparency. Controlling keratocyte activation and differentiation are key for the inhibition and prevention of fibrosis. Ophthalmic surgery techniques are continually developing to preserve and restore vision but corneal regression and scarring are often detrimental side effects and long term continuous follow up studies are lacking or discouraging. Appropriate corneal models may lead to a reduced need for corneal transplantation as presently there are insufficient numbers or suitable tissue to meet demand. Synthetic optical materials are under development for keratoprothesis although clinical use is limited due to implantation complications and high rejection rates. Tissue engineered corneas offer an alternative which more closely mimic the morphological, physiological and biomechanical properties of native corneas. However, replication of the native collagen fiber organization and retaining the phenotype of stromal cells which prevent scar-like tissue formation remains a challenge. Careful manipulation of culture environments are under investigation to determine a suitable environment that simulates native ECM organization and stimulates keratocyte migration and generation.

  12. Control of Scar Tissue Formation in the Cornea: Strategies in Clinical and Corneal Tissue Engineering

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    Wilson, Samantha L.; El Haj, Alicia J.; Yang, Ying

    2012-01-01

    Corneal structure is highly organized and unified in architecture with structural and functional integration which mediates transparency and vision. Disease and injury are the second most common cause of blindness affecting over 10 million people worldwide. Ninety percent of blindness is permanent due to scarring and vascularization. Scarring caused via fibrotic cellular responses, heals the tissue, but fails to restore transparency. Controlling keratocyte activation and differentiation are key for the inhibition and prevention of fibrosis. Ophthalmic surgery techniques are continually developing to preserve and restore vision but corneal regression and scarring are often detrimental side effects and long term continuous follow up studies are lacking or discouraging. Appropriate corneal models may lead to a reduced need for corneal transplantation as presently there are insufficient numbers or suitable tissue to meet demand. Synthetic optical materials are under development for keratoprothesis although clinical use is limited due to implantation complications and high rejection rates. Tissue engineered corneas offer an alternative which more closely mimic the morphological, physiological and biomechanical properties of native corneas. However, replication of the native collagen fiber organization and retaining the phenotype of stromal cells which prevent scar-like tissue formation remains a challenge. Careful manipulation of culture environments are under investigation to determine a suitable environment that simulates native ECM organization and stimulates keratocyte migration and generation. PMID:24955637

  13. Pirfenidone nanoparticles improve corneal wound healing and prevent scarring following alkali burn.

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    Sushovan Chowdhury

    Full Text Available To evaluate the effects of pirfenidone nanoparticles on corneal re-epithelialization and scarring, major clinical challenges after alkali burn.Effect of pirfenidone on collagen I and α-smooth muscle actin (α-SMA synthesis by TGFβ induced primary corneal fibroblast cells was evaluated by immunoblotting and immunocytochemistry. Pirfenidone loaded poly (lactide-co-glycolide (PLGA nanoparticles were prepared, characterized and their cellular entry was examined in primary corneal fibroblast cells by fluorescence microscopy. Alkali burn was induced in one eye of Sprague Dawley rats followed by daily topical treatment with free pirfenidone, pirfenidone nanoparticles or vehicle. Corneal re-epithelialization was assessed daily by flourescein dye test; absence of stained area indicated complete re-epithelialization and the time for complete re-epithelialization was determined. Corneal haze was assessed daily for 7 days under slit lamp microscope and graded using a standard method. After 7 days, collagen I deposition in the superficial layer of cornea was examined by immunohistochemistry.Pirfenidone prevented (P<0.05 increase in TGF β induced collagen I and α-SMA synthesis by corneal fibroblasts in a dose dependent manner. Pirfenidone could be loaded successfully within PLGA nanoparticles, which entered the corneal fibroblasts within 5 minutes. Pirfenidone nanoparticles but not free pirfenidone significantly (P<0.05 reduced collagen I level, corneal haze and the time for corneal re-epithelialization following alkali burn.Pirfenidone decreases collagen synthesis and prevents myofibroblast formation. Pirfenidone nanoparticles improve corneal wound healing and prevent fibrosis. Pirfenidone nanoparticles are of potential value in treating corneal chemical burns and other corneal fibrotic diseases.

  14. Implantable collamer lens for correction of ametropia in eyes with corneal scarring.

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    Ruiz-Rizaldos, A I; Baviera-Sabater, J; Ortega-Usobiaga, J

    2017-05-01

    Two cases are reported in which implantation of a collagen copolymer phakic intraocular lens (implantable collamer lens) corrected refractive errors in eyes with corneal scarring. A previous accident, in both cases, resulted in a central linear scar on the surface of the cornea of one eye. In the first patient, a corneal scar was visible in the left eye. The distance corrected visual acuity was 0.3 (-7.75 -4×160°). An uncorrected distance visual acuity of 0.25 was obtained by implanting an implantable collamer lens. In the second patient an oblique corneal scar was visible in the right eye. The distance corrected visual acuity was 0.25 (-8.75 -1.25×8°), and after implantation of the implantable collamer lens, uncorrected distance visual acuity was 0.25. The indications of the implantable collamer lens should be reviewed and possibly expanded. Copyright © 2016 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Ipsilateral rotational autokeratoplasty for central corneal scar: An alternative to penetrating keratoplasty.

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    Tsao, Wei-Shan; Lee, Yuan-Chieh

    2016-01-01

    A 49-year-old woman was referred to our clinic for penetrating keratoplasty. A central corneal scar involving the visual axis with high irregular astigmatism up to 15.8 D was noted. Because the scar was located mostly in the central cornea, ipsilateral rotational autokeratoplasty was suggested and performed. An 8.5-mm punch was used to trephine the cornea eccentrically and superiorly intentionally. The trephined corneal button was then rotated 150° to relocate the scar to the temporal upper part of the cornea. The graft was soon clear with a normal curvature centrally. The astigmatism was -0.5 D, the visual acuity was 20/40, and the endothelial cell loss was 2.66% 2 years after the operation. A rotational autograft carries no risk of immunological complications such as rejection associated with allografts and has lower endothelial cell loss rate. It can be an effective alternative to standard penetrating keratoplasty for some patients with central corneal scars.

  16. Rotational autokeratoplasty in pediatric patients for nonprogressive paracentral corneal scars.

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    Ramappa, Muralidhar; Pehere, Niranjan K; Murthy, Somasheila I; Chaurasia, Sunita; Rao, Harsha L; Sangwan, Virender S

    2012-12-01

    To report the outcomes of ipsilateral rotational autokeratoplasty (RAK) for nonprogressive paracentral corneal opacities in children Rotational is a autokeratoplasty viable alternative surgical option to allogenic keratoplasty. Graft survival at 2 years seems to be better than allogenic keratoplasty. Younger age and delay in presentation contribute to poorer visual outcomes after surgery. The authors have no proprietary or commercial interest in any of the materials discussed in this article. Copyright © 2012 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  17. Experimental assessment of corneal anisotropy.

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    Elsheikh, Ahmed; Brown, Michael; Alhasso, Daad; Rama, Paolo; Campanelli, Marino; Garway-Heath, David

    2008-02-01

    To determine the variation of corneal biomechanical properties with anatomical orientation. Strip specimens extracted from fresh porcine corneas were tested under uniaxial tension with strain rates representing static and dynamic loading conditions. The specimens were extracted from the vertical, horizontal, and 45 degrees diagonal directions. The load elongation results were used to derive the stress-strain behavior of each specimen. The average behavior for specimens taken in each anatomical direction was determined along with the effect of strain rate. Specimens from a small number of human corneas were included in the study to verify the findings. Specimens extracted from the vertical direction of porcine and human corneas demonstrated the highest strength (fracture stress) followed by horizontal then diagonal specimens. Vertical specimens were 10% to 20% stronger than horizontal specimens in porcine and human corneas. At low strain rates (1%/min), vertical specimens displayed similar stiffness (resistance to deformation) to horizontal specimens but greater stiffness than diagonal specimens. On increasing the strain rate to 500%/min, the stiffness behavior matched that of strength with vertical specimens being 10% to 20% stiffer than horizontal specimens in porcine and human corneas. The corneal anisotropic behavior is compatible with the preferential orientation of stromal fibrils in the vertical and horizontal directions. Quantifying the effect of this nonuniform fibril organization on corneal anisotropic behavior will be useful in developing numerical models of the cornea for applications where its integrity is compromised such as in simulating refractive surgery procedures.

  18. Deep anterior lamellar keratoplasty using big-bubble technique for treatment of corneal stromal scars.

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    Arslan, Osman Sevki; Ünal, Mustafa; Tuncer, Ibrahim; Yücel, Iclal

    2011-06-01

    To report the clinical outcomes of deep anterior lamellar keratoplasty (DALK) in patients with anterior corneal stromal scars associated with various etiologies. A total of 79 eyes of 79 patients with corneal stromal scars sparing the Descemet membrane and the endothelium underwent DALK by using big-bubble technique. The main outcome measures of the study were the ability to successfully complete DALK, intraoperative and postoperative complications, best spectacle-corrected visual acuity, refraction, and graft clarity. Seventy-two of the surgical procedures were carried out as DALK, and the mean follow-up time was 28.1 ± 17.9 months (range, 12-78 months). The most frequent indication for DALK surgery was postherpetic keratitis (44%). Complete Descemet membrane exposure via big bubble (descemetic DALK) could be achieved in 57 cases (79%). Fifteen eyes (21%) required layer-by-layer manual dissection (predescemetic DALK). Best spectacle-corrected visual acuity of 6/12 or better was present in 59 eyes (82%) postoperatively. The mean spherical equivalent and topographic astigmatism were -3.32 ± 2.13 (range, -9.13 to +4.75) and -2.97 ± 1.94 (range, -8.0 to +4.50) diopter, respectively. There were 2 instances of stromal graft rejection, which responded to medical therapy. DALK big-bubble technique may be a valuable and safe treatment in patients with corneal stromal scar with healthy endothelium. The visual and refractive outcomes are comparable to standard penetrating keratoplasty, avoiding the risk of endothelial rejection.

  19. Mitigating Scarring and Inflammation during Corneal Wound Healing using Nanofiber-Hydrogel Scaffolds

    Science.gov (United States)

    Fu, Amy

    Due to the universal lack of donor tissue, there has been emerging interest in engineering materials to stimulate living cells to restore the features and functions of injured organs. We are particularly interested in developing materials for corneal use, where the necessity to maintain the tissue's transparency presents an additional challenge. Every year, there are 1.5 -- 2 million new cases of monocular blindness due to irregular healing of corneal injuries, dwarfing the approximately 150,000 corneal transplants performed. The large gap between the need and availability of cornea transplantation motivates us to develop a wound-healing scaffold that can prevent corneal blindness. To develop such a scaffold, it is necessary to regulate the cells responsible for repairing the damaged cornea, namely myofibroblasts, which are responsible for the disordered and non-refractive index matched scar that leads to corneal blindness. Using in vitro assays, we identified that protein nanofibers of certain orientation can promote cell migration and modulate the myofibroblast phenotype. The nanofibers are also transparent, easy to handle and non-cytotoxic. To adhere the nanofibers to a wound bed, we examined the use of two different in situ forming hydrogels: an artificial extracellular matrix protein (aECM)-based gel and a photo-crosslinkable heparin-based gel. Both hydrogels can be formed within minutes, are transparent upon gelation and are easily tunable. Using an in vivo mouse model for epithelial defects, we show that our corneal scaffolds (nanofibers together with hydrogel) are well-tolerated (no inflammatory response or turbidity) and support epithelium regrowth. We developed an ex vivo corneal tissue culture model where corneas that are wounded and treated with our scaffold can be cultured while retaining their ability to repair wounds for up to 21 days. Using this technique, we found that the aECM-based treatment induced a more favorable wound response than the

  20. Experimental assessment of human corneal hysteresis.

    Science.gov (United States)

    Elsheikh, Ahmed; Wang, Defu; Rama, Paolo; Campanelli, Marino; Garway-Heath, David

    2008-03-01

    Hysteresis is a viscoelastic property characterized by the difference in behavior under loading and unloading. The aim of the study was to determine corneal hysteresis using experimental means. Twenty-nine human corneas with 50-95 year age were subjected to cycles of pressure loading and unloading. Two pressure application rates were adopted to approximate static and dynamic loading conditions. The behavior under both loading and unloading was found to stiffen with increased age. The unloading behavior appeared to be largely independent of the pressure level at which unloading started. The difference between the behavior patterns under loading and unloading was quantified and used as a measure of corneal hysteresis. The hysteresis area was significantly larger with faster loading and with decreased age. The trend for hysteresis to decrease with age is in agreement with previous clinical observations. Hysteresis was also found to increase with faster pressure application.

  1. [Corneal wound healing after penetrating keratoplasty with EGF application. Experimental studies].

    Science.gov (United States)

    Szaflik, J; Fryczkowski, A W; Liberek, I; Czubak, M; Brix, M; Broniek, G; Fryczkowski, P

    1999-01-01

    To check post penetrating keratoplasty (PK) corneal wound healing characteristics after epidermal growth factor (EGF) application and to compare it with controls. The PK was performed in the group of 72 young, healthy New Zealand rabbits (36 females and 36 males). Slit-lamp examination, tonometry and corneal topography by Tomey's corneal modeling system (TMS-1) were carried out before and after surgery. The PK was performed in both eyes. Half of animals were used as a bilateral donor for the other half, with a rule: right eye cornea to the right eye and left eye cornea to the left eye. As a result, after completed surgery 36 rabbits had bilateral grafts. The animals were divided into 3 equal groups (12 in each). Two drops of the human recombined EGF dissolved in the saline solution with concentration varied from 500 to 1500 ng in each drop were applied to the right eye according to schedule. The left eye was used as a control and did not receive EGF. Time of observation varied from 24 hours to 6 months. The tensinometry and the histopathologic study--light and electron microscopy were performed to determine corneal scarring. The wound healing pattern after PK was characteristic and constant in each group. The corneal wound healing significantly accelerated in the EGF treated group of rabbits compared with the controls (p times/day, after two weeks of application we noted increase of the wound strength up to 600 folds, comparing with controls. Well-organized scar was histologically seen on the 21st post-surgery day. The post-operative corneal astigmatism was less expressed in the eyes treated with EGF comparing to controls. These preliminary results of our experimental study indicated accelerated effect on the corneal wound healing after PK with topical, low dose hrEGF application. Clinical observation of utilization of similar low doses of the hrEGF after PK--is in progress.

  2. Scars

    Science.gov (United States)

    ... never go away completely. If the way a scar looks bothers you, various treatments might minimize it. These include surgical revision, dermabrasion, laser treatments, injections, chemical peels, and creams.

  3. Allograft Reaction After Latanoprost use Following Penetrating Keratoplasty for Corneal Scarring due to Herpetic Keratitis

    Directory of Open Access Journals (Sweden)

    Tahir Kansu Bozkurt

    2012-03-01

    Full Text Available A 27-year-old male patient with a corneal scar secondary to herpetic keratitis in the right eye underwent penetrating keratoplasty (PK. At the 14th month of follow-up, latanoprost was started to treat high intraocular pressure which was refractory to treatment. On the 15th day of latanoprost use, allograft reaction (AR developed. Insufficient clinical response despite intensive immunosuppressive therapy made us consider the possibility of recurrent herpetic keratouveitis secondary to steroid treatment. The dramatic reduction in the number of keratic precipitates with oral valacyclovir treatment confirmed this diagnosis. The graft remained clear 3 months after the AR treatment. Inflammation in eyes that had undergone PK jeopardizes the graft success by disrupting the immune privilege of anterior chamber. Considering the effects of prostaglandin analogues on blood-aqueous barrier, latanoprost use might have been related to allograft reaction in this case. Another remarkable characteristics of this case was the herpes simplex virus (HSV reactivation secondary to AR therapy. For this reason, oral acyclovir prophylaxis together with AR therapy would improve graft success in cases with HSV history. (Turk J Oph thal mol 2012; 42: 150-3

  4. Corneal Laceration

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    Full Text Available ... or apply pressure to eye avoid giving aspirin, ibuprofen or other non-steroidal, anti-inflammatory drugs. These ... lost sight from a corneal scar as a child. Now that I’m older, will a corneal ...

  5. Corneal Laceration

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    Full Text Available ... rub or apply pressure to eye avoid giving aspirin, ibuprofen or other non-steroidal, anti-inflammatory drugs. ... lost sight from a corneal scar as a child. Now that I’m older, will a corneal ...

  6. Effect of DATS on experimental corneal neovascularization induced by corneal suture in rats cornea

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    Xiao-Jun Zhou

    2017-11-01

    Full Text Available AIM: To study the effect of diallyl trisulfide(DATSon experimental corneal neovascularization(CNVin rats induced by corneal suture and detect the expression of vascular endothelial growth factor(VEGFand p-AKT in rats cornea. METHODS: The rat model of corneal neovascularization(CNVwas induced by corneal suture. Rats were randomly divided into Group A: physiological saline control group containing DMSO(10 rats; Group B: 25μmol/L DATS treatment group(10 rats; Group C: 50μmol/L DATS treatment group(10 rats; Group D: 100μmol/L DATS treatment group(10 rats; Group E: 200μmol/L DATS treatment group(10 rats. The occurrence and development of CNV were observed by slit-lamp microscope at 7d after suture, and the area of CNV were calculated.Two weeks later, HE staining was used to observe the pathological organization form of each cornea, and RT-PCR and Western blot were used to detect the expression of VEGF mRNA and protein expression of VEGF and p-AKT between each groups. RESULTS: The blood vessel area of Group C, D and E was compared with that of Group A, the difference was statistically significant(PPPCONCLUSION: DATS can inhibit corneal neovascularization of the rats induced by suture. Its mechanism may be associated with suppression of VEGF secretion, down-regulation of VEGF and inactivation of p-AKT.

  7. Neovascular growth in an experimental alkali corneal burn model.

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    Figueroa-Ortiz, L C; Martín Rodríguez, O; García-Ben, A; García-Campos, J

    2014-08-01

    To analyse the length and area of corneal surface occupied by vessels, and their location in an experimental model of alkali burn-induced corneal neovascularization. An injury to the central cornea of the right eye in 91 Sprague-Dawley rats was induced using a silver nitrate pencil. The rats were divided in 7 groups that were sacrificed 2, 4, 6, 8, 10, 12 and 14 days post-injury, and then perfused with a mixture of Chinese ink in PBS -phosphate buffer saline-. Corneas were flat-mounted processed and divided in 4 quadrants. Corneal neovascular growth parameters (length and area) and the location of these vessels were performed blind. The results were statistically analysed. Neovascular growth was observed from day 2, reaching its maximum peak in length and area on the 12th day post-injury. A slight reduction in corneal neovascularization was observed after this day. The vessels were initially located in the middle third of the stroma and tended to be observed in the anterior third during the course of the experiment. Neovascularisation was observed on day 2 post-injury in all sectors of corneal surface. Neovascular growth was uniform during the experiment. Neovessels were located in the middle and anterior third of the cornea. Copyright © 2012 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  8. Ipsilateral rotational autokeratoplasty: an alternative to penetrating keratoplasty in nonprogressive central corneal scars.

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    Murthy, S; Bansal, A K; Sridhar, M S; Rao, G N

    2001-07-01

    To report the outcome of ipsilateral rotational autokeratoplasty performed for nonprogressive central corneal opacities. Medical records of 27 patients who underwent ipsilateral rotational autokeratoplasty between June 1995 and December 1998 were retrospectively reviewed. The etiology of corneal opacity, preoperative visual acuity, and size of the trephine used was noted. Any intraoperative and early and late postoperative complications were noted in all patients. The final outcome, visual acuity, and astigmatism at final correction were analyzed. The main etiology of corneal opacity was trauma (44.4%), followed by resolved keratitis (29.6%). The size of the graft ranged from 6.5 to 9 mm. Fifteen patients underwent autokeratoplasty alone; additional procedures were combined in the remaining 12. Wound leak was the most common postoperative complication, which was seen in seven patients. The mean follow-up was 12.11 months (SD = 11.95 months). Five patients (18.5%) were lost to follow-up. Of the remaining 22, 19 (86.36%) had clear grafts and 3 (13.6%) had failed grafts. The mean astigmatism at final correction was 4.25 diopters cylinder (SD = 2.72). Final visual acuity of 20/80 or better was obtained in 13 cases (59.09%). Contrary to common belief, ipsilateral rotational autokeratoplasty is a safe and effective surgical procedure. It can be considered as an alternative procedure to penetrating keratoplasty in a scenario in which tissue scarcity exists, as well as in cases that have a high risk of developing immunologic allograft rejection. Further prospective studies with preoperative specular microscopy and postoperative corneal topography will provide greater insight into the usefulness of this procedure.

  9. Effects of new biomimetic regenerating agents on corneal wound healing in an experimental model of post-surgical corneal ulcers.

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    Alcalde, I; Íñigo-Portugués, A; Carreño, N; Riestra, A C; Merayo-Lloves, J M

    2015-10-01

    The purpose of this study is to assess the effectiveness of the topical application of cacicol regenerating agent (RGTA) in an experimental model of corneal ulcer after photorefractive keratectomy (PRK) in mice. Mice were subjected to PRK surgery with a 2.0mm ablation zone on the central cornea and 45mm of depth on a VISX Star S2 excimer laser. Corneas were treated topically with cacicol drops 1hour and 48hours after injury. Control groups received balanced salt solution (BSS) in the same dosage. Clinical and histopathological events were evaluated at 1, 2, 3 and 7 days after surgery. Sections obtained through the central region of the corneas were used to analyze the histopathological events of injured and healed corneas. αSMA (myofibroblast transformation), E cadherin (assembly of epithelial cells) and neuronal class III β-tubulin (innervation) were performed. Corneas treated topically with cacicol for 7 days showed a greater degree of transparency compared to controls. cacicol treated corneas showed improved epithelial cytoarchitecture. Analysis of αSMA profiles in the stroma showed that cacicol reduced or delayed the presence of myofibroblasts in the stroma compared to BSS (P<0.001). Finally, a putative neuroregenerative effect of cacicol was found in corneas subjected to an experimental PRK lesion. In some cases some interindividual variability could be observed due to the design of the experimental model. This is a limitation to consider, despite the statistical significance of the data. In a model of laser induced surgical lesions in the cornea, topical application of an RGTA (i.e. cacicol) could be involved in avoiding myofibroblast scarring formation and promoting nerve regeneration. Copyright © 2014 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  10. [Experimental research of correlation between anatomy structure of rabbit ear and creating hypertrophic scar animal model].

    Science.gov (United States)

    Zhu, Gui-Ying; Xu, Bin; Cai, Jing-Long

    2008-05-01

    To observe the anatomy structure of rabbit ear and the effect of different operation methods and post-operative treatments on the formation of hypertrophic scar. The experimental animals were 25 New Zealand white rabbits. 6 pieces of full skin specimens were obtained from each of the ears in 5 rabbits for histological examination. 6 full-thickness skin wounds (d = 8 mm) were made on different sites of ventral side of each ear in the other 20 rabbits. The total number of the wounds was 240. 120 wounds in 10 rabbits were divided into 4 groups randomly to receive different treatments on day 7 postoperatively. No treatment was performed in the other 120 wounds. The wounds healing and the scar formation were observed for six months. The scars were harvested 4 weeks and 8 weeks after operation for pathologic examination and measurement of scar elevation index (SEI). Histological analysis showed that the anatomy structure was different in different sites of the rabbit ear. The best sites for creating hypertrophic scar model were on the medial margin of the middle- and inferior part of ear. The depth of the wound should reach the cartilage membrane of the ear to facilitate the formation of hypertrophic scar. The second strip crust on day 7 postoperatively enhanced the wounds healing and minimized the scar proliferation and hypertrophy. There is a close correlation between the anatomy structure of the ear and the creation of hypertrophic scar animal model. The wound site, the depth of wound and the post-operative treatment will affect the formation of hypertrophic scar. The study can help to improve the successful rate of creating hypertrophic scar animal model.

  11. Corneal Laceration

    Medline Plus

    Full Text Available ... Answers How often and for how long should I use a hair dryer to treat my Fuchs’ dystrophy? May 06, 2017 I lost sight from a corneal scar as a child. Now that I’m older, will a corneal transplant help me? ...

  12. Cytokine mRNA expression during experimental corneal allograft rejection

    NARCIS (Netherlands)

    Torres, P. F.; de Vos, A. F.; van der Gaag, R.; Martins, B.; Kijlstra, A.

    1996-01-01

    Allograft rejection is the main cause of corneal graft failure. T lymphocytes and macrophages have been implied to be involved in corneal rejection, but little is known about the molecular mechanism in this process. In this study, cytokine mRNA expression in the cornea was analysed during

  13. Descemet's stripping automated endothelial keratoplasty (DSAEK) using corneal donor tissue not acceptable for use in penetrating keratoplasty as a result of anterior stromal scars, pterygia, and previous corneal refractive surgical procedures.

    Science.gov (United States)

    Phillips, Paul M; Terry, Mark A; Shamie, Neda; Chen, Edwin S; Hoar, Karen L; Stoeger, Chris; Friend, Daniel J; Saad, Hisham A

    2009-09-01

    The purpose of this study was to evaluate outcomes of Descemet's stripping automated endothelial keratoplasty (DSAEK) using anterior stromal flawed (ASF) donor corneas that were unsuitable for use in full-thickness penetrating keratoplasty as a result of stromal scars, pterygia, or previous corneal refractive surgery and to compare results with DSAEK using standard tissue. We conducted a review of our initial 42 (19 with 6-month follow up) consecutive DSAEK surgeries using ASF tissue compared with 357 (199 with 6-month follow up) time-matched controls using standard tissue. Intraoperative and perioperative complications, including dislocations and primary graft failures, were compared. Six-month best spectacle-corrected vision, incidence of rejection episodes, postoperative refractive astigmatism, keratometric values, pre- and postoperative topography-derived surface asymmetry index, and surface regularity index were compared. One surgeon-cut ASF tissue was perforated before surgery and was discarded. No surgeon-cut standard tissue was perforated. No intraoperative complications and no episodes of primary graft failure or pupillary block glaucoma occurred in either group. One (2.4%) postoperative graft dislocation and one (5.2%) graft rejection episode occurred in the study group. There were 10 (2.8%) dislocations and 8 (2.2%) graft rejection in the controls. A statistically similar significant improvement in best spectacle-corrected vision occurred in both groups. Corneal topography, pachymetry, and manifest astigmatism were not significantly different between groups. Postoperative results of DSAEK using donor tissue excluded from use in penetrating keratoplasty as a result of stromal flaws are equivalent to results using standard donor tissue. Central corneal thickness measurements should be performed before cutting to avoid tissue perforation. The use of ASF tissue for DSAEK will expand the cornea donor pool.

  14. Experimental circular keratotomy for correction of corneal astigmatism

    NARCIS (Netherlands)

    Wijdh, RH; van Rij, G

    1998-01-01

    PURPOSE: To investigate the effect of circular keratotomy depth and diameter on corneal astigmatism. METHODS: High astigmatism was induced in 25 human donor eyes by an anterior radial 7-0 silk suture across the corneoscleral limbus. With a 6.0, 6.5, 7.0, or 7.5 mm trephine, a 0.3 mm deep circular

  15. Apatinib-loaded nanoparticles suppress vascular endothelial growth factor-induced angiogenesis and experimental corneal neovascularization.

    Science.gov (United States)

    Lee, Jung Eun; Kim, Koung Li; Kim, Danbi; Yeo, Yeongju; Han, Hyounkoo; Kim, Myung Goo; Kim, Sun Hwa; Kim, Hyuncheol; Jeong, Ji Hoon; Suh, Wonhee

    2017-01-01

    Pathological angiogenesis is one of the major symptoms of severe ocular diseases, including corneal neovascularization. The blockade of vascular endothelial growth factor (VEGF) action has been recognized as an efficient strategy for treating corneal neovascularization. In this study, we aimed to investigate whether nanoparticle-based delivery of apatinib, a novel and selective inhibitor of VEGF receptor 2, inhibits VEGF-mediated angiogenesis and suppresses experimental corneal neovascularization. Water-insoluble apatinib was encapsulated in nanoparticles composed of human serum albumin (HSA)-conjugated polyethylene glycol (PEG). In vitro angiogenesis assays showed that apatinib-loaded HSA-PEG (Apa-HSA-PEG) nanoparticles potently inhibited VEGF-induced tube formation, scratch wounding migration, and proliferation of human endothelial cells. In a rat model of alkali burn injury-induced corneal neovascularization, a subconjunctival injection of Apa-HSA-PEG nanoparticles induced a significant decrease in neovascularization compared to that observed with an injection of free apatinib solution or phosphate-buffered saline. An in vivo distribution study using HSA-PEG nanoparticles loaded with fluorescent hydrophobic model drugs revealed the presence of a substantial number of nanoparticles in the corneal stroma within 24 h after injection. These in vitro and in vivo results demonstrate that apatinib-loaded nanoparticles may be promising for the prevention and treatment of corneal neovascularization-related ocular disorders.

  16. The impact of subconjuctivally injected EGF and VEGF inhibitors on experimental corneal neovascularization in rat model.

    Science.gov (United States)

    Sener, Ender; Yuksel, Nusen; Yildiz, Demir Kursat; Yilmaz, Bulent; Ozdemir, Ozdemir; Caglar, Yusuf; Degirmenci, Esra

    2011-11-01

    To investigate the inhibitory effect of subconjunctival application of VEGF antibodies bevacizumab, ranibizumab, pegaptanib, and HER2 antibody trastuzumab on corneal neovascularization in a rat model of experimental corneal neovascularization. Thirty male Wistar albino rats were included in the study. A chemical burn was induced in central cornea of one eye of the rats by a 75% silver nitrate and 25% potassium nitrate stick. Rats were randomly divided into five groups so that each group contained 6 subjects. Right after the chemical burn, 0.1 ml serum physiologic was injected subconjuctivally in control group (group 1). 1.25 mg/0.05 ml bevacizumab was injected in group 2; 1.2 mg/0.1 ml trastuzumab was injected in group 3; 0.5 mg/0.05 ml ranibizumab was injected in group-4; and 0.3 mg/0.1 ml pegaptanib was injected in group 5. On the 8th day of the experiment, rat corneas were photographed by digital photo-camera. Later, eyes of the sacrificed rats were enucleated and corneal speciements were histopathologically analyzed. The percentages of neovascularization on corneal photographs were examined with digital image analysis. The percentage of corneal neovascularization in all treatment groups was found to be significantly lower than the control group (p  0.05). In all treatment groups, fibroblast intensity was significantly lower than the control group. In terms of corneal thickness, no significant difference was observed between treatment and control groups (p > 0.05). Bevacizumab, ranibizumab, pegaptanib, and trastuzumab were found effective for the inhibition of corneal NV. In our study we detected that the most effective agent was bevacizumab.

  17. Designing a SCAR molecular marker for monitoring Trichoderma cf. harzianum in experimental communities* #

    Science.gov (United States)

    Pérez, Gabriel; Verdejo, Valentina; Gondim-Porto, Clarissa; Orlando, Julieta; Carú, Margarita

    2014-01-01

    Several species of the fungal genus Trichoderma establish biological interactions with various micro- and macro-organisms. Some of these interactions are relevant in ecological terms and in biotechnological applications, such as biocontrol, where Trichoderma could be considered as an invasive species that colonizes a recipient community. The success of this invasion depends on multiple factors, which can be assayed using experimental communities as study models. Therefore, the aim of this work is to develop a species-specific sequence-characterized amplified region (SCAR) marker to monitor the colonization and growth of T. cf. harzianum when it invades experimental communities. For this study, 16 randomly amplified polymorphic DNA (RAPD) primers of 10-mer were used to generate polymorphic patterns, one of which generated a band present only in strains of T. cf. harzianum. This band was cloned, sequenced, and five primers of 20–23 mer were designed. Primer pairs 2F2/2R2 and 2F2/2R3 successfully and specifically amplified fragments of 278 and 448 bp from the T. cf. harzianum BpT10a strain DNA, respectively. Both primer pairs were also tested against the DNA from 14 strains of T. cf. harzianum and several strains of different fungal genera as specificity controls. Only the DNA from the strains of T. cf. harzianum was successfully amplified. Moreover, primer pair 2F2/2R2 was assessed by quantitative real-time polymerase chain reaction (PCR) using fungal DNA mixtures and DNA extracted from fungal experimental communities as templates. T. cf. harzianum was detectable even when as few as 100 copies of the SCAR marker were available or even when its population represented only 0.1% of the whole community. PMID:25367789

  18. A review of corneal melting following kerato-refractive surgery.

    Science.gov (United States)

    Hodge, Christopher; Chan, Colin; Bali, Shveta Jindal; Sutton, Gerard

    2013-01-01

    Corneal melting is a rare complication that may occur following a number of different types of surgery. Keratolysis may lead to scarring, irregular astigmatism, photophobia and decreased vision. This article reviews the incidence, pathophysiology and treatment of this condition in kerato-refractive surgery. © 2012 The Authors; Clinical and Experimental Optometry © 2012 Optometrists Association Australia.

  19. Induction of corneal epithelium-like cells from cynomolgus monkey embryonic stem cells and their experimental transplantation to damaged cornea.

    Science.gov (United States)

    Kumagai, Yuta; Kurokawa, Manae S; Ueno, Hiroki; Kayama, Maki; Tsubota, Kazuo; Nakatsuji, Norio; Kondo, Yasushi; Ueno, Satoki; Suzuki, Noboru

    2010-04-01

    We previously reported the successful transplantation of corneal epithelium-like cells derived from mouse embryonic stem (ES) cells onto injured mouse cornea. Here, we tested whether nonhuman primate ES cells have ability to differentiate into corneal epithelial cells and whether monkey ES cell-derived corneal epithelium-like cells were applicable for the experimental transplantation to damaged cornea. Monkey ES cells were cultivated on type IV collagen-coated dishes for various days to induce differentiation into corneal epithelium-like cells. The differentiation was evaluated by reverse transcription-polymerase chain reaction and immunostaining. The corneal epithelium-like cells were transplanted to the injured mouse cornea. Reconstitution of the corneal epithelium was evaluated by immunostaining. The cells cultured on type IV collagen showed cobblestone-like appearance resembling epithelial cells. They expressed messenger RNA of pax6, p63, E-cadherin, CD44, proliferating cell nuclear antigen, keratin 3, and keratin 12. Protein expressions of pax6, keratin 3/12, p63, proliferating cell nuclear antigen, E-cadherin, and CD44 were confirmed by immunostaining. When the corneal epithelium-like cells were transplanted, they adhered to the corneal stroma, leading to formation of multiple cell layers. The grafted cells were stained with anti-human nuclear protein antibody, which cross-reacted with nuclei of monkey cells but not with those of mouse cells. They retained the expressions of keratin 3/12, E-cadherin, and CD44. We induced corneal epithelium-like cells from monkey ES cells with moderate efficiency. The cells were successfully transplanted onto the injured mouse cornea. This is the first demonstration that nonhuman primate ES cells were induced to differentiate into corneal epithelium-like cells, which were applicable for transplantation to an animal model of corneal injury.

  20. Research progress of corneal transplantation

    OpenAIRE

    Bing-Jie Zhang; Heng Sun; Yuan-Ping Zhang; Lin-Kun Ma

    2015-01-01

    Corneal transplantation is an ophthalmology treatment technique for corneal disease to help restore vision or control the development of corneal diseases by removing a scarred or damaged host cornea and replacing it with a clear and healthy donor cornea. Traditional corneal transplantation includes penetrating keratoplasty and lamellar keratoplasty. In recent ten years, deep lamellar keratoplasty and endothelial keratoplasty have gradually developed. At present, the development of keratoprost...

  1. Corneal transplantation in children.

    Science.gov (United States)

    Gabrić, N; Dekaris, I; Vojniković, B; Karaman, Z; Mravicić, I; Katusić, J

    2001-01-01

    The main purpose of the study was to describe the surgical success rate and visual results of penetrating keratoplasty in children. This retrospective study included children that underwent corneal transplantation at the Department of Ophthalmology, General Hospital "Sveti Duh", in the period 1994-1999. Patients' age ranged from 6 to 16 years. Twenty-five corneal transplants were performed in 24 eyes. Corneal pathologies were corneal leucoma, congenital dystrophy, corneal combustion, corneal scar after perforating injury, keratoconus, corneal melting, hematocornea and rekeratoplasty. The follow-up period was at least 6 months. The rate of graft survival was 1 year in 75% of eyes with congenital dystrophy and keratoconus. Hematocornea and rekeratoplasty ended with graft failure. Postoperative visual acuity improvement was recorded in 14 out of 25 eyes. Penetrating keratoplasty in children showed very good surgical success. The final visual outcome was affected by irreversible amblyopia.

  2. Effects of Honghua preserved amniotic membrane on scar healing in experimental glaucoma surgery

    Directory of Open Access Journals (Sweden)

    Yi Shao

    2014-04-01

    Full Text Available AIM: To investigate the efficacy and safety of Honghua preserved amniotic membrane (AM for preventing scar formation of the filtering bleb in a rabbit model of glaucoma trabeculectomy surgery.METHODS: Totally 36 rabbits (36 eyes were randomly divided into 3 groups:the experimental group (ocular trabeculectomy in combination with Honghua preserved AM transplantation, the control group (ocular trabeculectomy surgery in combination with AM implantation, and the blank group (single trabeculectomy. Clinical observations [including intraocular pressure (IOP, filtering blebs and complications], Masson-Trichrome staining, real-time quantitative reverse transcription-polymerase chain reaction (real-time PCR, Western blot were performed on different time points (D1, D7, D14, D21 and D56 after the surgery.RESULTS: After operated for 14d, there were statistically significant differences in the filtering blebs compared to the situation before operation (P<0.05, whereas no statistically difference on that among three groups (P>0.05. After 21d, the IOP of experimental group was lowest (P<0.05. There was significant difference between control group and blank group (P<0.05. On postoperative D14, the mean number of fibroblasts in the experimental group was significantly lower (40.6±10.2 compared to those in the control group (54.4±10.8 and blank group (68.2±11.6 (P<0.05, respectively. The mean numbers of the macrophage in the experimental and control groups were respcitively significantly lower versus the blank group (P<0.05, P<0.05, respectively. Compared to that in blank group, the level of transforming growth factor-β (TGF-β1 expression in sclera and conjunctival areas was reduced in the experimental and control groups on protein and mRNA level (P<0.05, but not significant difference between these two groups (P>0.05.CONCLUSION:The trabeculectory surgery with Honghua preserved AM can control IOP, sustain the functional filtration bleb, inhibit the

  3. VRP09 Reduction of Corneal Scarring Following Blast and Burn Injuries to Cornea Using siRNAs Targeting TGFb and CTGF

    Science.gov (United States)

    2012-10-01

    compare the effectiveness of siRNAs oligonucleotides and AAV -vectored siRNAs in rabbit models of blast and burn corneal injuries for reduction of...next phase of developing an effective antiscarring drug therapy for corneal blast and burn injuries. Starting with in vitro results and by using...particles that we generated with a commercially available kit of biodegradable polymers were tested in vitro using fresh rabbit globes that were

  4. Corneal Laceration

    Medline Plus

    Full Text Available ... What Is Corneal Laceration? Corneal Laceration Symptoms What Causes Corneal Laceration? Corneal Laceration Diagnosis Corneal Laceration Treatment ... the corneal laceration is deep enough it can cause a full thickness laceration. This is when the ...

  5. Corneal Laceration

    Medline Plus

    Full Text Available ... What Is Corneal Laceration? Corneal Laceration Symptoms What Causes Corneal Laceration? Corneal Laceration Diagnosis Corneal Laceration Treatment What Is Corneal Laceration? Leer en Español: ¿Qué ...

  6. Could Pyelonephritic Scarring Be Prevented by Anti-Inflammatory Treatment? An Experimental Model of Acute Pyelonephritis

    Directory of Open Access Journals (Sweden)

    Elif Bahat Özdoğan

    2014-01-01

    Full Text Available Objectives. This study aimed to demonstrate if the addition of anti-inflammatory treatment to antibiotic therapy shows any superiority to the treatment with antibiotic only. Methods. Forty-nine Wistar rats were divided into 7 groups. Pyelonephritis was performed by E. coli injection to upper pole of kidneys except control group. Group 2 was not treated. Ceftriaxone, ketoprofen, “ceftriaxone + ketoprofen,” methylprednisolone, and “ceftriaxone + methylprednisolone” were given in the groups. The technetium-99m-dimercaptosuccinic acid scintigraphies were performed in 3rd day to detect pyelonephritis and 10th week to detect renal scarring. All kidneys were also histopathologically evaluated. Results. When 3rd day and 10th week scintigraphies were compared, initial 2.00 ± 0.30 point pyelonephritis score resulted in 0.71 ± 0.36 renal scar score in “ceftriaxone + ketoprofen” group (P=0.039. Initial 2.00 ± 0.43 point pyelonephritis score resulted in 0.86 ± 0.26 renal scar score in “ceftriaxone + methylprednisolone” group (P=0.041. Renal scar score was declined in “ceftriaxone + ketoprofen” group and “ceftriaxone + methylprednisolone” group compared with no-treatment group on 10th week of the study (P=0.026, P=0.044. On histopathological evaluation, it was seen that renal scar prevalence and expansion declined significantly in “ceftriaxone + ketoprofen and ceftriaxone + methylprednisolone” (P=0.011, P=0.023. Conclusion. It was evidenced that ceftriaxone treatment in combination with ketoprofen or methylprednisolone declined scar formation in scintigraphic and histopathologic examinations of the kidneys.

  7. Pattern of corneal opacity in Ibadan, Nigeria | Ashaye | Annals of ...

    African Journals Online (AJOL)

    Background: The prevalence and causes of corneal blindness vary from one region of the world to another. There is even variation within the developing countries of Africa. Method: A retrospective review of 675 patients with corneal scarring out of the 3,753 new patients corneal scarring in patients attending the eye clinic of ...

  8. The management of cornea blindness from severe corneal scarring, with the Athens Protocol (transepithelial topography-guided PRK therapeutic remodeling, combined with same-day, collagen cross-linking

    Directory of Open Access Journals (Sweden)

    Kanellopoulos AJ

    2012-02-01

    Full Text Available Anastasios John KanellopoulosLaservision.gr Institute, Athens, Greece; Manhattan Eye, Ear and Throat Hospital, New York, NY, USA; New York University Medical School, New York, NY, USAPurpose: To evaluate the safety and efficacy of combined transepithelial topography-guided photorefractive keratectomy (PRK therapeutic remodeling, combined with same-day, collagen cross-linking (CXL. This protocol was used for the management of cornea blindness due to severe corneal scarring.Methods: A 57-year-old man had severe corneal blindness in both eyes. Both corneas had significant central scars attributed to a firework explosion 45 years ago, when the patient was 12 years old. Corrected distance visual acuity (CDVA was 20/100 both eyes (OU with refraction: +4.00, –4.50 at 135° in the right eye and +3.50, –1.00 at 55° in the left. Respective keratometries were: 42.3, 60.4 at 17° and 35.8, 39.1 at 151.3°. Cornea transplantation was the recommendation by multiple cornea specialists as the treatment of choice. We decided prior to considering a transplant to employ the Athens Protocol (combined topography-guided partial PRK and CXL in the right eye in February 2010 and in the left eye in September 2010. The treatment plan for both eyes was designed on the topography-guided wavelight excimer laser platform.Results: Fifteen months after the right eye treatment, the right cornea had improved translucency and was topographically stable with uncorrected distance visual acuity (UDVA 20/50 and CDVA 20/40 with refraction +0.50, –2.00 at 5°. We noted a similar outcome after similar treatment applied in the left eye with UDVA 20/50 and CDVA 20/40 with –0.50, –2.00 at 170° at the 8-month follow-up.Conclusion: In this case, the introduction of successful management of severe cornea abnormalities and scarring with the Athens Protocol may provide an effective alternative to other existing surgical or medical options.Keywords: Athens Protocol, collagen cross

  9. Experimental study of the survival of metastatic cancer cells in corneal organ culture.

    Science.gov (United States)

    Deb-Joardar, Nilanjana; Thuret, Gilles; Dumollard, Jean-Marc; Absi, Lena; Campos-Guyotat, Lydia; Peoc'h, Michel; Garraud, Olivier; Gain, Philippe

    2006-04-01

    Transmission of donor malignancy to the recipient could be one of the most disastrous complications of corneal grafting. Because of the scarcity of donor tissue and the lack of sufficient scientific evidence, the harvest of donor tissues from deaths due to systemic malignancy is permitted. This study was conducted to investigate the possible transmission of donor metastatic disease via corneal tissue preserved in organ culture (OC) conditions. The viability of four frequent human cancer cell lines (lung, breast, skin, and colon) was studied in OC. Various inoculums of cancer cells labeled with the membrane marker PKH67 were seeded on donor corneas and preserved in OC, followed by cell-tracking studies, histopathology, and immunohistochemistry. HLA matching of the dissected Descemet's membrane (DM) of preserved corneas was conducted, to demonstrate cell adherence. Primary cell culture was performed to confirm the viability of adherent tumor cells. Viability tests showed a poor but persistent survival of cancer cells after 2 weeks in OC. Cell tracking, histopathology, and immunohistochemistry demonstrated cancer cell adherence to donor endothelium. HLA typing of the DM of preserved corneas revealed the presence of cancer cell alleles. Primary culture of the DM showed cell proliferation that was identical with the original cancer cell line, according to HLA studies. The findings demonstrate that under laboratory conditions, metastatic cancer cells adhere to donor corneal tissue, survive, and retain proliferative capacity during storage in OC. Cell lines differ in their viability potential, as well as the pattern of adherence to donor endothelium. Further in vivo experimentation in laboratory animals is need to determine the safety of such harvests.

  10. Role of corneal collagen fibrils in corneal disorders and related pathological conditions

    Directory of Open Access Journals (Sweden)

    Hong-Yan Zhou

    2017-05-01

    Full Text Available The cornea is a soft tissue located at the front of the eye with the principal function of transmitting and refracting light rays to precisely sense visual information. Corneal shape, refraction, and stromal stiffness are to a large part determined by corneal fibrils, the arrangements of which define the corneal cells and their functional behaviour. However, the modality and alignment of native corneal collagen lamellae are altered in various corneal pathological states such as infection, injury, keratoconus, corneal scar formation, and keratoprosthesis. Furthermore, corneal recuperation after corneal pathological change is dependent on the balance of corneal collagen degradation and contraction. A thorough understanding of the characteristics of corneal collagen is thus necessary to develop viable therapies using the outcome of strategies using engineered corneas. In this review, we discuss the composition and distribution of corneal collagens as well as their degradation and contraction, and address the current status of corneal tissue engineering and the progress of corneal cross-linking.

  11. Research progress of corneal transplantation

    Directory of Open Access Journals (Sweden)

    Bing-Jie Zhang

    2015-06-01

    Full Text Available Corneal transplantation is an ophthalmology treatment technique for corneal disease to help restore vision or control the development of corneal diseases by removing a scarred or damaged host cornea and replacing it with a clear and healthy donor cornea. Traditional corneal transplantation includes penetrating keratoplasty and lamellar keratoplasty. In recent ten years, deep lamellar keratoplasty and endothelial keratoplasty have gradually developed. At present, the development of keratoprosthesis provides a new choice for the patients no suitable for traditional. The review describes current surgical techniques in the field of corneal transplantation about indications, postoperative complications, and so on.

  12. Results of combined antiangiogenic activity on corneal neovascularization. Experimental and morphological study

    Directory of Open Access Journals (Sweden)

    V. R. Mamikpnyan

    2014-01-01

    Full Text Available Results of comparative experimental and morphological study of activity on corneal neovascularization in rabbit’s eye of photodynamic therapy with Photosense and antiangiogenic therapy with Avastin (bevacizumab alone, and in its combination are represented. The treatment was performed in regimens: 1 photodynamic therapy with Photosense (single intravenous injection in dose of 0.3 mg/kg 72 h prior to laser irradiation, power density of irradiation 500 mW/cm2, wavelength 675 nm; 2 drug antiangiogenic therapy with Avastin (single subconjuctival introduction at dose of 1.25 mg; 3 photodynamic therapy with Photosense (in described regimen in combination with subconjuctival introduction of Avastin at dose of 1.25 mg immediately prior to irradiation. Combined photodynamic therapy with antiangiogenic therapy allows to obtain almost complete occlusion in all regions of corneal neovascular bed with shorter time interval comparing with those for monoregimens. In case of blood flow retention in great vessels courses of combined modality treatment may be repeated. The absence of side-effects on surrounding tissues and the recovery of optical characteristics of cornea may allow to use this upcoming method in clinical practice. 

  13. Influence of corneal astigmatism, corneal curvature and meridional differences on corneal hysteresis and corneal resistance factor.

    Science.gov (United States)

    Wong, Yin-zhi; Lam, Andrew K C

    2011-09-01

    This study investigated the influence of corneal astigmatism, corneal curvature and meridional differences on corneal hysteresis (CH) and the corneal resistance factor (CRF) in a group of normal Chinese persons. Ninety-five participants were recruited and data from the eye with higher corneal astigmatism were analysed. The anterior corneal curvature was measured by corneal topography. The Goldmann-correlated intraocular pressure (IOPg), corneal-compensated intraocular pressure (IOPcc), CH and CRF at different meridians (default horizontal position, 10°, 20° and 30° along the superotemporal and inferonasal meridians) were obtained from an ocular response analyser. The corneal powers at these specific meridians also were calculated. At the default position, the IOPg and CRF had weak correlations with corneal astigmatism, while the IOPcc and CH were not significantly correlated with corneal astigmatism. Both the IOPg and IOPcc were measured significantly higher at the default position. The CH and CRF were lower at the default position but the difference in the CRF from obliquity could not reach statistical significance. The CH was not significantly correlated with the corneal power at all meridians. The CRF correlated with the corneal power only at 30° superotemporal. Corneal astigmatism and head tilt did not have much effect on the measurement of CH and the CRF, both of which were lowest along the horizontal meridian. Clinically, the difference was small. The influence of corneal power on CH and the CRF was minimal. © 2011 The Authors. Clinical and Experimental Optometry © 2011 Optometrists Association Australia.

  14. Relationship between neutrophil-mediated oxidative injury during acute experimental pyelonephritis and chronic renal scarring.

    OpenAIRE

    Meylan, P R; Markert, M; Bille, J; Glauser, M P

    1989-01-01

    Previous experiments with rats have suggested that pyelonephritic scarring after acute ascending Escherichia coli pyelonephritis partly results from excessive polymorphonuclear leukocyte (PMN) infiltration and activation in the kidney parenchyma. We have studied the role of PMN oxidative metabolism in generating tissue injury during acute pyelonephritis. Rats with acute pyelonephritis were treated with dapsone (25 mg/kg twice daily for 3 days), a compound known to prevent PMN oxidant damage. ...

  15. Progress in corneal wound healing

    Science.gov (United States)

    Ljubimov, Alexander V.; Saghizadeh, Mehrnoosh

    2015-01-01

    Corneal wound healing is a complex process involving cell death, migration, proliferation, differentiation, and extracellular matrix remodeling. Many similarities are observed in the healing processes of corneal epithelial, stromal and endothelial cells, as well as cell-specific differences. Corneal epithelial healing largely depends on limbal stem cells and remodeling of the basement membrane. During stromal healing, keratocytes get transformed to motile and contractile myofibroblasts largely due to activation of transforming growth factor-β system. Endothelial cells heal mostly by migration and spreading, with cell proliferation playing a secondary role. In the last decade, many aspects of wound healing process in different parts of the cornea have been elucidated, and some new therapeutic approaches have emerged. The concept of limbal stem cells received rigorous experimental corroboration, with new markers uncovered and new treatment options including gene and microRNA therapy tested in experimental systems. Transplantation of limbal stem cell-enriched cultures for efficient re-epithelialization in stem cell deficiency and corneal injuries has become reality in clinical setting. Mediators and course of events during stromal healing have been detailed, and new treatment regimens including gene (decorin) and stem cell therapy for excessive healing have been designed. This is a very important advance given the popularity of various refractive surgeries entailing stromal wound healing. Successful surgical ways of replacing the diseased endothelium have been clinically tested, and new approaches to accelerate endothelial healing and suppress endothelial-mesenchymal transformation have been proposed including Rho kinase (ROCK) inhibitor eye drops and gene therapy to activate TGF-β inhibitor SMAD7. Promising new technologies with potential for corneal wound healing manipulation including microRNA, induced pluripotent stem cells to generate corneal epithelium, and

  16. Acne Scars

    Science.gov (United States)

    ... Hands Age Spots Aging Skin Birthmarks Burn Scars Cellulite Crow's Feet Droopy Eyelids Excess Fat Excessive Sweating ... Hands Age Spots Aging Skin Birthmarks Burn Scars Cellulite Crow's Feet Droopy Eyelids Excess Fat Excessive Sweating ...

  17. A review on static splinting therapy to prevent burn scar contracture: Do clinical and experimental data warrant its clinical application?

    NARCIS (Netherlands)

    Schouten, H.J.; Nieuwenhuis, M.K.; van Zuijlen, P.P.M.

    2012-01-01

    Background: Static splinting therapy is widely considered an essential part in burn rehabilitation to prevent scar contractures in the early phase of wound healing. However, scar contractures are still a common complication. In this article we review the information concerning the incidence of scar

  18. Microbiologic, Pharmacokinetic, and Clinical Effects of Corneal Collagen Cross-Linking on Experimentally Induced Pseudomonas Keratitis in Rabbits.

    Science.gov (United States)

    Cosar, C Banu; Kucuk, Mutlu; Celik, Ekrem; Gonen, Tansu; Akyar, Isin; Serteser, Mustafa; Tokat, Fatma; Ince, Umit

    2015-10-01

    To determine the effects of corneal collagen cross-linking (CXL) on the penetration of topical 0.5% moxifloxacin, on the number of colony-forming units (CFUs) in the cornea, and on the clinical course in a rabbit eye model of experimentally induced Pseudomonas aeruginosa keratitis. In this prospective animal study, experimental Pseudomonas corneal ulcers were induced in 56 corneas of 28 albino New Zealand rabbits. The corneas were randomly divided into the following 4 groups: the control group (14 eyes), the MOX group (moxifloxacin) (14 eyes), the MOX + CXL group (14 eyes), and the CXL group (14 eyes). On day 4 of the experiment, the eyes in the control group were enucleated and CFU counting was performed. On day 10 of the experiment, all eyes were enucleated and CFU counting was performed. In the MOX and MOX + CXL groups, the moxifloxacin level in the cornea, aqueous humor, iris, plasma, and serum was measured by reverse-phase high-performance liquid chromatography. The difference in the corneal CFU count between the MOX group and the MOX + CXL group was not significant (P = 0.317). Clinical improvement was greatest in the MOX + CXL group (P < 0.001). The mean corneal moxifloxacin level was 0.391 ± 0.09 μg·mg in the MOX group versus 0.291 ± 0.09 μg·mg in the MOX + CXL group; as such, CXL did not have a significant effect on antibiotic penetrance (P = 0.386). Clinical improvement was greatest in the MOX + CXL group. The synergistic effect of CXL on corneal ulcer treatment is not through antibiotic penetrance.

  19. Corneal Laceration

    Medline Plus

    Full Text Available ... Corneal Laceration? Corneal Laceration Diagnosis Corneal Laceration Treatment What Is Corneal Laceration? Leer en Español: ¿Qué Es una Laceración de la Córnea? Written By: Daniel ...

  20. A numerical-experimental protocol to characterize corneal tissue with an application to predict astigmatic keratotomy surgery.

    Science.gov (United States)

    Ariza-Gracia, M Á; Ortillés, Á; Cristóbal, J Á; Rodríguez Matas, J F; Calvo, B

    2017-10-01

    Tonometers are intended to determine the intraocular pressure (IOP) and the quality of corneal tissue. In contrast to the physiological state of stress of the cornea, tonometers induce non-physiological bending stress. Recently, the use of a single experiment to calibrate a set of corneal mechanical properties was suggested to be an ill-posed problem. Thus, we propose a numerical-experimental protocol that uses inflation and indentation experiments simultaneously, restricting the optimization space to circumvent the ambiguity of the fitting. For the first time, both corneal behaviors, i.e., biaxial tension (physiological) and bending (non-physiological), are taken into account. The experimental protocol was performed using an animal model (New Zealand rabbit's cornea). The patient-specific geometry and IOP were registered using a MODI topographer (CSO, Italy) and an applanation tonometer, respectively. The mechanical response was evaluated using inflation and indentation experiments. Subsequently, the optimal set of material properties is identified via an inverse finite element method. To validate the methodology, an in vivo incisional refractive surgery (astigmatic keratotomy, AK) is performed on four animals. The optical outcomes showed a good agreement between the real and simulated surgeries, indicating that the protocol can provide a reliable set of mechanical properties that enables further applications and simulations. After a reliable ex vivo database of inflation experiments is built, our protocol could be extended to humans. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Alternatives to allograft corneal transplantation.

    Science.gov (United States)

    Jhanji, Vishal; Sharma, Namrata; Agarwal, Tushar; Vajpayee, Rasik B

    2010-07-01

    Corneal transplantation is the most commonly performed solid organ transplantation in the world. Despite a glorious history of more than a 100 years, the success of conventional corneal transplantation surgery is marred by problems like graft rejection,graft infection and associated glaucoma due to long-term use of topical corticosteroids.In addition there is a dearth of donor corneal tissue in some parts of the world which subsequently adds on to the existing burden on the eye banks every year. We propose alternatives to the conventional corneal transplantation surgery for the management of corneal scarring. The potential use of alternatives to allograft corneal transplantation surgery has been described by corneal surgeons around the world. These techniques consist of nonsurgical interventions like contact lens fitting. Surgical alternatives include excimer laser phototherapeutic keratectomy, optical iridectomy, rotational autokeratoplasty and contralateral autokeratoplasty. Although these techniques are not practiced routinely, however, their appropriate utilization would clearly help the corneal surgeons to get rid of certain problems associated with allograft corneal transplantation. Careful selection of patients can yield encouraging results with the use of these alternative techniques. Visual outcomes may not be as good as after a routine keratoplasty; nevertheless, this setback is outweighed by advantages such as absence of corneal graft rejection. We also believe that the use of these techniques would at least partially resolve the issue of scarcity of donor corneal tissue in the developing world.

  2. Modulation of scar tissue formation using different dermal regeneration templates in the treatment of experimental full-thickness wounds.

    NARCIS (Netherlands)

    Druecke, D.; Lamme, E.N.; Hermann, S.; Pieper, J.S.; May, P.S.; Steinau, H.U.; Steinstraesser, L.

    2004-01-01

    The recovery of skin function is the goal of each burn surgeon. Split-skin graft treatment of full-thickness skin defects leads to scar formation, which is often vulnerable and instable. Therefore, the aim of this study was to analyze wound healing and scar tissue formation in acute full-thickness

  3. Myocardial scar imaging by standard single-energy and dual-energy late enhancement CT: Comparison with pathology and electroanatomic map in an experimental chronic infarct porcine model.

    Science.gov (United States)

    Truong, Quynh A; Thai, Wai-Ee; Wai, Bryan; Cordaro, Kevin; Cheng, Teresa; Beaudoin, Jonathan; Xiong, Guanglei; Cheung, Jim W; Altman, Robert; Min, James K; Singh, Jagmeet P; Barrett, Conor D; Danik, Stephan

    2015-01-01

    Myocardial scar is a substrate for ventricular tachycardia and sudden cardiac death. Late enhancement CT imaging can detect scar, but it remains unclear whether newer late enhancement dual-energy (LE-DECT) acquisition has benefit over standard single-energy late enhancement (LE-CT). We aim to compare late enhancement CT using newer LE-DECT acquisition and single-energy LE-CT acquisitions with pathology and electroanatomic map (EAM) in an experimental chronic myocardial infarction (MI) porcine study. In 8 pigs with chronic myocardial infarction (59 ± 5 kg), we performed dual-source CT, EAM, and pathology. For CT imaging, we performed 3 acquisitions at 10 minutes after contrast administration: LE-CT 80 kV, LE-CT 100 kV, and LE-DECT with 2 postprocessing software settings. Of the sequences, LE-CT 100 kV provided the best contrast-to-noise ratio (all P ≤ .03) and correlation to pathology for scar (ρ = 0.88). LE-DECT overestimated scar (both P = .02), whereas LE-CT images did not (both P = .08). On a segment basis (n = 136), all CT sequences had high specificity (87%-93%) and modest sensitivity (50%-67%), with LE-CT 100 kV having the highest specificity of 93% for scar detection compared to pathology and agreement with EAM (κ = 0.69). Standard single-energy LE-CT, particularly 100 kV, matched better to pathology and EAM than dual-energy LE-DECT for scar detection. Larger human trials as well as more technical studies that optimize varying different energies with newer hardware and software are warranted. Copyright © 2015 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

  4. Corneal Diseases in Children in The Gambia | Onabolu | Nigerian ...

    African Journals Online (AJOL)

    trauma in 23 (32.4%) vernal kerato-conjunctivitis in 16 (22.54%), congenital eye diseases in 12 (16.9%), corneal infections in 12 (16.9%), corneal scarring from unknown causes in 5 (7.04%) and corneal dystrophy/degenerations in 3 patients. Ten patients (14%) became bilaterally blind while 22 patients (31%) suffered ...

  5. Corneal Ulcer

    Science.gov (United States)

    ... Español Eye Health / Eye Health A-Z Corneal Ulcer Sections What Is a Corneal Ulcer? Corneal Ulcer ... Diagnosis Corneal Ulcer Treatment What Is a Corneal Ulcer? Leer en Español: ¿Qué es una Úlcera de ...

  6. [Tissular and mechanical effects observed with an experimental femtosecond laser microkeratome for corneal refractive surgery].

    Science.gov (United States)

    Touboul, D; Salin, F; Mortemousque, B; Courjaud, A; Chabassier, P; Mottay, E; Léger, F; Colin, J

    2005-03-01

    Despite progress in mechanical microkeratomes used in refractive surgery, mechanical complications during cutting of the cornea still occur. Cutting by laser could reduce these complications and to date, the femtosecond laser is the only potential candidate for this purpose. Our study reports preliminary results with a femtosecond microkeratome for cutting porcine corneas ex vivo. We first examined the fundamental principles of the interaction between the femtosecond laser and the corneal stroma, including the volume of tissue lesions, the laser breakdown threshold of the stroma and the laser ablation selectivity. We then analyzed the quality of cutting corneal flaps with the laser, focusing on collateral tissue effects and the roughness of the interfaces observed both histologically and with scanning electron microscopy. The photoablative and photodisruptive effects were very similar with the femtosecond laser. This characteristic is specific to ultrashort impulsion photodisruptor lasers and allows for a very precise surgical procedure. The laser-induced breakdown threshold of porcine corneal stroma was found to be 0.55 J/cm2. Collateral tissue lesions were on the submicrometer level. The roughness of the stromal bed was optimal for postage stamp cutting, providing very many contiguous points of impact which were as spherical as possible. Corneal photodisruption with a femtosecond laser is reproducible and extremely accurate. The optomechanical parameters involved with this technique require great technological skill and should be placed in experienced hands.

  7. [An experimental research of recombinant human epidermal growth factor on corneal wound healing].

    Science.gov (United States)

    Zheng, R; Jin, X; Yang, B; Li, B; Li, L; Xu, Z; Zhu, H

    1998-05-01

    To investigate the effects of recombinant human epidermal growth factor (rhEGF) eye drops on corneal wound healing. Twenty-four white rabbits were randomly divided into 4 groups, 6 rabbits 12 eyes each. Anterior keratectomy of 8 mm in diameter and 1/3 cornea in thickness was performed on each eye. Each of the following concentrations of rhEGF: 1, 10, 100 microg/ml eye drops or normal saline (control) was applied four times daily for a week respectively for one group. The wound area was determined by computer imaging analysis. The mean epithelial healing rate of rhEGF 1, 10, 100 microg/ml groups was 9.31, 9.96, 9.31 mm(2)/day respectively, significantly greater than 8.11 mm(2)/day of the control group. The action of rhEGF of 10 microg/ml was somewhat better than that of 1 or 100 microg/ml, and no significant difference was noticed among the three rhEGF groups. Moderate inflammation and corneal neovascularization were induced in the rhEGF 100 microg/ml treated group. rhEGF 1 - 10 microg/ml can accelerate corneal wound healing in the rabbit with no adverse side-effects. It may be used to treat serious corneal trauma and ulcer clinically.

  8. Topical 1% Nalbuphine on corneal sensivity and epitheilization after experimental lamellar keratectomy in rabbits Nalbufina 1% tópica sobre a sensibilidade e a epitelização corneal após ceratectomia lamelar experimental

    Directory of Open Access Journals (Sweden)

    Miguel Ladino Silva

    2012-04-01

    Full Text Available The present study was aimed to evaluate the effects of topical 1% nalbuphine on corneal sensitivity and re-epithelialization, after lamellar keratectomy in rabbits. All protocols were approved by the Animal Care Comission of São Paulo State University (Protocol 028793-08 and were conducted in accordance with the Institutional Animal Committee and the Association for Research in Vision and Ophthalmology (ARVO statement for the use of animals in research. Surgeries were performed on the left eye (Nalbuphine Group and on the right eye (Control Group. Two groups were formed (n=10 and corneas received either 30µl of 1% nalbuphine (NG or 30µl of 0,9% saline (CG. Treatments occurred at 7, 11, 15 and 19 hours. After the surgery, the corneas were stained with fluorescein and photographed daily; corneal touch threshold (CTT was assessed with Cochet-Bonnet aesthesiometer, at 7 and 19 hours, 20 minutes after treatments. Data were statistically compared with repeated measures ANOVA and Bonferroni post-hoc test, and T test (P0.05; however, a higher area under the curve for both parameters was observed in the NG (2771, in comparison to CG (2164. Topical 1% nalbuphine did not change significantly corneal sensitivity and re-epithelialization, after experimental lamellar keratectomy in rabbits.Avaliaram-se os efeitos da nalbufina 1% sobre o limiar de sensibilidade corneal (LSC e a epitelização corneal em coelhos submetidos à ceratectomia lamelar unilateral. Os procedimentos foram aprovados pela Comissão de Ética no Uso de Animais da Faculdade de Ciências Agrarias e Veterinárias da Universidade Estadual Paulista (Protocolo no 028793-08, de acordo com as normas do Institutional Animal Committee and the Association for Research in Vision and Ophthalmology (ARVO. Conceberam-se dois grupos (n=10 e os olhos foram tratados com 30µl de Nalbufina 1% (Olho esquerdo - GN ou com 30µl de solução salina (Olho direito - GC, às 7, 11, 15 e 19 horas das

  9. Experimental Models for Investigating Intra-Stromal Migration of Corneal Keratocytes, Fibroblasts and Myofibroblasts

    Directory of Open Access Journals (Sweden)

    Lisha Ma

    2012-03-01

    Full Text Available Following laser vision correction, corneal keratocytes must repopulate areas of cell loss by migrating through the intact corneal stroma, and this can impact corneal shape and transparency. In this study, we evaluate 3D culture models for simulating this process in vitro. Buttons (8 mm diameter were first punched out of keratocyte populated compressed collagen matrices, exposed to a 3 mm diameter freeze injury, and cultured in serum-free media (basal media or media supplemented with 10% FBS, TGFb1 or PDGF BB. Following freeze injury, a region of cell death was observed in the center of the constructs. Although cells readily migrated on top of the matrices to cover the wound area, a limited amount of cell migration was observed within the constructs. We next developed a novel “sandwich” model, which better mimics the native lamellar architecture of the cornea. Using this model, significant migration was observed under all conditions studied. In both models, cells in TGFb and 10% FBS developed stress fibers; whereas cells in PDGF were more dendritic. PDGF stimulated the most inter-lamellar migration in the sandwich construct. Overall, these models provide insights into the complex interplay between growth factors, cell mechanical phenotypes and the structural properties of the ECM.

  10. Acne Scars

    Science.gov (United States)

    ... different skin problem. Image used with permission of Journal of the American Academy of Dermatology. J Am Acad Dermatol 2001;45:116 . References: ... Images of acne scars used with permission of Journal of the American Academy of Dermatology . J Am Acad Dermatol 2001;45:109-17 ...

  11. Evaluation of the safety of intracameral trypan blue injection on corneal tissue using oxidative stress parameters and apoptotic activity: an experimental study

    Directory of Open Access Journals (Sweden)

    Ali Akal

    2014-12-01

    Full Text Available Purpose: The present experimental study aimed to investigate the effects of intracameral trypan blue (TB on oxidative stress parameters and apoptosis in corneal tissue. Methods: Thirty rats were randomly assigned to three groups of 10 rats each: the sham group (Group 1; control group (Group 2; and treatment group (Group 3. The control group was administered 0.01 cc of balanced salt solution. The treatment group was administered 0.006 mg/0.01 cc of TB. The total antioxidant status (TAS and total oxidant status (TOS in corneal tissue and blood were measured and the oxidative stress index (OSI was calculated. Finally, corneal tissue histopathology was evaluated using staining for caspase-3 and -8, and apoptotic activity was examined. Results: The TAS, TOS and OSI levels in the blood samples were not significantly different (p>0.05 for all. Compared with the sham and control groups, the TOS and OSI levels in corneal tissue were significantly different in the treatment group (p0.05. Immunohistochemical staining for caspase-3 and caspase-8 demonstrated higher apoptotic activity in the TB group than in the sham and control groups. Conclusion: The present study showed that intracameral TB injection is safe systematically but may be toxic to corneal tissue, as demonstrated using oxidative stress parameters and histopathological evaluation.

  12. Nationwide reduction in the number of corneal transplantations for keratoconus following the implementation of cross-linking

    NARCIS (Netherlands)

    Godefrooij, Daniel A; Gans, Renze; Imhof, Saskia M; Wisse, Robert P L

    PURPOSE: Keratoconus is characterized by corneal ectasia and irregular astigmatism, which can lead to diminished vision and corneal scarring. Approximately 10-20% of patients with keratoconus eventually require a corneal transplant. Corneal cross-linking (CXL) is a relatively new treatment that may

  13. The value of corneal transplantation in reducing blindness.

    Science.gov (United States)

    Garg, P; Krishna, P V; Stratis, A K; Gopinathan, U

    2005-10-01

    To analyse the role of keratoplasty in reducing world blindness due to corneal diseases. Review of published literature. We collected and analysed articles published in the English language literature related to the prevalence and causes of blindness in different parts of the world, causes of corneal blindness, and outcome of corneal transplantation for various corneal diseases. A total of 80% of the world's blind live in developing countries. Retinal diseases are the most important causes of blindness (40-54%) in established economy nations while cataract (44-60%) and corneal diseases (8-25%) are the most common causes of blindness in countries with less developed economies. Keratitis during childhood, trauma, and keratitis during adulthood resulting in a vascularized corneal scar and adherent leucoma are the most frequent causes of corneal blindness in developing countries. Corneal diseases are responsible for 20% of childhood blindness. Nearly 80% of all corneal blindness is avoidable. The outcome of keratoplasty for vascularized corneal scar and adherent leucoma is unsatisfactory, necessitating repeat surgery in a high proportion of these cases. Other barriers for keratoplasty in these nations are suboptimal eye banking, lack of trained human resources, and infrastructure. Since the developing world carries most of the load of corneal blindness and the major causes of corneal blindness are corneal scar and active keratitis, development of corneal transplantation services need a comprehensive approach encompassing medical standards in eye banking, training of cornea specialists and eye banking personnel and exposure of ophthalmologists to care of corneal transplants for better follow-up care. However, concerted efforts should be made to develop and implement prevention strategies since most corneal blindness is preventable.

  14. Corneal Laceration

    Medline Plus

    Full Text Available ... Now that I’m older, will a corneal transplant help me? May 15, 2015 Why Do My ... May Have A Future Alternative to Full Corneal Transplantation Nov 29, 2016 Combating Eye Injuries from Air ...

  15. Evaluation of UVA Cytotoxicity for Human Endothelium in an Ex Vivo Corneal Cross-linking Experimental Setting.

    Science.gov (United States)

    Mooren, Pepijn; Gobin, Laure; Bostan, Nezahat; Wouters, Kristien; Zakaria, Nadia; Mathysen, Danny G P; Koppen, Carina

    2016-01-01

    To evaluate endothelial cytotoxicity after exposure of human corneas to ultraviolet-A (UVA) (λ = 365 nm; 5.4 J/cm(2)) in an experimental ex vivo corneal cross-linking setting. Sixteen pairs of human donor corneas were cut into two pieces. One piece of each cornea was treated with 0.025% riboflavin solution prior to UVA irradiation (5 minutes; 18 mW/cm(2)), whereas the other piece was not irradiated but treated with riboflavin (right eye) or preservation medium (left eye). By irradiating from the endothelial side, the UVA dosage applied to endothelial cells exceeded at least eight times the cytotoxic threshold established in animal models (0.65 J/cm(2)). Endothelial cell counts were performed by two independent investigators after storage (4 to 5 days at 31 °C) and staining (trypan blue, alizarin red). Normality (Q-Q plot; Shapiro-Wilk test) and equivalence (mixed-effects modeling with a 10% equivalence threshold) of the endothelial cell counts of the different groups were evaluated. Equivalence of mean endothelial cell density between both groups was observed: 2,237 ± 208 cells/mm(2) in UVA-irradiated pieces and 2,290 ± 281 cells/mm(2) in control pieces (mean difference of 53 ± 240 cells/mm(2) between both groups). Despite direct irradiation of human donor endothelium using the clinical dosage for cross-linking, equivalence in endothelial cell counts was observed between irradiated tissues and controls. Ex vivo human corneal endothelial cells seem to be far more resistant to riboflavin-enhanced UVA irradiation than previously estimated by animal experiments. Copyright 2016, SLACK Incorporated.

  16. Corneal dystrophies

    Directory of Open Access Journals (Sweden)

    Klintworth Gordon K

    2009-02-01

    Full Text Available Abstract The term corneal dystrophy embraces a heterogenous group of bilateral genetically determined non-inflammatory corneal diseases that are restricted to the cornea. The designation is imprecise but remains in vogue because of its clinical value. Clinically, the corneal dystrophies can be divided into three groups based on the sole or predominant anatomical location of the abnormalities. Some affect primarily the corneal epithelium and its basement membrane or Bowman layer and the superficial corneal stroma (anterior corneal dystrophies, the corneal stroma (stromal corneal dystrophies, or Descemet membrane and the corneal endothelium (posterior corneal dystrophies. Most corneal dystrophies have no systemic manifestations and present with variable shaped corneal opacities in a clear or cloudy cornea and they affect visual acuity to different degrees. Corneal dystrophies may have a simple autosomal dominant, autosomal recessive or X-linked recessive Mendelian mode of inheritance. Different corneal dystrophies are caused by mutations in the CHST6, KRT3, KRT12, PIP5K3, SLC4A11, TACSTD2, TGFBI, and UBIAD1 genes. Knowledge about the responsible genetic mutations responsible for these disorders has led to a better understanding of their basic defect and to molecular tests for their precise diagnosis. Genes for other corneal dystrophies have been mapped to specific chromosomal loci, but have not yet been identified. As clinical manifestations widely vary with the different entities, corneal dystrophies should be suspected when corneal transparency is lost or corneal opacities occur spontaneously, particularly in both corneas, and especially in the presence of a positive family history or in the offspring of consanguineous parents. Main differential diagnoses include various causes of monoclonal gammopathy, lecithin-cholesterol-acyltransferase deficiency, Fabry disease, cystinosis, tyrosine transaminase deficiency, systemic lysosomal storage

  17. Experimental study of plasmid TGF-beta 1 DNA gene transfer with lipofectamine into rabbit corneal epithelial cells in vitro.

    Science.gov (United States)

    Huang, Qiong; Hu, Yanhua; Jiang, Fagang; Chen, Hong

    2002-01-01

    To investigate whether the TGF-beta 1 plasmid DNA carried by lipofectamine could be introduced into cultured rabbit corneal epithelial cells, specific expression of the plasmid pMAM TGF-beta 1 in the cultured corneal epithelial cells was studied. Two days after 12 h of transfection of pMAMT-GF-beta 1 mediated by lipofectamine into the cultured corneal epithelial cells, the TGF-beta 1 protein expression specific for pMAMTGF-beta 1 in the cells was detected by means of immunohistochemical staining and the positive rate was 23.37%. The results suggested that foreign plasmid DNA could be effectively delivered into cultured rabbit corneal epithelial cells by means of lipofectamine, and this will provide a promising method of studying TGF-beta 1 on the mechanism of physiology and pathology concerned with corneal epithelial cells.

  18. Facial Scar Revision: Understanding Facial Scar Treatment

    Science.gov (United States)

    ... facial plastic surgeon Facial Scar Revision Understanding Facial Scar Treatment When the skin is injured from a cut ... A facial plastic surgeon has many options for treating and improving facial scars. “After the accident, I thought I would never ...

  19. Comparison between lamellar keratoplasties produced by conjunctival pedicle and free corneal autografts. Experimental study in the dog (Canis familiaris - LINNAEUS, 1758

    Directory of Open Access Journals (Sweden)

    José Luiz Laus

    1996-03-01

    Full Text Available A comparative study of conjunctival pedicle and corneal autografts, for experimental healing of superficial keratectomies in dogs (Canis familiaris was performed. It was carried out by using 24 animals, and the technical procedures were analysed according to clinical, histologic and scanning electron microscopy parameters, in early and late postoperative periods. The obtained results are believed to represent feasible methods of proteresis, applied to the healing ophthalmic surgery. There were few, irrelevant differences between the two tested techniques.

  20. Galectin-3 Inhibition by a Small-Molecule Inhibitor Reduces Both Pathological Corneal Neovascularization and Fibrosis.

    Science.gov (United States)

    Chen, Wei-Sheng; Cao, Zhiyi; Leffler, Hakon; Nilsson, Ulf J; Panjwani, Noorjahan

    2017-01-01

    Corneal neovascularization and scarring commonly lead to significant vision loss. This study was designed to determine whether a small-molecule inhibitor of galectin-3 can inhibit both corneal angiogenesis and fibrosis in experimental mouse models. Animal models of silver nitrate cautery and alkaline burn were used to induce mouse corneal angiogenesis and fibrosis, respectively. Corneas were treated with the galectin-3 inhibitor, 33DFTG, or vehicle alone and were processed for whole-mount immunofluorescence staining and Western blot analysis to quantify the density of blood vessels and markers of fibrosis. In addition, human umbilical vein endothelial cells (HUVECs) and primary human corneal fibroblasts were used to analyze the role of galectin-3 in the process of angiogenesis and fibrosis in vitro. Robust angiogenesis was observed in silver nitrate-cauterized corneas on day 5 post injury, and markedly increased corneal opacification was demonstrated in alkaline burn-injured corneas on days 7 and 14 post injury. Treatment with the inhibitor substantially reduced corneal angiogenesis and opacification with a concomitant decrease in α-smooth muscle actin (α-SMA) expression and distribution. In vitro studies revealed that 33DFTG inhibited VEGF-A-induced HUVEC migration and sprouting without cytotoxic effects. The addition of exogenous galectin-3 to corneal fibroblasts in culture induced the expression of fibrosis-related proteins, including α-SMA and connective tissue growth factor. Our data provide proof of concept that targeting galectin-3 by the novel, small-molecule inhibitor, 33DFTG, ameliorates pathological corneal angiogenesis as well as fibrosis. These findings suggest a potential new therapeutic strategy for treating ocular disorders related to pathological angiogenesis and fibrosis.

  1. Laser treatment of scars

    Science.gov (United States)

    Fitzpatrick, Richard E.

    1994-09-01

    Fifteen patients with erythematous/hypertrophic scar/span>s and eleven patients with post- inflammatory brown hyperpigmentation of scars were treated with flashlamp pump pulsed-dye lasers. The red scars were treated with a wavelength of 585 nm and a pulse width of 450 msec. The brown scars were treated with a wavelength of 510 nm and a pulse width of 300 nsec. The erythematous scars improved an average of 77% after 1.8 treatments, and 46% of these scars had complete resolution of the erythema. The hyperpigmented scars had an average improvement of 80% after 1.5 treatments, and 45% of these patients had complete resolution of the hyperpigmentation. An unexpected benefit of treatment of these scars was softening and flattening of the hypertrophic scar tissue and normalization of the surface of the scar. Repeated treatments were noted to result in cumulative and progressive improvement in all aspects of these scars.

  2. Use of fibrin glue derived from snake venom in the repair of deep corneal ulcers: experimental study in dogs (Canis familiaris, Linnaeus, 1758

    Directory of Open Access Journals (Sweden)

    R. L. Sampaio

    2007-01-01

    Full Text Available Fibrin glue has been researched as an alternative method for tissue synthesis and is known for its capability to promote hemostasis at the application site, good approximation of wound edges and fast healing. The current study consisted in the application of fibrin glue derived from snake venom as treatment for experimental corneal ulcers. Twenty-one dogs had their corneas experimentally prepared through lamellar keratectomy (of standardized diameter and depth. Animals were divided into seven groups of three animals each. Six experimental groups were periodically evaluated and collection was carried out on the 1st, 3rd, 7th, 15th, 30th and 60th post-operative days, whereas one control group was evaluated throughout the experiment. Analyses consisted in the clinical evolution and in the histopathological study of all operated on eyes. Results indicated that fibrin glue was efficient in repairing keratectomy wounds in dogs and contributed to an earlier healing phenomenon, avoiding edema formation and keeping corneal clearness. The use of fibrin glue derived from snake venom showed to be easy to apply, feasible with animal models and of low cost, avoiding the lesion progress and allowing fast and appropriate corneal healing.

  3. Corneal biomechanical properties from air-puff corneal deformation imaging

    Science.gov (United States)

    Marcos, Susana; Kling, Sabine; Bekesi, Nandor; Dorronsoro, Carlos

    2014-02-01

    The combination of air-puff systems with real-time corneal imaging (i.e. Optical Coherence Tomography (OCT), or Scheimpflug) is a promising approach to assess the dynamic biomechanical properties of the corneal tissue in vivo. In this study we present an experimental system which, together with finite element modeling, allows measurements of corneal biomechanical properties from corneal deformation imaging, both ex vivo and in vivo. A spectral OCT instrument combined with an air puff from a non-contact tonometer in a non-collinear configuration was used to image the corneal deformation over full corneal cross-sections, as well as to obtain high speed measurements of the temporal deformation of the corneal apex. Quantitative analysis allows direct extraction of several deformation parameters, such as apex indentation across time, maximal indentation depth, temporal symmetry and peak distance at maximal deformation. The potential of the technique is demonstrated and compared to air-puff imaging with Scheimpflug. Measurements ex vivo were performed on 14 freshly enucleated porcine eyes and five human donor eyes. Measurements in vivo were performed on nine human eyes. Corneal deformation was studied as a function of Intraocular Pressure (IOP, 15-45 mmHg), dehydration, changes in corneal rigidity (produced by UV corneal cross-linking, CXL), and different boundary conditions (sclera, ocular muscles). Geometrical deformation parameters were used as input for inverse finite element simulation to retrieve the corneal dynamic elastic and viscoelastic parameters. Temporal and spatial deformation profiles were very sensitive to the IOP. CXL produced a significant reduction of the cornea indentation (1.41x), and a change in the temporal symmetry of the corneal deformation profile (1.65x), indicating a change in the viscoelastic properties with treatment. Combining air-puff with dynamic imaging and finite element modeling allows characterizing the corneal biomechanics in-vivo.

  4. Therapeutic Effect of Human Adipose Tissue-Derived Mesenchymal Stem Cells in Experimental Corneal Failure Due to Limbal Stem Cell Niche Damage.

    Science.gov (United States)

    Galindo, Sara; Herreras, José M; López-Paniagua, Marina; Rey, Esther; de la Mata, Ana; Plata-Cordero, María; Calonge, Margarita; Nieto-Miguel, Teresa

    2017-10-01

    Limbal stem cells are responsible for the continuous renewal of the corneal epithelium. The destruction or dysfunction of these stem cells or their niche induces limbal stem cell deficiency (LSCD) leading to visual loss, chronic pain, and inflammation of the ocular surface. To restore the ocular surface in cases of bilateral LSCD, an extraocular source of stem cells is needed to avoid dependence on allogeneic limbal stem cells that are difficult to obtain, isolate, and culture. The aim of this work was to test the tolerance and the efficacy of human adipose tissue-derived mesenchymal stem cells (hAT-MSCs) to regenerate the ocular surface in two experimental models of LSCD that closely resemble different severity grades of the human pathology. hAT-MSCs transplanted to the ocular surface of the partial and total LSCD models developed in rabbits were well tolerated, migrated to inflamed tissues, reduced inflammation, and restrained the evolution of corneal neovascularization and corneal opacity. The expression profile of the corneal epithelial cell markers CK3 and E-cadherin, and the limbal epithelial cell markers CK15 and p63 was lost in the LSCD models, but was partially recovered after hAT-MSC transplantation. For the first time, we demonstrated that hAT-MSCs improve corneal and limbal epithelial phenotypes in animal LSCD models. These results support the potential use of hAT-MSCs as a novel treatment of ocular surface failure due to LSCD. hAT-MSCs represent an available, non-immunogenic source of stem cells that may provide therapeutic benefits in addition to reduce health care expenses. Stem Cells 2017;35:2160-2174. © 2017 AlphaMed Press.

  5. Paradigm shifts in corneal transplantation.

    Science.gov (United States)

    Tan, Donald T H; Anshu, Arundhati; Mehta, Jodhbir S

    2009-04-01

    Conventional corneal transplantation, in the form of penetrating keratoplasty (PK), involves full-thickness replacement of the cornea, and is a highly successful procedure. However, the cornea is anatomically a multi-layered structure. Pathology may only affect individual layers of the cornea, hence selective lamellar surgical replacement of only the diseased corneal layers whilst retaining unaffected layers represents a new paradigm shift in the field. Recent advancements in surgical techniques and instrumentation have resulted in several forms of manual, microkeratome and femto-second laser-assisted lamellar transplantation procedures. Anterior lamellar keratoplasty (ALK) aims at replacing only diseased or scarred corneal stroma, whilst retaining the unaffected corneal endothelial layer, thus obviating the risk of endothelial allograft rejection. Posterior lamellar keratoplasty/endothelial keratoplasty (PLK/EK) involves the replacement of the dysfunctional endothelial cell layer only. Whilst significant technical and surgical challenges are involved in performing lamellar micro-dissection of a tissue which is only 0.5 mm thick, the benefits of a more controlled surgical procedure and improved graft survival rates have resulted in a shift away from conventional PK. This review details the current advances in emerging lamellar corneal surgical procedures and highlights the main advantages and disadvantages of these new lamellar corneal procedures.

  6. Corneal manifestations of ocular demodex infestation.

    Science.gov (United States)

    Kheirkhah, Ahmad; Casas, Victoria; Li, Wei; Raju, Vadrevu K; Tseng, Scheffer C G

    2007-05-01

    To report the corneal manifestations in eyes with Demodex infestation of the eyelids. Noncomparative, interventional case series. This retrospective review included six patients with Demodex blepharitis who also exhibited corneal abnormalities, which led to suspicion of limbal stem cell deficiency in three cases. All patients received weekly lid scrubs with 50% tea tree oil and a daily lid scrubs with tea tree shampoo for a minimum of six weeks. Improvement of symptoms and corneal and conjunctival signs were evaluated. All six patients exhibited ocular irritation and conjunctival inflammation, while meibomian gland dysfunction (n = 5), rosacea (n = 4), and decreased vision (n = 3) also were noted despite prior treatments with oral tetracycline, topical steroids with antibiotics, and lid scrub with baby shampoo. These patients were proven to have Demodex folliculorum (n = 6) and Demodex brevis (n = 3) by microscopic examination of epilated lashes. Their corneal manifestation included superficial corneal vascularization (six eyes of five cases), marginal corneal infiltration (two eyes of two cases), phlyctenule-like lesion (one eye of one case), superficial corneal opacity (two eyes of two cases), and nodular corneal scar (two eyes of two cases). After treatment, the Demodex count was reduced from 6.8 +/- 2.8 to 1 +/- 0.9 (standard deviation; P = .001). All patients showed dramatic resolution of ocular irritation, conjunctival inflammation, and all inflammatory, but not scarred, corneal signs; three patients showed improved vision. A variety of corneal pathologic features together with conjunctival inflammation, commonly noted in rosacea, can be found in patients with Demodex infestation of the eyelids. When conventional treatments for rosacea fail, one may consider lid scrub with tea tree oil to eradicate mites as a new treatment.

  7. Corneal ulcers: For the general practitioner

    African Journals Online (AJOL)

    the skin, e.g. herpes zoster scars, lid lacerations, burns. Lid malposition should be excluded. Facial nerve function must be assessed as dysfunction could affect ... Corneal in ltrate seen as haziness or whitening of the usually transparent cornea is universal to infective ulcers in varying degrees. is signi es the inflammatory ...

  8. [Corneal biomechanics].

    Science.gov (United States)

    Torres, R M; Merayo-Lloves, J; Jaramillo, M A; Galvis, V

    2005-04-01

    To review the corneal biomechanic concepts and to analyse, clarify and understand their relevance in refractive surgery. A literature review has been done using different databases. Corneal biomechanic concepts are not new and are applied implicitly in numerous surgical procedures. Their origin is related to tonometry studies, but they gained in popularity when they were linked to the treatment of keratoconus, a pathology in which the mechanical properties of the cornea are altered. Factors determining corneal stability were thus defined. Corneal biomechanics have also been used following refractive surgery to study post-operative keratectasia and to improve ablation patterns, which ignores the corneal response. The new ablation systems need to include the biomechanical factors, which motivate research conducted in physical-mathematical models and in corneal wound healing, improving our knowledge about the corneal biomechanical response. The corneal biomechanic concepts have gained in popularity with the advent of refractive surgery, although they did exist previously. Their relevance is linked to improvements in the ablation systems used in an attempt to obtain more accurate and reliable results.

  9. Corneal Laceration

    Medline Plus

    Full Text Available ... Tips & Prevention News Ask an Ophthalmologist Patient Stories Español Eye Health / Eye Health A-Z Corneal Laceration ... Laceration Treatment What Is Corneal Laceration? Leer en Español: ¿Qué Es una Laceración de la Córnea? Written ...

  10. Corneal Laceration

    Medline Plus

    Full Text Available ... Health Find an Ophthalmologist Academy Store Eye Health A-Z Symptoms Glasses & Contacts Tips & Prevention News Ask ... Ophthalmologist Patient Stories Español Eye Health / Eye Health A-Z Corneal Laceration Sections What Is Corneal Laceration? ...

  11. The experimental treatment of corneal graft rejection with the interleukin-1 receptor antagonist (IL-1ra gene.

    Directory of Open Access Journals (Sweden)

    Jin Yuan

    Full Text Available PURPOSE: To investigate the protective effects of interleukin-1 receptor antagonist (IL-1ra gene transfer in a rat model of corneal graft rejection. METHODS: We constructed a recombinant plasmid (pcDNA3.1-hIL-1ra with high IL-1ra expression in eukaryotic cells. Using a Wistar-SD rat model of corneal graft rejection, we examined the effects of IL-1ra in vivo after cationic polymer jetPEI-mediated nonviral gene delivery. Four groups were included: negative controls (group I, n = 20, pcDNA3.1-hIL-1ra corneal stromal injection (group II, n = 34, pcDNA3.1-hIL-1ra anterior chamber injection (group III, n = 34, and 500 µg/ml IL-1ra protein subconjunctiva injection (group IV, n = 20. IL-1ra expression after transfection was evaluated by real-time polymerase chain reaction (RT-PCR and western blotting. The rejection indices of corneal grafts were analysed in the different groups. The expression levels of transforming growth factor β1 (TGF-β1, inflammatory chemokines including RANTES, interleukin-1 (IL-1 and the numbers of CD4+ and CD8+ T cells in the grafts were determined by biochemical assays at different time points after corneal transplantation. RESULTS: Various degrees of inflammatory cell infiltration and graft neovascularisation were observed by histopathology. After injecting the pcDNA3.1-hIL-1ra plasmid into the cornea, IL-1ra mRNA and protein expression was detected in the corneal stroma and reached a peak on day 3. The graft survival curves indicated that the corneal transparency rates of grafts in the IL-1ra gene-treated group and the IL-1ra protein-treated group were higher compared with the untreated group (P<0.05. During the period of acute rejection, TGF-β1, RANTES, IL-1α and IL-1β levels in the grafts in the IL-1ra treatment groups were lower than the control group (P<0.05. CD4+ and CD8+ T cell counts were reduced significantly in the corneal grafts of groups II, III and IV compared with group I (P<0.05. CONCLUSION

  12. Enhancement of Corneal Visibility in Optical Coherence Tomography Images with Corneal Opacification.

    Science.gov (United States)

    Chung, Cheuk Wang; Ang, Marcus; Farook, Mohamed; Strouthidis, Nicholas G; Mehta, Joddhbir S; Mari, Jean Martial; Girard, Michaël J A

    2016-09-01

    To establish and to rank the performance of a corneal adaptive compensation (CAC) algorithm in enhancing corneal images with scars acquired from three commercially available anterior segment optical coherence tomography (ASOCT) devices. Horizontal B-scans of the cornea were acquired from 10 patients using three ASOCT devices (Spectralis, RTVue, and Cirrus). We compared ASOCT image quality (with and without CAC) by computing the intralayer contrast (a measure of shadow removal), the interlayer contrast (a measure of tissue boundary visibility), and the tissue/background contrast (a measure of overall corneal visibility). All six groups (Spectralis, RTVue, Cirrus, Spectralis+CAC, RTVue+CAC, and Cirrus+CAC) were ranked according to a global performance index that averaged all contrast quantities. CAC provided mean intralayer contrasts improvement for all devices (all P images of corneal scars may be enhanced by CAC through shadow removal, improved tissue boundary visibility, and enhanced corneal visibility against the image background. RTVue produces the finest baseline images but the best image quality can be achieved by applying CAC to Spectralis images. CAC could enhance visibility of corneal images with scars acquired from commercially available ASOCT devices and could aid preoperative planning of patients for ophthalmic procedures.

  13. Altered expression of type XIII collagen in keratoconus and scarred human cornea: Increased expression in scarred cornea is associated with myofibroblast transformation.

    Science.gov (United States)

    Määttä, Marko; Väisänen, Timo; Väisänen, Marja-Riitta; Pihlajaniemi, Taina; Tervo, Timo

    2006-05-01

    Type XIII collagen (ColXIII) is a transmembrane protein thought to be involved in cell-cell and cell-matrix interactions. We report here on its presence in the normal human cornea and compare the results for keratoconus and scarred corneas. Immunohistochemistry and in situ hybridization were applied to human corneal samples obtained by penetrating keratoplasty. In the normal human cornea, ColXIII was immunolocalized to the corneal epithelial cells, and to a lesser degree to the stromal keratocytes. The keratoconus cases showed otherwise similar results, but in areas containing Bowman membrane disruptions showed thinned epithelial cells reduced immunostaining for ColXIII, whereas occasionally pronounced immunoreactivity was seen in the stromal keratocytes. The corneal scar samples contained highly increased ColXIII immunostaining by stromal cells in the fibrotic foci, whereas the peripheral areas showed less intense immunostaining. In situ hybridization confirmed that the corneal epithelium and keratocytes actively synthesize the transcript. Immunostaining with alphaSMA revealed that a substantial proportion of the ColXIII mRNA-expressing cells in the stromal scar tissues was myofibroblasts and that these areas lack CD34 immunoreactivity. The results indicate that ColXIII, which is predominantly confined to the basal corneal cells in the normal cornea, may have a role in the adhesion of corneal epithelial cells to each other and to the underlying basement membrane. Additionally, highly increased expression in scarred corneas suggests that it participates in the corneal wound healing process.

  14. Inflammation and oxidative stress in corneal tissue in experimental keratitis due to Fusarium solani: Amelioration following topical therapy with voriconazole and epigallocatechin gallate.

    Science.gov (United States)

    Ruban, Vasanthakumar V; Archana, Philip T; Sundararajan, Mahalingam; Geraldine, Pitchairaj; Thomas, Philip A

    2017-10-24

    Combined antifungal and antioxidant therapy may help to reduce oxidative stress in fungal keratitis. Experimental Fusarium solani keratitis was induced by application of F. solani conidia to scarified cornea (right eye) of 16 rabbits (another four rabbits were negative controls [Group I]). Five days later, F. solani-infected animals began receiving hourly topical saline alone (Group II), voriconazole (10 mg/mL) alone (Group III), epigallocatechin gallate (EGCG, 10 mg/mL) alone (Group IV) or voriconazole and EGCG (Group V). Twenty days post-inoculation, corneal lesions were graded. After animal sacrifice, excised corneas underwent histopathological and microbiological investigations. Corneal tissue levels/activities of interleukin 1 beta (IL-1β) and tumour necrosis factor alpha (TNF-α) gene mRNA transcripts, matrix metalloproteinase (MMP) 2 and 9 proteins, malondialdehyde (MDA) and reduced glutathione (GSH), and superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx), were also measured. Clinical and histopathological scores (severity of corneal lesions; [P  Groups IV and III > Groups V and I. Mean SOD, CAT, GPx and GSH levels (P solani keratitis, as manifested by improved clinical, histological, microbiological and molecular parameters. © 2017 Blackwell Verlag GmbH.

  15. Corneal topography.

    Science.gov (United States)

    Seitz, B; Behrens, A; Langenbucher, A

    1997-08-01

    In the review period, limitations of individual Placido disk-based topography systems have been studied and new principles, such as raster photogrammetry, pancorneal slit topography, laser holographic interferometry, and confocal laser scanning topography, have been introduced for laboratory or clinical work. Both Fourier analysis and Zernike decomposition of topographic height data seem to be powerful new tools for cross-sectional analysis of complex topographic corneal images, such as after cataract surgery, penetrating keratoplasty, and refractive surgery, as well as for longitudinal studies of corneal changes, such as in schoolchildren. Subdividing into rational optical components may improve consistency and standardization of topography data from different systems. Topography-based flying-spot-mode excimer laser photoablation after Zernike decomposition of topography height data has been proposed for correction of irregular corneal astigmatism. Topography-based central power measurements are of increasing value for intraocular lens power calculation before cataract surgery in eyes with irregular corneal surfaces, such as in keratoconus or after refractive surgery procedures. Quantitative and qualitative classification of corneal topography maps after corneal transplantation following conventional mechanical and nonmechanical trephination or after refractive surgery may lead to a better understanding of impaired visual acuity despite a clear graft or despite significantly reduced ametropia or corneal astigmatism.

  16. Corneal complications of vernal keratoconjunctivitis.

    Science.gov (United States)

    Solomon, Abraham

    2015-10-01

    Vernal keratoconjunctivitis (VKC) is a severe bilateral chronic allergic inflammatory disease of the ocular surface. In most of the cases, the disease is limited to the tarsal conjunctiva and to the limbus. However, in the more severe cases, the cornea may be involved, leading to potentially sight threatening complications. Prompt recognition of these complications is crucial in the management of VKC, which is one of the most severe ocular allergic diseases. A vicious cycle of inflammation occurs as a result of a set of reciprocal interactions between the conjunctiva and the cornea, which results in damage to the corneal epithelium and corneal stoma, and to the formation of shield ulcers and plaques, infectious keratitis, keratoconus, scarring, and limbal stem cell deficiency. These corneal complications can cause permanent decrease or loss of vision in children suffering from VKC. Corneal complications in VKC are the result of an on-going process of uncontrolled inflammation. Proper recognition of the corneal complications in VKC is crucial, as most of these can be managed or prevented by a combination of medical and surgical measures.

  17. Comparison of the effects of subconjunctival and topical anti-VEGF therapy (bevacizumab on experimental corneal neovascularization

    Directory of Open Access Journals (Sweden)

    Ozdemir Ozdemir

    2014-08-01

    Full Text Available Purpose: To compare the effects of bevacizumab applied either subconjunctivally or topically, in a rat model of corneal neovascularization induced by alkali burn. Methods: The right corneas of 24 Wistar-Albino rats were cauterized with silver nitrate sticks. The rats were divided randomly and equally into three groups: no treatment control (n=8, subconjunctival bevacizumab treatment (n=8, and topical bevacizumab treatment (n=8. Immediately following cauterization, the subconjunctival group was treated with a 0.05 ml (1.25 mg bevacizumab subconjunctival injection. The topical group was treated with 10 mg/ml bevacizumab twice daily, and the control group received subconjunctival saline injections twice daily. The burn stimulus and neovascularization scores were evaluated using a technique previously described by Mahoney and Waterbury. Digital photographs were obtained before the eyes were enucleated and corneal sections were then analyzed by histopathology. Results: The mean burn stimulus score was 1.86 ± 0.6 and there was no statistical difference between the groups (p=0.730. The mean neovascularization scores in the subconjunctival and topical bevacizumab groups were statistically lower than the control group (p<0.05. The mean percentage area of corneal neovascularization was 82.5 ± 22.1 in the control group, 42.7 ± 15.0 in the subconjunctival group, and 55.8 ± 18.2 in the topical group. The differences between the control and treatment groups were statistically significant (p<0.05. Histopathology showed that the treatment groups presented less neovascularization, inflammation, and fibroblast activity than the control group (p<0.05. Conclusions: This study demonstrates that both subconjunctival and topical administrations of bevacizumab inhibit corneal neovascularization and decrease inflammation and fibroblast activity in a rat model of corneal neovascularization induced by alkali burn.

  18. Corneal Laceration

    Medline Plus

    Full Text Available ... by something sharp flying into the eye. It can also be caused by something striking the eye ... If the corneal laceration is deep enough it can cause a full thickness laceration. This is when ...

  19. Corneal Laceration

    Medline Plus

    Full Text Available ... itself. A corneal laceration is a very serious injury and requires immediate medical attention to avoid severe ... 27, 2015 Dark Spot in Vision After Blunt Trauma Dec 21, 2014 Pain a Year After Eyelid ...

  20. Corneal Laceration

    Medline Plus

    Full Text Available ... the blood and may increase bleeding after you have finished protecting the eye, see a physician immediately ... Jun 30, 2017 People with Advanced Keratoconus May Have A Future Alternative to Full Corneal Transplantation Nov ...

  1. Corneal Laceration

    Medline Plus

    Full Text Available ... People with Advanced Keratoconus May Have A Future Alternative to Full Corneal Transplantation Nov 29, 2016 Combating Eye Injuries from ... of Service For Advertisers For Media Ophthalmology Job Center © American Academy of Ophthalmology 2017 ...

  2. Corneal Laceration

    Medline Plus

    Full Text Available ... inflammatory drugs. These drugs thin the blood and may increase bleeding after you have finished protecting the ... a hair dryer to treat my Fuchs’ dystrophy? May 06, 2017 I lost sight from a corneal ...

  3. Corneal Laceration

    Medline Plus

    Full Text Available ... By: Devin A Harrison MD Sep. 01, 2017 The cornea is the clear front window of the eye . A corneal laceration is a cut on the cornea. It is usually caused by something sharp ...

  4. Corneal Laceration

    Medline Plus

    Full Text Available ... itself. A corneal laceration is a very serious injury and requires immediate medical attention to avoid severe ... Ask an Ophthalmologist Answers Did my traumatic brain injury cause early cataracts? Jan 21, 2018 Did I ...

  5. Corneal Laceration

    Medline Plus

    Full Text Available ... caused by something striking the eye with significant force, like a metallic hand tool. A corneal laceration ... and preserving your vision. Privacy Policy Related Top 5 Eye Health Stories of 2017 Dec 21, 2017 ...

  6. Corneal Laceration

    Medline Plus

    Full Text Available ... itself. A corneal laceration is a very serious injury and requires immediate medical attention to avoid severe ... Dangerous for Your Eyes Sep 20, 2017 Eye Injuries from Laundry Packets On the Rise Jun 30, ...

  7. A Rat Excised Larynx Model of Vocal Fold Scar

    Science.gov (United States)

    Welham, Nathan V.; Montequin, Douglas W.; Tateya, Ichiro; Tateya, Tomoko; Choi, Seong Hee; Bless, Diane M.

    2009-01-01

    Purpose: To develop and evaluate a rat excised larynx model for the measurement of acoustic, aerodynamic, and vocal fold vibratory changes resulting from vocal fold scar. Method: Twenty-four 4-month-old male Sprague-Dawley rats were assigned to 1 of 4 experimental groups: chronic vocal fold scar, chronic vocal fold scar treated with 100-ng basic…

  8. Scar revision - slideshow

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/presentations/100098.htm Scar revision - series—Normal anatomy To use the sharing ... entire body, and acts as a protective barrier. Scar tissue forms as skin heals after an injury ( ...

  9. Acne scar subcision

    Directory of Open Access Journals (Sweden)

    B S Chandrashekar

    2010-01-01

    Full Text Available Subcision is a simple and safe office surgery procedure for treatment of depressed acne scars. It can easily be combined with other treatments such as laser, dermaroller and scar revisions for maximum efficacy.

  10. Corneal collagens.

    Science.gov (United States)

    Robert, L; Legeais, J M; Robert, A M; Renard, G

    2001-05-01

    Cornea is a highly differentiated tissue rich in extracellular matrix (ECM) specifically distributed in space in order to insure its dual role--transparency and protection of inner eye-tissues. Corneal ECM is especially rich in collagens. Since the characterisation of a number of distinct collagen types it appeared that most of them are present in the cornea. Their synthesis follows a specific program of sequential expression of the different collagen types to be synthesised during the development and maturation of the cornea. The precise regulation of the diameter and orientation of fibers, and of the interfibrillar spaces is partially at least attributed to interactions between glycosaminoglycans and collagens. The 'program' of vectorial collagen synthesis and GAG-collagen interactions changes also with age and in several pathological conditions as corneal dystrophies and wound healing. The Maillard reaction, especially in diabetes, is one of these important factors involved in age-dependent modifications of corneal structure and function. Far from being inert, corneal collagens were shown to have relatively short half-lives. The biosynthesis of corneal collagens was studied also during wound healing. The refibrillation of wounded corneas does not follow the original 'program' of ECM-synthesis as shown by the comparative study of wound healing using biochemical and morphometric methods. This review recapitulates briefly previous and recent studies on corneal collagens in order to present to clinicians and scientists an overview of the state of the art of this important field at the intersection of eye research and matrix biology.

  11. Myocardial Scar Imaging by Standard Single-Energy and Dual-Energy Late Enhancement Computed Tomography: Comparison to Pathology and Electroanatomical Map in an Experimental Chronic Infarct Porcine Model

    Science.gov (United States)

    Truong, Quynh A.; Thai, Wai-ee; Wai, Bryan; Cordaro, Kevin; Cheng, Teresa; Beaudoin, Jonathan; Xiong, Guanglei; Cheung, Jim W.; Altman, Robert; Min, James K.; Singh, Jagmeet P.; Barrett, Conor D.; Danik, Stephan

    2015-01-01

    Background Myocardial scar is a substrate for ventricular tachycardia and sudden cardiac death. Late enhancement computed tomography (CT) imaging can detect scar, but it remains unclear whether newer late enhancement dual-energy (LE-DECT) acquisition has benefit over standard single-energy late enhancement (LE-CT). Objective We aim to compare late enhancement CT using newer LE-DECT acquisition and single-energy LE-CT acquisitions to pathology and electroanatomical map (EAM) in an experimental chronic myocardial infarction (MI) porcine study. Methods In 8 chronic MI pigs (59±5 kg), we performed dual-source CT, EAM, and pathology. For CT imaging, we performed 3 acquisitions at 10 minutes post-contrast: LE-CT 80 kV, LE-CT 100 kV, and LE-DECT with two post-processing software settings. Results Of the sequences, LE-CT 100 kV provided the best contrast-to-noise ratio (all p≤0.03) and correlation to pathology for scar (ρ=0.88). While LE-DECT overestimated scar (both p=0.02), LE-CT images did not (both p=0.08). On a segment basis (n=136), all CT sequences had high specificity (87–93%) and modest sensitivity (50–67%), with LE-CT 100 kV having the highest specificity of 93% for scar detection compared to pathology and agreement with EAM (κ 0.69). Conclusions Standard single-energy LE-CT, particularly 100kV, matched better to pathology and EAM than dual-energy LE-DECT for scar detection. Larger human trials as well as more technical-based studies that optimize varying different energies with newer hardware and software are warranted. PMID:25977115

  12. EXPERIMENTAL REPAIR OF DEEP CORNEAL DEFECTS USING A BIO-CONSTRUCT COMPRISING A COLLAGEN TYPE I MATRIX LOADED WITH BUCCAL EPITHELIAL CELLS

    Directory of Open Access Journals (Sweden)

    N. S. Egorova

    2017-01-01

    Full Text Available The  research  objective was  to study the  reparative effects of  the  collagen  type  I bio-construct loaded  with buccal epithelial cells, on the rabbit cornea after experimental keratectomy at various stages of treatment (on the 3rd, 7th, 14th, 3 0th days.Material  and methods.  The  experiments were  conducted on 20 rabbits  of  the  Chinchilla breed that  were  operated on cornea of both eyes aiming to inflict epithelial and stromal cornea defects. The collagen-based bio-construct bearing buccal epithelial cells was placed  over the cornea of the experimental eyes. The  cornea of the control  eyes was covered with smooth contact lens. After the surgery, a temporal blepharorrhaphy was performed and kept for 3 days. We studied macroand microscopic pattern of corneal regeneration at 3, 7, 14, and 30 days of experiment.Results. When  using the collaged-based bio-construct containing buccal epithelial cells, the complete epithelialization of the corneal defect occurred at mean 7 days earlier compared to that in the control eyes. Thus, the offered bio-construct stimulated the cell migration and proliferation at early stages of treatment (3–7 days reducing the inflammation activity.Conclusion. The bio-construct comprising a collagen type  I matrix loaded with buccal epithelial cells can provide an effective treatment option for corneal defects.

  13. Post-burn scars and scar contractures

    Directory of Open Access Journals (Sweden)

    Goel Arun

    2010-10-01

    Full Text Available The mortality and morbidity from burns have diminished tremendously over the last six to seven decades. However, these do not truly reflect whether the victim could go back to society as a useful person or not and lead a normal life because of the inevitable post-burn scars, contractures and other deformities which collectively have aesthetic and functional considerations. This article gives an overview of the post-burn scars and scar contractures, especially their prevention, minimisation and principles of management.

  14. Visual management of aphakia with concomitant severe corneal irregularity by mini-scleral design contact lenses

    Directory of Open Access Journals (Sweden)

    Fateme Alipur

    2016-03-01

    Conclusion: Miniscleral contact lenses can be considered a safe and effective option in aphakia patients with concurrent corneal scarring secondary to ocular injury for whom surgical intervention would be complicated.

  15. Preparation and characterization of different sizes of ethosomes encapsulated with 5-fluorouracil and its experimental study of permeability in hypertrophic scar.

    Science.gov (United States)

    Mao, Xiaohui; Wo, Yan; He, Rong; Qian, Yunliang; Zhang, Yixin; Cui, Daxiang

    2010-07-01

    With the aim of investigating scar penetration efficiency of different sizes of ethosomes encapsulated with Fluorouracil, three kinds of ethosomes with different sizes were prepared by extruding the vesicles through polycarbonate membrane filters, their encapsulation efficiency of Fluorouracil (5-FU) were investigated by dialysis method, their scar-penetration efficiencies were analyzed by filling Rodanmin 6GO into ethosomes and using confocal laser scanning microscopy (CLSM). The prepared ethosomes were 216 +/- 19 nm, 107 +/- 13 nm, and 65 +/- 10 nm in diameter respectively, and exhibited good dispersibility. Their encapsulation efficiency of 5-FU were 12%, 34%, and 41%, respectively. The results indicated that the 5-FU penetration was reversely related to the size of the size of the ethosomes. The ethosomes of 65 nm in diameter exhibited maximal fluorescence penetration efficiency which could reach the deep layer of dermis of hypertrophic scar. In conclusion, three different sizes of 5-FU ethosomes were prepared successfully, the ethosomes of 65 nm in diameter with 5-FU can penetrate scar high efficiently, which has potential in application such as anti-scar drug carriers in scar therapy in near future.

  16. Corneal Transplantation

    DEFF Research Database (Denmark)

    Hjortdal, Jesper Østergaard

    Corneal transplantation has been performed for more than 100 years. Until 15 years ago the state-of-the art type of transplantation was penetrating keratoplasty, but since the start of this millennium, newly designed surgical techniques have developed considerably. Today, the vast majority...... with less risk of rejection episodes. Besides covering updated chapters on penetrating keratoplasty, and anterior and posterior lamellar procedures, this textbook also gives a thorough overview of the history of corneal transplantation and a detailed presentation of the microstructural components....... Economic considerations on cost and benefi t of medical treatment and surgical procedures are today an integrated part of the health system in many countries, and a chapter covers these aspects of corneal transplantation. This textbook is aimed at presenting an updated review of the new techniques...

  17. Corneal Higher-order Aberrations and Visual Improvement Following Corneal Transplantation in Treating Herpes Simplex Keratitis.

    Science.gov (United States)

    Shimizu, Eisuke; Yamaguchi, Takefumi; Tomida, Daisuke; Yagi-Yaguchi, Yukari; Satake, Yoshiyuki; Tsubota, Kazuo; Shimazaki, Jun

    2017-12-01

    To examine corneal higher-order aberrations (HOAs) and visual improvement following corneal transplantation in treating corneal scar caused by herpes simplex keratitis (HSK). Retrospective consecutive case series. This study included a total of 52 eyes: 18 eyes of normal subjects, and 34 eyes of consecutive patients with corneal scar owing to HSK who underwent penetrating keratoplasty (PKP, 17 eyes) or deep anterior lamellar keratoplasty (DALK, 17 eyes). HOAs of the anterior, posterior surfaces and the total cornea were analyzed by anterior segment optical coherence tomography. The correlations between corneal HOAs and visual improvement were also analyzed. Mean logarithm of the minimal angle of resolution (logMAR) visual acuity significantly improved from 1.40 ± 0.70 to 0.46 ± 0.45 after corneal transplantation (P transplantation (PKP: from 1.16 ± 0.59 μm to 0.58 ± 0.35 μm, P = .035, DALK: from 0.94 ± 0.57 μm to 0.37 ± 0.18 μm, P = .004). Visual acuity following corneal transplantation was correlated with the corneal HOAs at 12 months (r = 0.53, P = .01). Visual improvement at 3, 6, and 12 months was positively correlated with preoperative HOAs of the total cornea and posterior surface (all P transplantation in eyes with HSK. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Corneal Intelligence

    African Journals Online (AJOL)

    Murdoch3

    the damping effect of the tissue to an applied force) or corneal compliance being the major risk factor. Figure 1. The percentage of participants in the observation group who developed primary open-angle glaucoma (median follow-up, 72 months) ...

  19. Corneal ulcers

    African Journals Online (AJOL)

    visual acuity chart. • fluorescein strips. • topical anaesthetic eye drops. • direct ophthalmoscope. Examination. Assessing vision with a Snellen visual acuity chart gives a clue as to the extent of the problem (e.g. a corneal abrasion with good vision is unlikely to require specialist intervention). Each eye should be tested ...

  20. Corneal Intelligence

    African Journals Online (AJOL)

    Murdoch3

    Corneal Intelligence. Ian Murdoch. Institute of Ophthalmology, Bath Street, London. In 2002, the ocular hypertension treatment study (OHTS) published their results. This study had taken 1636 ocular hypertensives. 1, 2. (IOP 24-32mmHg) and randomized them to receive therapy or no therapy. The primary outcome of the ...

  1. Phototherapeutic Keratectomy Outcomes in Superficial Corneal Opacities

    Directory of Open Access Journals (Sweden)

    Khalid Al Arfaj

    2011-01-01

    Full Text Available Purpose Compare the effectiveness of Phototherapeutic keratectomy (PTK in treatment corneal dystrophies versus superficial corneal scars: visual outcomes, recurrence rate and safety profile. Methods PTK was performed in 51 eyes of 51 patients. Data regarding the indications for PTK, ablation depth, symptomatic relief, pre-and postoperative best spectacle-corrected visual acuity (BSCVA, spherical equivalent changes, recurrence and complications were analyzed. The indications for PTK in our study were classified into two categories – group A: patients with corneal dystrophies (n = 23 and the other group B (n = 28 with other indications. Results The average age of the patients was 47 years (±16.4. The mean follow up period was 15.16 months (±10.01 months. Post operatively, there were no significant complications. While the overall BSCVA in the patients improved from 20/41 (0.484 to 20/32 (0.645, group A showed improvement from 20/35 (0.561 to 20/29 (0.687, as compared to group B in which BSCVA improved from 20/47 (0.421 to 20/33 (0.611. The most common indication in group A was granular corneal dystrophy (n = 10 and the most common indication in group B was post traumatic/infectious corneal scar or opacity (n = 10. Eighty-six percent (n = 44 of all patients had alleviation of symptoms. Recurrence of symptoms was seen in 3 eyes of recurrent corneal erosions which required retreatment. Conclusion PTK is a safe and effective procedure. The outcome of this study suggests that PTK improves BSCVA. PTK appears to improve ocular surface health. Furthermore, PTK can be recommended to most patients with corneal dystrophies as a treatment modality prior to other more invasive procedure (viz. penetrating keratoplasty.

  2. Intrastromal corneal ring implants for corneal thinning disorders: an evidence-based analysis.

    Science.gov (United States)

    2009-01-01

    progressively thins causing a cone-like bulge or forward protrusion in response to the normal pressure of the eye. Thinning occurs primarily in the stoma layers and is believed to be a breakdown in the collagen network. This bulging can lead to an irregular shape or astigmatism of the cornea and, because the anterior part of the cornea is largely responsible for the focusing of light on the retina, results in loss of visual acuity. This can make even simple daily tasks, such as driving, watching television or reading, difficult to perform. Keratoconus (KC) is the most common form of corneal thinning disorder and is a noninflammatory chronic disease process. Although the specific causes of the biomechanical alterations that occur in KC are unknown, there is a growing body of evidence to suggest that genetic factors may play an important role. KC is a rare condition (cornea, cause local separation of the corneal lamellae resulting in a shortening of the arc length of the anterior corneal curvature and flattening the central cornea. Increasing segment thickness results in greater lamellar separation with increased flattening of the cornea correcting for myopia by decreasing the optical power of the eye. Corneal implants also improve corneal astigmatism but the mechanism of action for this is less well understood. Treatment with corneal implants is considered for patients who are contact lens intolerant, having adequate corneal thickness particularly around the area of the implant incision site and without central corneal scarring. Those with central corneal scarring would not benefit from implants and those without an adequate corneal thickness, particularly in the region that the implants are being inserted, would be at increased risk for corneal perforation. Patients desiring to have visual rehabilitation that does not include glasses or contact lenses would not be candidates for corneal ring implants. Placement of the implants is an outpatient procedure with topical anesthesia

  3. Story on Scars

    Science.gov (United States)

    ... doesn't and it bothers you, there are treatments that can make a scar less noticeable, such as skin-smoothing medicated creams, ... doctor to find out if any of these treatments would be right for ... bothering you about your scar and how you feel on the inside. Because ...

  4. Laser scar revision.

    Science.gov (United States)

    Lupton, Jason R; Alster, Tina S

    2002-01-01

    A variety of lasers can be used to treat scars and striae effectively. It is of paramount importance that the type of scar be properly classified on initial examination so that the most appropriate method of treatment can be chosen. Classification also allows the laser surgeon to discuss with the patient the anticipated response to treatment. The 585-nm pulsed dye laser (PDL) is the most appropriate system for treating hypertrophic scars, keloids, erythematous scars, and striae. The PDL carries a low risk of side effects and complications when operated at appropriate treatment parameters and time intervals. Atrophic scars are best treated with ablative CO2 and Er:YAG lasers; however, proliferative keloids and hypertrophic scars should not be vaporized because of the high risk of scar recurrence or progression. The appropriate choice and use of lasers can significantly improve most scars. As research in laser-skin interaction continues, further refinements in laser technology coupled with the addition of alternate treatment procedures will allow improved clinical efficacy and predictability.

  5. Severe microbial keratitis and associated perforation after corneal crosslinking for keratoconus.

    Science.gov (United States)

    Rana, M; Lau, A; Aralikatti, A; Shah, S

    2015-04-01

    To report two cases of microbial keratitis with subsequent corneal perforation immediately following corneal collagen crosslinking (CXL). Retrospective case note review. First case was a 19 year old female presented with staphylococcal corneal abscess 3 days post CXL procedure. Corneal perforation occurred during hospital admission and was successfully treated with corneal gluing. Microbial keratitis eventually resolved, with both topical and systemic antibiotics therapy, resulting in a vascularized corneal scar. Second case was an 18 year old male whom developed Methicillin Resistant Staphylococcus aureus (MRSA) corneal abscess 5 days after CXL procedure for progressive keratoconus. Corneal perforation occurred 48 h after presentation and patient underwent uneventful corneal gluing. Although infective keratitis was successfully treated with topical therapy, patient had visual outcome of count fingers due to scarring. CXL has been widely used in the treatment of corneal ectatic conditions and complications, such as infective keratitis, are uncommon post procedure. We present two cases of severe microbial keratitis with subsequent corneal perforation within 7 days of CXL. The exact mechanism for the accelerated keratolysis process is unclear. Nonetheless, patients should be well-informed of such potentially devastating complication. Copyright © 2014. Published by Elsevier Ltd.

  6. Variation of corneal refractive index with hydration

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young L; Walsh, Joseph T Jr.; Goldstick, Thomas K; Glucksberg, Matthew R [Biomedical Engineering Department, Northwestern University, Evanston, IL 60208 (United States)

    2004-03-07

    We report the effect of changes in the corneal hydration on the refractive index of the cornea. Using optical coherence tomography (OCT), the geometrical thickness and the group refractive index of the bovine cornea were derived simultaneously as the corneal hydration was varied. The corneal hydration was then calculated from the corneal thickness. The group refractive index of the cornea increased non-linearly as the cornea dehydrated. In addition, a simple mathematical model was developed, based on the assumption that changes in corneal hydration occur only in the interfibrilar space with constant water content within the collagen fibrils. Good agreement between the experimental results and the mathematical model supports the assumption. The results also demonstrate that the measurement of refractive index is a quantitative indicator of corneal hydration.

  7. Scar Ectopic Pregnancy

    OpenAIRE

    Patel, Madhuri Arvind

    2015-01-01

    Scar ectopic pregnancy is the rarest form of ectopic pregnancy and has been increasingly diagnosed all over the world. This is a life-threatening form of abnormal implantation of embryo within the myometrium and fibrous tissues in a previous scar on the uterus, especially following caesarean section. With the increasing rate of caesarean section, there is a substantial increase in this condition with better understanding of this disease. The early and accurate diagnosis with timely management...

  8. Biointegration of corneal macroporous membranes based on poly(ethyl acrylate) copolymers in an experimental animal model.

    Science.gov (United States)

    Alió del Barrio, Jorge L; Chiesa, Massimo; Gallego Ferrer, Gloria; Garagorri, Nerea; Briz, Nerea; Fernandez-Delgado, Jorge; Sancho-Tello Valls, Maria; Botella, Carmen Carda; García-Tuñón, Ignacio; Bataille, Laurent; Rodriguez, Alejandra; Arnalich-Montiel, Francisco; Gómez Ribelles, Jose L; Antolinos-Turpín, Carmen M; Gómez-Tejedor, Jose A; Alió, Jorge L; De Miguel, Maria P

    2015-03-01

    Currently available keratoprosthesis models (nonbiological corneal substitutes) have a less than 75% graft survival rate at 2 years. We aimed at developing a model for keratoprosthesis based on the use of poly(ethyl acrylate) (PEA)-based copolymers, extracellular matrix-protein coating and colonization with adipose-derived mesenchymal stem cells. Human adipose tissue derived mesenchymal stem cells (h-ADASC) colonization efficiency of seven PEA-based copolymers in combination with four extracellular matrix coatings were evaluated in vitro. Then, macroporous membranes composed of the optimal PEA subtypes and coating proteins were implanted inside rabbit cornea. After a 3-month follow-up, the animals were euthanized, and the clinical and histological biointegration of the implanted material were assessed. h-ADASC adhered and survived when cultured in all PEA-based macroporous membranes. The addition of high hydrophilicity to PEA membranes decreased h-ADASC colonization in vitro. PEA-based copolymer containing 10% hydroxyethyl acrylate (PEA-HEA10) or 10% acrylic acid (PEA-AAc10) monomeric units showed the best cellular colonization rates. Collagen plus keratan sulfate-coated polymers demonstrated enhanced cellular colonization respect to fibronectin, collagen, or uncoated PEAs. In vivo implantation of membranes resulted in an extrusion rate of 72% for PEA, 50% for PEA-AAc10, but remarkably of 0% for PEA-HEA10. h-ADASC survival was demonstrated in all the membranes after 3 months follow-up. A slight reduction in the extrusion rate of h-ADASC colonized materials was observed. No significant differences between the groups with and without h-ADASC were detected respect to transparency or neovascularization. We propose PEA with low hydroxylation as a scaffold for the anchoring ring of future keratoprosthesis. © 2014 Wiley Periodicals, Inc.

  9. Clinical evaluation of rigid gas permeable contact lenses and visual outcome after repaired corneal laceration.

    Science.gov (United States)

    Zheng, Bin; Shen, Lijun; Walker, Maria K; Zhang, Zongduan; Zheng, Jingwei; She, Xiangjun; Zhou, Jing; Xu, Zhaoxia; Chen, Yan

    2015-01-01

    To evaluate the clinical value of rigid gas permeable contact lenses (RGPCLs) in patients with traumatic corneal scarring and address implications of primary corneal repair. Eighteen subjects with a history of corneal laceration were fit with RGPCLs. Scar locations were divided into two zones; each patient was examined using Pentacam. Entering data included uncorrected visual acuity (UCVA), spectacle-corrected visual acuity (SVA), time between injury and RGPCL fitting, location and size of scar, and amount of corneal astigmatism. Follow-up data included RGPCL visual acuity (RGPCLVA), RGPCL-related complications, and dropout characteristics. Visual acuity values were converted to logMAR for analysis. No serious complications occurred. The average time between suture removal and RGPCL fitting was 5.7±5.5 months. Average corneal astigmatism was -3.44±2.09 diopters. One subject had developed corneal ectasia. RGPCLVA was more than 0.1 in three subjects: one experienced primary corneal repair complications, and two subjects (contact lens is an ideal method for evaluating visual potential in patients with traumatic corneal astigmatism. Pentacam examinations of those patients with poor RGPCLVA can help an ophthalmologist find and understand existing problems in suture techniques.

  10. Corneal Transplantation in Children

    OpenAIRE

    Gabrić, N.; Dekaris, I.; Vojniković, B.; Karaman, Ž.; Mravičić, I.; Katušić, J.

    2001-01-01

    The main purpose of the study was to describe the surgical success rate and visual results of penetrating keratoplasty in children. This retrospective study included children that underwent corneal transplantation at the Department of Ophthalmology, General Hospital »Sveti Duh«, in the period 1994–1999. Patients’ age ranged from 6 to 16 years. Twenty-five corneal transplants were performed in 24 eyes. Corneal pathologies were corneal leucoma, congenital dystrophy, corneal combu...

  11. Corneal Complications And Visual Impairment In Vernal Keratoconjunctivitis Patients.

    Science.gov (United States)

    Arif, Abdus Salam; Aaqil, Bushra; Siddiqui, Afsheen; Nazneen, Zainab; Farooq, Umer

    2017-01-01

    Vernal kerato-conjunctivitis (VKC) is an infrequent but serious form of allergic conjunctivitis common in warm and humid areas where air is rich in allergens. It affects both eyes asymmetrically. Although VKC is a self-limiting disease but visions affecting corneal complications influence the quality of life in school children. The aim of this study was to list the corneal complications due to this condition and to find out the extent of visual impairment among VKC patients. This cross-sectional study was conducted in the department of Ophthalmology, Benazir Bhutto Shaheed Hospital on 290 eyes of diagnosed cases of VKC. The diagnosis of VKC was made on the basis of history and examination. Visual acuity was recorded using Snellen's notation and visual impairment was classified according to World Health Organization classification for visual disabilities. The mean age of presentation was 10.83±6.13 years. There were 207 (71.4%) males and 83 (28.6%) females. Corneal scarring was observed in 59 (20.3%) eyes. Keratoconus was found to be in 17 (5.9%) eyes. Shield ulcer was detected in 09 (3.1%) eyes while 07 (2.4%) eyes had corneal neovascularization. Majority of the patients with visual loss had corneal scarring and the complication that led to severe visual loss in most of the eyes was Keratoconus. Vernal kerato-conjunctivitis in the presence of corneal complications is a sight threatening disease and can lead to severe visual impairment.

  12. Bilateral Keratoconus and Corneal Hydrops Associated with Eye Rubbing in a 7-year-old Girl

    Directory of Open Access Journals (Sweden)

    Mahmoud-Reza Panahi-Bazaz

    2014-01-01

    Full Text Available Purpose: To report a young child with bilateral keratoconus in the context of vernal keratoconjunctivitis (VKC who developed bilateral corneal hydrops associated with eye rubbing, and to discuss the pathogenesis and review the pertinent literature. Case Report: A seven-year-old girl with VKC and asymmetric keratoconus developed corneal hydrops due to habitual eye rubbing. Corneal edema subsided within 16 weeks in her right eye and 9 weeks in the left eye with subsequent corneal scarring. Conclusion: Continuous mechanical trauma, such as eye rubbing, plays a significant role in the pathogenesis of keratoconus and subsequent hydrops even in childhood.

  13. Scar massage for hypertrophic burns scarring-A systematic review.

    Science.gov (United States)

    Ault, P; Plaza, A; Paratz, J

    2017-06-29

    Scar massage is used in burn units globally to improve functional and cosmetic outcomes of hypertrophic scarring following a burn, however, the evidence to support this therapy is unknown. To review the literature and assess the efficacy of scar massage in hypertrophic burn scars. MEDLINE, PubMed, Embase, CINAHL and the Cochrane Library were searched using the key words "burn", "burn injury", "thermal injury" and "scar", "hypertrophic scar" and "massage", "manipulation", "soft tissue mobilisation", "soft tissue manipulation". The articles were scored by the assessors using the Physiotherapy Evidence Database (PEDro) scale and outcome measures on range of motion (ROM), cosmesis (vascularity, pliability, height), pain scores, pruritus, and psychological measures of depression and anxiety were extracted. Eight publications were included in the review with 258 human participants and 15 animal subjects who received scar massage following a thermal injury resulting in hypertrophic scarring. Outcome measures that demonstrated that scar massage was effective included scar thickness as measured with ultrasonography (p=0.001; g=-0.512); depression (Centre for Epidemiologic Studies - Depression [CES-D]) (p=0.031; g=-0.555); pain as measured with Visual Analogue Scale (VAS) (p=0.000; g=-1.133) and scar characteristics including vascularity (p=0.000; g=-1.837), pliability (p=0.000; g=-1.270) and scar height (p=0.000; g=-2.054). Outcome measures that trended towards significance included a decrease in pruritus (p=0.095; g=-1.157). It appears that there is preliminary evidence to suggest that scar massage may be effective to decrease scar height, vascularity, pliability, pain, pruritus and depression in hypertrophic burns scaring. This review reflects the poor quality of evidence and lack of consistent and valid scar assessment tools. Controlled, clinical trials are needed to develop evidence-based guidelines for scar massage in hypertrophic burns scarring. Copyright © 2017

  14. A brief history of corneal transplantation: From ancient to modern

    Directory of Open Access Journals (Sweden)

    Alexandra X Crawford

    2013-01-01

    Full Text Available This review highlights many of the fundamental concepts and events in the development of corneal transplantation - from ancient times to modern. Tales of eye, limb, and even heart transplantation appear in ancient and medieval texts; however, in the scientific sense, the original concepts of corneal surgery date back to the Greek physician Galen (130-200 AD. Although proposals to provide improved corneal clarity by surgical interventions, including keratoprostheses, were better developed by the 17 th and 18 th centuries, true scientific and surgical experimentation in this field did not begin until the 19 th century. Indeed, the success of contemporary corneal transplantation is largely the result of a culmination of pivotal ideas, experimentation, and perseverance by inspired individuals over the last 200 years. Franz Reisinger initiated experimental animal corneal transplantation in 1818, coining the term "keratoplasty". Subsequently, Wilhelmus Thorne created the term corneal transplant and 3 years later Samuel Bigger, 1837, reported successful corneal transplantation in a gazelle. The first recorded therapeutic corneal xenograft on a human was reported shortly thereafter in 1838-unsurprisingly this was unsuccessful. Further progress in corneal transplantation was significantly hindered by limited understanding of antiseptic principles, anesthesiology, surgical technique, and immunology. There ensued an extremely prolonged period of debate and experimentation upon the utility of animal compared to human tissue, and lamellar versus penetrating keratoplasty. Indeed, the first successful human corneal transplant was not performed by Eduard Zirm until 1905. Since that first successful corneal transplant, innumerable ophthalmologists have contributed to the development and refinement of corneal transplantation aided by the development of surgical microscopes, refined suture materials, the development of eye banks, and the introduction of

  15. Fibrin glue-assisted for the treatment of corneal perforationsusing glycerin-cryopreserved corneal tissue

    Directory of Open Access Journals (Sweden)

    Nuo Dong

    2014-04-01

    Full Text Available AIM: To evaluate the outcomes and safety of lamellar keratoplasty (LK assisted by fibrin glue in corneal perforations.METHODS: Six eyes of 6 patients affected by different corneal pathologies (2 posttraumatic corneal scar and 3 bacterial keratitis underwent LK procedures by using fibrin glue. The mean corneal perforation diameter was 1.35±0.64mm (range, 0.7-2.5mm, and the greatest diameter of the ulcerative stromal defect was 2.47±0.77mm in average (range, 1.5-3.5mm. The donor corneal lamella diameters were 0.20-mm larger and thicker than the recipient to restore a physiologic corneal thickness and shape:mean donor diameter was 8.34±0.28mm (range, 8.2-8.7mm and mean thickness was 352±40.27mm (range, 220-400mm. Mean follow-up was 7.33±1.97 months (range, 6-11 months. Postoperatively, the graft status, graft clarity, anterior chamber response, the visual prognosis, intraocular pressures, and postoperative complications were recorded.RESULTS: All the corneal perforations were successfully healed after the procedure. The best-corrected visual acuity (BCVA ranged from 20/1 000 to 20/50 in their initial presentation, and from 20/100 to 20/20 in their last visit, showed increase in all the patients. No major complications such as graft dislocation and graft failure were noted. Neovascularization developed in the superficial stroma of donor graft in 1 case. High intraocular pressure developed on day 2 after surgery, while was remained in normal range after application of anti-glaucomatous eyedrops for 1 week in 1 case.CONCLUSION: Fibrin glue-assisted sutureless LK is valuable for maintaining the ocular integrity in the treatment of corneal perforations.

  16. Customised component corneal transplantation: a blessing for three patients.

    Science.gov (United States)

    Sati, Alok; Shankar, Sandeep; Jha, Ashok; Gurunadh, Velamakanni Satyanarayana

    2014-08-21

    The existing acute shortage of good quality donor corneas in a developing country like India, prompted us to attempt customised component corneal transplantation. Using this surgical strategy, one corneoscleral button was used for three recipients. Anterior and posterior lamellar discs were used for anterior lamellar keratoplasty and Descemet's stripping endothelial keratoplasty in patients with superficial corneal scar and pseudophakic bullous keratopathy, respectively. From the remnant peripheral corneoscleral rim, a patch graft was taken and used for a case of perforated corneal ulcer. Postoperatively, the two earlier mentioned cases achieved visual acuities of 20/30 and 20/60, respectively, whereas the latter mentioned patient with the patch graft achieved good tectonic stability. This case report highlights the optimal utilisation of a corneoscleral button by customising it for three recipients. Moreover, a patch graft has been introduced in the armamentarium of customised component corneal transplantation for the first time. 2014 BMJ Publishing Group Ltd.

  17. Histologic, ultrastructural, and immunofluorescent evaluation of human laser-assisted in situ keratomileusis corneal wounds.

    Science.gov (United States)

    Dawson, Daniel G; Kramer, Theresa R; Grossniklaus, Hans E; Waring, George O; Edelhauser, Henry F

    2005-06-01

    To evaluate human corneas after laser-assisted in situ keratomileusis at different postoperative intervals. Thirty-eight postmortem corneas from 20 patients with postoperative intervals from 2 months to 6.5 years after laser-assisted in situ keratomileusis surgery were collected from eye banks. The corneas were trisected and processed for conventional histologic analysis, transmission electron microscopy, and immunofluorescence. Light microscopy and transmission electron microscopy showed focal undulations in Bowman layer, focal epithelial hypertrophic modifications, and a variably thick (range, 0.4-16.4-mum) lamellar stromal interface scar in all specimens. The flap wound margin, which was adjacent to the epithelium, healed by producing an approximately 8-mum-thick hypercellular fibrotic stromal scar, whereas the central and paracentral wound regions healed differently because a thinner (approximately 5-mum) hypocellular primitive stromal scar was present in all the corneas examined. Immunofluorescence identified increased type 3 collagen and myofibroblasts in the hypercellular fibrotic scar regions and decreased or absent levels of all corneal stromal components other than type 1 collagen in the hypocellular primitive scar regions. After laser-assisted in situ keratomileusis surgery, the keratocyte-mediated production of a variably thick lamellar corneal stromal scar occurs, resulting in 2 regional types of scarring. The hypercellular fibrotic scar at the wound margin is usually visible clinically and functions to hold the flap in place, while the more central hypocellular primitive scar is not visible clinically and allows easy lifting of the flap postoperatively.

  18. The use of rigid gas permeable contact lenses in scarred corneas.

    Science.gov (United States)

    Kanpolat, A; Ciftçi, O U

    1995-01-01

    Perforating corneal injuries often result in scarred corneas in which adequate visual rehabilitation cannot be achieved with spectacles due to irregular corneal surface. In these eyes, the presence of aphakia often adds to the problem with the coexistence of anisometropia. In this study, rigid gas permeable (RGP) contact lenses were fit in 33 post-traumatic scarred corneas of 33 patients. Twenty-seven of the 33 eyes (82%) were successfully fit without complications for an average follow-up of 19.3 months. The success rate was observed to be lower (50%) for patients less than 10 years old, whereas it was 100% in patients older than 20 years. The six failures included two eyes with amblyopia and unsatisfactory visual acuity, two eyes in two patients who lacked motivation to use contact lenses, and two eyes that were contact lens intolerant. There was no significant correlation between the failure groups and the location and size of the corneal scar. The only contact lens related complication was punctate epithelial keratitis in three of the 33 eyes (9%). The results of this study indicate that RGP contact lenses are successful in the majority of patients (82%) with post-traumatic scarred corneas, especially in the adult age group, and may obviate corneal surgery in these patients.

  19. [Nanostructured bioplastic material for traumatic corneal injuries].

    Science.gov (United States)

    Kanyukov, V N; Stadnikov, A A; Trubina, O M; Yakhina, O M

    2015-01-01

    To substantiate the use of nanostructured bioplastic material for the treatment of traumatic eye injuries. The study enrolled 96 eyes of 48 rabbits and was carried out in 3 series of experiments, different in the type of induced corneal trauma: mechanical erosion, alkaline or acid burn. The animals were clinically monitored and sacrificed for morphological investigation at days 3, 7, 14, 30, and 90. The size of mechanical corneal erosions was repeatedly evaluated with fluorescein eye stain test. In the experimental group, Hyamatrix biomaterial was topically administered according to an original technique. In the controls, soft contact lenses were inserted and sutured. Complete closure of the epithelial defect with no impact on corneal properties was achieved in 3 days in the experimental group and in4 days in the control group. As for alkaline and acid corneal burns, experimental and control groups received Hyamatrix biomaterial and Solcoseryl eye gel correspondingly. In the experimental group of alkaline burn the defect closed by day 7, in the controls--by day 10-11. Acid-induced corneal edema also resolved by day 7 in the experimental group and by day 14 in the control group. 1. The results of this experimental and morphological study prove the hyaluronic acid-derived nanostructured bioplastic material effective in accelerating corneal re-epithelialization after mechanical erosions as compared with the controls. 2. Topical application of the hyaluronic acid-derived nanostructured bioplastic material shortens the exudative phase of inflammation, promotes corneal defect closure with formation of a more subtle opacification, and stimulates corneal restoration after chemical burns.

  20. Optimal size and location for corneal rotational autografts: a simplified mathematical model.

    Science.gov (United States)

    Afshari, Natalie A; Duncan, Scott M; Tanhehco, Tasha Y; Azar, Dimitri T

    2006-03-01

    To calculate clinical guidelines for the optimal location and size of a rotational autokeratoplasty. The ideal graft size and trephine decentration for a rotational autograft were calculated based on scar location using geometric models. Mathematical variables were set to maximize postoperative visual acuity and for generalization of the geometric model. This model was used in a rotational autokeratoplasty of a patient with a history of a corneal scar and diplopia. An 8-mm autograft was decentered 0.5 mm superiorly and rotated 180 degrees to relocate the scar to the superior aspect of the cornea, out of the patient's vision. For cases that satisfy the given variables, a graft diameter of 8 mm with a decentration of 0.5 mm balances maximization of scar removal and scar movement superiorly, with minimization of discrepancy in corneal thickness after rotation. For scars that are alpha degrees from horizontal, the graft should be rotated 180 - alpha degrees . By using these calculations, the autograft in this case successfully resolved the diplopia and improved visual acuity. A rotational autograft can be an effective alternative to standard penetrating keratoplasty for some patients with corneal scars. We establish a mathematical model for most clinical instances of a rotational autograft, in which an 8-mm graft with a decentration of 0.5 mm best satisfies the goals of surgery.

  1. Surgical scar revision: An overview

    Directory of Open Access Journals (Sweden)

    Shilpa Garg

    2014-01-01

    Full Text Available Scar formation is an inevitable consequence of wound healing from either a traumatic or a surgical intervention. The aesthetic appearance of a scar is the most important criteria to judge the surgical outcome. An understanding of the anatomy and wound healing along with experience, meticulous planning and technique can reduce complications and improve the surgical outcome. Scar revision does not erase a scar but helps to make it less noticeable and more acceptable. Both surgical and non-surgical techniques, used either alone or in combination can be used for revising a scar. In planning a scar revision surgeon should decide on when to act and the type of technique to use for scar revision to get an aesthetically pleasing outcome. This review article provides overview of methods applied for facial scar revision. This predominantly covers surgical methods.

  2. Can Acne Scars Be Removed?

    Science.gov (United States)

    ... Arrhythmias Abuse Love and Romance Understanding Other People Can Acne Scars Be Removed? KidsHealth > For Teens > Can Acne Scars Be Removed? Print A A A ... acné? Different Types of Acne Scars from acne can seem like double punishment — first you had to ...

  3. Inhibition of Corneal Neovascularization with the Combination of Bevacizumab and Plasmid Pigment Epithelium-Derived Factor-Synthetic Amphiphile INTeraction-18 (p-PEDF-SAINT-18 Vector in a Rat Corneal Experimental Angiogenesis Model

    Directory of Open Access Journals (Sweden)

    Ching-Hsein Chen

    2013-04-01

    Full Text Available Bevacizumab, a 149-kDa protein, is a recombinant humanized monoclonal antibody to VEGF. PEDF, a 50-kDa glycoprotein, has demonstrated anti-vasopermeability properties. In this study, we demonstrated that the combination of bevacizumab and plasmid pigment epithelium-derived factor-synthetic amphiphile INTeraction-18 (p-PEDF-SAINT-18 has a favorable antiangiogenic effect on corneal NV. Four groups (Group A: 0 μg + 0 μg, B: 0.1 μg + 0.1 μg, C: 1 μg + 1 μg, and D: 10 μg + 10 μg of bevacizumab + p-PEDF-SAINT-18 were prepared and implanted into the rat subconjunctival substantia propria 1.5 mm from the limbus on the temporal side. Then, 1 μg of p-bFGF-SAINT-18 was prepared and implanted into the rat corneal stroma 1.5 mm from the limbus on the same side. The inhibition of NV was observed and quantified from days 1 to 60. Biomicroscopic examination, western blot analysis and immunohistochemistry were used to analyze the 18-kDa bFGF, 50-kDa PEDF and VEGF protein expression. No inhibition activity for normal limbal vessels was noted. Subconjunctival injection with the combination of bevacizumab and p-PEDF-SAINT-18 successfully inhibited corneal NV. The bFGF and PEDF genes were successfully expressed as shown by western blot analysis, and a mild immune response to HLA-DR was shown by immunohistochemistry. We concluded that the combination of bevacizumab and p-PEDF-SAINT-18 may have more potent and prolonged antiangiogenic effects, making it possible to reduce the frequency of subconjunctival.Bevacizumab, a 149-kDa protein, is a recombinant humanized monoclonalantibody to VEGF. PEDF, a 50-kDa glycoprotein, has demonstrated anti-vasopermeabilityproperties. In this study, we demonstrated that the combination of bevacizumaband plasmid pigment epithelium-derived factor-synthetic amphiphile INTeraction-18(p-PEDF-SAINT-18 has a favorable antiangiogenic effect on corneal NV. Four groups(Group A: 0 μg + 0 μg, B: 0.1 μg + 0.1 μg, C: 1 μg + 1 μg, and

  4. The Effect of Corneal Epithelium on Corneal Curvature in Patients with Keratoconus.

    Science.gov (United States)

    Akcay, Emine Kalkan; Uysal, Betul Seher; Sarac, Ozge; Ugurlu, Nagehan; Yulek, Fatma; Cagil, Nurullah; Aslan, Nabi

    2015-01-01

    To investigate the effects of corneal epithelium on corneal curvature in patients with keratoconus. This is a prospective, nonrandomized study. Fifty-nine eyes of 47 patients diagnosed as keratoconus and for whom corneal collagen crosslinking (CXL) was recruited in this study. This study is a single-center clinical trial. Pregnancy, lactation, connective tissue disease, corneal thickness below 350 μm, severe dry eyes, or scar of corneal surgery were exclusion criteria. Before and during CXL procedure after removing the corneal epithelium, maximum values of corneal apical curvature, simulated keratometry 1 (Sim-K1), simulated keratometry 2 (Sim-K2), temporal and inferior curvature values, all of which are 1.5 mm from the corneal center, were calculated. These values before and after removal of epithelium were compared statistically. Mean age of patients was 23.30 ± 5.5 (12-38) years. Twenty-eight (59%) were male while 19 (41%) were female. Mean values measured before and after removing the corneal epithelium were: apical curvature; 59.19 ± 7.2 (47.06-82.40) diopter (D) and 61.70 ± 8.8 (49.19-92.66) D (p = 0.001), SimK1; 47.57 ± 4.3 (39.14-64.57) D and 48.23 ± 4.3 (41.89-66.70) D (p = 0.001), SimK2; 52.04 ± 5.3 (43.56-69.34) D and 53.34 ± 5.6 (43.73-70.89) D (p = 0.001), inferior curvature; 53,85 ± 5.2 (43.47-76.56) D and 55.05 ± 5.8 (44.56-81.93) D (p = 0.002), temporal curvature 49.49 ± 5.1 (41.50-71.03) D and 51.53 ± 5.4 (41.58-73.34) D (p = 0.001), respectively. In keratoconus patients during CXL treatment, after removing the corneal epithelium, more steepness is detected in the curvature of the steeper area of the cornea. When evaluating patients with keratoconus, the masking effect of corneal epithelium on values of curvature should be taken into consideration.

  5. Targeted corneal transplantation.

    Science.gov (United States)

    Jhanji, Vishal; Mehta, Jod S; Sharma, Namrata; Sharma, Bhavana; Vajpayee, Rasik B

    2012-07-01

    Corneal transplantation surgery has moved from an era of conventional penetrating keratoplasty to selective replacement of the diseased corneal layer with complementary healthy donor corneal tissue. Anterior lamellar transplantation surgeries do not involve replacement of corneal endothelium, consequently eliminating the occurrence of endothelial rejection. Similarly, in diseases affecting the corneal endothelium, selective replacement with a lamellar lenticule bearing healthy endothelium provides better outcomes in terms of ocular surface, lesser astigmatism and quick visual recovery. In addition to the advantages of enhanced surgical outcomes, targeted corneal transplantation allows the use of one donor cornea for more than one recipient, thereby offering a viable solution to the problem of paucity of donor corneas. Evolving techniques of corneal transplantation have enabled better utilization of donor corneal tissue. Anterior lamellar as well as endothelial keratoplasty surgeries have become first-choice surgeries in appropriately selected cases. This review briefly discusses some of these novel surgical techniques. A better understanding of targeted corneal transplantation would lead to adaptation of the concept of component corneal surgery. This would further enable the corneal surgeons to circumvent the problem of donor corneal shortage especially in the developing world.

  6. Corneal Higher-Order Aberrations in Infectious Keratitis.

    Science.gov (United States)

    Shimizu, Eisuke; Yamaguchi, Takefumi; Yagi-Yaguchi, Yukari; Dogru, Murat; Satake, Yoshiyuki; Tsubota, Kazuo; Shimazaki, Jun

    2017-03-01

    To characterize the corneal higher-order aberrations (HOAs) in eyes with Acanthamoeba keratitis (AK), bacterial keratitis (BK), and fungal keratitis (FK). Retrospective consecutive case series. This retrospective study includes 18 normal subjects and 63 eyes of 62 consecutive patients with corneal scarring due to AK (20 eyes), BK (35 eyes), and FK (8 eyes) from 2010 to 2016. HOAs of the anterior and posterior surfaces and the total cornea were analyzed by anterior segment optical coherence tomography. Corneal HOA patterns were assigned on the basis of corneal topography maps. Corneal opacity grading was assigned on the basis of slit-lamp examinations. We evaluated corneal HOAs, corneal opacity grading, and their correlation with visual acuity. HOAs of the total cornea within a 4-mm diameter were significantly larger in eyes with infectious keratitis (AK, 1.15 ± 2.06 μm; BK, 0.91 ± 0.88 μm; FK, 1.39 ± 1.46 μm) compared with normal controls (0.09 ± 0.01 μm, all, P keratitis were associated with poorer visual acuity values. Asymmetric pattern was the most common topographic pattern in infectious keratitis. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Microkeratome-assisted corneal tattooing: a case report.

    Science.gov (United States)

    Fogla, Rajesh; Gupta, Arvind; Indumathy, T R

    2010-04-01

    The purpose of this study was to report a new technique of microkeratome-assisted corneal tattooing for cosmetic improvement in a young female patient with adherent leucoma. The para-axial adherent leucoma had resulted from penetrating corneal injury sustained at the age of 2 years. A nasal hinged partial corneal flap of 140 μm thickness was raised using the microkeratome. The flap extended to just beyond the medial margin of the leucoma. Organic dye powder was spread on the stromal bed over the leucomatous scar as well as on the undersurface of the corneal flap corresponding to the area of opacity. The flap was then repositioned and a bandage contact lens placed. The staining dye powder completely concealed the leucomatous opacity with good cosmesis and patient satisfaction. Corneal topography and best-corrected visual acuity remained unchanged at last follow up of 9 months. Microkeratome-assisted corneal tattooing appears to be a safe, effective, and precise method of corneal tattooing.

  8. Anti-Inflammatory and Antioxidative Effects of Camellia japonica on Human Corneal Epithelial Cells and Experimental Dry Eye: In Vivo and In Vitro Study.

    Science.gov (United States)

    Lee, Hyo Seok; Choi, Joo-Hee; Cui, Lian; Li, Ying; Yang, Jee Myung; Yun, Je-Jung; Jung, Ji Eun; Choi, Won; Yoon, Kyung Chul

    2017-02-01

    To analyze the anti-inflammatory and antioxidative effects of Camellia japonica (CJ) on human corneal epithelial (HCE) cells and its therapeutic effects in a mouse model of experimental dry eye (EDE). Camellia japonica extracts of varying concentrations (0.001%, 0.01%, and 0.1%) were used to treat HCE cells. Dichlorofluorescein diacetate (DCF-DA) and dihydroethidium (DHE) assays were performed. The production of peroxiredoxin (PRX) 1-6 and manganese-dependent superoxide dismutase (MnSOD) in HCE cells was assessed using Western blot analysis. Furthermore, eye drops containing 0.001%, 0.01%, or 0.1% CJ extract or a balanced salt solution (BSS) were applied to the EDE. Clinical parameters were measured 7 days after treatment. The levels of inflammatory markers and intracellular reactive oxygen species (ROS) were measured. Treatment with 0.01% and 0.1% CJ extracts decreased apoptosis in HCE cells. In addition, band intensities of PRX 1, 4, and 5, as well as MnSOD, after hydrogen peroxide (H2O2) treatment showed a significant improvement after pretreatment with 0.01% and 0.1% CJ extracts. Mice treated with 0.1% CJ extract showed significantly improved clinical parameters when compared to those of the EDE control and BSS groups. A significant decrease in the levels of inflammatory markers and intracellular ROS was observed in the 0.01% and 0.1% CJ extract groups. Camellia japonica extracts promoted antioxidative protein expression and suppressed apoptosis in HCE cells. Furthermore, CJ extracts improved clinical signs of dry eye and reduced oxidative stress and the expression of inflammatory markers, suggesting that eye drops containing CJ extract could be used as an adjunctive treatment for dry eye.

  9. Interventions for acne scars.

    Science.gov (United States)

    Abdel Hay, Rania; Shalaby, Khalid; Zaher, Hesham; Hafez, Vanessa; Chi, Ching-Chi; Dimitri, Sandra; Nabhan, Ashraf F; Layton, Alison M

    2016-04-03

    Acne scarring is a frequent complication of acne and resulting scars may negatively impact on an affected person's psychosocial and physical well-being. Although a wide range of interventions have been proposed, there is a lack of high-quality evidence on treatments for acne scars to better inform patients and their healthcare providers about the most effective and safe methods of managing this condition. This review aimed to examine treatments for atrophic and hypertrophic acne scars, but we have concentrated on facial atrophic scarring. To assess the effects of interventions for treating acne scars. We searched the following databases up to November 2015: the Cochrane Skin Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library (2015, Issue 10), MEDLINE (from 1946), EMBASE (from 1974), and LILACS (from 1982). We also searched five trials registers, and checked the reference lists of included studies and relevant reviews for further references to randomised controlled trials. We include randomised controlled trials (RCTs) which allocated participants (whether split-face or parallel arms) to any active intervention (or a combination) for treating acne scars. We excluded studies dealing only or mostly with keloid scars. Three review authors independently extracted data from each of the studies included in this review and evaluated the risks of bias. We resolved disagreements by discussion and arbitration supported by a method expert as required. Our primary outcomes were participant-reported scar improvement and any adverse effects serious enough to cause participants to withdraw from the study. We included 24 trials with 789 adult participants aged 18 years or older. Twenty trials enrolled men and women, three trials enrolled only women and one trial enrolled only men. We judged eight studies to be at low risk of bias for both sequence generation and allocation concealment. With regard to blinding we judged

  10. Measuring Scars of Periodic Orbits

    CERN Document Server

    Kaplan, L

    1999-01-01

    The phenomenon of periodic orbit scarring of eigenstates of classically chaotic systems is attracting increasing attention. Scarring is one of the most important ``corrections'' to the ideal random eigenstates suggested by random matrix theory. This paper discusses measures of scars and in so doing also tries to clarify the concepts and effects of eigenfunction scarring. We propose a new, universal scar measure which takes into account an entire periodic orbit and the linearized dynamics in its vicinity. This measure is tuned to pick out those structures which are induced in quantum eigenstates by unstable periodic orbits and their manifolds. It gives enhanced scarring strength as measured by eigenstate overlaps and inverse participation ratios, especially for longer orbits. We also discuss off-resonance scars which appear naturally on either side of an unstable periodic orbit.

  11. Equine corneal stromal abscesses

    DEFF Research Database (Denmark)

    Henriksen, M. D. L.; Andersen, P. H.; Plummer, C. E.

    2013-01-01

    The last 30 years have seen many changes in the understanding of the pathogenesis and treatment of equine corneal stromal abscesses (SAs). Stromal abscesses were previously considered an eye problem related to corneal bacterial infection, equine recurrent uveitis, corneal microtrauma and corneal...... foreign bodies in horses. They were more commonly diagnosed in horses living in subtropical climatic areas of the world. Therapeutic recommendations to treat equine SAs were historically nearly always a medical approach directed at bacteria and the often associated severe iridocyclitis. Today...... the pathogenesis of most equine SAs appears to be more often related to fungal inoculation of the anterior corneal stroma followed by posterior migration of the fungi deeper into the corneal stroma. There is also now an increased incidence of diagnosis of corneal SAs in horses living in more temperate climates...

  12. Ways to Improve (Visual) Outcome in Corneal Transplantation, Corneal Pathology

    NARCIS (Netherlands)

    M.C. Bartels (Marjolijn)

    2005-01-01

    textabstractThe normally transparent cornea can lose its ability to refract light regularly from various conditions. Among these conditions are corneal opacities and corneal diseases leading to a distortion of the corneal contour. Vision might be restored by a corneal transplantation. Corneal

  13. Corneal Stroma Regeneration with Acellular Corneal Stroma Sheets and Keratocytes in a Rabbit Model.

    Science.gov (United States)

    Ma, Xiao Yun; Zhang, Yun; Zhu, Dan; Lu, Yang; Zhou, Guangdong; Liu, Wei; Cao, Yilin; Zhang, Wen Jie

    2015-01-01

    Acellular corneal stroma matrix has been used for corneal stroma engineering. However, because of its compact tissue structure, regrowth of keratocytes into the scaffold is difficult. Previously, we developed a sandwich model for cartilage engineering using acellular cartilage sheets. In the present study, we tested this model for corneal stroma regeneration using acellular porcine corneal stroma (APCS) sheets and keratocytes. Porcine corneas were decellularized by NaCl treatment, and the APCS was cut into 20-μm-thick sheets. A rabbit corneal stroma defect model was created by lamellar keratoplasty and repaired by transplantation of five pieces of APCS sheets with keratocytes. Six months after transplantation, transparent corneas were present in the experimental group, which were confirmed by anterior segment optical coherence tomography examination and transmittance examination. The biomechanical properties in the experimental group were similar to those of normal cornea. Histological analyses showed an even distribution of keratocytes and well-oriented matrix in the stroma layer in the experimental group. Together, these results demonstrated that the sandwich model using acellular corneal stroma sheets and keratocytes could be potentially useful for corneal stroma regeneration.

  14. Corneal Stroma Regeneration with Acellular Corneal Stroma Sheets and Keratocytes in a Rabbit Model.

    Directory of Open Access Journals (Sweden)

    Xiao Yun Ma

    Full Text Available Acellular corneal stroma matrix has been used for corneal stroma engineering. However, because of its compact tissue structure, regrowth of keratocytes into the scaffold is difficult. Previously, we developed a sandwich model for cartilage engineering using acellular cartilage sheets. In the present study, we tested this model for corneal stroma regeneration using acellular porcine corneal stroma (APCS sheets and keratocytes. Porcine corneas were decellularized by NaCl treatment, and the APCS was cut into 20-μm-thick sheets. A rabbit corneal stroma defect model was created by lamellar keratoplasty and repaired by transplantation of five pieces of APCS sheets with keratocytes. Six months after transplantation, transparent corneas were present in the experimental group, which were confirmed by anterior segment optical coherence tomography examination and transmittance examination. The biomechanical properties in the experimental group were similar to those of normal cornea. Histological analyses showed an even distribution of keratocytes and well-oriented matrix in the stroma layer in the experimental group. Together, these results demonstrated that the sandwich model using acellular corneal stroma sheets and keratocytes could be potentially useful for corneal stroma regeneration.

  15. A STUDY ON PREVALENCE AND CAUSES OF CORNEAL BLINDNESS IN PAEDIATRIC AGE GROUP

    Directory of Open Access Journals (Sweden)

    E. Ramadevi

    2017-12-01

    Full Text Available BACKGROUND Corneal disease is responsible for less than 2% of blindness in children in industrialised countries. In poor countries of the world, corneal scarring occurs due to vitamin A deficiency, measles and ophthalmia neonatorum. Thus, corneal disease is an important cause of blindness among children living in developing nations, which already carry a major burden of blindness. The aim of the study is to study the1. Prevalence of corneal blindness in the paediatric age group. 2. Causes of corneal blindness in the paediatric age group. 3. Morbidity of corneal blindness in the paediatric age group. MATERIALS AND METHODS It was cross-sectional observational study. Study Period- December 2014 to August 2016. Study Done- Government General Hospital, Kakinada. Sample Size- 50 patients. Inclusion Criteria- Children of age group 6 to 12 years with corneal blindness who have attended the outpatient department during the study period. Exclusion Criteria- Children with childhood blindness other than corneal pathology. Study Tools- Predesigned, semi-structured questionnaire regarding age, sex and age of onset of visual loss, laterality, history of ocular injury, vitamin A immunisation, family history of consanguinity and place of residence and socioeconomic status was taken. Visual acuity was measured using an E optotype and Landolt broken C chart with best corrected vision. Visual loss was classified according to the WHO categories of visual impairment. Ophthalmic examination was done by slit lamp and B scan. RESULTS Ocular trauma and corneal ulcers are most common cause of corneal blindness. 84% of corneal blindness cases were preventable and curable. CONCLUSION Trauma was the commonest cause of corneal blindness followed by infectious keratitis. 84% of corneal blindness was preventable and curable. Most causes of corneal blindness were avoidable.

  16. Nationwide reduction in the number of corneal transplantations for keratoconus following the implementation of cross-linking.

    Science.gov (United States)

    Godefrooij, Daniel A; Gans, Renze; Imhof, Saskia M; Wisse, Robert P L

    2016-11-01

    Keratoconus is characterized by corneal ectasia and irregular astigmatism, which can lead to diminished vision and corneal scarring. Approximately 10-20% of patients with keratoconus eventually require a corneal transplant. Corneal cross-linking (CXL) is a relatively new treatment that may help prevent the need for corneal transplantation. Here, we investigated whether the introduction of CXL has reduced the number of corneal transplants performed annually. Data regarding the transplantation procedures performed in patients under the age of 50 years were extracted from the Dutch National Organ Transplant Registry. The number of corneal transplants performed prior to (i.e. in 2005 through 2007) and following the introduction of CXL (i.e. in 2012 through 2014) were compared. Furthermore, a trend analysis on annual keratoplasties over time was performed. Approximately 25% fewer corneal transplants were performed in the 3-year period following the introduction of CXL compared to the 3-year period prior to the introduction of CXL (201 versus 269 transplants, respectively; p = 0.005). Age, gender and visual acuity were similar between the patient groups in the two time periods. Trend analysis also demonstrated a significant decrease in the amount of corneal transplants (p = 0.001). Significantly fewer corneal transplants were performed for treating keratoconus following the nationwide introduction of CXL. This reduction suggests that corneal cross-linking can significantly reduce the need for corneal transplantation. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  17. Corneal Fibroblasts as Sentinel Cells and Local Immune Modulators in Infectious Keratitis

    Directory of Open Access Journals (Sweden)

    Ken Fukuda

    2017-08-01

    Full Text Available The cornea serves as a barrier to protect the eye against external insults including microbial pathogens and antigens. Bacterial infection of the cornea often results in corneal melting and scarring that can lead to severe visual impairment. Not only live bacteria but also their components such as lipopolysaccharide (LPS of Gram-negative bacteria contribute to the development of inflammation and subsequent corneal damage in infectious keratitis. We describe the important role played by corneal stromal fibroblasts (activated keratocytes as sentinel cells, immune modulators, and effector cells in infectious keratitis. Corneal fibroblasts sense bacterial infection through Toll-like receptor (TLR–mediated detection of a complex of LPS with soluble cluster of differentiation 14 (CD14 and LPS binding protein present in tear fluid. The cells then initiate innate immune responses including the expression of chemokines and adhesion molecules that promote the recruitment of inflammatory cells necessary for elimination of the infecting bacteria. Infiltrated neutrophils are activated by corneal stromal collagen and release mediators that stimulate the production of pro–matrix metalloproteinases by corneal fibroblasts. Elastase produced by Pseudomonas aeruginosa (P. aeruginosa activates these released metalloproteinases, resulting in the degradation of stromal collagen. The modulation of corneal fibroblast activation and of the interaction of these cells with inflammatory cells and bacteria is thus important to minimize corneal scarring during treatment of infectious keratitis. Pharmacological agents that are able to restrain such activities of corneal fibroblasts without allowing bacterial growth represent a potential novel treatment option for prevention of excessive scarring and tissue destruction in the cornea.

  18. Acne Scar Treatment: A Multimodality Approach Tailored to Scar Type.

    Science.gov (United States)

    Zaleski-Larsen, Lisa A; Fabi, Sabrina G; McGraw, Timothy; Taylor, Mark

    2016-05-01

    Acne scarring can be classified into atrophic icepick, boxcar, and rolling scars in addition to keloidal and hypertrophic scars. Additionally, these scars can be erythematous, hyperpigmented, and/or hypopigmented. Each scar type has a different structural cause warranting a customized approach. Many cosmetic options exist to address these changes individually, but little literature exists about the safety and efficacy of combining such procedures and devices. A Medline search was performed on combination treatments because it relates to facial acne scarring, and results are summarized. Practical applications for these combinations of procedures are also discussed. Studies examining the efficacy and safety of ablative, nonablative, fractionated, and nonfractionated lasers, dermabrasion, chemical peels, needling, subcision, radiofrequency, stem cell therapy, fat transplantation, platelet-rich plasma, and hyaluronic acid dermal fillers for acne scars were found. The authors review their experience in combining these techniques. Review of the literature revealed multiple single options for facial acne scarring treatment with minimal evidence in the literature found on the safety and efficacy of combining such procedures and devices. The authors' experience is that combining acne scar treatment techniques can be performed safely and synergistically with optimal patient outcomes.

  19. Update on Postsurgical Scar Management

    Science.gov (United States)

    Commander, Sarah Jane; Chamata, Edward; Cox, Joshua; Dickey, Ryan M.; Lee, Edward I.

    2016-01-01

    Postoperative scar appearance is often a significant concern among patients, with many seeking advice from their surgeons regarding scar minimization. Numerous products are available that claim to decrease postoperative scar formation and improve wound healing. These products attempt to create an ideal environment for wound healing by targeting the three phases of wound healing: inflammation, proliferation, and remodeling. With that said, preoperative interventions, such as lifestyle modifications and optimization of medical comorbidities, and intraoperative interventions, such as adherence to meticulous operative techniques, are equally important for ideal scarring. In this article, the authors review the available options in postoperative scar management, addressing the benefits of multimodal perioperative intervention. Although numerous treatments exist, no single modality has been proven superior over others. Therefore, each patient should receive a personalized treatment regimen to optimize scar management. PMID:27478420

  20. Early Intervention Stem Cell-Based Therapy (EISCBT) for Corneal Burns and Trauma

    Science.gov (United States)

    2016-10-01

    corneal bandage (ReCoBand) that can be applied in the battlefield to prevent permanent scarring of the cornea after trauma , blast, or burn wounds . In the...AWARD NUMBER: W81XWH-14-1-0465 TITLE: Early Intervention Stem Cell-Based Therapy (EISCBT) for Corneal Burns and Trauma PRINCIPAL INVESTIGATOR...Intervention Stem Cell-Based Therapy (EISCBT) for Corneal Burns and Trauma 5a. CONTRACT NUMBER W81WH-14-1-0465 5b. GRANT NUMBER 5c. PROGRAM

  1. Scar outcomes in dermatological surgery.

    Science.gov (United States)

    Kim, Burcu; Sgarioto, Melissa; Hewitt, Daniel; Paver, Robert; Norman, Julia; Fernandez-Penas, Pablo

    2018-02-01

    Significant functional impairment and psychological burden may result from poor scar quality and its impact on patient's quality of life has been well-established. It is important to identify measures to reduce the risk of surgical complications. 212 patients undergoing dermatological surgery were recruited from March 2011 to February 2014. Their age, sex, surgical site, closure type, defect size (length and width), scar length, number of deep sutures, suture type and size were recorded. The patients were followed up at 6 weeks and 6 months for complications including abscess formation, granuloma formation, scar spreading, suture spitting and hypertrophic scar formation. At 6 weeks complications included suture spitting (14%), granuloma (11%), scar spreading (7%), hypertrophic scarring (3%) and abscess formation (1%), and at 6 months; scar spreading (17%), hypertrophic scarring (2%) and suture spitting (1%). In our multivariate analysis there were no predictors for spreading or spitting at 6 weeks, and only the defect size width was a predictor for granulomas in the stepwise analysis. For scar spreading at 6 months, younger age, site (trunk or limbs), higher number of deep sutures and surgeon were independent predictors (P sutures more superficially to the skin surface and was throwing more knots per closure; factors that we did not record in our study and merit further study. © 2017 The Australasian College of Dermatologists.

  2. Periorbital Scar Correction.

    Science.gov (United States)

    Chambers, Christopher B; Moe, Kristen S

    2017-02-01

    Periorbital scarring with eyelid retraction can have serious visual effects and can lead to loss of vision or even loss of the eye. Understanding of eyelid anatomy and the delicate balance of its structural supports is critical for the identification of the eyelid disorder responsible for the cicatrix and helps to guide treatment. The 2-finger test and lateral distraction of the lid can also be of significant help in proper diagnosis of the underlying disorder. Proper reconstruction with respect to the anterior and posterior lamellae helps to ensure a favorable outcome. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Preliminary studies of rabbit corneal structure using laser beams

    Science.gov (United States)

    Carstocea, Benone D.; Gafencu, Otilia L.; Apostol, Silvia; Ionita, Marcel A.; Pascu, Mihail-Lucian; Moise, N.; Popescu, Gheorghe; Roman, Miruna; Hogiu, S.

    1996-12-01

    A new method for corneal structure investigation is reported. The light reflected form rabbit cornea is recorded by a video-camera so that the images of epithelium and endothelium are obtained. Because of the great magnification factor due to the corneal curvature, the characteristics of the cells can be directly visualized. The theoretical evaluation of the optical magnification fits reasonably well the experimental results for collimated laser beams; therefore in the future it will be possible to determine with a good accuracy the corneal cell dimensions. Corneal diagnosis based on this method is discussed.

  4. Vanishing corneal vessels

    Science.gov (United States)

    Nicholson, Luke; Chana, Rupinder

    2013-01-01

    We wish to highlight the importance of acknowledging the accompanying effects of topical phenylephrine drops on the eye other than its intended mydriasis. We reported a case of a 92-year-old woman with a corneal graft who was noted to have superficial corneal vascularisation which was not documented previously. After the instillation of topical tropicamide 1% and phenylephrine 2.5%, for funduscopy, the corneal vascularisation was not visible. When reassessed on another visit, tropicamide had no effect on the vessels and only phenylephrine did. We wish to highlight that when reviewing patients in cornea clinics, instilling phenylephrine prior to being seen may mask important corneal vascularisation. PMID:24121816

  5. Corona sign: manifestation of peripheral corneal epithelial edema as a possible marker of the progression of corneal endothelial dysfunction.

    Science.gov (United States)

    Inoue, Tomoyuki; Hara, Yuko; Kobayashi, Takeshi; Zheng, Xiaodong; Suzuki, Takashi; Shiraishi, Atsushi; Ohashi, Yuichi

    2016-09-01

    To describe a characteristic form of the corona sign and its clinical relevance to the degree of corneal endothelial decompensation and investigate the underlying mechanism using a rabbit model. These observational cases include 31 patients undergoing penetrating keratoplasty (PKP) and 15 patients undergoing Descemet stripping automated endothelial keratoplasty (DSAEK) with special attention to the circumferentially developed corneal epithelial edema. We also conducted a laboratory observation of horizontal water flow in the rabbit cornea. We consistently observed the corona sign at the superior periphery during the initial stage of corneal endothelial decompensation after PKP. With progressive corneal endothelial cellular loss, the epithelial edema gradually expanded circumferentially in the periphery. The endothelial cellular density associated with the corona sign significantly (P corona sign compared with a superior corona sign. After DSAEK, however, the corneal epithelial edema subsided from the center but persisted peripherally as a corona sign in all cases. By 3 months postoperatively, the epithelial edema was confined to the superior periphery along with uneventful corneal endothelial healing. Rabbit experiments showed that total corneal endothelial decompensation decreased the horizontal intracorneal water migration (Inoue-Ohashi phenomenon) in the corneal periphery and induced peripheral corneal edema. The slit-lamp microscopic findings of the corona-like epithelial edema in the peripheral cornea are associated with the stage of corneal endothelial function. To support this, the developmental mechanism of the corona sign was demonstrated experimentally.

  6. [Results of tectonic epikeratoplasty in the management of corneal perforations].

    Science.gov (United States)

    Machowicz-Matejko, Eulalia; Rakowska, Ewa; Zagórski, Zbigniew

    2010-01-01

    To present therapeutic application of tectonic epikeratoplasty as logical patch in severe ocular surface disorders. Full thickness corneo-scleral transplants, 14 mm in diameter were used in 67 operations of 41 patients with corneal perforation or descemetocele. (14 women and 27 men), in the period 1998-2008. The mean age of patients was 55.2 +/- 17.7 years (range 15-82). The transplants were sutured over the limbus or the scleral rim and was implanted under the conjunctiva after 360 degrees peritomy. Donor tissue unsuitable for penetrating keratoplasty because of poor endothelium or corneal scarring, was obtained from Lublin Eye Bank. We observed closing of the perforation in all cases. Healing of the ulceration with scar formation and new vessels ingrowth was noted. In some eyes repeated epikeratoplasties were performed. Tectonic epikeratoplasty is a safe and simple method of treatment of corneal perforations. It provides a biological patch stimulating the healing of corneal defects. It gives time for systemic treatment before further ocular surface reconstructive procedures can be performed.

  7. Cesarean scar pregnancy

    DEFF Research Database (Denmark)

    Petersen, Kathrine Birch; Hoffmann, Elise; Rifbjerg Larsen, Christian

    2016-01-01

    OBJECTIVE: To study treatment modalities for cesarean scar pregnancies (CSPs), focusing on efficacy and complications in relation to study quality. DESIGN: Systematic review. SETTING: Not applicable. PATIENT(S): A total of 2,037 women with CSP. INTERVENTION(S): Review of MEDLINE, EMBASE, and Coch......OBJECTIVE: To study treatment modalities for cesarean scar pregnancies (CSPs), focusing on efficacy and complications in relation to study quality. DESIGN: Systematic review. SETTING: Not applicable. PATIENT(S): A total of 2,037 women with CSP. INTERVENTION(S): Review of MEDLINE, EMBASE......, and Cochrane Library to find studies including five or more women. Data were extracted on primary treatment modality/efficacy, complications, and future fertility. The level of evidence was categorized according to Oxford Centre for Evidence-based Medicine guidelines. Quality was assessed using The Cochrane...... Collaboration's Risk of Bias Tools for Randomized Controlled Trials and the modified Delphi techniques for case series. Meta-analysis was impossible owing to multifarious treatments. MAIN OUTCOME MEASURE(S): Successful first-line treatment. Complications were hysterectomy, laparotomy, bleeding >1,000 m...

  8. Medicated ocular bandages and corneal health: potential excipients and active pharmaceutical ingredients.

    Science.gov (United States)

    Zidan, Ghada; Rupenthal, Ilva D; Greene, Carol; Seyfoddin, Ali

    2017-09-21

    Corneal blindness can occur due to improper healing of the corneal tissues after induced injury or abrasion which can be accidental, pathogenic, or after corneal surgery. Abnormal regulation of the healing mechanisms can lead to corneal opacity. Reducing inflammation and promoting epithelial wound healing are crucial for scar-free corneal recovery without eyesight complications. Current approaches for corneal wound healing involve amniotic membrane (AM) bandages, bandage contact lenses (BCL), and collagen shields in conjunction with frequent administration of therapeutic eye drops. The problem with eye drops is poor bioavailability and patient incompliance that might lead to corneal wound healing complications and poor clinical outcomes. Various methods have been proposed for loading drugs into medicated bandage lenses. There are advantages and limitations associated with each technique regarding the ease of manufacture, drug loading, release kinetics, and suitability with various therapeutics and hydrogel types. There is still, however, no drug-eluting corneal bandage on the market despite the need for such a convenient and cost-efficient strategy for corneal wound healing. This review will highlight materials and therapeutics that can be used in medicated ocular bandages and various ways of incorporating drugs, while discussing the limitations and challenges associated with bringing medicated ocular bandages in the market.

  9. Characterization of Corneal Indentation Hysteresis.

    Science.gov (United States)

    Ko, Match W L; Dongming Wei; Leung, Christopher K S

    2015-01-01

    Corneal indentation is adapted for the design and development of a characterization method for corneal hysteresis behavior - Corneal Indentation Hysteresis (CIH). Fourteen porcine eyes were tested using the corneal indentation method. The CIH measured in enucleated porcine eyes showed indentation rate and intraocular pressure (IOP) dependences. The CIH increased with indentation rate at lower IOP ( 25 mmHg). The CIH was linear proportional to the IOP within an individual eye. The CIH was positively correlated with the IOP, corneal in-plane tensile stress and corneal tangent modulus (E). A new method based on corneal indentation for the measurement of Corneal Indentation Hysteresis in vivo is developed. To our knowledge, this is the first study to introduce the corneal indentation hysteresis and correlate the corneal indentation hysteresis and corneal tangent modulus.

  10. Femtosecond laser-assisted sutureless anterior lamellar keratoplasty for superficial corneal opacities.

    Science.gov (United States)

    Jabbarvand, Mahmoud; Hashemian, Hesam; Khodaparast, Mehdi; Ghadimi, Hadi; Khalilipour, Elias

    2014-11-01

    To evaluate the visual and refractive outcomes, endothelial cell count (ECC), ocular surface changes, corneal aberrations, and biomechanical profile changes after femtosecond laser-assisted anterior lamellar keratoplasty surgery for superficial corneal scars. Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran. Prospective case series. Patients with superficial corneal scars had femtosecond laser-assisted anterior lamellar keratoplasty. Visual and refractive results, ECC, ocular surface changes, corneal aberrations, and biomechanical profiles were assessed preoperatively and for 1 year postoperatively. Nineteen eyes (19 patients) were evaluated. A significant decline occurred in refractive astigmatism and corneal astigmatism after 1 year. There was a nonsignificant reduction in corneal hysteresis and the corneal resistance factor from preoperatively to 1 year postoperatively. The corneal-compensated intraocular pressure (IOP) and Goldmann-correlated IOP increased during the follow-up; the increase was not significant. A statistically insignificant reduction in the root mean square for trefoil and spherical aberrations occurred between 1 month and 1 year postoperatively (P=.1 and P=.4, respectively). The decreases in primary coma and total higher-order aberrations approached significance (P=.08 and P=.07, respectively). There were no significant changes in the central corneal thickness, ECC, or ocular surface parameters. No intraoperative complications occurred. Femtosecond laser-assisted anterior lamellar keratoplasty was an efficient and safe procedure for improving the quality of vision in patients with anterior corneal pathology, and the results remained stable during the 1-year follow-up. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  11. Pathological and Immunohistochemical Alterations of the Cornea in Congenital Corneal Opacification Secondary to Primary Congenital Glaucoma and Peters Anomaly.

    Science.gov (United States)

    Al Shamrani, Mohammed; Al Hati, Khitam; Alkatan, Hind; Alharby, Mosa; Jastaneiah, Sabah; Song, Jonathan; Edward, Deepak P

    2016-02-01

    To examine the immunohistochemical alterations in the corneal stroma in Peters anomaly (PA) and congenital glaucoma (CG) compared with age-matched normals and acquired adult corneal scarring (AACS). The clinical features of PA and CG patients who underwent penetrating keratoplasty were recorded. Immunohistochemistry of cornea and control tissue (normal and acquired corneal scars) was performed with antibodies against collagen types I, III, keratan sulfate, lumican, decorin, and smooth muscle actin followed by semiquantitative analysis of immunolabeling. Clinical features in 2 groups were consistent with PA and CG. Microscopy showed thickened stromal collagen bundles in PA (n = 15), CG (n = 11), and AACS (n = 20) compared with normals (n = 18). PA and CG had distinct immunophenotypes compared with controls. Type I collagen labeling was more intense in CG compared with PA (intensity grading (IG) 2.73 vs. 2.07; P corneas and so does PA from AACS. The similarities between CG and AACS suggest that CG scarring has an acquired component.

  12. Cutaneous Scarring: A Clinical Review

    Directory of Open Access Journals (Sweden)

    Richard Baker

    2009-01-01

    Full Text Available Cutaneous scarring can cause patients symptoms ranging from the psychological to physical pain. Although the process of normal scarring is well described the ultimate cause of pathological scarring remains unknown. Similarly, exactly how early gestation fetuses can heal scarlessly remains unsolved. These questions are crucial in the search for a preventative or curative antiscarring agent. Such a discovery would be of enormous medical and commercial importance, not least because it may have application in other tissues. In the clinical context the assessment of scars is becoming more sophisticated and new physical, medical and surgical therapies are being introduced. This review aims to summarise some of the recent developments in scarring research for non-specialists and specialists alike.

  13. corneal pyogenic granuloma

    African Journals Online (AJOL)

    GB

    2012-09-14

    Sep 14, 2012 ... Figure 3: A child with pyogenic cornea granuloma intra operatively. After excision of the mass, central corneal stromal defect developed. The patient was followed up for more than a month with topical antibiotic and cycloplegic. Subsequently, the defect healed and leucoma corneal opacity (figure.

  14. Corneal biomechanics - a review.

    Science.gov (United States)

    Kling, Sabine; Hafezi, Farhad

    2017-05-01

    In recent years, the interest in corneal biomechanics has strongly increased. The material properties of the cornea determine its shape and therefore play an important role in corneal ectasia and related pathologies. This review addresses the molecular origin of biomechanical properties, models for their description, methods for their characterisation, techniques for their modification, and computational simulation approaches. Recent research has focused on developing non-contact techniques to measure the biomechanical properties in vivo, on determining structural and molecular abnormalities in pathological corneas, on developing and optimising techniques to reinforce the corneal tissue and on the computational simulation of surgical interventions. A better understanding of corneal biomechanics will help to improve current refractive surgeries, allow an earlier diagnosis of ectatic disorders and a better quantification of treatments aiming at reinforcing the corneal tissue. © 2017 The Authors Ophthalmic & Physiological Optics © 2017 The College of Optometrists.

  15. The effect of burn rehabilitation massage therapy on hypertrophic scar after burn: a randomized controlled trial.

    Science.gov (United States)

    Cho, Yoon Soo; Jeon, Jong Hyun; Hong, Aram; Yang, Hyeong Tae; Yim, Haejun; Cho, Yong Suk; Kim, Do-Hern; Hur, Jun; Kim, Jong Hyun; Chun, Wook; Lee, Boung Chul; Seo, Cheong Hoon

    2014-12-01

    To evaluate the effect of burn rehabilitation massage therapy on hypertrophic scar after burn. One hundred and forty-six burn patients with hypertrophic scar(s) were randomly divided into an experimental group and a control group. All patients received standard rehabilitation therapy for hypertrophic scars and 76 patients (massage group) additionally received burn scar rehabilitation massage therapy. Both before and after the treatment, we determined the scores of visual analog scale (VAS) and itching scale and assessed the scar characteristics of thickness, melanin, erythema, transepidermal water loss (TEWL), sebum, and elasticity by using ultrasonography, Mexameter(®), Tewameter(®), Sebumeter(®), and Cutometer(®), respectively. The scores of both VAS and itching scale decreased significantly in both groups, indicating a significant intragroup difference. With regard to the scar characteristics, the massage group showed a significant decrease after treatment in scar thickness, melanin, erythema, TEWL and a significant intergroup difference. In terms of scar elasticity, a significant intergroup difference was noted in immediate distension and gross skin elasticity, while the massage group significant improvement in skin distensibility, immediate distension, immediate retraction, and delayed distension. Our results suggest that burn rehabilitation massage therapy is effective in improving pain, pruritus, and scar characteristics in hypertrophic scars after burn. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  16. Update on hypertrophic scar treatment

    Science.gov (United States)

    Rabello, Felipe Bettini; Souza, Cleyton Dias; Júnior, Jayme Adriano Farina

    2014-01-01

    Scar formation is a consequence of the wound healing process that occurs when body tissues are damaged by a physical injury. Hypertrophic scar/span>s and keloids are pathological scar/span>s resulting from abnormal responses to trauma and can be itchy and painful, causing serious functional and cosmetic disability. The current review will focus on the definition of hypertrophic scar/span>s, distinguishing them from keloids and on the various methods for treating hypertrophic scarring that have been described in the literature, including treatments with clearly proven efficiency and therapies with doubtful benefits. Numerous methods have been described for the treatment of abnormal scars, but to date, the optimal treatment method has not been established. This review will explore the differences between different types of nonsurgical management of hypertrophic scar/span>s, focusing on the indications, uses, mechanisms of action, associations and efficacies of the following therapies: silicone, pressure garments, onion extract, intralesional corticoid injections and bleomycin. PMID:25141117

  17. CORNEAL BLINDNESS AND XENOTRANSPLANTATION

    Science.gov (United States)

    Lamm, Vladimir; Hara, Hidetaka; Mammen, Alex; Dhaliwal, Deepinder; Cooper, David K.C.

    2014-01-01

    Approximately 39 million people are blind worldwide, with an estimated 285 million visually impaired. The developing world shoulders 90% of the world’s blindness, with 80% of causative diseases being preventable or treatable. Blindness has a major detrimental impact on the patient, community, and healthcare spending. Corneal diseases are significant causes of blindness, affecting at least 4 million people worldwide. The prevalence of corneal disease varies among parts of the world. Trachoma, for instance, is the second leading cause of blindness in Africa, after cataracts, but is rarely found today in developed nations. When preventive strategies have failed, corneal transplantation is the most effective treatment for advanced corneal disease. The major surgical techniques for corneal transplantation include penetrating keratoplasty (PK), anterior lamellar keratoplasty (ALK), and endothelial keratoplasty (EK). Indications for corneal transplantation vary among countries, with Fuchs’ dystrophy being the leading indication in the U.S. and keratoconus in Australia. With the exception of the US, where EK will soon overtake PK as the most common surgical procedure, PK is the overwhelming procedure of choice. Success using corneal grafts in developing nations, such as Nepal, demonstrates the feasibility of corneal transplantation on a global scale. The number of suitable corneas from deceased human donors that becomes available will never be sufficient, and so research into various alternatives, e.g., stem cells, amniotic membrane transplantation, synthetic and biosynthetic corneas, and xenotransplantation, is progressing. While each of these has potential, we suggest that xenotransplantation holds the greatest potential for a corneal replacement. With the increasing availability of genetically-engineered pigs, pig corneas may alleviate the global shortage of corneas in the near future. PMID:25268248

  18. Corneal Graft Rejection: Incidence and Risk Factors

    Directory of Open Access Journals (Sweden)

    Alireza Baradaran-Rafii

    2008-12-01

    corneal vascularization, anterior synechiae, irritating sutures, active inflammation, regrafting, additional surgery, trauma, uncontrolled intraocular pressure, history of graft rejection, recurrent herpetic infection, eccentric grafting and corneal scarring. Recipient age and donor cornea size do not seem to be risk factors for corneal graft rejection.

  19. Patch Grafting Using a Cryopreserved Descemet Stripping Automated Endothelial Keratoplasty Flap for Treating Corneal Perforation

    Directory of Open Access Journals (Sweden)

    Arisa Okada

    2016-04-01

    Full Text Available A 73-year-old woman with a corneal perforation of undetermined etiology was treated with corneal patch grafting. A residual partial-thickness corneal button obtained during a previous Descemet stripping automated endothelial keratoplasty (DSAEK surgery and stored at –80°C in Optisol GS for 3 months was used as a patch graft. Five days postoperatively, the anterior chamber was reformed and the perforation was masked by the donor cornea. During the next several weeks, gradual displacement of the anterior edge of the donor cornea in the limbal direction occurred. Seven weeks postoperatively, further displacement of the donor cornea resulted in unmasking of the perforated area. At this time, the corneal defect was closed by stromal scar tissue and corneal epithelium. Five months postoperatively, best corrected visual acuity was 1.0 without marked astigmatism and intraocular pressure was 9 mm Hg in the left eye. From this case, we learned that cryopreserved DSAEK flaps stored longer than reported previously can be used as patch grafts to treat emergency conditions. Scar tissue can fill a corneal stromal defect 1 mm in diameter during temporary patch grafting for less than 2 months.

  20. Avaliação anatomopatológica de cicatrizes uterinas de acordo com o tipo de sutura cirúrgica (modelo experimental Anatomopathological evaluation of uterine scars according to the type of surgical suture (experimental model

    Directory of Open Access Journals (Sweden)

    Rogério Gomes dos Reis Guidoni

    2007-12-01

    parâmetros macroscópicos e microscópicos avaliados.PURPOSE: to compare macro and microscopically, surgical uterine sutures in female rabbits, after caesarean section utilizing separate, continuous and continuous anchored suture stitches. METHODS: three New Zealand female rabbits in their first pregnancy were used. The caesarean section was carried out at the 26th day of gestation and three incisions were performed in each uterus. The hysterorrhaphy was performed with a 00 Vicryl® thread, and a different suture technique was employed for each incision. Total hysterectomy and adnexectomy were done at the 60th day post-delivery with the preservation of eventual adhesions for the evaluation of the surgical scars. The extent of scar retraction, amount of fibrin deposit and the suture integrity were evaluated through macroscopy. For the evaluation through microscopy, hematoxylin eosin technique was used for cellular colorimetry, and Masson's trichrom to evidence collagen. The statistical non-parametric Friedman's test was employed for the matching hypothesis, and Fisher's exact test to verify the homogeneity of the techniques (level of significance: 5%. RESULTS: a total of 18 scars were obtained (six scars per suture. The following mean values were obtained for the longitudinal (0.5/0.4/0.5, p=0.069 and transversal retraction degrees (0.3/0.4/0.3, p=0.143 respectively for separate, continuous and continuous anchored suture techniques. All sutures presented regular fibrin deposit, no adhesions and integral absorption of the stitches. The mean value of the blood vessels (158.5/139.3/172.1; p=0.293, fibroblasts (351.6/345.8/354.3; p=0.311 and of collagen percentage (44.0/45.5/48.5; p=0.422 were calculated through microscopy, respectively for separate, continuous and continuous anchored suture techniques. CONCLUSIONS: the type of hysterorrhaphy technique of caesarean section in female rabbits did not generate any significant statistical difference in the macroscopic and

  1. Corneal grafting and aggressive medication for corneal defects in graft-versus-host disease following bone marrow transplantation.

    Science.gov (United States)

    Tarnawska, D; Wylegała, E

    2007-12-01

    To evaluate the clinical outcomes of corneal grafting for severe dry eye complications in bone marrow transplant recipients. Eleven eyes of nine patients with severe corneal complications of chronic graft-versus-host disease were treated from 2000 to 2005. The subjects underwent penetrating keratoplasty (n=9 eyes; seven for perforation and two for leucoma) or deep anterior lamellar keratoplasty (n=2 eyes) for deep postinflammatory stromal scarring without endothelial abnormalities. Patients were observed for graft survival, visual acuity, and postoperative complications. During the follow-up period (mean=21.6 months), nine grafts (82%) remained clear or almost entirely clear and gained more than two logarithmic units of best-corrected visual acuity. Two regrafts were necessary as the primary grafts became cloudy after 9 and 11 months. Persistent epithelial defects occurred in seven eyes (64%), cataract in six (55%), ocular hypertension in five (45%), corneal calcareous degeneration in two (18%), loss of clarity in two (18%), and sterile ulceration in one (9%). Corneal grafting was effective for restoring corneal clarity and improving visual function in this series of patients. Although the complication ratio was high and some patients required regrafting, there was a clinical improvement in the majority of patients.

  2. Biosynthetic corneal implants for replacement of pathologic corneal tissue: performance in a controlled rabbit alkali burn model.

    Science.gov (United States)

    Hackett, Joanne M; Lagali, Neil; Merrett, Kimberley; Edelhauser, Henry; Sun, Yifei; Gan, Lisha; Griffith, May; Fagerholm, Per

    2011-02-03

    To evaluate the performance of structurally reinforced, stabilized recombinant human collagen-phosphorylcholine (RHCIII-MPC) hydrogels as corneal substitutes in a rabbit model of severe corneal damage. One eye each of 12 rabbits received a deep corneal alkali wound. Four corneas were implanted with RHCIII-MPC hydrogels. The other eight control corneas were implanted with either allografts or a simple cross-linked RHCIII hydrogel. In all cases, 6.25 mm diameter, 350 μm thick buttons were implanted by anterior lamellar keratoplasty to replace damaged corneal tissue. Implants were followed for nine months by clinical examination and in vivo confocal microscopy, after which implanted corneas were removed and processed for histopathological and ultrastructural examination. Alkali exposure induced extensive central corneal scarring, ocular surface irregularity, and neovascularization in one case. All implants showed complete epithelial coverage by four weeks postoperative, but with accompanying suture-induced vascularization in 6 out of 12 cases. A stable, stratified epithelium with hemidesmosomal adhesion complexes regenerated over all implants, and subbasal nerve regeneration was observed in allograft and RHCIII-MPC implants. Initially acellular biosynthetic implants were populated with host-derived keratocytes as stromal haze subsided and stromal collagen was remodeled. Notably, RHCIII-MPC implants exhibited resistance to vascular ingrowth while supporting endogenous cell and nerve repopulation. Biosynthetic implants based on RHC promoted cell and nerve repopulation in alkali burned rabbit eyes. In RHCIII-MPC implants, evidence of an enhanced resistance to neovascularization was additionally noted.

  3. Corneal biomechanics: a review.

    Science.gov (United States)

    Piñero, David P; Alcón, Natividad

    2015-03-01

    Biomechanics is often defined as 'mechanics applied to biology'. Due to the variety and complexity of the behaviour of biological structures and materials, biomechanics is better defined as the development, extension and application of mechanics for a better understanding of physiology and physiopathology and consequently for a better diagnosis and treatment of disease and injury. Different methods for the characterisation of corneal biomechanics are reviewed in detail, including those that are currently commercially available (Ocular Response Analyzer and CorVis ST). The clinical applicability of the parameters provided by these devices are discussed, especially in the fields of glaucoma, detection of ectatic disorders and orthokeratology. Likewise, other methods are also reviewed, such as Brillouin microscopy or dynamic optical coherence tomography and others with potential application to clinical practice but not validated for in vivo measurements, such as ultrasonic elastography. Advantages and disadvantages of all these techniques are described. Finally, the concept of biomechanical modelling is revised as well as the requirements for developing biomechanical models, with special emphasis on finite element modelling. © 2014 The Authors. Clinical and Experimental Optometry © 2014 Optometry Australia.

  4. Tuberculin reaction and BCG scar

    DEFF Research Database (Denmark)

    Timmermann, Clara Amalie Gade; Biering-Sørensen, Sofie; Aaby, Peter

    2015-01-01

    rate ratio (MRR) comparing children with a BCG scar with those without was 0.42 (95% CI = 0.19; 0.93). There was a similar tendency for TST positivity: MRR = 0.47 (95% CI = 0.14; 1.54). For LBW children who had both a positive TST reaction and a scar, the MRR was 0.22 (95% CI = 0.05; 0.87). For NBW...

  5. Changing Indications and Surgical Techniques for Corneal Transplantation Between 2004 and 2009 at a Tertiary Referral Center

    Science.gov (United States)

    Zare, Mohammad; Javadi, Mohammad A.; Einollahi, Bahram; Karimian, Farid; Rafie, Ali R. B.; Feizi, Sepehr; Azimzadeh, Ahmad

    2012-01-01

    Purpose: The aim of this study is to report the indications, techniques, and clinical outcomes of corneal transplantation and investigate any changing trends in surgical techniques over a 6 year period. Materials and Methods: Records of patients who had undergone any kind of corneal transplantation at Labbafinejad Medical Center, Tehran, Iran, from January 2004 to December 2009 were reviewed to determine the indications and types of corneal transplantation. Postoperative best-corrected visual acuity, refractive error, graft clarity, and complications were reported. Results: During this period, 1859 eyes of 1624 patients with a mean age of 41.3 ± 21.3 years underwent corneal transplantation. The most common indication was keratoconus (38.4%) followed by aphakic/pseudophakic bullous keratopathy (11.7%), previous failed grafts (10.6%), infectious corneal ulcers (10.1%), non-herpetic corneal scars (7.6%), trachoma keratopathy (4.7%), stromal corneal dystrophies (4.6%), post-herpetic corneal scar (3.7%), Fuchs’ endothelial dystrophy (0.8%), and congenital hereditary endothelial dystrophy (0.4%). Techniques of corneal transplantation included penetrating keratoplasty (PKP; 70.9%), deep anterior lamellar keratoplasty (DALK; 20.1%), conventional lamellar keratoplasty (LKP; 4.4%), and Descemet's stripping automated endothelial keratoplasty (DSAEK; 2.3%). Over the study period, there was a significant increase in the relative frequency of infectious corneal ulcers, failed grafts, and trachoma keratopathy. Additionally, a significant reduction was observed in PKP and LKP procedures, and volume of DALK and DSAEK increased significantly. At final follow-up, 69.0% of grafts were clear in the PKP group. This figure was 82.6%, 82.7%, and 97.6% in the DALK, LKP, and DSAEK groups, respectively. Conclusion: Keratoconus was the most common indication and PKP was the most prevalent technique used for corneal transplantation. However, significant changes in the indications and

  6. Corneal transplant - slideshow

    Science.gov (United States)

    ... ency/presentations/100082.htm Corneal transplant - series—Normal anatomy To use the sharing features on this page, ... Bethesda, MD 20894 U.S. Department of Health and Human Services National Institutes of Health Page last updated: ...

  7. Corneal Viscoelastic Properties from Finite-Element Analysis of In Vivo Air-Puff Deformation

    Science.gov (United States)

    Kling, Sabine; Bekesi, Nandor; Dorronsoro, Carlos; Pascual, Daniel; Marcos, Susana

    2014-01-01

    Biomechanical properties are an excellent health marker of biological tissues, however they are challenging to be measured in-vivo. Non-invasive approaches to assess tissue biomechanics have been suggested, but there is a clear need for more accurate techniques for diagnosis, surgical guidance and treatment evaluation. Recently air-puff systems have been developed to study the dynamic tissue response, nevertheless the experimental geometrical observations lack from an analysis that addresses specifically the inherent dynamic properties. In this study a viscoelastic finite element model was built that predicts the experimental corneal deformation response to an air-puff for different conditions. A sensitivity analysis reveals significant contributions to corneal deformation of intraocular pressure and corneal thickness, besides corneal biomechanical properties. The results show the capability of dynamic imaging to reveal inherent biomechanical properties in vivo. Estimates of corneal biomechanical parameters will contribute to the basic understanding of corneal structure, shape and integrity and increase the predictability of corneal surgery. PMID:25121496

  8. Electron microscopic and immunohistochemical examination of scarred human cornea re-treated by excimer laser.

    Science.gov (United States)

    Bleckmann, Heinrich; Schnoy, Norbert; Kresse, Hans

    2002-04-01

    To elucidate differences, at the macromolecular level, in corneal tissue subjected to repeated argon fluoride excimer treatment. A light microscopic, electron microscopic, and immunohistochemical study was performed on a scarred human cornea. Keratocytes were enlarged with an expanded endoplasmic reticulum and exhibited a fibroblastic appearance. Amorphous material was observed extracellularly. Collagen fibrils exhibited a disordered arrangement while banding patterns and diameter were normal. Immunohistochemical investigation of several collagen types, of collagen-associated proteoglycans, and of basement membrane components demonstrated an enhanced immunoreactivity of all of them in the scarred area. Type V collagen was found as a normal component of the epithelial basement membrane whereas types I and III collagen were present beneath Bowman's layer. Excimer-laser-treated sections revealed considerably stronger subepithelial staining for collagen types I, III, IV, and V. Laminin-1, a typical component of basement membranes, was detectable throughout the scarred tissue. The small proteoglycans decorin and fibromodulin accumulated in a patch-like manner in the scarred tissue below the epithelium, whereas biglycan was expressed by the epithelium and throughout the stroma. Lumican was expressed most strongly by the epithelium and rather equally distributed in the excimer-laser-treated and in the normal stroma. Effects of argon laser treatment of the cornea must be regarded as a process acting over many months. Intra- and extracellular structures and components are involved and influence the unpredictable shape of the corneal architecture.

  9. Curative effect comparison of stem cell transplantation of supprior-inferior autologous corneal limbus in the treatment of pterygium

    Directory of Open Access Journals (Sweden)

    Zheng-Jun Hu

    2015-08-01

    Full Text Available AIM: To compare the curative effect of autologous corneal limbus stem cell with bulbar conjunctiva transplantation of supprior-inferior bulbar conjunctiva in the treatment of pterygium and effect of postoperative scarring on bulbar conjunctiva on performing glaucoma filtration surgery in the future.METHODS: A total of 182 patients(252 eyeswith initial pterygium were divided into two groups by sortition randomization method. Eighty-five patients of the group A(110 eyesaccepted pterygium resection combined stem cell transplantation of supprior autologous corneal limbus, while 97 patients of the group B(142 eyesof pterygium excision combined stem cell transplantation of inferior autologous corneal limbus in treatment of pterygium. Postoperative follow-up from 1~12mo. Recurrence rate and conjunctival scar formation after autologous corneal limbus stem cells being taken were observed in the two groups to judge the impact on the future glaucoma filtration surgery.RESULTS: After follow-up from 1~12mo, there was no significant difference of postoperative recurrence between the group A and group B(χ2=0.015, P>0.05. Stem cell taken from supprior autologous corneal limbus in the group A caused supprior bulbar conjunctiva scarring, while it caused inferior scarring in the group B. For routine glaucoma filtration surgery usually is being done in the upper bulbar conjunctiva, on the nose or superior bulbar conjunctival area above the temporal region, and the above healthy bulbar conjunctiva has being kept in the group B which retained area for future glaucoma filtration surgery.CONCLUSION: Autologous corneal limbus stem cell transplantation of supprior-inferior bulbar conjunctiva could be effective in the treatment of pterygium, but stem cell transplantation of inferior autologous corneal limbus could keep area for glaucoma filtration surgery.

  10. Distrofia corneal de Schnyder

    Directory of Open Access Journals (Sweden)

    Michel Guerra Almaguer

    Full Text Available La principal entidad hereditaria con depósitos de lípidos en el estroma corneal es la distrofia cristalina central, conocida como distrofia de Schnyder, quien la describió en Suiza en 1927. Se caracteriza por depósitos blanco-amarillentos en el estroma corneal central y superficial. Se presenta un paciente de 28 años, del sexo masculino y piel negra, con antecedente de salud anterior. Acudió a consulta y refirió una disminución de la visión y cambio de coloración progresiva de ambos ojos, de años de evolución. En la exploración oftalmológica de ambos ojos se apreciaron lesiones blanquecinas anulares a nivel del estroma corneal, con ligera turbidez corneal central. Los estudios refractivos realizados constataron un astigmatismo hipermetrópico simple. El resto del examen oftalmológico fue negativo. Para el diagnóstico de certeza se empleó el microscopio confocal. Se concluye que el caso presenta una distrofia corneal estromal de tipo cristalina, de Schnyder.

  11. Fillers for the improvement in acne scars

    Directory of Open Access Journals (Sweden)

    Wollina U

    2015-09-01

    Full Text Available Uwe Wollina,1 Alberto Goldman2 1Department of Dermatology and Allergology, Academic Teaching Hospital, Dresden-Friedrichstadt, Dresden, Germany; 2Clinica Goldman, Porto Alegre, Rio Grande do Sul, Brazil Abstract: Acne is a common inflammatory disease. Scarring is an unwanted end point of acne. Both atrophic and hypertrophic scar types occur. Soft-tissue augmentation aims to improve atrophic scars. In this review, we will focus on the use of dermal fillers for acne scar improvement. Therefore, various filler types are characterized, and available data on their use in acne scar improvement are analyzed. Keywords: acne, scars, dermal fillers, injection, extracellular matrix

  12. Rare complications of cesarean scar

    Directory of Open Access Journals (Sweden)

    Divyesh Mahajan

    2013-01-01

    Full Text Available Cesarean scar pregnancy (CSP and cesarean scar dehiscence (CSD are the most dreaded complications of cesarean scar (CS. As the incidence of CS is increasing worldwide, so is the incidence of CSP, especially in cases with assisted reproduction techniques. It is of utmost importance to diagnose CSP in the early first trimester, as it can lead to myometrial rupture with fatal outcome. On the other hand, CSD may be encountered during pregnancy or in the postpartum period. CSD in the postpartum period is very rare and can cause secondary postpartum hemorrhage (PPH leading to increased maternal morbidity or even death if not diagnosed and managed promptly. Both complications can be diagnosed on ultrasonography (USG and confirmed on magnetic resonance imaging (MRI. These two conditions carry high morbidity and mortality. In this article, we highlight the role of imaging in the early diagnosis and management of these conditions.

  13. Ruptured Cesarean Scar Ectopic Pregnancy

    Directory of Open Access Journals (Sweden)

    Sujatha BS

    2017-07-01

    Full Text Available A pregnancy with implantation on the scar of a past cesarean section is uncommon. However such pregnancies are on the rise due to the increasing number of lower segment cesarean section. One of the complications of such a pregnancy is uterine rupture in early pregnancy which can be life threatening to the patient. The following is a report of a patient who presented at 10 weeks of gestational age with features of hypovolemic shock and lower position of the gestational sac in relation to the uterus with normal fetal heart rate. The diagnosis of ruptured cesarean scar pregnancy was made only after laparotomy.

  14. In Vitro Corneal Tomography of Donor Cornea Using Anterior Segment OCT.

    Science.gov (United States)

    Janunts, Edgar; Langenbucher, Achim; Seitz, Berthold

    2016-05-01

    The aim of this study was to establish a tomographic screening method for revealing potential pathologies in corneal donors before keratoplasty so they may be excluded as candidates for corneal transplantation. Donor corneal tomographies were measured in a viewing chamber filled with preservation medium and with the use of a clinical optical coherence tomography (OCT) device. Custom-written software was developed to extract corneal surfaces from the raw data, which were analyzed in the central and peripheral regions. An adaptive nonlinear edge-enhancement algorithm was used to observe scars within the corneal volume. The thickness distribution map was analyzed to detect keratoconus and corneas with extreme topographic irregularities. Measurements were repeated 5 times to assess reproducibility. Eight corneas were investigated: 6 randomly selected intact donors, unsuitable for implantation because of low endothelial cell densities, and 2 keratoconus corneas, excised from patients during corneal transplantation. A major thickness abnormality was detected in one of the intact donor corneas, so it was excluded from further analysis. The keratoconus corneas were clearly evident in optical coherence tomography cross-sectional images, and similarly, they could easily be identified by analyzing the thickness map. Overall, the measurements were reliable and had a Cronbach's alpha coefficient greater than 0.8. Donor corneal examination using sterile viewing chambers was found to be suitable as a pre-keratoplasty advanced screening routine. A proof of concept was demonstrated, which could identify both irregular corneas and those affected by keratoconus.

  15. Indications for Corneal Transplantation at a Tertiary Referral Center in Tehran

    Directory of Open Access Journals (Sweden)

    Mohammad Zare

    2010-01-01

    Full Text Available Purpose: To report the indications and techniques of corneal transplantation at a tertiary referral center in Tehran over a 3-year period. Methods: Records of patients who had undergone any kind of corneal transplantation at Labbafinejad Medical Center, Tehran, Iran from March 2004 to March 2007 were reviewed to determine the indications and types of corneal transplantation. Results: During this period, 776 eyes of 756 patients (including 504 male subjects with mean age of 41.3±21.3 years underwent corneal transplantation. The most common indication was keratoconus (n=317, 40.8% followed by bullous keratopathy (n=90, 11.6%, non-herpetic corneal scars (n=62, 8.0%, infectious corneal ulcers (n=61, 7.9%, previously failed grafts (n=61, 7.9%, endothelial and stromal corneal dystrophies (n=28, 3.6%, and trachoma keratopathy (n=26, 3.3%. Other indications including Terrien′s marginal degeneration, post-LASIK keratectasia, trauma, chemical burns, and peripheral ulcerative keratitis constituted the rest of cases. Techniques of corneal transplantation included penetrating keratoplasty (n=607, 78.2%, deep anterior lamellar keratoplasty (n=108, 13.9%, conventional lamellar keratoplasty (n=44, 5.7%, automated lamellar therapeutic keratoplasty (n=8, 1.0%, and Descemet stripping endothelial keratoplasty (n=6, 0.8% in descending order. The remaining cases were endothelial keratoplasty and sclerokeratoplasty. Conclusion: In this study, keratoconus was the most common indication for penetrating keratoplasty which was the most prevalent technique of corneal transplantation. However, deep anterior lamellar keratoplasty is emerging as a growing alternative for corneal pathologies not involving the endothelium.

  16. Effect of sodium hyaluronate in treating fungal corneal ulcer

    Directory of Open Access Journals (Sweden)

    Jun-Hua Fan

    2013-12-01

    Full Text Available AIM: To retrospectively analyze the effects of sodium hyaluronate in treating fungal corneal ulcer.METHODS: Since June, 2006, there were 178 patients(178 eyeswith fungal corneal ulcer receiving medical treatment in our hospital. Among them, 81 patients(81 eyesas the control group received the traditional antifungal treatment with the natamycin and fluconazole being the major medicine, from June 2006 to June 2008. While, 97 patients(97 eyesas the treatment group received sodium hyaluronate treatment based on traditional antifungal treatment during the period of June 2008 to March 2010. Effects of two therapeutic methods were compared and analyzed. RESULTS: Of the 97 cases in the treatment group, the average hospital stay was: 14.15±4.23d, with 90 cases(92.8%cured, 5 cases(5.2%improved, 2 cases(2.1%ineffective, the final visual acuity of 51.6% patients better than 0.3. Of the 81 cases in the control group, average hospital stay was: 17.26±6.23d, with 69 cases(85.2%cured, 7 cases(8.6%improved, 5 cases(6.2%ineffective, the final visual acuity of 39.5% patients better than 0.3. After statistical analysis, the average hospital stay, the cure rate, the effective rate and the final visual acuity in both groups showed statistically significant difference(PCONCLUSION: Sodium hyaluronate can promote fungal corneal ulcer healing, improve the cure rate and reduce the formation of corneal scar.

  17. Effects of altered corneal stiffness on native and postoperative LASIK corneal biomechanical behavior: A whole-eye finite element analysis.

    Science.gov (United States)

    Roy, Abhijit Sinha; Dupps, William J

    2009-10-01

    To investigate the impact of corneal elasticity on corneal shape changes before and after simulated LASIK with and without consideration of whole-eye biomechanics. A finite element whole-eye model of a human eye was constructed. The cornea was modeled as hyperelastic and incompressible using experimental data representing a range of corneal stiffness. The corneal response to intraocular pressure loading and LASIK for 2.00, 4.00, and 6.00 diopters of spherical myopia was analyzed as a function of corneal stiffness and limbal boundary conditions. Myopic LASIK produced different degrees of central flattening and postoperative ametropia in low-stiffness and high-stiffness corneas. Although a cornea-only model demonstrated maximum stresses and displacements in the central cornea and predicted residual myopia, a whole-eye model with equivalent corneal stiffness predicted greater paracentral displacements and less myopic undercorrection. In a whole-eye model with a stiffer cornea, maximum displacements shifted further toward the limbus, favoring additional mechanically mediated central flattening and refractive overcorrection (hyperopia). In postoperative LASIK models thinned by high myopic corrections, corneal stiffening caused central cornea flattening. Differences in the corneoscleral stiffness relationship affect simulated refractive outcomes after LASIK and may be a source of individual variation in refractive surgery outcomes. A whole-eye model allowing limbal motion illustrates a stiffness-dependent biomechanical balance between central corneal flattening and pre-ectatic weakening of the corneal apex not demonstrated in previous computational models and provides insight into under- and overcorrection in myopic LASIK and the previously unexplained phenomenon of corneal flattening after therapeutic collagen cross-linking for keratoconus. Copyright 2009, SLACK Incorporated.

  18. Scars of Invariant Manifolds in Interacting Few-Body Systems

    CERN Document Server

    Papenbrock, T; Weidenmüller, H A

    1997-01-01

    We present a novel extension of the concept of scars for the wave functions of classically chaotic few--body systems of identical particles with rotation and permutation symmetry. Generically there exist manifolds in classical phase space which are invariant under the action of a common subgroup of these two symmetries. Such manifolds are associated with highly symmetric configurations and, if sufficiently stable, support quantum resonances. Although not directly associated to individual periodic orbits, the resonances nevertheless cause scars which signify collective motion on the quantum level and which should be experimentally observable.

  19. Airbag induced corneal ectasia.

    Science.gov (United States)

    Mearza, Ali A; Koufaki, Fedra N; Aslanides, Ioannis M

    2008-02-01

    To report a case of airbag induced corneal ectasia. Case report. A patient 3 years post-LASIK developed bilateral corneal ectasia worse in the right eye following airbag deployment in a road traffic accident. At last follow up, best corrected vision was 20/40 with -4.00/-4.00 x 25 in the right eye and 20/25 with -1.25/-0.50 x 135 in the left eye. This is a rare presentation of trauma induced ectasia in a patient post-LASIK. It is possible that reduction in biomechanical integrity of the cornea from prior refractive surgery contributed to this presentation.

  20. Cutaneous leiomyosarcoma arising in a smallpox scar

    National Research Council Canada - National Science Library

    Pol, Robert A; Dannenberg, Hilde; Robertus, Jan-Lukas; van Ginkel, Robert J

    2012-01-01

    ...% of all superficial soft tissue sarcomas. Although the development of various malignancies in scar tissue is well known, we report the first case of a CLM developing in a small pox scar. Case presentation...

  1. Acne Scars: Pathogenesis, Classification and Treatment

    OpenAIRE

    Fabbrocini, Gabriella; Annunziata, M. C.; D'Arco, V.; De Vita, V.; Lodi, G.; Mauriello, M. C.; Pastore, F.; Monfrecola, G.

    2010-01-01

    Acne has a prevalence of over 90% among adolescents and persists into adulthood in approximately 12%–14% of cases with psychological and social implications. Possible outcomes of the inflammatory acne lesions are acne scars which, although they can be treated in a number of ways, may have a negative psychological impact on social life and relationships. The main types of acne scars are atrophic and hypertrophic scars. The pathogenesis of acne scarring is still not fully understood, but seve...

  2. Soft tissue trauma and scar revision.

    Science.gov (United States)

    Mobley, Steven R; Sjogren, Phayvanh P

    2014-11-01

    Numerous techniques and treatments have been described for scar revision, with most studies focusing on the adult population. A comprehensive review of the literature reveals a paucity of references related specifically to scar revision in children. This review describes the available modalities in pediatric facial scar revision. The authors have integrated current practices in soft tissue trauma and scar revision, including closure techniques and materials, topical therapy, steroid injection, cutaneous laser therapy, and tissue expanders. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Midcervical scar satisfaction in thyroidectomy patients.

    Science.gov (United States)

    Best, Amy R; Shipchandler, Taha Z; Cordes, Susan R

    2017-05-01

    Assess long-term patient satisfaction with conventional thyroidectomy scars and the impact of thyroidectomy scars on patient quality of life. Validated survey administration and retrospective review of clinical and demographic data. Patients who underwent conventional thyroidectomy through years 2000 to 2010 were identified and administered the validated Patient Scar Assessment Questionnaire. Mean satisfaction, appearance and scar-consciousness scores were determined. Thirty-seven patients also measured the length of their current scar. Patient demographic and operative data were collected retrospectively from the medical record. Data were analyzed with one-way analysis of variance and independent samples t testing. Sixty of 69 patients perceived the appearance of their scar to be "good" or "excellent." Sixty-three patients (91.3%) were satisfied with all scar outcomes; 67 (97.1%) were satisfied with the overall appearance of their scar. Mean total satisfaction score was 17.3 (scar; 65 (94.2%) reported no attempt to hide their scar. Seven patients (10.1%) indicated any likelihood of pursuing scar revision. Females had significantly higher total satisfaction scores, consciousness scores, and satisfaction with appearance scores. The effect of perceived scar length was significant for scar-consciousness, not patient satisfaction. The majority of patients were satisfied with their thyroidectomy scar appearance. Few patients reported a desire to hide the scar or pursue revision. Women were more likely to be dissatisfied than men. Length may play a role in scar consciousness. 4 Laryngoscope, 127:1247-1252, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  4. Fillers for the improvement in acne scars

    OpenAIRE

    Wollina U; Goldman A

    2015-01-01

    Uwe Wollina,1 Alberto Goldman2 1Department of Dermatology and Allergology, Academic Teaching Hospital, Dresden-Friedrichstadt, Dresden, Germany; 2Clinica Goldman, Porto Alegre, Rio Grande do Sul, Brazil Abstract: Acne is a common inflammatory disease. Scarring is an unwanted end point of acne. Both atrophic and hypertrophic scar types occur. Soft-tissue augmentation aims to improve atrophic scars. In this review, we will focus on the use of dermal fillers for acne scar improvement. Therefore...

  5. Endometriosis in an episiotomy scar

    Directory of Open Access Journals (Sweden)

    Mine islimye Taskin

    2016-03-01

    Full Text Available Endometriosis that is defined as the presence of functional endometrial tissue outside the uterine cavity is seen 5-10% of reproductive age women. Endometriosis can be seen any other site of the body; but the most frequently affected areas are ovaries, pelvic peritoneum, uterosacral ligament and Douglas pouche. Several teories exist for the development of endometriosis including retrograde menstruation, venous or lymphatic metastasis and immun dysfunction. Endometriosis of the perineum and vulva are extremely rare with the most common sites being episiotomy scars. Scar endometriosis is likely to be caused by mechanical transplantation of endometrium from the uterine cavity into the wound at the time of the surgery. The primary treatment for scar endometriosis is total surgical excision of the lesion. It is important not to leave residual tissue during surgery to prevent the recurrence. Here we present a patient who had her vaginal delivery 5 years ago, have a complaint of painful vulvar lump at the right mediolateral episiotomy scar since 1 year during her every menstruation period and whose final diagnosis was endometriosis after surgical removal and histopathologic examination. Althought vulvar endometrosis is rare, it should be considered in the patients who had a vaginal delivery and complaining painful vulvar lump with swelling in her mestrual cycle. [Cukurova Med J 2016; 41(1.000: 164-166

  6. Objective Scar Assessment Tools: A Clinimetric Appraisal

    NARCIS (Netherlands)

    Verhaegen, P.D.H.M.; van der Wal, M.B.A.; Middelkoop, E.; van Zuijlen, P.P.M.

    2011-01-01

    Background: Scars may lead to an array of cosmetic, psychological, and functional problems. Different scar features can be distinguished (i.e., color, thickness, relief, pliability, and surface area) that are clinically relevant and contribute to the quality and judgment of a scar. Today, objective

  7. Spontaneous Corneal Hydrops in a Patient with a Corneal Ulcer

    Directory of Open Access Journals (Sweden)

    Hatim Batawi

    2016-01-01

    Full Text Available Purpose: We report the case of a 77-year-old man with no history of keratoconus or other ectatic disorders who presented with corneal hydrops in the setting of a corneal ulcer. The risk factors, pathogenesis and treatment options of corneal hydrops are discussed. Method: This is an observational case report study. Results: A 77-year-old man presented with a 1-day history of severe pain, redness, mucous discharge and photophobia in the right eye. A slit-lamp examination of the right eye showed an area of focal corneal edema and protrusion. Within the area of edema and protrusion, there was an infiltrate with an overlying epithelial defect consistent with an infectious corneal ulcer. The Seidel test showed no leakage, so a clinical diagnosis of corneal hydrops associated with nonperforated corneal ulcer was made. With appropriate antibiotic treatment, the corneal ulcer and hydrops both resolved over a 1-month period. Conclusion: Corneal hydrops can occur in the setting of corneal infections.

  8. Massive corneal edema treated with corneal cross-linking.

    Science.gov (United States)

    Laborante, A; Buzzonetti, L; Longo, C

    2012-01-01

    Massive corneal edema disrupts the fine architecture of corneal stroma that guarantees its transparency, causing opacities that seriously impair clear vision and are usually solved by corneal transplant. Corneal cross-linking, a treatment developed to halt keratoconus progression, results in a loss of water and a compaction of corneal stroma. It might therefore be useful to improve the pathologic edematous condition of some corneas, ameliorating visual acuity and allowing more time for a surgical procedure of keratoplasty. Six patients with visual impairing corneal edemas further to lens phacoemulsification, penetrating keratoplasty, or post-infective neovascularization were treated with corneal cross-linking alone, or in combination with amniotic membrane apposition with or without anti-angiogenic therapy. All patients partly resolved the edematous condition, improving both corneal transparency and visual acuity. Corneal cross-linking appears to be a useful method to treat massive corneal edemas, so that keratoplasty can be at least delayed, and need not to be an emergency treatment in these cases.

  9. Effect of HMME-PDT with different parameters in rabbit ear model: a possible way for hypertrophic scarring

    Science.gov (United States)

    Cai, Hong; Gu, Ying; Zeng, Jing; Li, Shao-ran; Sun, Qiang; Wang, Ying; Shi, Dong-wen; Zhang, Lu-yong

    2007-11-01

    Background and Objective: Hypertrophic scar is a pathological scar that grows aberrantly by excessive deposition of collagens in the dermis. It is known that photodynamic therapy (PDT) contributes to a variety of diseases, however, the use of inhibiting scar formation has not been fully explored. The purpose of this study is to investigate the effect of HMME-PDT (Photodynamic therapy induced by Hematoporphyrin Monomethyl Ether) with different parameters on hypertrophic scar in rabbit ear. Materials and Methods: After the placement of 7-mm diameter dermal wounds on each ear, the acute model of dermal hypertrophic scar in the New Zealand white rabbits was established. Scar wounds were randomly separated into 2 groups: the experimental group received HMME-PDT with different parameters, and the control group received no special treatment. Specimens were harvested from scar wounds on postoperative day 28. Scar and hypertrophic index (HI) were observed by haematoxylin-eosin staining. Results: Compared with the control group, scar formation was inhibited by HMME-PDT in the experimental group with parameters as follows: photosensitizer dose 10mg/kg, power density 20mw/cm2, fluence 5J/cm2, meanwhile, HI was decreased significantly. Conclusion: HMME-PDT may play a role in inhibiting hypertrophic scarring in rabbit ear. The biological effect is determined by the dose of photosensitizer, interval between the injection of photosensitizer and irradiation, power density and energy fluence.

  10. [Integrated diagnosis and treatment of scar].

    Science.gov (United States)

    Cen, Y; Chen, J J

    2016-11-20

    Scar is the common disease in the field of burn and plastic surgery, and its diagnosis and treatment should be involved in overwhelming majority hospitals. There are many substandard methods and medical hidden dangers in diagnosis and treatment of scar, due to the unevenness of doctors' clinical experience. According to the classification of integral scar and diabrotic scar, the problems related to diagnosis and treatment of scar are systemically summarized and normalized in this article for decrease in the incidence of adverse events and medical hidden dangers.

  11. Forensic analysis of rockfall scars

    Science.gov (United States)

    de Vilder, Saskia J.; Rosser, Nick J.; Brain, Matthew J.

    2017-10-01

    We characterise and analyse the detachment (scar) surfaces of rockfalls to understand the mechanisms that underpin their failure. Rockfall scars are variously weathered and comprised of both discontinuity release surfaces and surfaces indicative of fracturing through zones of previously intact rock, known as rock bridges. The presence of rock bridges and pre-existing discontinuities is challenging to quantify due to the difficulty in determining discontinuity persistence below the surface of a rock slope. Rock bridges form an important control in holding blocks onto rockslopes, with their frequency, extent and location commonly modelled from the surface exposure of daylighting discontinuities. We explore an alternative approach to assessing their role, by characterising failure scars. We analyse a database of multiple rockfall scar surfaces detailing the areal extent, shape, and location of broken rock bridges and weathered surfaces. Terrestrial laser scanning and gigapixel imagery were combined to record the detailed texture and surface morphology. From this, scar surfaces were mapped via automated classification based on RGB pixel values. Our analysis of the resulting data from scars on the North Yorkshire coast (UK) indicates a wide variation in both weathering and rock bridge properties, controlled by lithology and associated rock mass structure. Importantly, the proportion of rock bridges in a rockfall failure surface does not increase with failure size. Rather larger failures display fracturing through multiple rock bridges, and in contrast smaller failures fracture occurs only through a single critical rock bridge. This holds implications for how failure mechanisms change with rockfall size and shape. Additionally, the location of rock bridges with respect to the geometry of an incipient rockfall is shown to determine failure mode. Weathering can occur both along discontinuity surfaces and previously broken rock bridges, indicating the sequential stages of

  12. Differential expression of collagen types XVIII/endostatin and XV in normal, keratoconus, and scarred human corneas.

    Science.gov (United States)

    Määttä, Marko; Heljasvaara, Ritva; Sormunen, Raija; Pihlajaniemi, Taina; Autio-Harmainen, Helena; Tervo, Timo

    2006-04-01

    This study was designed to clarify the expression of 2 closely related collagen (Col) types XVIII and XV, and the proteolytically derived endostatin fragment of ColXVIII in normal, keratoconus, and scarred human corneas. Immunohistochemistry, in situ hybridization, immunoelectron microscopy, and Western immunoblotting were used for human corneal samples obtained from penetrating keratoplasty. In the normal cornea, ColXVIII was immunolocalized to the corneal and conjunctival epithelial basement membrane (EBM), Descemet s membrane, and the limbal and conjunctival capillaries. Immunoreaction for endostatin was otherwise similar, but it also was present in corneal epithelial cells. Western immunoblotting showed that normal cornea contains several endostatin fragments ranging from 20 to 100 kDa. ColXV was present in the EBM of the limbus and conjunctiva, but not in EBM of the clear cornea. In situ hybridization revealed that corneal basal epithelial cells were responsible for the synthesis of ColXVIII mRNA. Keratoconus cases were characterized by an irregular EBM immunoreactivity for ColXVIII and endostatin and patchy immunoreactivity beneath EBM. In scarred corneas, highly increased immunoreactivity for ColXVIII, endostatin, and ColXV was present within stroma. The results indicate that ColXVIII and ColXV are differentially expressed in normal human corneas. Constant expression of ColXVIII by corneal EBM suggests that it is an important structural molecule. Aberrant expression of ColXVIII, endostatin, and ColXV in keratoconus and scarred corneas emphasizes the active role these molecules in the wound healing process.

  13. Reliability and Photographic Equivalency of the Scar Cosmesis Assessment and Rating (SCAR) Scale, an Outcome Measure for Postoperative Scars.

    Science.gov (United States)

    Kantor, Jonathan

    2017-01-01

    Until recently, no ideal valid, feasible, and reliable scar scale existed to effectively assess the quality of postoperative linear scars. The Scar Cosmesis Assessment and Rating (SCAR) scale was developed and validated as a tool to assess the quality of postoperative scars in clinical and research settings. To assess the reliability of using photographs in lieu of live patient scar rating assessments, and to determine the interrater and intrarater reliability of the SCAR scale. This was a reliability study to assess clinicians' interrater and intrarater reliability, as well as the reliability of using high-quality macrophotographs of postoperative scars. Patients were from a private practice dermatology clinic, with assessed scars representing a range of surgical procedures including those performed by dermatologists, plastic surgeons, and general surgeons. Assessments were performed by an international multidisciplinary team from dermatology, plastic surgery, surgical oncology, emergency medicine, and physiatry, using photographs and live patient assessments. A single photograph was assessed for each patient's scar. Data were obtained between August 3, 2015, and January 18, 2016. Data analysis occurred between January 18, 2016, and July 29, 2016. Using the intraclass correlation coefficient (ICC), the scale was tested for photographic equivalency as well as interrater reliability and intrarater reliability by 5 raters on a set of 80 total patient scars, 20 of which were analyzed for photographic equivalency and the remaining 60 of which were analyzed for interrater and intrarater reliability. The SCAR scale that measures postoperative scar cosmesis, with scores ranging from 0 (best possible scar) to 15 (worst possible scar), based on 6 clinician and 2 patient items was used. Of those 60 in the photographic subgroup, 10 were rated using not only the SCAR scale but also the Patient and Observer Scar Assessment Scale and the Vancouver Scar Scale, and 10 were

  14. Outcomes of ablative fractional laser scar treatment.

    Science.gov (United States)

    Kim, Deok-Woo; Hwang, Na-Hyun; Yoon, Eul-Sik; Dhong, Eun-Sang; Park, Seung-Ha

    2015-04-01

    Ablative fractional laser (AFL) systems are commonly used to treat various scars, and recent reports have indicated that early scar treatment with fractional lasers has good aesthetic results. Some scars respond dramatically to AFL treatment, incurring high levels of patient satisfaction; however, other scars respond poorly or became worse after treatment. This study was designed to clarify prognostic factors that predict AFL scar treatment outcomes. A total of 108 patients were included in this study. The fractional laser treatments were repeated every 4 weeks until the scar site was acceptable and no additional improvement was expected or the patient discontinued the treatment. The scar improvements were defined as changes in the Manchester scar scale (MSS) from before to after laser treatment. A digital camera was used to acquire digital photographs of the scars under the same light source, the same background, exposure, and white balance. This study developed a modification of the MSS for image analysis in which colour assessment was based on L*a*b* colour co-ordinates of the digital images. The mean MSS values prior to and after laser treatments were 11.6 ± 3.6 and 9.5 ± 2.9, respectively (p treatment improved the qualities of each scar, and the improvements were evident in colour and contour. Scar elevation, pigmentation, high vascularity, early onset of treatment, and the number of treatment sessions were directly related to scar improvement after AFL therapy (p treatments were effective methods for scar treatment. Clinicians can use these prognostic factors to determine treatment plans and to estimate scar improvement after AFL treatment.

  15. Corneal collagen crosslinking in keratoconus and other eye disease

    Directory of Open Access Journals (Sweden)

    Adel Alhayek

    2015-04-01

    Full Text Available Keratoconus is a condition characterized by biomechanical instability of the cornea, presenting in a progressive, asymmetric and bilateral way. Corneal collagen crosslinking (CXL with riboflavin and Ultraviolet-A (UVA is a new technique of corneal tissue strengthening that combines the use of riboflavin as a photo sensitizer and UVA irradiation. Studies showed that CXL was effective in halting the progression of keratoconus over a period of up to four years. The published studies also revealed a reduction of max K readings by more than 2 D, while the postoperative spherical equivalent (SEQ was reduced by an average of more than 1 D and refractive cylinder decreased by about 1 D. The major indication for the use of CXL is to inhibit the progression of corneal ecstasies, such as keratoconus and pellucid marginal degeneration. CXL may also be effective in the treatment and prophylaxis of iatrogenic keratectasia, resulting from excessively aggressive photo ablation. This treatment has been used to treat infectious corneal ulcers with apparent favorable results. Most recent studies demonstrate the beneficial impact of CXL for iatrogenic ecstasies, pellucid marginal degeneration, infectious keratitis, bullous keratopathy and ulcerative keratitis. Several long-term and short-term complications of CXL have been studied and documented. The possibility of a secondary infection after the procedure exists because the patient is subject to epithelial debridement and the application of a soft contact lens. Formation of temporary corneal haze, permanent scars, endothelial damage, treatment failure, sterile infiltrates, bullous keratopathy and herpes reactivation are the other reported complications of this procedure.

  16. Corneal collagen crosslinking in keratoconus and other eye disease

    Science.gov (United States)

    Alhayek, Adel; Lu, Pei-Rong

    2015-01-01

    Keratoconus is a condition characterized by biomechanical instability of the cornea, presenting in a progressive, asymmetric and bilateral way. Corneal collagen crosslinking (CXL) with riboflavin and Ultraviolet-A (UVA) is a new technique of corneal tissue strengthening that combines the use of riboflavin as a photo sensitizer and UVA irradiation. Studies showed that CXL was effective in halting the progression of keratoconus over a period of up to four years. The published studies also revealed a reduction of max K readings by more than 2 D, while the postoperative spherical equivalent (SEQ) was reduced by an average of more than 1 D and refractive cylinder decreased by about 1 D. The major indication for the use of CXL is to inhibit the progression of corneal ecstasies, such as keratoconus and pellucid marginal degeneration. CXL may also be effective in the treatment and prophylaxis of iatrogenic keratectasia, resulting from excessively aggressive photo ablation. This treatment has been used to treat infectious corneal ulcers with apparent favorable results. Most recent studies demonstrate the beneficial impact of CXL for iatrogenic ecstasies, pellucid marginal degeneration, infectious keratitis, bullous keratopathy and ulcerative keratitis. Several long-term and short-term complications of CXL have been studied and documented. The possibility of a secondary infection after the procedure exists because the patient is subject to epithelial debridement and the application of a soft contact lens. Formation of temporary corneal haze, permanent scars, endothelial damage, treatment failure, sterile infiltrates, bullous keratopathy and herpes reactivation are the other reported complications of this procedure. PMID:25938065

  17. Computational Model for Corneal Transplantation

    Science.gov (United States)

    Cabrera, Delia

    2003-10-01

    We evaluated the refractive consequences of corneal transplants using a biomechanical model with homogeneous and inhomogeneous Young's modulus distributions within the cornea, taking into account ablation of some stromal tissue. A FEM model was used to simulate corneal transplants in diseased cornea. The diseased cornea was modeled as an axisymmetric structure taking into account a nonlinearly elastic, isotropic formulation. The model simulating the penetrating keratoplasty procedure gives more change in the postoperative corneal curvature when compared to the models simulating the anterior and posterior lamellar graft procedures. When a lenticle shaped tissue was ablated in the graft during the anterior and posterior keratoplasty, the models provided an additional correction of about -3.85 and -4.45 diopters, respectively. Despite the controversy around the corneal thinning disorders treatment with volume removal procedures, results indicate that significant changes in corneal refractive power could be introduced by a corneal transplantation combined with myopic laser ablation.

  18. "Double bubble" deep anterior lamellar keratoplasty for management of corneal stromal pathologies.

    Science.gov (United States)

    Jhanji, Vishal; Beltz, Jacqueline; Sharma, Namrata; Graue, Enrique; Vajpayee, Rasik B

    2011-08-01

    'Big Bubble' deep anterior lamellar keratoplasty (DALK) is becoming an accepted corneal transplantation technique for keratoconus and other anterior stromal corneal pathologies that spare the Descemet's membrane (DM) and endothelium. However, it is not always possible to conclusively recognise formation and identification of the 'Big Bubble'. We describe the surgical technique of DALK called 'Double Bubble' technique that allows the surgeon to definitely and immediately identify the formation of an adequate big bubble. DALK was performed using the 'Double Bubble' technique in twelve eyes of twelve patients with corneal stromal pathologies (keratoconus, 9 eyes; macular corneal dystrophy, 2 eyes; postinfectious keratitis corneal stromal scar, 1 eye) at the Royal Victorian Eye and Ear Hospital, Melbourne. Big bubble was successfully formed in 10 eyes. Maximum-depth deep lamellar keratoplasty was performed in two eyes. There were no instances of intraoperative perforation of the DM. All grafts were clear at last follow-up. Best-corrected visual acuity of ≥20/40 was achieved in all the cases at last follow-up (6-12 months). 'Double Bubble' DALK helps in identification of the big bubble and has the potential to increase the success of standard 'Big Bubble' DALK in patients with corneal stromal pathologies sparing the DM and endothelium.

  19. Corneal Cross-Linking: An Example of Photoinduced Polymerization as a Treatment Modality in Keratoconus.

    Science.gov (United States)

    Kubrak-Kisza, Magdalena; Kisza, Krystian Jerzy; Misiuk-Hojło, Marta

    2016-01-01

    The cornea is one of the principal refractive elements in the human eye and plays a crucial role in the process of vision. Keratoconus is the most common corneal dystrophy, found mostly among young adults. It is characterized by a reduced number of collagen cross-links in the corneal stroma, resulting in reduced biomechanical stability and an abnormal shape of the cornea. These changes lead to progressive myopia, corneal thinning, central scarring and irregular astigmatism, causing severely impaired vision. Hard contact lenses, photorefractive keratectomy or intracorneal rings are the most common treatment options for refractive error caused by keratoconus. However, these techniques do not treat the underlying cause of the corneal ectasia and therefore are not able to stop the progression of the disease. Riboflavin photoinduced polymerization of corneal collagen, also known as corneal cross-linking (CXL), has been introduced as the first therapy which, by stabilizing the structure of the cornea, prevents the progression of keratoconus. It stiffens the cornea using the photo-sensitizer riboflavin in combination with ultraviolet irradiation. This is a current review of the CXL procedure as a therapy for keratoconus, which relies on photoinduced polymerization of human tissue. We have focused on its biomechanical and physiological influences on the human cornea and have reviewed the previous and current biochemical theories behind cross-linking reactions in the cornea.

  20. Handheld SFDI/polarimetric imaging device for objective evaluation of hypertrophic scars (Conference Presentation)

    Science.gov (United States)

    Ramella-Roman, Jessica C.; Montejo, Karla; Sevilla, Nicole; Stoff, Susan; Gonzalez, Mariacarla; Chue-Sang, Joseph

    2017-02-01

    Scars can be debilitating and cause serious functional limitations, significantly reduced physical function and loss of ability to perform normal daily activities. Scar formation is not fully understood and the treatment options have been hampered by the lack of an objective diagnostic tool to assess scars. Presently, assessment of hypertrophic scars has been based on subjective clinician rankings using a four-parameter scale called the Vancouver Scar Scale (VSS) or the Patient Observer Scar Assessment Scale (POSAS) but no objective, standardized tool for quantifying scar severity is available, despite known inadequacies of the subjective scales. We have developed a hand-held multi modal system consisting of a combined Spatial Frequency Domain Imager (SFDI) used for the assessment of tissue molecular components and a polarimeter for structural measurements. The SFDI capability is provided by an Arduino board controlled spectrally and polarimetric diverse Light Emitting Diodes (LED) ring illuminator. For SFDI imagery, the LEDs are combined with sinusoidal patterns. A single pattern snapshot SFDI approach is used to observe and quantify the biological components in the scar tissue including: oxygenated and de oxygenated hemoglobin, water, and melanin. The SFDI system is integrated with a reduced Mueller Matrix polarimetric system, whose illumination is also included in the LED's ring, and providing for the assessment of collagen orientation through Mueller Matrix decomposition. The design of the system and experimental work on phantoms will be presented.

  1. Effect of human adipose derived stem cells on scar formation and remodeling in a pig model: a pilot study.

    Science.gov (United States)

    Yun, In Sik; Jeon, Yeo Reum; Lee, Won Jai; Lee, Jae Wook; Rah, Dong Kyun; Tark, Kwan Chul; Lew, Dae Hyun

    2012-10-01

    Adipose-derived stem cells (ASCs) have positive effects in the wound healing process. To clarify whether ASCs positively mitigate scar formation in the wound remodeling process. Full-thickness skin defects were created on the dorsal skin of Yorkshire pigs. After the defects were transformed into early scars, ASCs were injected, and the same amount of phosphate buffered saline (PBS) was injected in the control group. Clinical and histologic examinations were performed. In the experimental group, the areas of scars were smaller than those of control groups. The color of scars was more similar to that of the surrounding normal tissue, and scar pliability was better. The number of mast cells decreased, and more-mature collagen arrangement was noted. In the early period of scar remodeling, the expression of transforming growth factor beta (TGF-β)3 and matrix metalloproteinase 1 (MMP1) was greater in the experimental group than in control group. In the late period, the level of alpha smooth muscle actin and tissue inhibitor of metalloproteinase 1 were dramatically less, although the level of MMP1 was lower in the experimental group than in control group. Local injection of ASCs decreases scar size and provides better color quality and scar pliability. It decreases the activity of mast cells and inhibits the action of TGF-β against fibroblasts and positively stimulates scar remodeling through greater expression of MMP molecules. © 2012 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

  2. Human corneal epithelial subpopulations

    DEFF Research Database (Denmark)

    Søndergaard, Chris Bath

    2013-01-01

    subpopulations in human corneal epithelium using a combination of laser capture microdissection and RNA sequencing for global transcriptomic profiling. We compared dissociation cultures, using either expansion on γ-irradiated NIH/3T3 feeder cells in serum-rich medium or expansion directly on plastic in serum......-free EpiLife medium, using a range of physiologically relevant oxygen concentrations (2%, 5%, 10%, 15% and 20%). Using immunocytochemistry and advanced fluorescence microscopy, cells were characterized regarding growth, cell cycle distribution, colony-forming efficiency (CFE), phenotypes...... was not dependent on the system used for propagation (Bath et al. 2013a). Laser capture microdissection was used to isolate cellular subpopulations in situ from the spatially defined differentiation pathway in human corneal epithelium according to an optimized protocol for maintenance of expression profiles...

  3. Biomechanics of Corneal Ring Implants

    OpenAIRE

    Daxer, Albert

    2015-01-01

    Purpose: To evaluate the biomechanics of corneal ring implants by providing a related mathematical theory and biomechanical model for the treatment of myopia and keratoconus. Methods: The spherical dome model considers the inhomogeneity of the tunica of the eye, dimensions of the cornea, lamellar structure of the corneal stroma, and asphericity of the cornea. It is used in this study for calculating a strengthening factor sf for the characterization of different ring-shaped corneal implant de...

  4. Corneal biomechanics: a review

    OpenAIRE

    Piñero Llorens, David Pablo; Alcón, Natividad

    2014-01-01

    Biomechanics is often defined as ‘mechanics applied to biology’. Due to the variety and complexity of the behaviour of biological structures and materials, biomechanics is better defined as the development, extension and application of mechanics for a better understanding of physiology and physiopathology and consequently for a better diagnosis and treatment of disease and injury. Different methods for the characterisation of corneal biomechanics are reviewed in detail, including those that a...

  5. Airbag-induced corneal flap.

    Science.gov (United States)

    Liyanage, Sidath E; Mearza, Ali A

    2009-02-01

    To describe a case of airbag-induced corneal flap in a previously normal cornea. Case report. A 27-year-old woman presented with complete loss of vision in her left eye following a road traffic accident which involved airbag deployment. There was no previous ocular history. Examination revealed a large corneal flap of 6mm in diameter, extending to the depth of anterior stroma. This was accompanied by a traumatic optic neuropathy. One month follow-up revealed complete reattachment of the corneal flap. This is the first reported case of a corneal flap induced by airbag deployment in a cornea with previously normal architecture.

  6. Stem cells and corneal epithelial maintenance: insights from the mouse and other animal models.

    Science.gov (United States)

    Mort, Richard L; Douvaras, Panagiotis; Morley, Steven D; Dorà, Natalie; Hill, Robert E; Collinson, J Martin; West, John D

    2012-01-01

    Maintenance of the corneal epithelium is essential for vision and is a dynamic process incorporating constant cell production, movement and loss. Although cell-based therapies involving the transplantation of putative stem cells are well advanced for the treatment of human corneal defects, the scientific understanding of these interventions is poor. No definitive marker that discriminates stem cells that maintain the corneal epithelium from the surrounding tissue has been discovered and the identity of these elusive cells is, therefore, hotly debated. The key elements of corneal epithelial maintenance have long been recognised but it is still not known how this dynamic balance is co-ordinated during normal homeostasis to ensure the corneal epithelium is maintained at a uniform thickness. Most indirect experimental evidence supports the limbal epithelial stem cell (LESC) hypothesis, which proposes that the adult corneal epithelium is maintained by stem cells located in the limbus at the corneal periphery. However, this has been challenged recently by the corneal epithelial stem cell (CESC) hypothesis, which proposes that during normal homeostasis the mouse corneal epithelium is maintained by stem cells located throughout the basal corneal epithelium with LESCs only contributing during wound healing. In this chapter we review experimental studies, mostly based on animal work, that provide insights into how stem cells maintain the normal corneal epithelium and consider the merits of the alternative LESC and CESC hypotheses. Finally, we highlight some recent research on other stem cell systems and consider how this could influence future research directions for identifying the stem cells that maintain the corneal epithelium.

  7. Desiccating stress stimulates expression of matrix metalloproteinases by the corneal epithelium.

    Science.gov (United States)

    Corrales, Rosa M; Stern, Michael E; De Paiva, Cintia S; Welch, Jonathan; Li, De-Quan; Pflugfelder, Stephen C

    2006-08-01

    To determine the effects of experimental dryness on production of matrix metalloproteinases (MMPs) and their physiological inhibitors (TIMPs) by the corneal epithelium. Experimental dry eye (EDE) was created in two strains of mice: BALB/c and C57BL/6. Real-time PCR was performed with MMP and TIMP probes, and the results were analyzed by the comparative C(T) method, selecting the relative mRNA levels in untreated control samples as calibrator. Immunofluorescent staining with specific antibodies immunolocalized MMP proteins in situ. MMP enzymatic activity was evaluated in tears and corneal lysates. Corneal permeability to Oregon green dextran (OGD) and sodium fluorescein was measured. Corneal smoothness was evaluated by graded regularity of a ring reflected off the corneal surface. Desiccating stress significantly increased levels of MMP-1, -3, -9, and -10 transcripts in the corneal epithelium in C57BL/6 mice, but had no effect on levels of MMP transcripts in the corneal epithelium of BALB/c mice. There was no change in levels of TIMP transcripts except for TIMP-4 which significantly increased on day 10 in C57BL/6 mice. The MMP-1, -3, and -9 concentration in tears significantly increased compared with control levels after EDE for 4 and 6 days, respectively, in C57BL/6 and BALB/c. Changes in MMP protein expression detected by immunofluorescent staining were similar to changes in gene transcripts for most MMPs. EDE increased corneal permeability to OGD and fluorescein and corneal surface irregularity. Corneal dryness stimulates production of certain MMPs in a strain-dependent fashion and causes the disruption of the corneal barrier, thus increasing permeability and corneal irregularity.

  8. Correlations between corneal hysteresis, intraocular pressure, and corneal central pachymetry.

    Science.gov (United States)

    Touboul, David; Roberts, Cynthia; Kérautret, Julien; Garra, Caroline; Maurice-Tison, Sylvie; Saubusse, Elodie; Colin, Joseph

    2008-04-01

    To analyze the correlation between corneal hysteresis (CH) measured with the Ocular Response Analyzer (ORA, Reichert) and ultrasonic corneal central thickness (CCT US) and intraocular pressure measured with Goldmann applanation tonometry (IOP GA). Bordeaux 2 University, Ophthalmology Department, Bordeaux, France. This study comprised 498 eyes of 258 patients. Corneal hysteresis, corneal resistance factor (CRF), and IOP corneal-compensated (IOPcc) were provided by the ORA device; CCT US and IOP GA were also measured in each eye. The study population was divided into 5 groups: normal (n = 122), glaucoma (n = 159), keratoconus (n = 88), laser in situ keratomileusis (LASIK) (n = 78), and photorefractive keratectomy (n = 39). The Pearson correlation was used for statistical analysis. Corneal hysteresis was not strongly correlated with IOP or CCT US. The mean CH in the LASIK (8.87 mm Hg) and keratoconus (8.34 mm Hg) groups was lower than in the glaucoma (9.48 mm Hg) and normal (10.26 mm Hg) groups. The lower the CH, the lower its correlation with IOPcc and IOP GA. A CH higher than the CRF was significantly associated with the keratoconus and post-LASIK groups. Corneal hysteresis, a new corneal parameter, had a moderate dependence on IOP and CCT US. Weaker corneas could be screened with ORA parameters, and low CH could be considered a risk factor for underestimation of IOP. The CCT US should continue to be considered a useful parameter.

  9. Changes in corneal hysteresis after clear corneal cataract surgery.

    Science.gov (United States)

    Hager, Annette; Loge, Kristina; Füllhas, Marc-Oliver; Schroeder, Bernd; Grossherr, Martin; Wiegand, Wolfgang

    2007-09-01

    To assess the changes in corneal hysteresis (CH) as measured by the Ocular Response Analyzer (ORA; Reichert Ophthalmic Instruments, Buffalo, New York, USA) to describe the influence of clear corneal cataract surgery on corneal viscoelastic properties and intraocular pressure (IOP) measured by noncontact tonometry (NCT) and Goldmann applanation tonometry (GAT). Retrospective, interventional, comparative study. One hundred and one eyes of 101 consecutive patients who underwent routine clear corneal cataract surgery were evaluated. CH, NCT, and central corneal thickness (CCT) were measured by ORA before surgery and at postoperative day 1. A control group of 48 pseudophakic eyes (surgery >3 months previously) was included. CCT increased from 556.82 +/- 32.5 microm before surgery to 580.26 +/- 45.5 microm after surgery (P corneal cataract surgery, CH is diminished, whereas CCT is increased significantly. Postoperative corneal edema leads to a change of corneal viscoelastic properties, resulting in a lower damping capacity of the cornea. It is supposed that GAT and NCT measurements are significantly different because of postoperative changes in viscoelastic properties of the cornea.

  10. Biomechanical relationships between the corneal endothelium and Descemet's membrane.

    Science.gov (United States)

    Ali, Maryam; Raghunathan, VijayKrishna; Li, Jennifer Y; Murphy, Christopher J; Thomasy, Sara M

    2016-11-01

    The posterior face of the cornea consists of the corneal endothelium, a monolayer of cuboidal cells that secrete and attach to Descemet's membrane, an exaggerated basement membrane. Dysfunction of the endothelium compromises the barrier and pump functions of this layer that maintain corneal deturgesence. A large number of corneal endothelial dystrophies feature irregularities in Descemet's membrane, suggesting that cells create and respond to the biophysical signals offered by their underlying matrix. This review provides an overview of the bidirectional relationship between Descemet's membrane and the corneal endothelium. Several experimental methods have characterized a richly topographic and compliant biophysical microenvironment presented by the posterior surface of Descemet's membrane, as well as the ultrastructure and composition of the membrane as it builds during a lifetime. We highlight the signaling pathways involved in the mechanotransduction of biophysical cues that influence cell behavior. We present the specific example of Fuchs' corneal endothelial dystrophy as a condition in which a dysregulated Descemet's membrane may influence the progression of disease. Finally, we discuss some disease models and regenerative strategies that may facilitate improved treatments for corneal dystrophies. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Intrastromal application of riboflavin for corneal crosslinking.

    Science.gov (United States)

    Seiler, Theo G; Fischinger, Isaak; Senfft, Tim; Schmidinger, Gerald; Seiler, Theo

    2014-06-10

    To experimentally evaluate the efficacy of corneal crosslinking (CXL) by injecting the photomediator riboflavin into the corneal stroma via intrastromal channels. Five groups of pig corneas, nine each, were compared regarding stress-strain relationship and UV-absorption. Group 1 had intrastromal channels floated with riboflavin 0.5%-solution followed by UVA-irradiation (3 mW/cm(2) for 30 minutes); group 2 was handled like group 1, but were irradiated with 9 mW/cm(2) for 10 minutes; group 3 was treated according to the Dresden protocol (epi-off, 9 mW/cm(2) for 10 minutes); group 4 had the identical channel system, no riboflavin but identical irradiation; group 5 with native corneas served as a control group. The intrastromal channels were created with a femtosecond laser. The stress-strain relations were measured in corneal strips using a uniaxial material tester at strains up to 12%. The UV-transmission of the corneas was measured in groups 1, 3, and 5. The stress needed for a 10% strain was significantly increased by 82% in the corneas treated with the Dresden protocol compared with native cornea (P = 0.0005). With intrastromal application of riboflavin the significant increase was 87% (P = 0.0005) in group 1 and 64% (P = 0.007) in group 2. The channel formation alone did not alter biomechanics (P = 0.923). The corneal UVA-transmission was 2.4% after intrastromal riboflavin application, 8.9% after the treatment according to the Dresden protocol, and 57.9% in native corneas. The experiments demonstrate the intrastromal application of riboflavin by means of intrastromal channels a feasible "epi-on" approach for CXL. More experimental data are needed before clinical testing. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

  12. Corneal ectasia after excimer laser keratorefractive surgery: histopathology, ultrastructure, and pathophysiology.

    Science.gov (United States)

    Dawson, Daniel G; Randleman, J Bradley; Grossniklaus, Hans E; O'Brien, Terrence P; Dubovy, Sander R; Schmack, Ingo; Stulting, R Doyle; Edelhauser, Henry F

    2008-12-01

    To evaluate the histopathology and ultrastructure of corneas developing ectasia after LASIK or photorefractive keratectomy (PRK). Retrospective case series. Thirteen specimens from 12 patients undergoing corneal transplantation for progressive ectasia after LASIK (12 specimens) or PRK (1 specimen) were obtained for histopathologic and ultrastructural evaluation. All 13 ectatic corneas were submitted in formalin for light microscopy. Nine specimens were bisected, and the second half was placed in 2.5% glutaraldehyde for transmission electron microscopy (TEM). Corneal histopathology, ultrastructure, and pathophysiology. Light microscopy of the post-LASIK specimens showed corneal epithelial hypoplasia and occasional foci of epithelial hyperplasia, Bowman's layer breaks, a normal stromal thickness of the LASIK flap, a normal thickness of the hypocellular primitive stromal scar, a thinned residual stromal bed (RSB), and larger than normal artifacteous interlamellar clefts in the RSB of the ectatic region. The post-PRK specimen showed similar findings with the addition of a thinned hypercellular fibrotic stromal scar. TEM showed thinning of the collagen lamellae and loss of lamellar number in the RSB of post-LASIK ectasia corneas or throughout the entire corneal stromal bed in the post-PRK ectasia cornea, with the posterior aspect of the corneal stroma being most affected. Histopathologic and ultrastructural studies suggest that interlamellar and interfibrillar biomechanical slippage occurs when the cornea becomes ectatic after LASIK or PRK in the postoperative stress-bearing regions of the corneal stroma. This 2-phase chronic biomechanical failure process is similar to that seen in keratoconus. Composite sciences classify this chronic biomechanical failure process as interfiber fracture. The authors have no proprietary or commercial interest in any materials discussed in this article.

  13. Acne Scars: Pathogenesis, Classification and Treatment

    Directory of Open Access Journals (Sweden)

    Gabriella Fabbrocini

    2010-01-01

    Full Text Available Acne has a prevalence of over 90% among adolescents and persists into adulthood in approximately 12%–14% of cases with psychological and social implications. Possible outcomes of the inflammatory acne lesions are acne scars which, although they can be treated in a number of ways, may have a negative psychological impact on social life and relationships. The main types of acne scars are atrophic and hypertrophic scars. The pathogenesis of acne scarring is still not fully understood, but several hypotheses have been proposed. There are numerous treatments: chemical peels, dermabrasion/microdermabrasion, laser treatment, punch techniques, dermal grafting, needling and combined therapies for atrophic scars: silicone gels, intralesional steroid therapy, cryotherapy, and surgery for hypertrophic and keloidal lesions. This paper summarizes acne scar pathogenesis, classification and treatment options.

  14. A Case of Multiple Spontaneous Keloid Scars

    Directory of Open Access Journals (Sweden)

    Abdulhadi Jfri

    2015-07-01

    Full Text Available Keloid scars result from an abnormal healing response to cutaneous injury or inflammation that extends beyond the borders of the original wound. Spontaneous keloid scars forming in the absence of any previous trauma or surgical procedure are rare. Certain syndromes have been associated with this phenomenon, and few reports have discussed the evidence of single spontaneous keloid scar, which raises the question whether they are really spontaneous. Here, we present a 27-year-old mentally retarded single female with orbital hypertelorism, broad nasal bridge, repaired cleft lip and high-arched palate who presented with progressive multiple spontaneous keloid scars in different parts of her body which were confirmed histologically by the presence of typical keloidal collagen. This report supports the fact that keloid scars can appear spontaneously and are possibly linked to a genetic factor. Furthermore, it describes a new presentation of spontaneous keloid scars in the form of multiple large lesions in different sites of the body.

  15. Retrospective evaluation of corneal reconstruction using ACell Vet(™) alone in dogs and cats: 82 cases.

    Science.gov (United States)

    Chow, Derek W Y; Westermeyer, Hans D

    2016-09-01

    To retrospectively evaluate the complications, graft clarity, and outcomes associated with the use of commercially available porcine urinary bladder submucosa (ACell Vet(™) ) alone for corneal reconstruction in dogs and cats. Dogs or cats receiving an ACell Vet(™) graft for corneal reconstruction due to severe ulcerative keratitis or after a keratectomy to remove a corneal sequestrum were included. All received a single layer of ACell Vet(™) , bandage contact lens, and temporary tarsorrhaphy. Bandage contact lens and temporary tarsorrhaphy were removed after graft vascularization or epithelialization. Topical steroids, cyclosporine, tacrolimus were started after epithelialization. Based on their last examination, outcomes were categorized into five groups based on the presence of corneal vessels, appearance of the scar, and the ability to visualize the posterior and/or the anterior segment through the grafted area. There were 82 eyes included in the study, with 68 eyes with sufficient follow-up time for final assessment. Scarring was minimal in 47 eyes, moderate but not enough to obscure visualization of the posterior segment in 12, and severe in nine. There were five eyes that developed phthisis bulbi, glaucoma or were enucleated and nine that were lost to follow up. Graft dehiscence occurred in 19 eyes. Twelve healed without additional surgical intervention while three required a second graft, two became phthisical, and two were enucleated. Corneal reconstruction with ACell Vet(™) alone is a viable alternative and results in minimal scarring and complications in cats. In dogs, scarring is more pronounced than in cats and graft dehiscence rate is higher compared to conventional techniques. © 2015 American College of Veterinary Ophthalmologists.

  16. Metallic corneal foreign bodies: an occupational health hazard

    Directory of Open Access Journals (Sweden)

    Zeynep Gursel Ozkurt

    2014-04-01

    Full Text Available Purpose: To analyze the risk factors, outcomes, demographic characteristics, and attitudes of workers with metallic corneal foreign body (FB injury. Methods: One hundred consecutive patients who presented with a metallic corneal FB to the eye clinic at Diyarbakir Training and Research Hospital were evaluated. The patients completed a questionnaire and were examined to determine features of the injury. Results: All patients were male. The mean age was 32.46 ± 1.03 years. Fiftyfive percent of the patients were unregistered workers, 59% were working in the metal industry sector, and 65% injuries resulted from metal cutting. Protective goggles were available in the workplace of 64% patients. However, 57% patients were not wearing goggles when the accident occurred, and 43% were injured despite goggle use. Most patients (52% attempted to remove FBs by themselves. FBs were located in the central zone of the cornea in 16% patients. Rust marks remained after FB removal in 26% patients. Corneal scars from previous FB injuries were present in 58% patients. Only 8% workplaces provided compensation for physician visits for occupation related illnesses. Conclusions: Workplaces with a high risk for eye injuries should increase their protective measures, and educational programs should be implemented for both workers and occupational physicians. The government should enforce laws regarding unregistered workers in a better manner.

  17. Scar Revision Surgery: The Patient's Perspective

    Directory of Open Access Journals (Sweden)

    Benjamin H Miranda

    2015-11-01

    Full Text Available BackgroundInsufficient satisfaction outcome literature exists to assist consultations for scar revision surgery; such outcomes should reflect the patient's perspective. The aim of this study was to prospectively investigate scar revision patient satisfaction outcomes, according to specified patient-selection criteria.MethodsPatients (250 were randomly selected for telephone contacting regarding scar revisions undertaken between 2007-2011. Visual analogue scores were obtained for scars pre- and post-revision surgery. Surgery selection criteria were; 'presence' of sufficient time for scar maturation prior to revision, technical issues during or wound complications from the initial procedure that contributed to poor scarring, and 'absence' of site-specific or patient factors that negatively influence outcomes. Patient demographics, scar pathogenesis (elective vs. trauma, underlying issue (functional/symptomatic vs. cosmetic and revision surgery details were also collected with the added use of a real-time, hospital database.ResultsTelephone contacting was achieved for 211 patients (214 scar revisions. Satisfaction outcomes were '2% worse, 16% no change, and 82% better'; a distribution maintained between body sites and despite whether surgery was functional/symptomatic vs. cosmetic. Better outcomes were reported by patients who sustained traumatic scars vs. those who sustained scars by elective procedures (91.80% vs. 77.78%, P=0.016 and by females vs. males (85.52% vs. 75.36%, P<0.05, particularly in the elective group where males (36.17% were more likely to report no change or worse outcomes versus females (16.04% (P<0.01.ConclusionsSuccessful scar revision outcomes may be achieved using careful patient selection. This study provides useful information for referring general practitioners, and patient-surgeon consultations, when planning scar revision.

  18. Differential precision of corneal Pentacam HR measurements in early and advanced keratoconus.

    Science.gov (United States)

    Flynn, Tom H; Sharma, Daya P; Bunce, Catey; Wilkins, Mark R

    2016-09-01

    Serial Scheimpflug corneal tomography to monitor the progression of keratoconus has become standard practice in most countries where corneal cross-linking is available. The tomographic definitions of progression are, however, poorly defined. The aims of this study were: (a) to estimate the 95% limits of intraobserver and interobserver agreement of corneal shape parameters on Pentacam in patients with keratoconus and (b) to investigate whether these limits of agreement varied according to disease severity. 96 adult patients with keratoconus and no corneal scarring or history of previous surgery were recruited from a corneal clinic in a tertiary ophthalmology hospital. One eye of each subject was scanned twice by each of the two observers with the Pentacam HR. 95% limits of intraobserver and interobserver agreement for K1, K2, Kmax and corneal thickness at the thinnest corneal location (TCT) were calculated. Reproducibility of keratometry measures was better for early keratoconus than advanced keratoconus. In patients of Pentacam-derived Krumeich stage 1 or 2, the 95% limits of interobserver agreement for Kmax were from -0.90 to 1.01. In patients of Pentacam-derived Krumeich stage >2, the 95% limits of interobserver agreement for Kmax were from -3.71 to 3.86. Keratometric measurements on Pentacam HR are less reproducible in advanced keratoconus than in early keratoconus. In patients of Pentacam-derived Krumeich stage 1 or 2, an increase in K1, K2 or Kmax of more than 1 dioptre is likely to represent the real change in the corneal shape. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  19. Prevalence of scars and "mini-scars", and their impact on quality of life in Japanese patients with acne.

    Science.gov (United States)

    Hayashi, Nobukazu; Miyachi, Yoshiki; Kawashima, Makoto

    2015-07-01

    There have been very few studies on the prevalence and severity of acne scars in Japanese patients. The aim of the present study was to investigate the prevalence of acne scars and their impact on the quality of life (QOL) in Japanese acne patients. Acne scars were classified as mini-scars (atrophic scars of ≥0.5 and scars (≥2 mm in diameter), and hypertrophic scars. The severity of acne and acne scars were evaluated. The background of patients and their QOL in relation to acne were assessed. Of 240 subjects, 218 (90.8%) had scars. All patients with scars had mini-scars; 61.2% and 14.2% of 240 had atrophic scars and hypertrophic scars, respectively. Severe scarring was found in patients who had experienced severe acne symptoms, although 15.0% of patients with scars had experienced only mild acne symptoms. The total Dermatology Life Quality Index score was significantly higher in patients with scars than in patients without scars (5.9 ± 4.4 vs 4.2 ± 4.1). Almost all the patients had small atrophic scars with a diameter of 0.5 or more and less than 2 mm, which we have termed "mini-scars". Acne scars had a negative impact on patient QOL. Early initiation of treatment is recommended to avoid acne scars. © 2015 Japanese Dermatological Association.

  20. Cutaneous osteosarcoma arising from a burn scar

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Min A.; Yi, Jaehyuck [Kyungpook National University, Department of Radiology, College of Medicine, Daegu (Korea, Republic of); Kyungpook National University Hospital, Department of Radiology, Daegu (Korea, Republic of); Chae, Jong Min [Kyungpook National University, Department of Pathology, College of Medicine, Daegu (Korea, Republic of)

    2017-04-15

    Tumors that develop in old burn scars are usually squamous cell carcinomas. Sarcomas have also been reported, albeit rarely. To our knowledge, there has been only one case report of an extraskeletal osteosarcoma arising in a prior burn scar reported in the English-language literature, mainly discussing the clinicopathological features. Herein, we present a case of cutaneous osteosarcoma visualized as a mineralized soft-tissue mass arising from the scar associated with a previous skin burn over the back. This seems to be the first report describing the imaging features of a cutaneous osteosarcoma from an old burn scar. (orig.)

  1. Ruptured Cesarean Scar Ectopic Pregnancy

    OpenAIRE

    Sujatha BS; Sunanda Bharatnur; Samarth Virmani; Shripad Hebbar; Arijit Bishnu

    2017-01-01

    A pregnancy with implantation on the scar of a past cesarean section is uncommon. However such pregnancies are on the rise due to the increasing number of lower segment cesarean section. One of the complications of such a pregnancy is uterine rupture in early pregnancy which can be life threatening to the patient. The following is a report of a patient who presented at 10 weeks of gestational age with features of hypovolemic shock and lower position of the gestational sac in relation to the u...

  2. A Dual Role for Corneal Dendritic Cells in Herpes Simplex Keratitis: Local Suppression of Corneal Damage and Promotion of Systemic Viral Dissemination.

    Directory of Open Access Journals (Sweden)

    Kai Hu

    Full Text Available The cornea is the shield to the foreign world and thus, a primary site for peripheral infections. However, transparency and vision are incompatible with inflammation and scarring that may result from infections. Thus, the cornea is required to perform a delicate balance between fighting infections and preserving vision. To date, little is known about the specific role of antigen-presenting cells in viral keratitis. In this study, utilizing an established murine model of primary acute herpes simplex virus (HSV-1 keratitis, we demonstrate that primary HSV keratitis results in increased conventional dendritic cells (cDCs and macrophages within 24 hours after infection. Local depletion of cDCs in CD11c-DTR mice by subconjuntival diphtheria toxin injections, led to increased viral proliferation, and influx of inflammatory cells, resulting in increased scarring and clinical keratitis. In addition, while HSV infection resulted in significant corneal nerve destruction, local depletion of cDCs resulted in a much more severe loss of corneal nerves. Further, local cDC depletion resulted in decreased corneal nerve infection, and subsequently decreased and delayed systemic viral transmission in the trigeminal ganglion and draining lymph node, resulting in decreased mortality of mice. In contrast, sham depletion or depletion of macrophages through local injection of clodronate liposomes had neither a significant impact on the cornea, nor an effect on systemic viral transmission. In conclusion, we demonstrate that corneal cDCs may play a primary role in local corneal defense during viral keratitis and preserve vision, at the cost of inducing systemic viral dissemination, leading to increased mortality.

  3. A Dual Role for Corneal Dendritic Cells in Herpes Simplex Keratitis: Local Suppression of Corneal Damage and Promotion of Systemic Viral Dissemination

    Science.gov (United States)

    Hu, Kai; Harris, Deshea L.; Yamaguchi, Takefumi; von Andrian, Ulrich H.; Hamrah, Pedram

    2015-01-01

    The cornea is the shield to the foreign world and thus, a primary site for peripheral infections. However, transparency and vision are incompatible with inflammation and scarring that may result from infections. Thus, the cornea is required to perform a delicate balance between fighting infections and preserving vision. To date, little is known about the specific role of antigen-presenting cells in viral keratitis. In this study, utilizing an established murine model of primary acute herpes simplex virus (HSV)-1 keratitis, we demonstrate that primary HSV keratitis results in increased conventional dendritic cells (cDCs) and macrophages within 24 hours after infection. Local depletion of cDCs in CD11c-DTR mice by subconjuntival diphtheria toxin injections, led to increased viral proliferation, and influx of inflammatory cells, resulting in increased scarring and clinical keratitis. In addition, while HSV infection resulted in significant corneal nerve destruction, local depletion of cDCs resulted in a much more severe loss of corneal nerves. Further, local cDC depletion resulted in decreased corneal nerve infection, and subsequently decreased and delayed systemic viral transmission in the trigeminal ganglion and draining lymph node, resulting in decreased mortality of mice. In contrast, sham depletion or depletion of macrophages through local injection of clodronate liposomes had neither a significant impact on the cornea, nor an effect on systemic viral transmission. In conclusion, we demonstrate that corneal cDCs may play a primary role in local corneal defense during viral keratitis and preserve vision, at the cost of inducing systemic viral dissemination, leading to increased mortality. PMID:26332302

  4. Papular Acne Scars of the Nose and Chin: An Under-recognised Variant of Acne Scarring

    OpenAIRE

    Ali, Faisal R; Michael Kirk; Vishal Madan

    2016-01-01

    Background: Scarring following acne vulgaris is common and can be of profound psychosocial consequence. Aims and Objectives: We have clinically noted a variant of acne scarring, overlooked by previous categorisation schemes, which we have denominated as papular acne scars of the nose and chin. We sought to characterise these novel entities further. Materials and Methods: Initially, we identified 14 patients with papular acne scars of the nose and chin in a cosmetic dermatology clinic, of whom...

  5. Clinical observation of corneal lamellar debridement combined with sutureless amniotic membrane transplantation for the treatment of superficial fungal keratitis

    Directory of Open Access Journals (Sweden)

    Huang Zhang

    2014-09-01

    Full Text Available AIM:To evaluate the clinical efficacy of corneal lamellar debridement combined with sutureless amniotic membrane transplantation for the treatment of superficial fungal keratitis.METHODS:Totally 22 cases(22 eyeswith superficial fungal keratitis were referred to our hospital from April 2012 to October 2013. The patients with persistent cornea ulcer after treatment of local and systemic antifungal drugs underwent corneal lamellar debridement combined with sutureless amniotic membrane transplantation, and the recipient bed was covered with an amniotic membrane using fibrin sealant during the operation. All patients were still given topical antifungal therapy for 1-2mo after operation. The followed-up time was 3mo or above. We observed the corneal healing and amniotic membrane adhesion by split lamp microscope, and investigated the transformation of amniotic membrane and fungal infection recurrence with confocal microscope. RESULTS: Corneal edema and anterior chamber reaction of 21 patients disappeared gradually, and no amniotic membrane graft dissolved and shed off within 1-2wk postoperatively. Two weeks after operation, the graft integrated into the corneal and the corneal wounds' thickness increased gradually, the corneal epithelium reconstructed and corneas became clear. Four weeks after operation, the corneal scarring developed gradually and fluorescence staining was negative. Nineteen cases' amniotic membranes that adhered with the cornea dissolved 4wk after operation. There were different degrees of corneal nebula or macula remained 3mo postoperatively. All patients' vision improved in varying degrees, except in 1 case with fungal keratitis who had been cured by lamellar keratoplasty.CONCLUSION:Corneal lamellar debridement combined with sutureless amniotic membrane transplantation can effectively remove the foci of inflammation, improve the local efficacy, shorten the operation time, relieve the postoperative reaction, and promote cornea

  6. Suppressed inflammatory gene expression during human hypertrophic scar compared to normotrophic scar formation

    NARCIS (Netherlands)

    van den Broek, L.J.; van der Veer, W.M.; de Jong, E.H.; Gibbs, S.; Niessen, F.B.

    2015-01-01

    Hypertrophic scar formation is a result of adverse cutaneous wound healing. The pathogenesis of hypertrophic scar formation is still poorly understood. A problem next to the lack of suitable animal models is that often normal skin is compared to hypertrophic scar (HTscar) and not to normotrophic

  7. Physiological Implications of Myocardial Scar Structure.

    Science.gov (United States)

    Richardson, William J; Clarke, Samantha A; Quinn, T Alexander; Holmes, Jeffrey W

    2015-09-20

    Once myocardium dies during a heart attack, it is replaced by scar tissue over the course of several weeks. The size, location, composition, structure, and mechanical properties of the healing scar are all critical determinants of the fate of patients who survive the initial infarction. While the central importance of scar structure in determining pump function and remodeling has long been recognized, it has proven remarkably difficult to design therapies that improve heart function or limit remodeling by modifying scar structure. Many exciting new therapies are under development, but predicting their long-term effects requires a detailed understanding of how infarct scar forms, how its properties impact left ventricular function and remodeling, and how changes in scar structure and properties feed back to affect not only heart mechanics but also electrical conduction, reflex hemodynamic compensations, and the ongoing process of scar formation itself. In this article, we outline the scar formation process following a myocardial infarction, discuss interpretation of standard measures of heart function in the setting of a healing infarct, then present implications of infarct scar geometry and structure for both mechanical and electrical function of the heart and summarize experiences to date with therapeutic interventions that aim to modify scar geometry and structure. One important conclusion that emerges from the studies reviewed here is that computational modeling is an essential tool for integrating the wealth of information required to understand this complex system and predict the impact of novel therapies on scar healing, heart function, and remodeling following myocardial infarction. Copyright © 2015 John Wiley & Sons, Inc.

  8. Bilateral Alterations in Corneal Nerves, Dendritic Cells and Tear Cytokine Levels in Ocular Surface Disease

    Science.gov (United States)

    Yamaguchi, Takefumi; Hamrah, Pedram; Shimazaki, Jun

    2017-01-01

    This review summarizes recent literature regarding corneal imaging in human subjects using in vivo confocal microscopy and corneal immune cells, nerves, and tear cytokine levels in ocular surface diseases as well as corneal immune privilege. The significance of interactions between corneal immune cells and nerves in health, neurotrophic keratopathy, and infectious keratitis are discussed. Furthermore, bilateral alterations of immune cells and nerves in clinically unilateral corneal diseases and the link to changes of tear cytokines or neuropeptide levels in contralateral eyes are described. Recent studies reported increased density and morphologic changes of corneal dendritic cells in ocular surface disease that correlated with a decrease in sub-basal nerve corneal nerves, suggesting potential interactions between the immune and nervous systems in the cornea. Although the relevance of tear cytokines is poorly understood, tear cytokines might have an important role in the pathogenesis of ocular surface diseases. In humans and experimental animal models, alterations in immune cells, cytokines and immunomodulatory neuropeptide levels in contralateral eyes might mediate the incidence of bilateral infectious keratitis and loss of immune privilege of the cornea in bilateral corneal transplantation or neurotrophic keratopathy cases. The discovery of bilateral alterations of immune cells and nerves in ocular surface diseases is considered the missing link between the immune and nervous systems in the cornea, and demonstrates how studies of animal models and human patients aid our understanding of human corneal disease phenomena. PMID:27617877

  9. Numerical model of optical coherence tomographic vibrography imaging to estimate corneal biomechanical properties.

    Science.gov (United States)

    Kling, Sabine; Akca, Imran B; Chang, Ernest W; Scarcelli, Giuliano; Bekesi, Nandor; Yun, Seok-Hyun; Marcos, Susana

    2014-12-06

    Most techniques measuring corneal biomechanics in vivo are biased by side factors. We demonstrate the ability of optical coherence tomographic (OCT) vibrography to determine corneal material parameters, while reducing current prevalent restrictions of other techniques (such as intraocular pressure (IOP) and thickness dependency). Modal analysis was performed in a finite-element (FE) model to study the oscillation response in isolated thin corneal flaps/eye globes and to analyse the dependency of the frequency response function on: corneal elasticity, viscoelasticity, geometry (thickness and curvature), IOP and density. The model was verified experimentally in flaps from three bovine corneas and in two enucleated porcine eyes using sound excitation (100-110 dB) together with a phase-sensitive OCT to measure the frequency response function (range 50-510 Hz). Simulations showed that corneal vibration in flaps is sensitive to both, geometrical and biomechanical parameters, whereas in whole globes it is primarily sensitive to corneal biomechanical parameters only. Calculations based on the natural frequency shift revealed that flaps of the posterior cornea were 0.8 times less stiff than flaps from the anterior cornea and cross-linked corneas were 1.6 times stiffer than virgin corneas. Sensitivity analysis showed that natural vibration frequencies of whole globes were nearly independent from corneal thickness and IOP within the physiological range. OCT vibrography is a promising non-invasive technique to measure corneal elasticity without biases from corneal thickness and IOP.

  10. Numerical model of optical coherence tomographic vibrography imaging to estimate corneal biomechanical properties

    Science.gov (United States)

    Kling, Sabine; Akca, Imran B.; Chang, Ernest W.; Scarcelli, Giuliano; Bekesi, Nandor; Yun, Seok-Hyun; Marcos, Susana

    2014-01-01

    Most techniques measuring corneal biomechanics in vivo are biased by side factors. We demonstrate the ability of optical coherence tomographic (OCT) vibrography to determine corneal material parameters, while reducing current prevalent restrictions of other techniques (such as intraocular pressure (IOP) and thickness dependency). Modal analysis was performed in a finite-element (FE) model to study the oscillation response in isolated thin corneal flaps/eye globes and to analyse the dependency of the frequency response function on: corneal elasticity, viscoelasticity, geometry (thickness and curvature), IOP and density. The model was verified experimentally in flaps from three bovine corneas and in two enucleated porcine eyes using sound excitation (100–110 dB) together with a phase-sensitive OCT to measure the frequency response function (range 50–510 Hz). Simulations showed that corneal vibration in flaps is sensitive to both, geometrical and biomechanical parameters, whereas in whole globes it is primarily sensitive to corneal biomechanical parameters only. Calculations based on the natural frequency shift revealed that flaps of the posterior cornea were 0.8 times less stiff than flaps from the anterior cornea and cross-linked corneas were 1.6 times stiffer than virgin corneas. Sensitivity analysis showed that natural vibration frequencies of whole globes were nearly independent from corneal thickness and IOP within the physiological range. OCT vibrography is a promising non-invasive technique to measure corneal elasticity without biases from corneal thickness and IOP. PMID:25320067

  11. Effectiveness of Autologous Fat Grafting in Adherent Scars: Results Obtained by a Comprehensive Scar Evaluation Protocol.

    Science.gov (United States)

    Jaspers, Mariëlle E H; Brouwer, Katrien M; van Trier, Antoine J M; Groot, Marloes L; Middelkoop, Esther; van Zuijlen, Paul P M

    2017-01-01

    Nowadays, patients normally survive severe traumas such as burn injuries and necrotizing fasciitis. Large skin defects can be closed but the scars remain. Scars may become adherent to underlying structures when the subcutical fat layer is damaged. Autologous fat grafting provides the possibility of reconstructing a functional sliding layer underneath the scar. Autologous fat grafting is becoming increasingly popular for scar treatment, although large studies using validated evaluation tools are lacking. The authors therefore objectified the effectiveness of single-treatment autologous fat grafting on scar pliability using validated scar measurement tools. Forty patients with adherent scars receiving single-treatment autologous fat grafting were measured preoperatively and at 3-month follow-up. The primary outcome parameter was scar pliability, measured using the Cutometer. Scar quality was also evaluated by the Patient and Observer Scar Assessment Scale and the DSM II ColorMeter. To prevent selection bias, measurements were performed following a standardized algorithm. The Cutometer parameters elasticity and maximal extension improved 22.5 percent (p Scar Assessment Scale scores improved from 3.6 to 2.9 on the observer scale, and from 5.1 to 3.8 on the patient scale (both p scar and normal skin remained unaltered. For the first time, the effect of autologous fat grafting on functional scar parameters was ascertained using a comprehensive scar evaluation protocol. The improved scar pliability supports the authors' hypothesis that the function of the subcutis can be restored to a certain extent by single-treatment autologous fat grafting. Therapeutic, IV.

  12. Corneal structure and transparency

    Science.gov (United States)

    Meek, Keith M.; Knupp, Carlo

    2015-01-01

    The corneal stroma plays several pivotal roles within the eye. Optically, it is the main refracting lens and thus has to combine almost perfect transmission of visible light with precise shape, in order to focus incoming light. Furthermore, mechanically it has to be extremely tough to protect the inner contents of the eye. These functions are governed by its structure at all hierarchical levels. The basic principles of corneal structure and transparency have been known for some time, but in recent years X-ray scattering and other methods have revealed that the details of this structure are far more complex than previously thought and that the intricacy of the arrangement of the collagenous lamellae provides the shape and the mechanical properties of the tissue. At the molecular level, modern technologies and theoretical modelling have started to explain exactly how the collagen fibrils are arranged within the stromal lamellae and how proteoglycans maintain this ultrastructure. In this review we describe the current state of knowledge about the three-dimensional stromal architecture at the microscopic level, and about the control mechanisms at the nanoscopic level that lead to optical transparency. PMID:26145225

  13. Animal study on transplantation of human umbilical vein endothelial cells for corneal endothelial decompensation

    Directory of Open Access Journals (Sweden)

    Li Cui

    2014-06-01

    Full Text Available AIM: To explore the feasibility of culturing human umbilical vein endothelial cells(HUVECon acellular corneal stroma and performing the posterior lamellar endothelial keratoplasty(PLEKtreating corneal endothelial decompensation.METHODS: Thirty New-Zealand rabbits were divided into three groups randomly, 10 rabbits for experimental group, 10 for stroma group and 10 for control group. Corneal endothelial cells were removed to establish animal model of corneal endothelial failure. PLEK was performed on the rabbits of experimental group and stroma group, and nothing was transplantated onto the rabbits of control group with the deep layer excised only. Postoperative observation was taken for 3mo. The degree of corneal edema and central corneal thickness were recorded for statistical analysis.RESULTS: Corneas in experimental group were relieved in edema obviously compared with that in stroma group and the control group, and showed increased transparency 7d after the operation. The average density of endothelial cells was 2 026.4±129.3cells/mm2, and average central corneal thickness was 505.2±25.4μm in experimental group, while 1 535.6±114.5μm in stroma group and 1 493.5±70.2μm in control group 3mo after operation.CONCLUSION:We achieved preliminary success in our study that culturing HUVEC on acellular corneal stroma and performing PLEK for corneal endothelial decompensation. HUVEC transplanted could survive in vivo, and have normal biological function of keeping cornea transparent. This study provides a new idea and a new way clinically for the treatment of corneal endothelial diseases.

  14. Prevention and curative management of hypertrophic scar formation

    NARCIS (Netherlands)

    Bloemen, M.C.; Veer, van der W.M.; Ulrich, M.; Zuijlen, van P.P.; Niessen, F.B.; Middelkoop, E.

    2009-01-01

    Although hypertrophic scarring commonly occurs following burns, many aspects such as incidence of and optimal treatment for scar hypertrophy remain unclear. This review will focus on hypertrophic scar formation after burn in particular, exploring multiple treatment options and describing their

  15. Cutaneous leiomyosarcoma arising in a smallpox scar

    NARCIS (Netherlands)

    Pol, Robert A.; Dannenberg, Hilde; Robertus, Jan-Lukas; van Ginkel, Robert J.

    2012-01-01

    Background: Cutaneous leiomyosarcoma (CLM) is a very rare smooth muscle tumour that accounts for about 2-3% of all superficial soft tissue sarcomas. Although the development of various malignancies in scar tissue is well known, we report the first case of a CLM developing in a small pox scar. Case

  16. Answers to Common Questions about Scars

    Science.gov (United States)

    ... or more level with the surrounding skin. Another treatment that might be recommended is dermabrasion, a process of sanding down the scar surface, again in an effort to make it more level with the surrounding skin. What is a keloid? A keloid is a tumor of scar tissue ...

  17. Recurrent Carcinoma in Mastectomy Scars | Onuigbo | International ...

    African Journals Online (AJOL)

    Aim: To study the patterns of recurrence of carcinoma in mastectomy scars. Methods: A 30?year retrospective analysis was carried out as regards surgical specimens . of mastectomy scars received by the author from numerous surgeons working in several hospitals with special reference to patients of the Igbo ethnic group.

  18. A Clinimetric Overview of Scar Assessment Scales

    NARCIS (Netherlands)

    van der Wal, M.B.A.; Verhaegen, P.D.H.M.; Middelkoop, E.; van Zuijlen, P.P.M.

    2012-01-01

    Standardized validated evaluation instruments are mandatory to increase the level of evidence in scar management. Scar assessment scales are potentially suitable for this purpose, but the most appropriate scale still needs to be determined. This review will elaborate on several clinically relevant

  19. Tissue Engineering of Corneal Endothelium

    Directory of Open Access Journals (Sweden)

    Satoru Yamagami

    2012-10-01

    Full Text Available Human corneal endothelial cells (HCECs do not replicate after wounding. Therefore, corneal endothelial deficiency can result in irreversible corneal edema. Descemet stripping automated endothelial keratoplasty (DSAEK allows selective replacement of the diseased corneal endothelium. However, DSAEK requires a donor cornea and the worldwide shortage of corneas limits its application. This review presents current knowledge on the tissue engineering of corneal endothelium using cultured HCECs. We also provide our recent work on tissue engineering for DSAEK grafts using cultured HCECs. We reconstructed DSAEK grafts by seeding cultured DiI-labelled HCECs on collagen sheets. Then HCEC sheets were transplanted onto the posterior stroma after descemetorhexis in the DSAEK group. Severe stromal edema was detected in the control group, but not in the DSAEK group throughout the observation period. Fluorescein microscopy one month after surgery showed numerous DiI-labelled cells on the posterior corneal surface in the DSAEK group. Frozen sections showed a monolayer of DiI-labelled cells on Descemet’s membrane. These findings indicate that cultured adult HCECs, transplanted with DSAEK surgery, maintain corneal transparency after transplantation and suggest the feasibility of performing DSAEK with HCECs to treat endothelial dysfunction.

  20. Linear and Nonlinear Theory of Eigenfunction Scars

    CERN Document Server

    Kaplan, L

    1998-01-01

    The theory of scarring of eigenfunctions of classically chaotic systems by short periodic orbits is extended in several ways. The influence of short-time linear recurrences on correlations and fluctuations at long times is emphasized. We include the contribution to scarring of nonlinear recurrences associated with homoclinic orbits, and treat the different scenarios of random and nonrandom long-time recurrences. The importance of the local classical structure around the periodic orbit is emphasized, and it is shown for an optimal choice of test basis in phase space, scars must persist in the semiclassical limit. The crucial role of symmetry is also discussed, which together with the nonlinear recurrences gives a much improved account of the actual strength of scars for given classical orbits and in individual wavefunctions. Quantitative measures of scarring are provided and comparisons are made with numerical data.

  1. Corneal Confocal Microscopy Detects Corneal Nerve Damage in Patients Admitted With Acute Ischemic Stroke.

    Science.gov (United States)

    Khan, Adnan; Akhtar, Naveed; Kamran, Saadat; Ponirakis, Georgios; Petropoulos, Ioannis N; Tunio, Nahel A; Dargham, Soha R; Imam, Yahia; Sartaj, Faheem; Parray, Aijaz; Bourke, Paula; Khan, Rabia; Santos, Mark; Joseph, Sujatha; Shuaib, Ashfaq; Malik, Rayaz A

    2017-11-01

    Corneal confocal microscopy can identify corneal nerve damage in patients with peripheral and central neurodegeneration. However, the use of corneal confocal microscopy in patients presenting with acute ischemic stroke is unknown. One hundred thirty patients (57 without diabetes mellitus [normal glucose tolerance], 32 with impaired glucose tolerance, and 41 with type 2 diabetes mellitus) admitted with acute ischemic stroke, and 28 age-matched healthy control participants underwent corneal confocal microscopy to quantify corneal nerve fiber density, corneal nerve branch density, and corneal nerve fiber length. There was a significant reduction in corneal nerve fiber density, corneal nerve branch density, and corneal nerve fiber length in stroke patients with normal glucose tolerance ( P stroke. Corneal confocal microscopy is a rapid noninvasive ophthalmic imaging technique that identifies corneal nerve fiber loss in patients with acute ischemic stroke. © 2017 American Heart Association, Inc.

  2. Corneal imaging of intrastromal femtosecond laser treatment for presbyopia (Intracor(®)).

    Science.gov (United States)

    Trinh, L; Francoz, M; Chong-Sit, D; Labbé, A; Dupont-Monod, S; Baudouin, C

    2013-10-01

    To evaluate anatomic appearance and corneal cellular modifications after monocular Intracor(®) procedure with two different anterior segment imaging techniques within the first postoperative year. Four patients underwent an Intracor(®) procedure in one eye performed at Clinique de la vision, and corneal imaging was performed in Quinze-Vingts National Ophthalmology Hospital. Slit-lamp photography, confocal microscopy with Heidelberg retinal tomography (HRT) and anterior segment spectral-domain optical coherence tomography (OCT) were performed 2 days, and 1, 6, and 12 months after the procedure. Confocal microscopy showed strong cellular activation of keratocytes within the first postoperative month which diminished over time. The linear femtosecond incisions appeared as hyper-reflective regular lines and reflectivity decreased throughout the follow-up period. After 6 months, a fibrotic process with appearance of corneal scars was visible as small intrastromal hyper-reflective lines and thick hyper-reflective spicules around the incisions and remained stable over time. On spectral-domain OCT, the size and depth of the incisions decreased from the center to the periphery. Visibility of the corneal femtosecond incisions on OCT decreased from day 2 until they almost disappeared at 12 months. The incision angles seemed to curve progressively from the center to the periphery in their deep portion on the peripheral rings. Corneal cellular modifications found on HRT, anatomical features, and the sizes of the intrastromal rings, may provide valuable information on this new refractive technique. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  3. Human Bone Derived Collagen for the Development of an Artificial Corneal Endothelial Graft. In Vivo Results in a Rabbit Model.

    Directory of Open Access Journals (Sweden)

    Natalia Vázquez

    Full Text Available Corneal keratoplasty (penetrating or lamellar using cadaveric human tissue, is nowadays the main treatment for corneal endotelial dysfunctions. However, there is a worldwide shortage of donor corneas available for transplantation and about 53% of the world's population have no access to corneal transplantation. Generating a complete cornea by tissue engineering is still a tough goal, but an endothelial lamellar graft might be an easier task. In this study, we developed a tissue engineered corneal endothelium by culturing human corneal endothelial cells on a human purified type I collagen membrane. Human corneal endothelial cells were cultured from corneal rims after corneal penetrating keratoplasty and type I collagen was isolated from remnant cancellous bone chips. Isolated type I collagen was analyzed by western blot, liquid chromatography -mass spectrometry and quantified using the exponentially modified protein abundance index. Later on, collagen solution was casted at room temperature obtaining an optically transparent and mechanically manageable membrane that supports the growth of human and rabbit corneal endothelial cells which expressed characteristic markers of corneal endothelium: zonula ocluddens-1 and Na+/K+ ATPase. To evaluate the therapeutic efficiency of our artificial endothelial grafts, human purified type I collagen membranes cultured with rabbit corneal endothelial cells were transplanted in New Zealand white rabbits that were kept under a minimal immunosuppression regimen. Transplanted corneas maintained transparency for as long as 6 weeks without obvious edema or immune rejection and maintaining the same endothelial markers that in a healthy cornea. In conclusion, it is possible to develop an artificial human corneal endothelial graft using remnant tissues that are not employed in transplant procedures. This artificial endothelial graft can restore the integrality of corneal endothelium in an experimental model of

  4. Corneal Biomechanical Findings in Contact Lens Induced Corneal Warpage

    OpenAIRE

    Fateme Alipour; Mojgan Letafatnejad; Amir Hooshang Beheshtnejad; Seyed-Farzad Mohammadi; Seyed Reza Ghaffary; Narges Hassanpoor; Mehdi Yaseri

    2016-01-01

    Purpose. To evaluate the difference in biomechanical properties between contact lens induced corneal warpage and normal and keratoconic eyes. Method. Prospective observational case control study, where 94 eyes of 47 warpage suspicious and 46 eyes of 23 keratoconic patients were included. Warpage suspected cases were followed until a definite diagnosis was made (warpage, normal, or keratoconus). Results. 44 eyes of 22 patients had contact lens related corneal warpage. 46 eyes of 23 people were...

  5. Intrastromal Corneal Ring Implants for Corneal Thinning Disorders

    Science.gov (United States)

    2009-01-01

    Executive Summary Objective The purpose of this project was to determine the role of corneal implants in the management of corneal thinning disease conditions. An evidence-based review was conducted to determine the safety, effectiveness and durability of corneal implants for the management of corneal thinning disorders. The evolving directions of research in this area were also reviewed. Subject of the Evidence-Based Analysis The primary treatment objectives for corneal implants are to normalize corneal surface topography, improve contact lens tolerability, and restore visual acuity in order to delay or defer the need for corneal transplant. Implant placement is a minimally invasive procedure that is purported to be safe and effective. The procedure is also claimed to be adjustable, reversible, and both eyes can be treated at the same time. Further, implants do not limit the performance of subsequent surgical approaches or interfere with corneal transplant. The evidence for these claims is the focus of this review. The specific research questions for the evidence review were as follows: Safety Corneal Surface Topographic Effects: Effects on corneal surface remodelling Impact of these changes on subsequent interventions, particularly corneal transplantation (penetrating keratoplasty [PKP]) Visual Acuity Refractive Outcomes Visual Quality (Symptoms): such as contrast vision or decreased visual symptoms (halos, fluctuating vision) Contact lens tolerance Functional visual rehabilitation and quality of life Patient satisfaction: Disease Process: Impact on corneal thinning process Effect on delaying or deferring the need for corneal transplantation Clinical Need: Target Population and Condition Corneal ectasia (thinning) comprises a range of disorders involving either primary disease conditions such as keratoconus and pellucid marginal corneal degeneration or secondary iatrogenic conditions such as corneal thinning occurring after LASIK refractive surgery. The condition

  6. [Transplantation of corneal endothelial cells].

    Science.gov (United States)

    Amano, Shiro

    2002-12-01

    Though conventional corneal transplantation has achieved great success, it still has several drawbacks including limited availability of donor corneas, recurrent allograft rejection, and subsequent graft failure in certain cases. Reconstructing clinically usable corneas by applying the technology of regenerative medicine can offer a solution to these problems, as well as making corneal transplantation a non-emergency surgery and enabling the usage of banked corneal cells. In the present study, we focused on corneal endothelium that is critical for corneal transparency and investigated the reconstruction of cornea utilizing cultured human corneal endothelial cells (HCECs). We succeeded in steadily culturing HCECs by using culture dishes pre-coated with extracellular matrix produced by calf corneal endothelial cells and culture media that contained basic fibroblast growth factor and fetal bovine serum. We performed the following analysis utilizing these cultured HCECs. The older the donor was, the more frequently large senescent cells appeared in the passaged HCECs. The telomeres of HCECs were measured as terminal restriction fragments (TRF) by Southern blotting. HCECs, in vivo from donors in their seventies had a long TRFs of over 12 kilobases. Passaging shortened the TRFs but there was no difference in TRFs among donors of various ages. These results indicated that shortening of telomere length is not related to senescence of HCECs. We investigated the role of advanced glycation end products (AGEs) in the senescence of in vivo HCECs. The results indicated that AGE-protein in the aqueous humor is endocytosed into HCECs via AGE receptors expressed on the surface of HCECs and damages HCECs by producing reactive oxygen species and inducing apoptosis, suggesting that AGEs, at least partly, cause the senescence of HECEs. HCECs were cultured using adult human serum instead of bovine serum to get rid of bovine material that can be infected with prions. Primary and passage

  7. The effect of topical scar treatment on postoperative scar pain and pruritus after total knee arthroplasty.

    Science.gov (United States)

    Kong, Chae-Gwan; Kim, Geon-Hyeong; Kim, Dong-Wook; In, Yong

    2014-04-01

    The surgical wound of total knee arthroplasty (TKA) needs continuous flexion and extension movement. Silicone gel treatment is widely used to treat hypertrophic scars and keloids since it is easily applied and prevents scar pain and itching. The aim of this study was to evaluate the clinical efficacy and safety of silicone gel applied to surgical scars of TKA on postoperative scar pain and pruritus. One hundred TKAs were randomized into a silicone gel group (silicone gel was applied to the wound after stitch-out for 1 month) or a placebo group. The postoperative scar pain and pruritus were evaluated with the use of a visual analog scale (VAS) at postoperative 3 months, 6 months and 1 year. Scar assessment was done using the Vancouver scar scale by evaluating scar pigmentation, vascularity, pliability, and height. Although silicone gel group showed better pigmentation and height scales than placebo group (P scar pain and pruritus VAS scores between the groups (P > 0.05). Application of silicone gel had no beneficial effects on scar pain and itching relief during the early postoperative period of TKA. I-Randomized Controlled Trial.

  8. Cutaneous leiomyosarcoma arising in a smallpox scar

    Science.gov (United States)

    2012-01-01

    Background Cutaneous leiomyosarcoma (CLM) is a very rare smooth muscle tumour that accounts for about 2–3% of all superficial soft tissue sarcomas. Although the development of various malignancies in scar tissue is well known, we report the first case of a CLM developing in a small pox scar. Case presentation A 66-year-old man presented with a painless, slow-growing lump in a small pox scar on his left shoulder. Histological biopsies showed the lesion to be a primary, well-differentiated cutaneous leiomyosarcoma. A CT scan of the thorax was conducted, which showed no signs of metastases. The complete lesion was then surgically excised, and histopathological examination revealed a radically excised cutaneous type leiomyosarcoma After 13 months’ review the patient was doing well with no evidence of tumour recurrence. Conclusions This is the first report of a CLM arising in a small pox scar. Although the extended time interval between scarring and malignant changes makes it difficult to advise strict follow-up for patients with small pox scars, one should be aware that atypical changes and/or symptoms occurring in a small pox scar could potentially mean malignant transformation. PMID:22799750

  9. Astrocyte scar formation aids CNS axon regeneration

    Science.gov (United States)

    Anderson, Mark A.; Burda, Joshua E.; Ren, Yilong; Ao, Yan; O’Shea, Timothy M.; Kawaguchi, Riki; Coppola, Giovanni; Khakh, Baljit S.; Deming, Timothy J.; Sofroniew, Michael V.

    2017-01-01

    Summary Transected axons fail to regrow in the mature central nervous system (CNS). Astrocyte scars are widely regarded as causal in this failure. Here, using three genetically targeted loss-of-function manipulations in adult mice, we show that preventing astrocyte scar formation, attenuating scar-forming astrocytes, or deleting chronic astrocyte scars all failed to result in spontaneous regrowth of transected corticospinal, sensory or serotonergic axons through severe spinal cord injury (SCI) lesions. In striking contrast, sustained local delivery via hydrogel depots of required axon-specific growth factors not present in SCI lesions, plus growth-activating priming injuries, stimulated robust, laminin-dependent sensory axon regrowth past scar-forming astrocytes and inhibitory molecules in SCI lesions. Preventing astrocyte scar formation significantly reduced this stimulated axon regrowth. RNA sequencing revealed that astrocytes and non-astrocyte cells in SCI lesions express multiple axon-growth supporting molecules. Our findings show that contrary to prevailing dogma, astrocyte scar formation aids rather than prevents CNS axon regeneration. PMID:27027288

  10. Cutaneous leiomyosarcoma arising in a smallpox scar.

    Science.gov (United States)

    Pol, Robert A; Dannenberg, Hilde; Robertus, Jan-Lukas; van Ginkel, Robert J

    2012-07-16

    Cutaneous leiomyosarcoma (CLM) is a very rare smooth muscle tumour that accounts for about 2-3% of all superficial soft tissue sarcomas. Although the development of various malignancies in scar tissue is well known, we report the first case of a CLM developing in a small pox scar. A 66-year-old man presented with a painless, slow-growing lump in a small pox scar on his left shoulder. Histological biopsies showed the lesion to be a primary, well-differentiated cutaneous leiomyosarcoma. A CT scan of the thorax was conducted, which showed no signs of metastases. The complete lesion was then surgically excised, and histopathological examination revealed a radically excised cutaneous type leiomyosarcoma After 13 months' review the patient was doing well with no evidence of tumour recurrence. This is the first report of a CLM arising in a small pox scar. Although the extended time interval between scarring and malignant changes makes it difficult to advise strict follow-up for patients with small pox scars, one should be aware that atypical changes and/or symptoms occurring in a small pox scar could potentially mean malignant transformation.

  11. Cutaneous leiomyosarcoma arising in a smallpox scar

    Directory of Open Access Journals (Sweden)

    Pol Robert A

    2012-07-01

    Full Text Available Abstract Background Cutaneous leiomyosarcoma (CLM is a very rare smooth muscle tumour that accounts for about 2–3% of all superficial soft tissue sarcomas. Although the development of various malignancies in scar tissue is well known, we report the first case of a CLM developing in a small pox scar. Case presentation A 66-year-old man presented with a painless, slow-growing lump in a small pox scar on his left shoulder. Histological biopsies showed the lesion to be a primary, well-differentiated cutaneous leiomyosarcoma. A CT scan of the thorax was conducted, which showed no signs of metastases. The complete lesion was then surgically excised, and histopathological examination revealed a radically excised cutaneous type leiomyosarcoma After 13 months’ review the patient was doing well with no evidence of tumour recurrence. Conclusions This is the first report of a CLM arising in a small pox scar. Although the extended time interval between scarring and malignant changes makes it difficult to advise strict follow-up for patients with small pox scars, one should be aware that atypical changes and/or symptoms occurring in a small pox scar could potentially mean malignant transformation.

  12. Corneal epithelium following penetrating keratoplasty.

    OpenAIRE

    Tsubota, K; Mashima, Y; Murata, H; Yamada, M.; Sato, N.

    1995-01-01

    AIMS--This study was designed to observe any changes to the corneal epithelium after penetrating keratoplasty. METHODS--The corneal epithelia of 26 patients were observed by specular microscopy 1 week, 1 month, 3 months, and 6 months following penetrating keratoplasty. RESULTS--After re-epithelialisation was confirmed by biomicroscopy 1 week after surgery, specular microscopy revealed many abnormal cells, including spindle shaped cells, nucleated cells, large cells, as well as irregular cell ...

  13. Chronic pesticide exposure and consequential keratectasia & corneal neovascularisation.

    Science.gov (United States)

    Sanyal, Shalini; Law, Atrayo; Law, Sujata

    2017-11-01

    Ocular toxicity as a consequence of chronic pesticide exposure is one of the health hazards caused due to extended exposure to pesticides. The cornea, due to its position as the outer ocular layer and its role in protecting the internal layers of the eye; is gravely affected by this xenobiotic insult to the eye, leading to ocular irritation and damage to normal vision. The deleterious effects of chronic pesticide exposure on the various corneal layers and the ocular risks involved therein, were explored by mimicking the on-field scenario. Cytological, histological and flowcytometric parameters were taken into consideration to determine the enhanced risk of corneal neovascularisation and keratectasia, specifically, keratoconus. Chronic exposure to pesticides leads to heightened ocular morbidity wherein there were visible pathophysiological changes to the ocular surface. The cornea was found to be adversely affected with visible protuberance in a cone-like shape, characteristic of keratoconus in a majority of the experimental animals. Further analyses revealed a detrimental impact on all the corneal layers and an amplified expression of inflammation markers such as TNF-α, VCAM-1 and ICAM-1. Additionally, it was found that post pesticide exposure, the corneal surface developed hypoxia, leading to a significant increase of angiogenesis promoting factors and consequential neovascularisation. Apart from ocular toxicity, chronic exposure to pesticides significantly increases the risks of keratectasia and corneal neovascularisation; disorders which lead to diminished vision and if untreated, blindness. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Corneal Topographic Changes After Eyelid Ptosis Surgery.

    Science.gov (United States)

    Savino, Gustavo; Battendieri, Remo; Riso, Monica; Traina, Salvatore; Poscia, Andrea; DʼAmico, Giovanni; Caporossi, Aldo

    2016-04-01

    To evaluate the corneal topography and the topographic changes after ptosis surgery on patients affected by congenital and acquired blepharoptosis. Twenty eyes of 17 patients affected by acquired and congenital ptosis underwent surgical correction through anterior levator complex tightening. Computerized tomography (Syrius Sistem; CSO) was used to analyze any change in corneal astigmatism (CYL), simulated keratometry, anterior corneal symmetry index front, apical keratometry front, and central corneal thickness. Visual acuity, margin reflex distance, and levator function were also measured. After surgical ptosis repair, corneal topography demonstrated a reduction in average keratometry of 0.15 ± 0.47 diopters (D) and in corneal astigmatism of 0.26 ± 1.12 D. Significant differences were found in apical keratometry front (-1.84 ± 1.76 D) and in best-corrected visual acuity (-0.18 ± 0.06 logMAR) in the postoperative examinations. Central corneal thickness did not show significant differences between preoperative and postoperative examinations. Postoperative topographic maps showed a reduction of symmetry index front (0.10 ± 0.64 D). Eyelid ptosis modifies anterior corneal surface inducing refractive errors and modifying corneal astigmatism in patients, thus affecting the quality of vision. The surgical correction of blepharoptosis induces anterior corneal surface modification, restoring corneal symmetry and regular corneal astigmatism. Postoperative corneal topography showed normal corneal contours.

  15. Biomechanical changes in the human cornea after transepithelial corneal crosslinking using iontophoresis.

    Science.gov (United States)

    Lombardo, Marco; Serrao, Sebastiano; Rosati, Marianna; Ducoli, Pietro; Lombardo, Giuseppe

    2014-10-01

    To evaluate the corneal response to variable intraocular pressure (IOP) in human eye globes after ultraviolet-A (UVA) transepithelial corneal crosslinking using iontophoresis. Fondazione G.B. Bietti IRCCS, Rome, Italy. Experimental study. Four human donor eye globes were treated with transepithelial crosslinking using iontophoresis and rapid UVA corneal irradiation, and 4 globes had standard crosslinking. Inflation experiments were performed on the globes before and after crosslinking. Topographic maps of the anterior and posterior cornea were acquired using Scheimpflug topography. Images were obtained using a mechanical regimen to analyze corneal strain in response to cyclic stress. Corneal shape changes were analyzed as a function of IOP, and corneal stress-strain curves were generated. Before crosslinking, instillation of hypotonic riboflavin-5-phosphate sodium 0.1% solution using iontophoresis increased corneal thickness by 5% and instillation of dextran-enriched riboflavin 0.1% solution decreased corneal thickness by 13%. Five minutes after treatment, both crosslinking procedures reduced corneal thickness by 2%. Young's modulus (E) of the anterior cornea increased by a mean of 1.8 times (from 1.6 to 2.9 MPa) and 1.9 times (from 1.3 to 2.5 MPa) after transepithelial crosslinking using iontophoresis and standard crosslinking, respectively. The E value of the posterior cornea also increased after both procedures (mean 1.7 times versus 3.1 times). Transepithelial crosslinking using iontophoresis increased the biomechanical strength of human corneal tissue in inflation testing of donor eye globes. The effect on corneal stiffness was almost comparable to that of standard crosslinking. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  16. Synchronous interferometric demodulation of Placido mires applied to corneal topography

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    Servin, Manuel

    2012-01-01

    This paper presents a novel digital interferometric method to demodulate Placido fringe patterns. This is a synchronous method which uses a computer-stored conic-wavefront as demodulating reference. Here we focuses on the experimental aspects to phase-demodulate Placido mires applied to corneal topography. This synchronous method is applied to two topographic Placido images and their de-modulated corneal-slope deformation is estimated. This conic-interferometric method is highly robust against typical "noisy" signals in Placido topography such as: reflected eyelashes and iris structures. That is because the eyelashes and the iris structure are high frequency "noisy" signals corrupting the reflected Placido mire, so they are filtered-out by this method. Digital synchronous interferometry is here applied for the first time to demodulate corneal topographic concentric-rings images (Patent pending at the USPTO).

  17. Biomechanical model of corneal transplantation.

    Science.gov (United States)

    Cabrera Fernández, D; Niazy, A M; Kurtz, R M; Djotyan, G P; Juhasz, T

    2006-03-01

    Refractive consequences of corneal transplants are analyzed using corneal biomechanical models assuming homogeneous and inhomogeneous stiffness distributions across the cornea. Additionally, refractive effects of grafts combined with volume removal procedures are also evaluated to develop methods to reduce postoperative refractive management of patients. Refinements of a two-dimensional finite element model are applied to simulate the biomechanical and refractive effects of different corneal transplant procedures: anterior lamellar keratoplasty, posterior lamellar keratoplasty, and penetrating keratoplasty. The models are based on a nonlinearly elastic, isotropic formulation. Predictions are compared with published clinical data. The model simulating the penetrating keratoplasty procedure predicts more change in the postoperative corneal curvature than models simulating anterior lamellar keratoplasty or posterior lamellar keratoplasty procedures. When a lenticle-shaped tissue with a central thickness of 50 microns and a diameter of 4 mm is removed from the anterior corneal surface along with the anterior lamellar keratoplasty or posterior lamellar keratoplasty, the models predict a refractive correction of -8.6 and -8.9 diopters, respectively. Simulations indicate that a posterior lamellar keratoplasty procedure is preferable for obtaining a better corneal curvature profile, eliminating the need for specific secondary treatments.

  18. Corneal topography in cataract surgery.

    Science.gov (United States)

    Martinez, C E; Klyce, S D

    1996-02-01

    Keratometry and corneal topography remain the most important means of evaluating induced corneal changes after surgery and have comparable sensitivities in the paracentral region of the cornea. However, keratometry gives no information about the peripheral cornea or about asymmetry of the cornea. Videokeratography should be performed after cataract surgery in cases in which best-corrected visual acuity is not adequate and there are no other obvious causes for poor vision to determine whether corneal irregularities are present. The recent literature on corneal topographic evaluation of induced astigmatism after cataract surgery suggests that in general, smaller, temporal incisions result in less astigmatism. Preoperatively, corneal topography can be used in the calculation of intraocular lens power as well as incision planning. Postoperatively, it can be used to detect tight sutures, torsion of the wound, internal wound gape, and irregular astigmatism, as well as to guide suture removal. In the future, corneal topography will become increasingly important in the determination of intraocular lens power in difficult cases such as patients undergoing combined cataract extraction and penetrating keratoplasty as well as patients with a history of radial keratotomy or photorefractive surgery.

  19. CONTACT LENS RELATED CORNEAL ULCER

    Directory of Open Access Journals (Sweden)

    AGARWAL P

    2010-01-01

    Full Text Available A corneal ulcer caused by infection is one of the major causes of blindness worldwide. One of the recent health concerns is the increasing incidence of corneal ulcers associated with contact lens user especially if the users fail to follow specific instruction in using their contact lenses. Risk factors associated with increased risk of contact lens related corneal ulcers are:overnight wear, long duration of continuous wear, lower socio-economic classes, smoking, dry eye and poor hygiene. The presenting symptoms of contact lens related corneal ulcers include eye discomfort, foreign body sensation and lacrimation. More serious symptoms are redness (especially circum-corneal injection, severe pain, photophobia, eye discharge and blurring of vision. The diagnosis is established by a thorough slit lamp microscopic examination with fluorescein staining and corneal scraping for Gram stain and culture of the infective organism. Delay in diagnosing and treatment can cause permanent blindness, therefore an early referral to ophthalmologist and commencing of antimicrobial therapy can prevent visual loss.

  20. Measurement of surgically induced corneal deformations using three-dimensional confocal microscopy.

    Science.gov (United States)

    Petroll, W M; Roy, P; Chuong, C J; Hall, B; Cavanagh, H D; Jester, J V

    1996-03-01

    The goal of this study was to develop and apply a new set of experimental techniques for measuring the local deformations induced by partial-thickness corneal incisions in situ. Eight adult cat eyes were enucleated and cannulated, with corneal viability maintained as close to in vivo conditions as possible and intraocular pressure (IOP) carefully controlled. Experimental measurements were made pre/post radial keratotomy (RK) surgery in situ at IOPs of 15, 30, and 45 mm Hg. Incision depth and cross-sectional profiles were measured at the midpoint of selected incisions using three-dimensional (3-D) tandem scanning confocal microscopy (TSCM); central corneal curvature was estimated using a commercial corneal topographical analysis system, and corneal thickness was assessed by both 3-D TSCM and ultrasonic pachymetry. Corneas were then processed for light microscopy and incision depth was measured histologically. Finite element models were developed for comparison with the experimental measurements. There was no significant change in central corneal thickness (-5.3 +/- 3.9%, n = 8) over the course of the experiments, demonstrating that normal endothelial cell function and normal stromal hydration was maintained. The in situ TSCM incision depth measurements were significantly correlated with the histological measurements (slope = 0.95, R = 0.854, p mechanical behavior of the cornea after refractive surgery. These data should provide the foundation for future studies into the relationships between local tissue mechanics and corneal wound healing.

  1. Inhibition of erythropoietin siRNA on corneal neovascularization of rabbit

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    Yu-Shun Xue

    2017-03-01

    Full Text Available AIM: To observe the expression of erythropoietin(EPOon the corneal of rabbit and evaluate the inhibition effect of EPO siRNA on corneal neovascularization(CNV. METHODS: Totally 22 healthy rabbits were randomly divided into 2 groups, which were experimental group and normal control group. Both eyes of rabbits in experimental group were chosen to establish corneal neovascularization model by alkali burn. The morphologic change of corneal was observed with slit lamp microscope and the area of CNV was calculated every day. After alkali burn, the right eye of the experimental group was accepted EPO siRNA injection under the conjunctiva, and the left eye was assigned to be experimental control group. The corneal with CNV was collected for immunohistochemistry at 3d, 7d, 14d, 21d after alkali burn, and the expression of EPO was measured. RESULTS: CNV began growing at the 3d after alkali burn in experimental group, and it was vigorous growing at 7d-14d period. The result of immunohistochemistry shows that the expression of EPO increased after the operation. Compared with experimental group, the rabbits who were treated by EPO siRNA was found with less neovascularization on their corneal, and the expression of EPO decreased. There were statistical significance between the two group at different time(PCONCLUSION: EPO is likely to play an important role on CNV growth, and EPO siRNA can inhibit the growth of CNV by restraining the expression of EPO.

  2. The Antifibrosis Effects of Peroxisome Proliferator-Activated Receptor δ on Rat Corneal Wound Healing after Excimer Laser Keratectomy

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    Yun Gu

    2014-01-01

    Full Text Available Corneal stromal fibrosis characterized by myofibroblasts and abnormal extracellular matrix (ECM is usually the result of inappropriate wound healing. The present study tested the hypothesis that the ligand activation of peroxisome proliferator-activated receptor (PPAR δ had antifibrosis effects in a rat model of corneal damage. Adult Sprague-Dawley rats underwent bilateral phototherapeutic keratectomy (PTK. The eyes were randomized into four groups: PBS, GW501516 (a selective agonist of PPARδ, GSK3787 (a selective antagonist of PPARδ, or GW501516 combined with GSK3787. The agents were subconjunctivally administered twice a week until sacrifice. The cellular aspects of corneal wound healing were evaluated with in vivo confocal imaging and postmortem histology. A myofibroblast marker (α-smooth muscle actin and ECM production (fibronectin, collagen type III and collagen type I were examined by immunohistochemistry and RT-PCR. At the early stages of wound healing, GW501516 inhibited reepithelialization and promoted angiogenesis. During the remodeling phase of wound healing, GW501516 attenuated the activation and proliferation of keratocytes, which could be reversed by GSK3787. GW501516 decreased transdifferentiation from keratocytes into myofibroblasts, ECM synthesis, and corneal haze. These results demonstrate that GW501516 controls corneal fibrosis and suggest that PPARδ may potentially serve as a therapeutic target for treating corneal scars.

  3. Corneal wound healing after excimer laser keratectomy.

    Science.gov (United States)

    Kaji, Yuichi; Yamashita, Hidetoshi; Oshika, Tetsuro

    2003-03-01

    Excimer laser keratectomy is widely used to correct refractive errors. Several complications of excimer laser keratectomy are reported including corneal infection, regression, corneal haze formation, glare and halo. Most of the complications are closely related to the corneal stromal wound healing process. In order to perform the excimer laser keratectomy with minimum complications, we should understand the mechanism of the corneal stroma wound healing process. In addition, such knowledge will help us to regulate the corneal stromal wound healing process in the future. In the present article, we discuss the molecular mechanism of the corneal stromal wound healing process after excimer laser keratectomy and its regulation by anti-inflammatory agents.

  4. Mononuclear cells in the corneal response to endotoxin

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    Howes, E.L.; Cruse, V.K.; Kwok, M.T.

    1982-04-01

    A severe keratitis can be produced after the direct injection of bacterial endotoxin, or lipopolysaccharide (LPS), in rabbits. Corneal inflammation can progress to scarring and vascularization within a 2 to 3 week period. Pretreatment with systemic adrenal corticosteroids (triamcinolone) prevents this response. Limbal cellular and vascular events were studied during the first 20 hr after injection of LPS in treated and nontreated rabbits. Perivascular limbal inflammatory cells were counted and limbal vascular permeability was assessed by extravasation of 131I-albumin and 125I-fibrinogen in the cornea. Corticosteroids decreased but did not prevent the early protein extravasation and profoundly altered the inflammatory cell population around blood vessels at the limbus. Mononuclear cells, particularly mononuclear phagocytes, were sharply reduced. It is proposed that these cell types play an important role in the perpetuation and amplification of the inflammatory response in this reaction.

  5. [Comparison of corneal wound healing of photorefractive keratectomy and laser in situ keratomileusis in rabbits].

    Science.gov (United States)

    Ma, Xiao-Hua; Li, Jing-Hai; Bi, Hong-Sheng; Zhou, Fang; Li, Yan

    2003-03-01

    extracellular matrix under the epithelium. Compared with PRK, LASIK ensures refractive stability with quick wound healing and minimal tissue proliferation resulting in a more promising corneal refractive surgery to correct myopia, especially more severe cases of myopia. The corneal wound healing especially the stromal healing is the key to the cause of haze and myopic regression. TGF-beta(1) may be involved in scar formation during wound healing by stimulating expression of collagen III and FN and is believed to be an important regulating factor.

  6. Focal Acne Scar Treatment (FAST), a new approach to atrophic acne scars: a case series.

    Science.gov (United States)

    Schweiger, Eric S; Sundick, Lauren

    2013-10-01

    Acne scars are a common concern in dermatology. Fractional CO2 laser resurfacing is a recent addition in our armamentarium of treatment options for acne scars and has been shown to be an excellent option for patients with atrophic acne scars. Patients with acne scars receiving fractional CO2 resurfacing usually have both the acne scars and surrounding unscarred areas treated in common practice. There has yet to be a study that looked at the implications of only focally treating the acne scars while leaving surrounding normal skin untreated. To evaluate the safety and efficacy of a focal approach to fractional CO2 laser treatment for acne scars, coined "Focal Acne Scar Treatment" or "FAST" This retrospective case series was conducted at Schweiger Dermatology, in New York, NY, with patients treated from November 2011 through May 2012. Overall, six patients (ages 18 to 48) were treated with the fractional CO2 laser resurfacing, using a so called "FAST" technique treating only the acne scars and leaving normal skin untreated. Evaluation was based on physician and patient assessment of improvement at one week and four weeks post-treatment. All six patients treated with the Focal Acne Scar Treatment technique of fractional CO2 laser resurfacing had significant improvement post treatment ranging from 40% to 70% as estimated by the treating dermatologist and patient at four weeks post treatment. Patient satisfaction was high following FAST method. Temporary post-inflammatory hyperpigmentation was seen in two patients but resolved after a single 1550 nm Erbium Glass fractional laser treatment. The Focal Acne Scar Treatment technique is an effective method of improving the appearance of atrophic acne scars. Higher energy and density levels can be used when utilizing this technique, resulting in improved outcomes when compared with whole face fractional CO2 laser resurfacing. Healing is improved and faster with this technique and no increased incidence of permanent adverse

  7. Corneal thickness changes after corneal collagen crosslinking for keratoconus and corneal ectasia: one-year results.

    Science.gov (United States)

    Greenstein, Steven A; Shah, Vinnie P; Fry, Kristen L; Hersh, Peter S

    2011-04-01

    To determine the changes in corneal thickness over time after corneal collagen crosslinking (CXL) for keratoconus and corneal ectasia. Cornea and refractive surgery subspecialty practice. Prospective randomized controlled clinical trial. Corneal thickness at the apex, thinnest point, and pupil center were measured using Scheimpflug imaging (Pentacam) at baseline and 1, 3, 6, and 12 months after CXL. The treatment group was compared with both a sham-procedure control group and a fellow-eye control group. Associations with clinical outcomes (uncorrected and corrected distance visual acuities and maximum keratometry) were analyzed. The study comprised 82 eyes, 54 with keratoconus and 28 with ectasia after laser in situ keratomileusis. The mean preoperative thinnest pachymetry was 440.7 μm ± 52.9 (SD). After CXL, the cornea thinned at 1 month (mean change -23.8 ± 28.7 μm; Pdegree of corneal thinning at 3 months and clinical outcomes after CXL. After CXL, the cornea thins and then recovers toward baseline thickness. The cause and implications of corneal thickness changes after CXL remain to be elucidated. No author has a financial or proprietary interest in any material or method mentioned. Additional disclosure is found in the footnotes. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  8. Assessment of scar quality after cleft lip closure

    NARCIS (Netherlands)

    Frans, F.A.; van Zuijlen, P.P.M.; Griot, J.P.W.D.; van der Horst, C.M.A.M.

    2012-01-01

    Objective: To assess scar quality after cleft lip repair. Design: The linear scars of patients with cleft lip with or without cleft palate were evaluated in a prospective study using the Patient and Observer Scar Assessment Scale. Linear regression was performed to identify which scar

  9. Assessment of scar quality after cleft lip closure

    NARCIS (Netherlands)

    Frans, Franceline A.; van Zuijlen, Paul P. M.; Griot, J. P. W. Don; van der Horst, Chantal M. A. M.

    2012-01-01

    To assess scar quality after cleft lip repair. The linear scars of patients with cleft lip with or without cleft palate were evaluated in a prospective study using the Patient and Observer Scar Assessment Scale. Linear regression was performed to identify which scar characteristics were important

  10. Medical makeup for concealing facial scars.

    Science.gov (United States)

    Mee, Donna; Wong, Brian J F

    2012-10-01

    Surgical, laser, and pharmacological therapies are all used to correct scars and surgical incisions, though have limits with respect to how well facial skin can be restored or enhanced. The use of cosmetics has long been a relevant adjunct to all scar treatment modalities. In recent years, technical advancements in the chemistry and composition of cosmetic products have provided the patient with a broader range of products to employ for concealing scars. This review will provide an overview of contemporary methods for concealing facial scars, birthmarks, and pigmentary changes without the use of traditional/dated, heavy appearing camouflage products. Additionally, general guidelines and information will be provided with respect to identifying competent makeup artists for care of the medical patient. The article by no means is meant to be a tutorial, but rather serves as a starting point in this allied field of medicine. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  11. Cesarean scar endometrioma: Case series

    Science.gov (United States)

    Çöl, Cavit; Yilmaz, Edip Erdal

    2014-01-01

    AIM: To evaluate endometrioma located at cesarean scatrix. METHODS: Medical data of 6 patients who presented to our institution with abdominal wall endometrioma were evaluated retrospectively and reviewed literature in this case series. The diagnostic approaches and treatment is discussed. RESULTS: All patients had a painful mass located at abdominal scars with history of cesarean section. The ages ranged from 31 to 34 and Doppler ultrasonography (US) detected hypoechoic mass with a mean diameter of 30 mm. Initial diagnosis was endometrioma in 4 and incisional hernia in 2 of 6 patients. Treatment was achieved with surgical excision in 5 patients, and one is followed by hormone suppression therapy with gonadotropin. CONCLUSION: Malignant or benign tumors of abdominal wall and incisional hernias should be kept in mind for diagnosis of endometrioma. Imaging methods like doppler US, computed tomography and magnetic resonance imaging should be used for differential diagnosis. Definitive diagnosis can only be made histopathologically. The treatment should be complete surgical excision and take care against intraoperative auto-inoculation of endometrial tissue in order to prevent recurrences. PMID:24868512

  12. Corneal stromal dystrophies: a clinical pathologic study

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    Elvira Barbosa Abreu

    2012-12-01

    Full Text Available INTRODUCTION: Corneal dystrophy is defined as bilateral and symmetric primary corneal disease, without previous associated ocular inflammation. Corneal dystrophies are classified according to the involved corneal layer in superficial, stromal, and posterior dystrophy. Incidence of each dystrophy varies according to the geographic region studied. PURPOSE: To evaluate the prevalence of stromal corneal dystrophies among corneal buttons specimens obtained by penetrating keratoplasty (PK in an ocular pathology laboratory and to correlate the diagnosis with patient age and gender. METHODS: Corneal button cases of penetrating keratoplasty from January-1996 to May-2009 were retrieved from the archives of The Henry C. Witelson Ophthalmic Pathology Laboratory and Registry, Montreal, Canada. The cases with histopathological diagnosis of stromal corneal dystrophies were stained with special stains (Peroxid acid Schiff, Masson trichrome, Congo red analyzed under polarized light, and alcian blue for classification and correlated with epidemiological information (age at time of PK and gender from patients' file. RESULTS: 1,300 corneal buttons cases with clinical diagnose of corneal dystrophy were retrieved. Stromal corneal dystrophy was found in 40 (3.1% cases. Lattice corneal dystrophy was the most prevalent with 26 cases (65%. Nineteen were female (73.07% and the PK was performed at average age of 59.3 years old. Combined corneal dystrophy was found in 8 (20% cases, 5 (62.5% of them were female and the average age of the penetrating keratoplasty was 54.8 years old. Granular corneal dystrophy was represented by 5 (12.5% cases, and 2 (40% of them were female. Penetrating keratoplasty was performed at average age of 39.5 years old in granular corneal dystrophy cases. Macular corneal dystrophy was present in only 1 (2.5% case, in a 36 years old female. CONCLUSION: Systematic histopathological approach and evaluation, including special stains in all stromal

  13. Inhibition of prolyl 4-hydroxylase reduces scar hypertrophy in a rabbit model of cutaneous scarring.

    Science.gov (United States)

    Kim, Injoong; Mogford, Jon E; Witschi, Claudia; Nafissi, Mehdi; Mustoe, Thomas A

    2003-01-01

    Hypertrophic scars result from excessive collagen deposition at sights of healing dermal wounds and can be functionally and cosmetically problematic. Pharmacological regulation of collagen synthesis and deposition is a direct approach to the control of scar tissue formation. We tested the ability of the phenanthrolinone derivative FG-1648 (in 0.5% Carbopol 971 PNF gel, pH 6.5), a prolyl 4-hydroxylase inhibitor, to reduce hypertrophic scar formation in a rabbit ear hypertrophic scar model. New Zealand White rabbits were divided into two treatment groups (n = 12 wounds per group with an equal number of controls): low-dose group: 0.5% FG-1648; high-dose group: 1% FG-1648. Left ears were used for treatment and right ear for control. Four 7-mm dermal ulcer wounds were made on each ear. The inhibitor was topically applied to the wound at the time of wounding and once daily up to postoperative day 7. Wounds were harvested at postoperative day 28 and scar hypertrophy quantified by measurement of the scar elevation index. All wounds showed complete healing. Treatment of wounds with 1% prolyl 4-hydroxylase inhibitor decreased the scar elevation index by 26% compared to control wounds (p < 0.01). Wounds treated with 0.5% FG-1648 inhibitor showed no difference in scar elevation compared to control wounds. These results suggest that inhibition of prolyl 4-hydroxylase may be a suitable agent for topical treatment for the prevention of hypertrophic scar tissue.

  14. Corneal Sparing Conjunctival Abrasion

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    Hamid Ehsani-Nia

    2017-07-01

    Full Text Available History of present illness: A 15-year-old male was transported to the emergency department via ambulance as a trauma activation after being struck by an automobile while jogging. Patient was alert and oriented, with no focal neurological deficits and no loss of consciousness. The patient complained of right eye foreign body sensation. Significant findings: Physical exam was significant for multiple broken teeth, multiple minor abrasions on the face, and fine shards of shattered glass on his face and hair. His right eye had conjunctival injection, with no signs of subconjunctival hemorrhage or ocular penetration. Vision, extraocular movement, and pupillary exam were grossly intact. Fluorescein staining with slit lamp exam with cobalt blue filter examination of the right eye revealed superficial bulbar conjunctival uptake of fluorescein dye staining an area of the conjunctiva inferior to the limbus 5 mm vertical by 2 mm horizontal (estimation by photo provided. No foreign bodies were visualized in the inferior fornix. These findings were consistent with superficial conjunctival abrasion. The exam noted sparing of the corneal epithelium. Discussion: The conjunctiva is a thin, transparent membrane covering the ocular surface from the corneal limbus to the posterior eyelid margin.1 When damaged, the patient will classically have a “foreign body” sensation. It is important to identify the extent of the injury as not extending over the cornea, and also to search for lodged foreign bodies that damage the conjunctiva further with each blink. Classically retained foreign bodies will form a linear and vertical pattern of staining with fluorescein.2,3 Fluorescein stains expose basement membrane and fluoresces bright green under ultraviolet light, thus indicating areas of damage in contrast to its surrounding tissue.4,5 In the setting of acute trauma, urgent Ophthalmologic consultation is indicated if there is anterior chamber hemorrhage, a ruptured or

  15. Central corneal thickness and corneal hysteresis associated with glaucoma damage.

    Science.gov (United States)

    Congdon, Nathan G; Broman, Aimee T; Bandeen-Roche, Karen; Grover, Davinder; Quigley, Harry A

    2006-05-01

    We sought to measure the impact of central corneal thickness (CCT), a possible risk factor for glaucoma damage, and corneal hysteresis, a proposed measure of corneal resistance to deformation, on various indicators of glaucoma damage. Observational study. Adult patients of the Wilmer Glaucoma Service underwent measurement of hysteresis on the Reichert Ocular Response Analyzer and measurement of CCT by ultrasonic pachymetry. Two glaucoma specialists (H.A.Q., N.G.C.) reviewed the chart to determine highest known intraocular pressure (IOP), target IOP, diagnosis, years with glaucoma, cup-to-disk ratio (CDR), mean defect (MD), pattern standard deviation (PSD), glaucoma hemifield test (GHT), and presence or absence of visual field progression. Among 230 subjects, the mean age was 65 +/- 14 years, 127 (55%) were female, 161 (70%) were white, and 194 (85%) had a diagnosis of primary open-angle glaucoma (POAG) or suspected POAG. In multivariate generalized estimating equation models, lower corneal hysteresis value (P = .03), but not CCT, was associated with visual field progression. When axial length was included in the model, hysteresis was not a significant risk factor (P = .09). A thinner CCT (P = .02), but not hysteresis, was associated with a higher CDR at the most recent examination. Neither CCT nor hysteresis was associated with MD, PSD, or GHT "outside normal limits." Thinner CCT was associated with the state of glaucoma damage as indicated by CDR. Axial length and corneal hysteresis were associated with progressive field worsening.

  16. Computational modeling of corneal refractive surgery

    Science.gov (United States)

    Cabrera Fernandez, Delia; Niazy, Abdel-Salam M.; Kurtz, Ronald M.; Djotyan, Gagik P.; Juhasz, Tibor

    2004-07-01

    A finite element method was used to study the biomechanical behavior of the cornea and its response to refractive surgery when stiffness inhomogeneities varying with depth are considered. Side-by-side comparisons of different constitutive laws that have been commonly used to model refractive surgery were also performed. To facilitate the comparison, the material property constants were identified from the same experimental data, which were obtained from mechanical tests on corneal strips and membrane inflation experiments. We then validated the resulting model by comparing computed refractive power changes with clinical results. The model developed provides a much more predictable refractive outcome when the stiffness inhomogeneities of the cornea and nonlinearities of the deformations are included in the finite element simulations. Thus, it can be stated that the inhomogeneous model is a more accurate representation of the corneal material properties in order to model the biomechanical effects of refractive surgery. The simulations also revealed that the para-central and peripheral parts of the cornea deformed less in response to pressure loading compared to the central cornea and the limbus. Furthermore, the deformations in response to pressure loading predicted by the non-homogeneous and nonlinear model, showed that the para-central region is mechanically enhanced in the meridional direction. This result is in agreement with the experimentally documented regional differences reported in the literature by other investigators.

  17. Burn Scar Biomechanics Following Pressure Garment Therapy

    Science.gov (United States)

    Kim, Jayne Y.; Willard, James J.; Supp, Dorothy M.; Roy, Sashwati; Gordillo, Gayle M.; Sen, Chandan K.; Powell, Heather M.

    2015-01-01

    Background The current standard of care for the prevention and treatment of scarring following burn injury is pressure garment therapy (PGT). Although this therapy has been used clinically for many years, controversy remains regarding its efficacy. The purpose of this study was to evaluate the efficacy of PGT in a female Red Duroc pig (fRDP) burn model where wound depth could be tightly controlled. Methods Full-thickness burn wounds were generated on fRDPs. At day 28 post-burn, PGT was applied to half of the wounds (10 mmHg), with control wounds covered with garments exerting no compression. Scar area, perfusion, hardness, and elasticity were quantified at days 0, 28, 42, 56, and 72 using computerized planimetry, Laser Doppler and torsional ballistometry. Scar morphology was assessed at days 28, 56 and 76 using histology, immunohistochemistry and transmission electron microscopy. Results Pressure garment therapy significantly hindered scar contraction with control scars contracting to 64.6 + 13.9% original area at day 72 while PGT scars contracted to 82.7 + 17.9% original area. PGT significantly reduced skin hardness and increased skin strength by 1.3X. No difference in perfusion or blood vessel density was observed. Average collagen fiber diameter was greater in control burns than PGT. Conclusions PGT was effective at reducing scar contraction and improving biomechanics compared to control scars. These results confirm the efficacy of pressure garments and highlight the need to further investigate the role of pressure magnitude and time of therapy application to enhance their efficacy for optimal biomechanics and patient mobility. PMID:25989300

  18. Cesarean Scar Pregnancy: A Case Report

    Directory of Open Access Journals (Sweden)

    Z Vahedpoor

    2015-07-01

    Conclusion: Previous cesarean scar pregnancy if not detected early can be associated with high morbidity and mortality. Therefore, the possibility of this pregnancy should be considered in pregnant women with uterine bleeding, abdominal pain as well as a history of cesarean section. It should be noted that after previous cesarean scar pregnancy was definitely diagnosed via ultrasound examination, treatment necessitates to be started utilizing methotrexate to ensure the future fertility of the mother.

  19. Substrates for Expansion of Corneal Endothelial Cells towards Bioengineering of Human Corneal Endothelium

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    Jesintha Navaratnam

    2015-09-01

    Full Text Available Corneal endothelium is a single layer of specialized cells that lines the posterior surface of cornea and maintains corneal hydration and corneal transparency essential for vision. Currently, transplantation is the only therapeutic option for diseases affecting the corneal endothelium. Transplantation of corneal endothelium, called endothelial keratoplasty, is widely used for corneal endothelial diseases. However, corneal transplantation is limited by global donor shortage. Therefore, there is a need to overcome the deficiency of sufficient donor corneal tissue. New approaches are being explored to engineer corneal tissues such that sufficient amount of corneal endothelium becomes available to offset the present shortage of functional cornea. Although human corneal endothelial cells have limited proliferative capacity in vivo, several laboratories have been successful in in vitro expansion of human corneal endothelial cells. Here we provide a comprehensive analysis of different substrates employed for in vitro cultivation of human corneal endothelial cells. Advances and emerging challenges with ex vivo cultured corneal endothelial layer for the ultimate goal of therapeutic replacement of dysfunctional corneal endothelium in humans with functional corneal endothelium are also presented.

  20. Quiste dermoide corneal bilateral

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    Michel Guerra Almaguer

    Full Text Available El dermoide es un tipo de coristoma (tejido embrionario normal en una localización anormal que afecta con frecuencia la córnea. Aparece como una masa sólida, blanca, redonda y elevada. Suele localizarse en el limbo inferotemporal, aunque puede hacerlo en cualquier lugar del globo ocular o de la órbita. Se presenta un paciente masculino, de 8 años de edad, quien desde su nacimiento muestra una mancha blanca en ambos ojos, agudeza visual sin corrección de movimiento de mano a 33 centímetros en el ojo derecho y percepción luminosa en el ojo izquierdo. En la exploración oftalmológica de ambos ojos se apreciaron lesiones blanquecinas sobre la córnea. Se le realizó exéresis del quiste y queratoplastia lamelar de ambos ojos, con resultados visuales satisfactorios. Se concluye que el caso presenta un quiste dermoide corneal bilateral.

  1. Fractional Carbon Dioxide Laser in Treatment of Acne Scars

    OpenAIRE

    Petrov, Andrej

    2016-01-01

    BACKGROUND: Scars appear as a result of skin damage during the process of the skin healing. There are two types of acne scars, depending on whether there is a loss or accumulation of collagen: atrophic and hypertrophic. In 80-90% it comes to scars with loss of collagen compared to smaller number of hypertrophic scars and keloids. AIM: The aim of the study was to determine efficiency and safety of fractional carbon dioxide laser in the treatment of acne scars. MATERIAL AN...

  2. Vitreous wick syndrome following a corneal relaxing incision.

    Science.gov (United States)

    Stainer, G A; Binder, P S

    1981-08-01

    A 55-year-old white female underwent a 7.5 mm penetrating keratoplasty for stromal scarring secondary to herpex simplex keratitis. Postoperatively, stromal vascularization and a prolonged graft rejection forced premature suture removal and a prolonged course of topical and systemic glucocorticoids. A mild anterior wound gape spontaneously closed with reduction of steroid therapy. Eighteen months after the original surgery, the patient underwent a relaxing corneal incision to correct 12 diopters of corneal astigmatism. During an inferior incision a small microperforation was noted and the procedure was terminated. Eleven days after the relaxing incision, the patient returned with a "vitreous wick" syndrome through the superior incision. The wound dehiscence and vitreous wick were repaired without incident and the astigmatism was reduced to 7 diopters. Incisions more than 3/4 depth in aphakic patients, or in patients who have required intense steroid therapy should be monitored closely for several days after surgery for microperforations or a wound dehiscence which may lead to a "vitreous wick" syndrome.

  3. Analysis of Frequency of Use of Different Scar Assessment Scales Based on the Scar Condition and Treatment Method

    OpenAIRE

    Seong Hwan Bae; Yong Chan Bae

    2014-01-01

    Analysis of scars in various conditions is essential, but no consensus had been reached on the scar assessment scale to select for a given condition. We reviewed papers to determine the scar assessment scale selected depending on the scar condition and treatment method. We searched PubMed for articles published since 2000 with the contents of the scar evaluation using a scar assessment scale with a Journal Citation Report impact factor >0.5. Among them, 96 articles that conducted a scar evalu...

  4. Femtosecond laser corneal refractive surgery

    Science.gov (United States)

    Kurtz, Ron M.; Spooner, Greg J. R.; Sletten, Karin R.; Yen, Kimberly G.; Sayegh, Samir I.; Loesel, Frieder H.; Horvath, Christopher; Liu, HsiaoHua; Elner, Victor; Cabrera, Delia; Muenier, Marie-Helene; Sacks, Zachary S.; Juhasz, Tibor

    1999-06-01

    We evaluated the efficacy, safety, and stability of femtosecond laser intrastromal refractive procedures in ex vivo and in vivo models. When compared with longer pulsewidth nanosecond or picosecond laser pulses, femtosecond laser-tissue interactions are characterized by significantly smaller and more deterministic photodisruptive energy thresholds, as well as reduced shock waves and smaller cavitation bubbles. We utilized a highly reliable, all-solid-state femtosecond laser system for all studies to demonstrate clinical practicality. Contiguous tissue effects were achieved by scanning a 5 μm focused laser spot below the corneal surface at pulse energies of approximately 2 - 4 microjoules. A variety of scanning patterns was used to perform three prototype procedures in animal eyes; corneal flap cutting, keratomileusis, and intrastromal vision correction. Superior dissection and surface quality results were obtained for lamellar procedures (corneal flap cutting and keratomileusis). Preliminary in vivo evaluation of intrastromal vision correction in a rabbit model revealed consistent and stable pachymetry changes, without significant inflammation or loss of corneal transparency. We conclude that femtosecond laser technology may be able to perform a variety of corneal refractive procedures with high precision, offering advantages over current mechanical and laser devices and techniques.

  5. An accessible approach for corneal topography

    OpenAIRE

    André Luís Beling da Rosa

    2013-01-01

    Corneal topography consists of measuring the corneal shape, which is a key factor for visual acuity. The exam is used, for instance, in keratoconus detection, personalized contact lens fitting, in pre- and post-procedures associated with refractive surgery and corneal transplants. This thesis presents an accessible, inexpensive and portable approach to perform corneal topographies. The results obtained with our prototype show a mean difference of about 0.02 millimeters, equivalent to 0.5% of ...

  6. No-visible-scar cholecystectomy

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    Tadeusz M. Wróblewski

    2010-12-01

    Full Text Available Introduction: Single incision laparoscopic surgery (SILS is a laparoscopic method providing a good cosmetic effect,but requiring the application of special ports and instruments enabling the surgeon to perform the procedure.We report three-ports cholecystectomy through umbilical and suprapubic incisions performed with typical laparos -copic instruments which calls no-visible-scar cholecystectomy (NVSC.Material and methods: Twenty patients with symptomatic cholelithiasis were qualified for NVSC. Typical CO2 pneumoperitoneumwas done after umbilical skin incision. Two ports of 5 mm were inserted in the maximum externaledges of this incision. After cystic duct and cystic artery dissection the right one was exchanged for a port of 11 mm.The second incision for the 11-mm trocar for the laparoscope was done in the suprapubic median line within the hairarea.Results: Cholecystectomies were performed without any conversion to classical laparoscopic cholecystectomy (LCHor open surgery. They were not technically identical due to the gradual improvement in the access and manipulationof instruments. The time of the intervention ranged from 2 hours during the introduction of the new method to 50 minfor the last procedures. No postoperative complications were observed and all patients were discharged not later thanafter conventional LCH.Conclusions: NVSC is a three-port laparoscopic intervention performed with typical laparoscopic instruments. It ismore convenient for the surgeon than single incision LCH, because the placement of the optic in the suprapubic regiongives more space for the instruments. It also provides a very good cosmetic effect of the intervention. The describedprocedure is easy to learn and in case of technical problems additional ports can be applied (as in typical LCH.

  7. Progress of research on corneal collagen cross-linking for corneal melting

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    Ke-Ren Xiao

    2016-06-01

    Full Text Available Corneal collagen cross-linking(CXLcould increase the mechanical strength, biological stability and halt ectasia progression due to covalent bond formed by photochemical reaction between ultraviolet-A and emulsion of riboflavin between collagen fibers in corneal stroma. Corneal melting is an autoimmune related noninfectious corneal ulcer. The mechanism of corneal melting, major treatment, the basic fundamental of ultraviolet-A riboflavin induced CXL and the clinical researches status and experiment in CXL were summarized in the study.

  8. [Applying deep lamellar keratoplasty in corneal disorders without endothelial abnormalities].

    Science.gov (United States)

    Wylegała, Edward; Wróblewska, Ewa Marta; Tarnawska, Dorota; Mierzwa, Marzena

    2003-01-01

    To present own experiences in the surgery of deep lamellar keratoplasty. 25 eye of 25 patients suffering from various corneal pathologies with preserved endothelium: 22 with keratoconus eyes, 2 with post-inflammatory scar and one eye with leucoma in Stevens-Johnson syndrome. Mean follow-up was 25.5 months (from 6 to 32). Main outcome measures were Non-Corrected and Best Corrected Visual Acuity (NCVA, BCVA), astigmatism, refractive error, IOP and corneal transparency. The surgery was performed in general anesthesia. In majority of cases the recipient stroma was trephined to a depth of 70% with 7.5 mm diameter vacuum trephine. In cases of intraoperative perforation of Descemet membrane with shallow anterior chamber we converted the procedure into penetrating keratoplasty. The donor lenticule was trephined in the artificial chamber with the 0.5 mm oversized manual trephine to a depth of 90%. In two cases after DLK was finished, limbal stem cell grafting was additionally performed. Postoperative NCVA ranged from 0.01 to 0.8 and BCVA from 0.1 to 0.8. Astigmatism ranged from 0.5 to 10.0 D. Refractive error ranged from -8.0 to +1.0 D. In follow-up period all grafts maintained transparent. The complications were mainly intraoperative perforations of Descemet membrane (9 cases): in 7 cases we convert the procedure into penetrating keratoplasty. In 2 cases the double chamber-forming was observed: in one case on 7 day following surgery the penetrating keratoplasty was performed, in other a spontaneous attachment was observed. We also observed loose sutures in 2 cases, inflammatory infiltrates in one case. Two cases of ocular hypertension was successfully treated by medication. Deep lamellar keratoplasty is an effective procedure for treating various diseases of corneal stroma with unaffected endothelium.

  9. Ocular dimensions, corneal thickness, and corneal curvature in quarter horses with hereditary equine regional dermal asthenia.

    Science.gov (United States)

    Badial, Peres R; Cisneros-Àlvarez, Luis Emiliano; Brandão, Cláudia Valéria S; Ranzani, José Joaquim T; Tomaz, Mayana A R V; Machado, Vania M; Borges, Alexandre S

    2015-09-01

    The aim of this study was to compare ocular dimensions, corneal curvature, and corneal thickness between horses affected with hereditary equine regional dermal asthenia (HERDA) and unaffected horses. Five HERDA-affected quarter horses and five healthy control quarter horses were used. Schirmer's tear test, tonometry, and corneal diameter measurements were performed in both eyes of all horses prior to ophthalmologic examinations. Ultrasonic pachymetry was performed to measure the central, temporal, nasal, dorsal, and ventral corneal thicknesses in all horses. B-mode ultrasound scanning was performed on both eyes of each horse to determine the dimensions of the ocular structures and to calculate the corneal curvature. Each corneal region examined in this study was thinner in the affected group compared with the healthy control group. However, significant differences in corneal thickness were only observed for the central and dorsal regions. HERDA-affected horses exhibited significant increases in corneal curvature and corneal diameter compared with unaffected animals. The ophthalmologic examinations revealed mild corneal opacity in one eye of one affected horse and in both eyes of three affected horses. No significant between-group differences were observed for Schirmer's tear test, intraocular pressure, or ocular dimensions. Hereditary equine regional dermal asthenia-affected horses exhibit decreased corneal thickness in several regions of the cornea, increased corneal curvature, increased corneal diameter, and mild corneal opacity. Additional research is required to determine whether the increased corneal curvature significantly impacts the visual accuracy of horses with HERDA. © 2014 American College of Veterinary Ophthalmologists.

  10. Phototoxic effects of 8-methoxypsoralen on rabbit corneal endothelium

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    Menon, I.A.; Basu, P.K.; Hasany, S.M.; Persad, S.D. (Univ. of Toronto, Ontario (Canada))

    1989-01-01

    The phototoxic effects of 8-methoxypsoralen (8-MOP) were investigated using the rabbit corneal endothelium in organ culture. The corneas were divided into four groups: (a) irradiated with a mercury vapor lamp (emitting UVA and visible radiation) in the presence of 8-MOP (experimental), (b) irradiated without 8-MOP (control A), (c) incubated with 8-MOP (control B) and (d) incubated without 8-MOP (control C). Specular and light microscopic examination showed that the experimental corneas had greater cellular damage compared to the control corneas. The effects of 8-MOP were restricted to certain localized areas of the cornea. However there was no significant difference in the amounts of 51Cr released from the labelled experimental and control corneas. These results show phototoxic damage of the corneal endothelial cells.

  11. Acute corneal hydrops in keratoconus

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    Prafulla K Maharana

    2013-01-01

    Full Text Available Acute corneal hydrops is a condition characterized by stromal edema due to leakage of aqueous through a tear in descemet membrane. The patient presents with sudden onset decrease in vision, photophobia, and pain. Corneal thinning and ectasias combined with trivial trauma to the eye mostly by eye rubbing is considered as the underlying cause. With conservative approach self-resolution takes around 2 to 3 months. Surgical intervention is required in cases of non-resolution of corneal edema to avoid complications and for early visual rehabilitation. Intracameral injection of air or gas such as perflouropropane is the most common surgical procedure done. Recent investigative modality such as anterior segment optical coherence tomography is an extremely useful tool for diagnosis, surgical planning, and postoperative follow up. Resolution of hydrops may improve the contact lens tolerance and visual acuity but most cases require keratoplasty for visual rehabilitation.

  12. [Corneal toxicity due to amantadine].

    Science.gov (United States)

    Avendaño-Cantos, E M; Celis-Sánchez, J; Mesa-Varona, D; Gálvez-Martínez, J; López-Arroquia, E; González Del Valle, F

    2012-09-01

    A 64 year-old female with Parkinson disease treated with amantadine for two years who suddenly suffered bilateral corneal oedema. It was initially treated as herpetic endotheliitis without improvement as we lacked information on her chronic treatment. The corneal oedema finally resolved after withdrawing the drug. Amantadine hydrochloride may produce endothelial dysfunction. Once the amantadine treatment is stopped, the corneal oedema may be reversible but endothelial density remains low. An ophthalmologist examination should be performed before the initiation of amantadine treatment in order to establish a risk: benefit ratio, especially in those patients with low endothelial density or any endothelial anomaly. Copyright © 2011 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  13. Vertical scar versus the inverted-T scar reduction mammaplasty : A 10-year follow-up

    NARCIS (Netherlands)

    Bouwer, Lesley R.; van der Biezen, Jan Jaap; Spronk, Cees A.; van der Lei, Berend

    2012-01-01

    A retrospective study was undertaken to evaluate whether the initial outcome of two types of reduction mammaplasty techniques (vertical scar reduction mammaplasty vs. the inverted-T scar reduction mammaplasty) remains stable in the long term: Sixty-nine patients who had undergone breast reduction

  14. Papular Acne Scars of the Nose and Chin: An Under-recognised Variant of Acne Scarring.

    Science.gov (United States)

    Ali, Faisal R; Kirk, Michael; Madan, Vishal

    2016-01-01

    Scarring following acne vulgaris is common and can be of profound psychosocial consequence. We have clinically noted a variant of acne scarring, overlooked by previous categorisation schemes, which we have denominated as papular acne scars of the nose and chin. We sought to characterise these novel entities further. Initially, we identified 14 patients with papular acne scars of the nose and chin in a cosmetic dermatology clinic, of whom two were female and rest were male. We then prospectively evaluated 100 consecutive patients attending our tertiary referral acne isotretinoin clinic and 49 patients attending a general dermatology clinic. Amongst 149 patients, from a general dermatology and tertiary acne clinic, soft papular scars were noted in four patients, distributed on the nose and chin. Three of the four patients were male, three patients had additional acne scars and the median age was 23.5. We have identified 18 patients with papular acne scars of the nose and chin and propose that this new category should be added to acne scarring classification schemes. Future work should be directed at corroborating the epidemiology of such lesions and describing effective treatment modalities.

  15. Papular acne scars of the nose and chin: An under-recognised variant of acne scarring

    Directory of Open Access Journals (Sweden)

    Faisal R Ali

    2016-01-01

    Full Text Available Background: Scarring following acne vulgaris is common and can be of profound psychosocial consequence. Aims and Objectives: We have clinically noted a variant of acne scarring, overlooked by previous categorisation schemes, which we have denominated as papular acne scars of the nose and chin. We sought to characterise these novel entities further. Materials and Methods: Initially, we identified 14 patients with papular acne scars of the nose and chin in a cosmetic dermatology clinic, of whom two were female and rest were male. We then prospectively evaluated 100 consecutive patients attending our tertiary referral acne isotretinoin clinic and 49 patients attending a general dermatology clinic. Results: Amongst 149 patients, from a general dermatology and tertiary acne clinic, soft papular scars were noted in four patients, distributed on the nose and chin. Three of the four patients were male, three patients had additional acne scars and the median age was 23.5. Conclusions: We have identified 18 patients with papular acne scars of the nose and chin and propose that this new category should be added to acne scarring classification schemes. Future work should be directed at corroborating the epidemiology of such lesions and describing effective treatment modalities.

  16. Prognosis of corneal wasp sting: case report and review of the literature.

    Science.gov (United States)

    Lai, Pinghong; Yang, Jun; Cui, Hua; Xie, Hui

    2011-12-01

    To report the ocular complications associated with corneal wasp sting and to highlight the importance of eye protection in case of wasp offense. This was a retrospective, observational chart review. A 34-year-old man was referred for severely decreased vision after being stung by a swap to the left cornea. Ophthalmologic examination showed a large corneal epithelial defect, anterior uveitis, and a left relative afferent pupillary defect. Vision was light perception. After treatment with cycloplegic, topical antibiotic, and systemic steroids for 2 weeks, the epithelial defect healed and anterior uveitis subsided; however, bulbous keratopathy and traumatic cataract developed. The visual acuity remained light perception with poor light projections. Twenty additional cases of corneal hymenoptera sting were reviewed from the English language literature, which shared certain characteristics including anterior uveitis, intractable glaucoma, traumatic cataract, toxic optic neuropathy, corneal scarring, and a catastrophic prognosis. Wasp stings of the cornea may bring disastrous ocular damages. Outdoor works should manage to protect your eyes when confronted with a hymenoptera attack.

  17. Stability of the laser in situ keratomileusis corneal flap in rabbit eyes.

    Science.gov (United States)

    Laurent, John M; Schallhorn, Steven C; Spigelmire, Jennifer R; Tanzer, David J

    2006-06-01

    To quantify the force required to dislodge a laser in situ keratomileusis (LASIK) corneal flap in rabbits and correlate that force with sources of injury to LASIK corneal flaps in humans. Animal Vivarium and Department of Ophthalmology, Naval Medical Center, San Diego, California, USA. Corneal flaps were cut in 56 eyes of 30 rabbits. A -8.00 diopter excimer ablation was also performed in 32 of the eyes. Injury testing, using a burst of CO2 from a modified paintball gun, was conducted from 1 to 9 days postoperatively. Impact force was compared to that generated by mechanical trauma (fingers and a small tree branch) striking a force gauge. Of 43 eyes tested for injury, flaps could not be dislocated in 11 eyes (26%). There was no significant difference between eyes treated with flap only and those that also had ablation. When flaps were dislodged, the required force generally resulted in extensive intraocular injury. There was no significant difference between the force required for flap dislocation on postoperative days 1 and 9. In rabbits, LASIK corneal flaps were very resistant to high-speed wind trauma as early as 24 hours postoperatively. Flap stability was robust prior to the formation of collagen scar tissue, probably due to epithelial bridging at the edge of the flap and an osmotic gradient across the flap-stromal bed interface. Although this study used a rabbit model, it seems likely that both these flap adhesion mechanisms would also provide stability to the LASIK flap in humans.

  18. A comparative study evaluating the clinical efficacy of skin tapes versus silicone gel for the treatment of posttrauma scar in the rabbit model

    Directory of Open Access Journals (Sweden)

    Chih-Chien Wang

    2014-01-01

    Full Text Available Background: Skin tape and silicone gel are two common over-the-counter preparations used to enhance the cosmesis of keloids and hypertrophic scars of posttrauma wounds. This animal study was performed to determine the clinical efficacy of skin tape versus silicone gel in subjects with scars. Materials and Methods: Three New Zealand rabbits that received total 12 incision wounds which two incision wounds on one ear side and subsequent primary suturing were studied. Stitches were removed after 1 week. Silicone gel was applied right upper side of the rabbit′s ear directly on surgical incision wounds, and skin tapes were also applied left upper side of the rabbit′s ear directly on another surgical incision wounds after 1 week of surgery. The lower incisions in both ears were covered with sterilized gauze and served as controls. We compared two experimental groups at binaural with using Vancouver Scar Scale, Manchester Scar Scale, and The Stony Brook Scar Evaluation Scale. These are widely used in clinical practice and research to document change in scar appearance. Results: We describe a rabbit model for incisional wounds and scarring outcome measures. The results of scar measuring devices demonstrated that skin tape reduced scar formation as well as silicone gel. Conclusions: The results of cosmetic demonstrated that skin tape reduced scar formation as well as silicone gel. However, the economical and effective materials were the important subject that suffices for clinical requirement. The application of these scar prevention devices to reduce scar formation after surgical incision is worthy of future investigation. Moreover, skin tape may represent a low-cost alternative and low scar formation for closure of surgical incisions.

  19. Posterior Corneal Surface Stability after Femtosecond Laser-Assisted Keratomileusis

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    Carlo Cagini

    2015-01-01

    Full Text Available The purpose of this study was to evaluate posterior corneal surface variation after femtosecond laser-assisted keratomileusis in patients with myopia and myopic astigmatism. Patients were evaluated by corneal tomography preoperatively and at 1, 6, and 12 months. We analyzed changes in the posterior corneal curvature, posterior corneal elevation, and anterior chamber depth. Moreover, we explored correlation between corneal ablation depth, residual corneal thickness, percentage of ablated corneal tissue, and preoperative corneal thickness. During follow-up, the posterior corneal surface did not have a significant forward corneal shift: no significant linear relationships emerged between the anterior displacement of the posterior corneal surface and corneal ablation depth, residual corneal thickness, or percentage of ablated corneal tissue.

  20. Long-term comparison of full-bed deep lamellar keratoplasty with penetrating keratoplasty in treating corneal leucoma caused by herpes simplex keratitis.

    Science.gov (United States)

    Wu, Shuang-Qing; Zhou, Ping; Zhang, Bei; Qiu, Wen-Ya; Yao, Yu-Feng

    2012-02-01

    To compare long-term outcomes of full-bed deep lamellar keratoplasty (DLK) with penetrating keratoplasty (PK) for treating corneal leucoma caused by herpes simplex keratitis (HSK). Retrospective, comparative, interventional case series. setting: Institutional. patients: Inclusion criteria were patients with corneal scarring induced exclusively by HSK who underwent primary graft of full-bed DLK or PK and completed a minimum of 12 months postoperative follow-up. There was no significant difference of corneal scarring and vascularization between the 2 groups before surgery. Choosing PK or full-bed DLK depended on the patient's own willingness, except those patients with a preoperative endothelial cell count of less than 700 cells/mm(2) or whose endothelial cell count was undetectable were encouraged to undergo only PK. Exclusion criteria were patients with a past history of corneal perforation, nonprimary graft, non-HSK-related corneal scars, and failure to complete a minimum of 12 months of postoperative follow-up. Fifty-eight eyes of 58 patients in the full-bed DLK group and 63 eyes of 63 patients in the PK group met the inclusion criteria. main outcome measures: Postoperative managements, recurrence of HSK, graft rejection, graft survival rate, visual acuity, and corneal endothelial density. The mean postoperative follow-up duration was 45.8 ± 30.9 months in the full-bed DLK group and 47.9 ± 27.2 months in the PK group (P = .70). As compared with the PK group, the full-bed DLK group experienced earlier suture removal (P = .01), needed fewer postoperative visits (P Corneal endothelial cell density was stable from 1 month through 5 years in the full-bed DLK group, but 51.3% cell loss was found in the PK group at 5 years after surgery. At the last visit, 66.1% of eyes with full-bed DLK grafts and 50.9% of eyes with PK grafts achieved a best-correct visual acuity of 0.5 or better (P = .10). Advantages of full-bed DLK over PK are no allograft rejection, longer graft

  1. Corneal Thickness as a Predictor of Corneal Transplant Outcome

    Science.gov (United States)

    Verdier, David D.; Sugar, Alan; Baratz, Keith; Beck, Roy; Dontchev, Mariya; Dunn, Steven; Gal, Robin L.; Holland, Edward J.; Kollman, Craig; Lass, Jonathan H.; Mannis, Mark J.; Penta, Jeffrey

    2013-01-01

    Purpose Assess corneal thickness (CT) and correlation with graft outcome after penetrating keratoplasty in the Cornea Donor Study. Methods 887 subjects with a corneal transplant for a moderate risk condition (principally Fuchs or pseudophakic corneal edema) had post-operative CT measurements throughout a 5 year follow up time. Relationships between baseline (recipient, donor, and operative) factors and CT were explored. Proportional hazards models were used to assess association between CT and graft failure. Relationship between CT and cell density was assessed with a longitudinal repeated measures model and Spearman correlation estimates. Results Higher longitudinal CT measurements were associated with diagnosis of pseudophakic or aphakic corneal edema (P 25mmHg during the first post-operative month (P=0.003), white (non-Hispanic) donor race (P=0.002) and respiratory causes of donor death (P600μm. In multivariate analysis, both 1 year CT and cell density were associated with subsequent graft failure (P=0.002 and 0.009). CT increase was modestly associated with endothelial cell loss during follow up (r=-0.29). Conclusion During the first 5 years following penetrating keratoplasty, CT can serve as a predictor of graft survival. However, CT is not a substitute for cell density measurement as both measures were independently predictive of graft failure. PMID:23343949

  2. Outcome of corneal transplantation in a private institution in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Omar N

    2013-06-01

    Full Text Available Nazri Omar,1,2 Charbel T Bou Chacra,1 Khalid F Tabbara1,3,4 1The Eye Center and The Eye Foundation for Research in Ophthalmology, Riyadh, Saudi Arabia; 2Department of Ophthalmology, Universiti Putra Malaysia, Serdang, Malaysia; 3Department of Ophthalmology, King Saud University, Riyadh, Saudi Arabia; 4The Wilmer Ophthalmological Institute of Johns Hopkins University School of Medicine, Baltimore, MD, USA Background: The aim of this work was to describe the indications, complications, and outcomes of penetrating keratoplasty (PKP in Saudi Arabia. Methods: In a retrospective, noncomparative interventional case series, the medical records of patients who underwent PKP from January 2000 to December 2008 and had a minimum follow-up of 6 months were reviewed. All corneas were obtained from eye banks in the US. Indications, complications, and outcomes of surgery were recorded. This study was approved by the institutional review board. Results: Eighty-five consecutive eyes were included in this study. There were 52 (61.2% males and 33 (38.8% females. The median age was 35.0 years (range 3–85 years, and the median follow-up period was 24 months (range 6–108 months. The indications for PKP were keratoconus, bullous keratopathy, corneal scars, corneal dystrophy, and corneal regraft. The overall graft survival time was 88.9 months ± 4.9 months (mean ± standard error of mean, 95% confidence interval [CI] 79.4 months -98.4 months while the 3-year and 5-year cumulative survival rates were 90.7% and 84.3%, respectively. Surgical indication (P = 0.038, immune rejection (P < 0.001, preoperative corneal vascularization (P = 0.022, and perioperative high intraocular pressure (P = 0.032 were associated significantly with corneal graft failure in univariate analysis. Multivariate analysis reduced these significant associations to rejection (P < 0.001 and vascularization (P = 0.009. Relative risk for failure in rejected cornea was 16.22 (95% CI 4.99–52.69 and

  3. Metalloproteinases in corneal diseases: degradation and processing.

    Science.gov (United States)

    Sakimoto, Tohru; Sawa, Mitsuru

    2012-11-01

    Matrix metalloproteinases (MMPs) are zinc-dependent endopeptidases with the potential to degrade all types of extracellular matrix. The ADAM (a disintegrin and metalloproteinase) family of peptidases was recently identified as cleaving the extracellular domain of transmembrane proteins. This was termed ectodomain shedding. We investigated the MMP expression in patients with corneal diseases and the potential role of ADAMs in corneal pathophysiology. We detected upregulation of the active form of MMP-2 and MMP-9 in the tear fluid from patients with corneal melting or recurrent corneal erosion. Using human corneal epithelial cells, we observed ADAM17-dependent ectodomain shedding of soluble tumor necrosis factor receptor 1 and soluble interleukin-6 (IL-6) receptor (sIL-6R). The production of sIL-6R was also induced by messenger RNA splicing in the human corneal epithelial cells. IL-6/sIL-6R-induced signal transducer and activator of transcription 3 phosphorylation was observed in cultured human corneal fibroblasts, suggesting that IL-6 trans-signaling induced inflammatory cellular signaling in the human corneal fibroblasts. We demonstrated that MMPs are significantly upregulated in collagen-destructive disorders of the cornea. Additionally, we observed that ectodomain shedding by ADAMs in corneal epithelial cells mediated the production of soluble cytokine receptors. Trans-signaling of IL-6 can induce an inflammatory response in corneal stroma, indicating the significance of IL-6 trans-signaling in ocular surface inflammation. Thus, MMPs and ADAMs play an important role in the pathophysiology of corneal diseases.

  4. Corneal Regeneration After Photorefractive Keratectomy: A Review☆

    Science.gov (United States)

    Tomás-Juan, Javier; Murueta-Goyena Larrañaga, Ane; Hanneken, Ludger

    2014-01-01

    Photorefractive keratectomy (PRK) remodels corneal stroma to compensate refractive errors. The removal of epithelium and the ablation of stroma provoke the disruption of corneal nerves and a release of several peptides from tears, epithelium, stroma and nerves. A myriad of cytokines, growth factors, and matrix metalloproteases participate in the process of corneal wound healing. Their balance will determine if reepithelization and stromal remodeling are appropriate. The final aim is to achieve corneal transparency for restoring corneal function, and a proper visual quality. Therefore, wound-healing response is critical for a successful refractive surgery. Our goal is to provide an overview into how corneal wounding develops following PRK. We will also review the influence of intraoperative application of mitomycin C, bandage contact lenses, anti-inflammatory and other drugs in preventing corneal haze and post-PRK pain. PMID:25444646

  5. Corneal Regeneration After Photorefractive Keratectomy: A Review.

    Science.gov (United States)

    Tomás-Juan, Javier; Murueta-Goyena Larrañaga, Ane; Hanneken, Ludger

    2015-01-01

    Photorefractive keratectomy (PRK) remodels corneal stroma to compensate refractive errors. The removal of epithelium and the ablation of stroma provoke the disruption of corneal nerves and a release of several peptides from tears, epithelium, stroma and nerves. A myriad of cytokines, growth factors, and matrix metalloproteases participate in the process of corneal wound healing. Their balance will determine if reepithelization and stromal remodeling are appropriate. The final aim is to achieve corneal transparency for restoring corneal function, and a proper visual quality. Therefore, wound-healing response is critical for a successful refractive surgery. Our goal is to provide an overview into how corneal wounding develops following PRK. We will also review the influence of intraoperative application of mitomycin C, bandage contact lenses, anti-inflammatory and other drugs in preventing corneal haze and post-PRK pain. Copyright © 2014 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

  6. History of corneal transplantation in Australia.

    Science.gov (United States)

    Coster, Douglas J

    2015-04-01

    Corneal transplantation is a triumph of modern ophthalmology. The possibility of corneal transplantation was first raised in 1797 but a century passed before Zirm achieved the first successful penetrating graft in 1905. Gibson reported the first corneal graft in Australia from Brisbane in 1940 and English established the first eye bank there a few years later. Corneal transplantation evolved steadily over the twentieth century. In the second half of the century, developments in microsurgery, including surgical materials such as monofilament nylon and strong topical steroid drops, accounted for improvements in outcomes. In 2013, approximately 1500 corneal transplants were done in Australia. Eye banking has evolved to cope with the rising demands for donor corneas. Australian corneal surgeons collaborated to establish and support the Australian Corneal Graft Registry in 1985. It follows the outcomes of their surgery and has become an important international resource for surgeons seeking further improvement with the procedure. © 2014 Royal Australian and New Zealand College of Ophthalmologists.

  7. Corneal biomechanical properties in floppy eyelid syndrome.

    Science.gov (United States)

    Muniesa, MaJesús; Muniesa Royo, MaJesús; March, Ana; March de Ribot, Ana; Sánchez-de-la-Torre, Manuel; Huerva, Valetín; Huerva Escanilla, Valetín; Jurjo, Carmen; Jurjo Campo, Carmen; Barbé, Ferran; Barbé Illa, Ferran

    2015-05-01

    To determine corneal biomechanical properties in patients with floppy eyelid syndrome (FES) and to compare them with eyes of controls. This case-control study included 208 eyes (72 eyes with FES and 136 without FES) of 107 patients (37 patients with FES and 70 without FES). Patients underwent a complete clinical eye examination that included corneal biomechanical evaluation carried out with the Reichert Ocular Response Analyzer. Corneal hysteresis (CH), corneal resistance factor (CRF), central corneal thickness (CCT), Goldmann-correlated intraocular pressure (IOPg), and corneal-compensated intraocular pressure (IOPcc) were evaluated. Mean CH was significantly lower in patients with FES than in those without FES (9.51 ± 1.56 vs. 11.66 ± 9.11; P corneal biomechanical properties could be changed in patients with FES, reflecting additional structural changes in FES.

  8. Scar Endometriosis at the Site of Cesarean Section

    OpenAIRE

    Ding, Dah-Ching; Hsu, Senzen

    2006-01-01

    Objective: Scar endometriosis is a rare condition. We report a case of scar endometriosis occurring at the site of an old cesarean section scar. Case Report: A 29-year-old multiparous woman complained of painful sensation during menstruation for 2 years that occurred at the site of her cesarean section surgical scar. On examination, there was a firm nodule measuring 2 × 1.5 cm in size at the mid-point of the scar. In view of the possibility of scar endometriosis, the mass was completely ex...

  9. Watermarking scar as an ultimate copy protection

    Science.gov (United States)

    Braci, Sofiane; Miraoui, Abdelkader; Delpha, Claude; Boyer, Rémy

    2010-02-01

    Strong and powerful attacks are able to make the watermark extraction impossible even if there is some watermarking. In this work, we call this residual information the scar and we use it to prove the existence of an attacked watermark. We evaluate the Scar by the mutual information between the embedded watermark and the attacked copies. It is well known that the mutual information between two random variables gives an evaluation of the shared information between the two variables. Thus, the attack can compromise the correct decoding by removing partialy the watermarking information. However, it is possible to make the watermarking existence proof possible when the mutual information between the embedded message and the attacked copies is above a certain threshold. We propose a practical way to use the scar by measuring the correlation between the attacked watermark and the original one.

  10. Fraxelated radiofrequency device for acne scars

    Science.gov (United States)

    Rao, Babar K.; Khokher, Sairah

    2012-09-01

    Acne scars can be improved with various treatments such as topical creams, chemical peels, dermal fillers, microdermabrasion, laser, and radiofrequency devices. Some of these treatments especially lasers and deep chemical peels can have significant side effects such as post inflammatory hyperpigmentation in darker skin types. Fraxelated RF Laser devices have been reported to have lower incidence of side effects in all skin phototypes. Nine patients between ages 18 and 35 of various skin phototypes were selected from a private practice and treated with a RF fraxelated device (E-matrix) for acne scars. Outcomes were measured by physician observation, subjective feedback received by patients, and comparison of before and after photographs. In this small group of patients with various skin phototypes, fraxelated radiofrequency device improved acne scars with minimal side effects and downtime.

  11. Corneal stroma microfibrils

    KAUST Repository

    Hanlon, Samuel D.

    2015-03-01

    Elastic tissue was first described well over a hundred years ago and has since been identified in nearly every part of the body. In this review, we examine elastic tissue in the corneal stroma with some mention of other ocular structures which have been more thoroughly described in the past. True elastic fibers consist of an elastin core surrounded by fibrillin microfibrils. However, the presence of elastin fibers is not a requirement and some elastic tissue is comprised of non-elastin-containing bundles of microfibrils. Fibers containing a higher relative amount of elastin are associated with greater elasticity and those without elastin, with structural support. Recently it has been shown that the microfibrils, not only serve mechanical roles, but are also involved in cell signaling through force transduction and the release of TGF-β. A well characterized example of elastin-free microfibril bundles (EFMBs) is found in the ciliary zonules which suspend the crystalline lens in the eye. Through contraction of the ciliary muscle they exert enough force to reshape the lens and thereby change its focal point. It is believed that the molecules comprising these fibers do not turn-over and yet retain their tensile strength for the life of the animal. The mechanical properties of the cornea (strength, elasticity, resiliency) would suggest that EFMBs are present there as well. However, many authors have reported that, although present during embryonic and early postnatal development, EFMBs are generally not present in adults. Serial-block-face imaging with a scanning electron microscope enabled 3D reconstruction of elements in murine corneas. Among these elements were found fibers that formed an extensive network throughout the cornea. In single sections these fibers appeared as electron dense patches. Transmission electron microscopy provided additional detail of these patches and showed them to be composed of fibrils (~10nm diameter). Immunogold evidence clearly

  12. Corneal surface reconstruction - a short review

    Directory of Open Access Journals (Sweden)

    Madhavan H N

    2009-01-01

    . Cells or tissues can be embedded in a liquid Mebiol gel solution at lower than 20°C and cultured three dimensionally in a hydrogel state at 37°C. The sol-gel transition temperature can be controlled by altering chemical composition of thermo-reversible gelation polymer (TGP. Mebiol Gel prevents the growth of the fibroblasts and it is not toxic to cells. In our earlier study, continuous culture cell lines 18 and we demonstrated that Mebiol Gel supported the growth of corneal limbal epithelial cells and these cells expressed both limbal and corneal phenotype, suggesting that limbal epithelial cells cultivated in Mebiol Gel would be a promising material for corneal surface tissue engineering. With this in view, we developed a novel method of cultivation of human limbal cells in a synthetic scaffold made of a thermo reversible polymer, that allows the limbal epithelial cells to survive, proliferate and differentiate into corneal epithelial cells and demonstrated the effectiveness of this polymer for corneal tissue engineering using an experimentally induced limbal deficiency in a rabbit model. In this report, the detailed procedure of the animal model and the results are discussed. We evaluated the efficacy of autologous expanded corneal epithelial cell transplants derived from harvested limbal biopsy cultured on a thermo-reversible polymer (Mebiol Gel for the management of unilateral limbal stem cell disease (LSCD.Corneal limbal biopsies from 12 rabbits were cultured on Mebiol Gel at 37°C. Cells were harvested from the dishes after 3 weeks by reducing temperature to 4°C. Autologous transplantation was undertaken to reconstruct the experimentally induced limbal stem cell deficiency in the rabbit eyes. The corneas of both eyes of all rabbits were harvested later for histological and RT-PCR studies. Reparative surgery was a total success in 7 (58.3%; score, 8-10, partial success in 2 (16.7%; score, 6-7 and failure in 3 (25%; score, <5. Histological and RT-PCR study

  13. Collagens and proteoglycans of the corneal extracellular matrix

    Directory of Open Access Journals (Sweden)

    Y.M. Michelacci

    2003-08-01

    Full Text Available The cornea is a curved and transparent structure that provides the initial focusing of a light image into the eye. It consists of a central stroma that constitutes 90% of the corneal depth, covered anteriorly with epithelium and posteriorly with endothelium. Its transparency is the result of the regular spacing of collagen fibers with remarkably uniform diameter and interfibrillar space. Corneal collagen is composed of heterotypic fibrils consisting of type I and type V collagen molecules. The cornea also contains unusually high amounts of type VI collagen, which form microfibrillar structures, FACIT collagens (XII and XIV, and other nonfibrillar collagens (XIII and XVIII. FACIT collagens and other molecules, such as leucine-rich repeat proteoglycans, play important roles in modifying the structure and function of collagen fibrils.Proteoglycans are macromolecules composed of a protein core with covalently linked glycosaminoglycan side chains. Four leucine-rich repeat proteoglycans are present in the extracellular matrix of corneal stroma: decorin, lumican, mimecan and keratocan. The first is a dermatan sulfate proteoglycan, and the other three are keratan sulfate proteoglycans. Experimental evidence indicates that the keratan sulfate proteoglycans are involved in the regulation of collagen fibril diameter, and dermatan sulfate proteoglycan participates in the control of interfibrillar spacing and in the lamellar adhesion properties of corneal collagens. Heparan sulfate proteoglycans are minor components of the cornea, and are synthesized mainly by epithelial cells. The effect of injuries on proteoglycan synthesis is discussed.

  14. Biomechanics of Corneal Ring Implants

    Science.gov (United States)

    2015-01-01

    Purpose: To evaluate the biomechanics of corneal ring implants by providing a related mathematical theory and biomechanical model for the treatment of myopia and keratoconus. Methods: The spherical dome model considers the inhomogeneity of the tunica of the eye, dimensions of the cornea, lamellar structure of the corneal stroma, and asphericity of the cornea. It is used in this study for calculating a strengthening factor sf for the characterization of different ring-shaped corneal implant designs. The strengthening factor is a measure of the amount of strengthening of the cornea induced by the implant. Results: For ring segments and incomplete rings, sf = 1.0, which indicates that these implants are not able to strengthen the cornea. The intracorneal continuous complete ring (MyoRing) has a strengthening factor of up to sf = 3.2. The MyoRing is, therefore, able to strengthen the cornea significantly. Conclusions: The result of the presented biomechanical analysis of different ring-shaped corneal implant designs can explain the different postoperative clinical results of different implant types in myopia and keratoconus. PMID:26312619

  15. Corneal Protection for Burn Patients

    Science.gov (United States)

    2013-10-01

    report, Figs. 2-7. Rose Bengal (RB) photosensitization was tested because RB is FDA-allowed as a diagnostic for corneal abrasions...incisions. J Cataract Refract Surg, 30, 2420-4. Personnel supported by this grant All personnel are employed by the Massachusetts General Hospital

  16. Biomechanics of Corneal Ring Implants.

    Science.gov (United States)

    Daxer, Albert

    2015-11-01

    To evaluate the biomechanics of corneal ring implants by providing a related mathematical theory and biomechanical model for the treatment of myopia and keratoconus. The spherical dome model considers the inhomogeneity of the tunica of the eye, dimensions of the cornea, lamellar structure of the corneal stroma, and asphericity of the cornea. It is used in this study for calculating a strengthening factor sf for the characterization of different ring-shaped corneal implant designs. The strengthening factor is a measure of the amount of strengthening of the cornea induced by the implant. For ring segments and incomplete rings, sf = 1.0, which indicates that these implants are not able to strengthen the cornea. The intracorneal continuous complete ring (MyoRing) has a strengthening factor of up to sf = 3.2. The MyoRing is, therefore, able to strengthen the cornea significantly. The result of the presented biomechanical analysis of different ring-shaped corneal implant designs can explain the different postoperative clinical results of different implant types in myopia and keratoconus.

  17. Corneale crosslinking voor progressieve keratoconus

    NARCIS (Netherlands)

    Wisse, Robert P L; Soeters, Nienke; Godefrooij, Daniel A.; De Koning-Tahzib, Nayyirih G.

    2016-01-01

    Keratoconus is a corneal disease with onset typically occurring during puberty or early adulthood. The cornea progressively thins and acquires a cone-like shape which negatively affects visual acuity. In the early stages, visual acuity can be corrected with glasses or contact lenses. In more

  18. Current Therapeutic Approach to Hypertrophic Scars

    Directory of Open Access Journals (Sweden)

    Zrinka Bukvić Mokos

    2017-06-01

    Full Text Available Abnormal scarring and its accompanying esthetic, functional, and psychological sequelae still pose significant challe nges. To date, there is no satisfactory prevention or treatment option for hypertrophic scars (HSs, which is mostly due to not completely comprehending the mechanisms underlying their formation. That is why the apprehension of regular and controlled physiological processes of scar formation is of utmost importance when facing hypertrophic scarring, its pathophysiology, prevention, and therapeutic approach. When treating HSs and choosing the best treatment and prevention modality, physicians can choose from a plethora of therapeutic options and many commercially available products, among which currently there is no efficient option that can successfully overcome impaired skin healing. This article reviews current therapeutic approach and emerging therapeutic strategies for the management of HSs, which should be individualized, based on an evaluation of the scar itself, patients’ expectations, and practical, evidence-based guidelines. Clinicians are encouraged to combine various prevention and treatment modalities where combination therapy that includes steroid injections, 5-fluorouracil, and pulsed-dye laser seems to be the most effective. On the other hand, the current therapeutic options are usually empirical and their results are unreliable and unpredictable. Therefore, there is an unmet need for an effective, targeted therapy and prevention, which would be based on an action or a modulation of a particular factor with clarified mechanism of action that has a beneficial effect on wound healing. As the extracellular matrix has a crucial role in cellular and extracellular events that lead to pathological scarring, targeting its components mostly by regulating bone morphogenetic proteins may throw up new therapeutic approach for reduction or prevention of HSs with functionally and cosmetically acceptable outcome.

  19. Quality of life and psychosocial impact of scarring and non-scarring alopecia in women.

    Science.gov (United States)

    Katoulis, Alexandros C; Christodoulou, Christos; Liakou, Aikaterini I; Kouris, Anargyros; Korkoliakou, Panagiota; Kaloudi, Eythymia; Kanelleas, Antonios; Papageorgiou, Charalabos; Rigopoulos, Dimitrios

    2015-02-01

    Alopecia is a common dermatological condition with mostly cosmetic consequences that, nevertheless, has significant psychological and psychosocial impact. To assess the impact of alopecia on quality of life and certain psychological domains and to compare it between scarring and non-scarring alopecia in Greek adult women. Forty-four women, aged 18-70 years, with scarring (n = 19) or non-scarring alopecia (n = 25) were recruited. All patients were evaluated by Dermatology Life Quality Index (DLQI), Hospital Anxiety and Depression Scale (HADS), Rosenberg Self-esteem Scale (RSES) and UCLA Loneliness Scale (UCLA-LS). Women with scarring alopecia had higher scores in DLQI, HADS and UCLA- LS and lower scores in RSES, compared to women with non-scarring alopecia. A statistically significant difference between the two groups was documented for DLQI (p = 0.0067), HADS (p = 0.0008), and HADS-Anxiety (HADS-A) (p alopecia compared with non-scarring alopecia, probably depicting the poorer prognosis of the former. © 2015 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  20. Functional Regeneration Beyond the Glial Scar

    Science.gov (United States)

    Cregg, Jared M.; DePaul, Marc A.; Filous, Angela R.; Lang, Brad T.; Tran, Amanda; Silver, Jerry

    2014-01-01

    Astrocytes react to CNS injury by building a dense wall of filamentous processes around the lesion. Stromal cells quickly take up residence in the lesion core and synthesize connective tissue elements that contribute to fibrosis. Oligodendrocyte precursor cells proliferate within the lesion and help to entrap dystrophic axon tips. Here we review evidence that this aggregate scar acts as the major barrier to regeneration of axons after injury. We also consider several exciting new interventions that allow axons to regenerate beyond the glial scar, and discuss the implications of this work for the future of regeneration biology. PMID:24424280

  1. Scar treatment variations by skin type.

    Science.gov (United States)

    Visscher, Marty O; Bailey, J Kevin; Hom, David B

    2014-08-01

    Patients and clinicians use skin color attributes such as color uniformity, color distribution, and texture to infer physiologic health status. Normalization of skin color, surface texture, and height are important treatment goals in the treatment of scars. Skin color, structure, and response to trauma, vary with ethnicity. The incidence of hypertrophic and keloid scar formation is influenced by these inherent skin attributes. Skin type influences the response to various modalities including laser therapy and surgical intervention, and skin differences must be considered in treatment planning to achieve optimal results. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. Transmission and scarring in graphene quantum dots

    Energy Technology Data Exchange (ETDEWEB)

    Huang Liang; Lai Yingcheng; Ferry, David K; Akis, Richard; Goodnick, Stephen M [Department of Electrical Engineering, Arizona State University, Tempe, AZ 85287 (United States)

    2009-08-26

    We study electronic transport in quantum-dot structures made of graphene. Focusing on the rectangular dot geometry and utilizing the non-equilibrium Green's function to calculate the transmission in the tight-binding framework, we find significant fluctuations in the transmission as a function of the electron energy. The fluctuations are correlated with the formation of quantum scarring states, or pointer states in the dot. Both enhancement and suppression of transmission have been observed. As the size of the quantum dot is increased, more scarring states can be formed, leading to stronger transmission or conductance fluctuations.

  3. Chronic caesarian section scar pain treated with fascial scar release techniques: A case series.

    Science.gov (United States)

    Wasserman, Jennifer B; Steele-Thornborrow, Jessica L; Yuen, Jeremy S; Halkiotis, Melissa; Riggins, Elizabeth M

    2016-10-01

    To describe outcomes of two subjects with chronically painful Caesarian section (C-section) scars following an intervention of specific myofascial scar release techniques. Case series. Over 1.3 million C-sections are performed annually in the US. Anywhere from 7 to 18% of those will develop chronic scar pain. Although anecdotal evidence supporting the use of fascial release in reducing surgical scar pain exists, almost no research has been published. Two subjects who both underwent two C-sections resulting in chronic discomfort of 6-9 years duration participated in this study. Both reported premenstrual pain, pain upon pressure to the lower abdomen, and pain during bowel movements. Subject 1 also reported sharp pain with bed mobility. Four, 30-min treatment sessions over a period of two weeks consisted of stretching the scar until a release in tissue tension was felt by the treating therapist. Outcome measures included pain and pressure tolerance using a Pressure Algometer, measurements of scar flexibility using an Adheremeter, and the Numeric Pain Rating Scale (NPRS). These measures were collected at baseline, five days after the final treatment and at four weeks. Both subjects demonstrated improvements in all outcome measures. At four weeks, pressure tolerance at all point improved as much as 79% (p < 0.0001) and scar mobility increased in all directions at all points as much as 200% (p < 0.0001). Following treatment, both subjects rated their premenstrual pain for all previously painful activities at 0/10 for the first time since their surgeries. These results suggest that scar release techniques may help reduce chronic scar pain in women who have had C-section surgery. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Corneal biomechanical parameters during pregnancy.

    Science.gov (United States)

    Sen, Emine; Onaran, Yüksel; Nalcacioglu-Yuksekkaya, Pinar; Elgin, Ufuk; Ozturk, Faruk

    2014-01-01

    To evaluate the variation in biomechanical properties and central corneal thickness (CCT) for each trimester during pregnancy and to compare the values with those in nonpregnant women. We prospectively studied the eyes of 32 pregnant and 34 age-matched non-pregnant women. The parameters included corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann-correlated intraocular pressure (IOP), and corneal-compensated IOP measured by the Ocular Response Analyzer (ORA). The CCT was also measured with an ultrasonic pachymeter attached to the ORA. The mean age was 27.0 ± 3.8 years in the study group and 28.0 ± 4.1 years in the control group. The mean CH measurement was 10.6 ± 1.4 mmHg in the study group and 10.1 ± 1.3 mmHg in the control group. The mean CRF value was 9.6 ± 1.7 mmHg in the study group and 10.0 ± 1.4 mmHg in the control group. The mean CCT value was 541.1 ± 22.4 µm in the study group and 536.5 ± 27.1 µm in the control group. No statistically significant differences were found regarding CH, CRF, or CCT values between the 2 groups (independent t test, p = 0.160, p = 0.355, p = 0.450, respectively). Hormonal changes during pregnancy may not affect corneal biomechanics. This may be due to the balanced effect of the various hormones on the cornea during pregnancy.

  5. Management of corneal bee sting

    Directory of Open Access Journals (Sweden)

    Razmjoo H

    2011-12-01

    Full Text Available Hassan Razmjoo1,2, Mohammad-Ali Abtahi1,2,4, Peyman Roomizadeh1,3, Zahra Mohammadi1,2, Seyed-Hossein Abtahi1,3,41Medical School, Isfahan University of Medical Sciences (IUMS; 2Ophthalmology Ward, Feiz Hospital, IUMS; 3Isfahan Medical Students Research Center (IMSRC, IUMS; 4Isfahan Ophthalmology Research Center (IORC, Feiz Hospital, IUMS, Isfahan, IranAbstract: Corneal bee sting is an uncommon environmental eye injury that can result in various ocular complications with an etiology of penetrating, immunologic, and toxic effects of the stinger and its injected venom. In this study we present our experience in the management of a middle-aged male with a right-sided deep corneal bee sting. On arrival, the patient was complaining of severe pain, blurry vision with acuity of 160/200, and tearing, which he had experienced soon after the injury. Firstly, we administered conventional drugs for eye injuries, including topical antibiotic, corticosteroid, and cycloplegic agents. After 2 days, corneal stromal infiltration and edema developed around the site of the sting, and visual acuity decreased to 100/200. These conditions led us to remove the stinger surgically. Within 25 days of follow-up, the corneal infiltration decreased gradually, and visual acuity improved to 180/200. We suggest a two-stage management approach for cases of corneal sting. For the first stage, if the stinger is readily accessible or primary dramatic reactions, including infiltration, especially on the visual axis, exist, manual or surgical removal would be indicated. Otherwise, we recommend conventional treatments for eye injuries. Given this situation, patients should be closely monitored for detection of any worsening. If the condition does not resolve or even deteriorates, for the second stage, surgical removal of the stinger under local or generalized anesthesia is indicated.Keywords: bee sting, stinger, cornea, removal, management, surgery

  6. Prophylactic effect of topical silica nanoparticles as a novel antineovascularization agent for inhibiting corneal neovascularization following chemical burn

    Directory of Open Access Journals (Sweden)

    Mehrdad Mohammadpour

    2015-01-01

    Conclusions: SiNPs is an effective modality for inhibiting corneal neovascularization following chemical burn in an experimental model. Further investigations are suggested for evaluation of its safety and efficacy in human eyes.

  7. [Corneal collagen cross-linking for keratoconus].

    Science.gov (United States)

    Zotov, V V; Pashtaev, N P; Pozdeeva, N A

    2015-01-01

    Over the last decade, corneal collagen cross-linking (CXL) has become a conventional treatment method for progressive keratoconus. Laboratory studies have shown that CXL increases the diameter of collagen fibers and also the number of intra- and interfibrillar cross-links, thus, increasing biomechanical strength of the irradiated cornea. As confirmed by a series of clinical and randomized controlled trials, CXL is able to slow down and, perhaps, to stop the progression of keratoconus. In most post-CXL patients visual acuity improves, while keratometric readings, spherical equivalent, and higher order aberrations reduce. Although published results prove CXL effective in the treatment of progressive keratoconus, its late consequences are yet unknown. This article reviews the stages of CXL development and results of published experimental and clinical studies. Prospects for CXL modifications that do not require epithelial debridement are discussed.

  8. Imaging, Reconstruction, And Display Of Corneal Topography

    Science.gov (United States)

    Klyce, Stephen D.; Wilson, Steven E.

    1989-12-01

    The cornea is the major refractive element in the eye; even minor surface distortions can produce a significant reduction in visual acuity. Standard clinical methods used to evaluate corneal shape include keratometry, which assumes the cornea is ellipsoidal in shape, and photokeratoscopy, which images a series of concentric light rings on the corneal surface. These methods fail to document many of the corneal distortions that can degrade visual acuity. Algorithms have been developed to reconstruct the three dimensional shape of the cornea from keratoscope images, and to present these data in the clinically useful display of color-coded contour maps of corneal surface power. This approach has been implemented on a new generation video keratoscope system (Computed Anatomy, Inc.) with rapid automatic digitization of the image rings by a rule-based approach. The system has found clinical use in the early diagnosis of corneal shape anomalies such as keratoconus and contact lens-induced corneal warpage, in the evaluation of cataract and corneal transplant procedures, and in the assessment of corneal refractive surgical procedures. Currently, ray tracing techniques are being used to correlate corneal surface topography with potential visual acuity in an effort to more fully understand the tolerances of corneal shape consistent with good vision and to help determine the site of dysfunction in the visually impaired.

  9. Corneal biomechanical properties in thyroid eye disease.

    Science.gov (United States)

    Karabulut, Gamze Ozturk; Kaynak, Pelin; Altan, Cıgdem; Ozturker, Can; Aksoy, Ebru Funda; Demirok, Ahmet; Yılmaz, Omer Faruk

    2014-06-01

    The purpose of this study is to investigate the effect of thyroid eye disease (TED) on the measurement of corneal biomechanical properties and the relationship between these parameters and disease manifestations. A total of 54 eyes of 27 individuals with TED and 52 eyes of 30 healthy control participants were enrolled. Thyroid ophthalmopathy activity was defined using the VISA (vision, inflammation, strabismus, and appearance/exposure) classification for TED. The intraocular pressure (IOP) measurement with Goldmann applanation tonometer (GAT), axial length (AL), keratometry, and central corneal thickness (CCT) measurements were taken from each patient. Corneal biomechanical properties, including corneal hysteresis (CH) and corneal resistance factor (CRF) and noncontact IOP measurements, Goldmann-correlated IOP (IOPg) and corneal-compensated IOP (IOPcc) were measured with the Ocular Response Analyzer (ORA) using the standard technique. Parameters such as best corrected visual acuity, axial length, central corneal thickness, and corneal curvature were not statistically significant between the two groups (p > 0.05). IOP measured with GAT was higher in participants with TED (p corneal resistance factor between groups. However, IOPg and IOPcc were significantly higher in TED patients. CH and VISA grading of TED patients showed a negative correlation (p = 0.007). In conclusion, TED affects the corneal biomechanical properties by decreasing CH. IOP with GAT and IOPg is found to be increased in these patients. As the severity of TED increases, CH decreases in these patients. Copyright © 2014. Published by Elsevier B.V.

  10. Clinical applications of corneal confocal microscopy

    Directory of Open Access Journals (Sweden)

    Mitra Tavakoli

    2008-06-01

    Full Text Available Mitra Tavakoli1, Parwez Hossain2, Rayaz A Malik11Division of Cardiovascular Medicine, University of Manchester and Manchester Royal Infirmary, Manchester, UK; 2University of Southampton, Southampton Eye Unit, Southampton General Hospital, Southampton, UKAbstract: Corneal confocal microscopy is a novel clinical technique for the study of corneal cellular structure. It provides images which are comparable to in-vitro histochemical techniques delineating corneal epithelium, Bowman’s layer, stroma, Descemet’s membrane and the corneal endothelium. Because, corneal confocal microscopy is a non invasive technique for in vivo imaging of the living cornea it has huge clinical potential to investigate numerous corneal diseases. Thus far it has been used in the detection and management of pathologic and infectious conditions, corneal dystrophies and ecstasies, monitoring contact lens induced corneal changes and for pre and post surgical evaluation (PRK, LASIK and LASEK, flap evaluations and Radial Keratotomy, and penetrating keratoplasty. Most recently it has been used as a surrogate for peripheral nerve damage in a variety of peripheral neuropathies and may have potential in acting as a surrogate marker for endothelial abnormalities.Keywords: corneal confocal microscopy, cornea, infective keratitis, corneal dystrophy, neuropathy

  11. Turning the tide of corneal blindness

    Directory of Open Access Journals (Sweden)

    Matthew S Oliva

    2012-01-01

    Full Text Available Corneal diseases represent the second leading cause of blindness in most developing world countries. Worldwide, major investments in public health infrastructure and primary eye care services have built a strong foundation for preventing future corneal blindness. However, there are an estimated 4.9 million bilaterally corneal blind persons worldwide who could potentially have their sight restored through corneal transplantation. Traditionally, barriers to increased corneal transplantation have been daunting, with limited tissue availability and lack of trained corneal surgeons making widespread keratoplasty services cost prohibitive and logistically unfeasible. The ascendancy of cataract surgical rates and more robust eye care infrastructure of several Asian and African countries now provide a solid base from which to dramatically expand corneal transplantation rates. India emerges as a clear global priority as it has the world′s largest corneal blind population and strong infrastructural readiness to rapidly scale its keratoplasty numbers. Technological modernization of the eye bank infrastructure must follow suit. Two key factors are the development of professional eye bank managers and the establishment of Hospital Cornea Recovery Programs. Recent adaptation of these modern eye banking models in India have led to corresponding high growth rates in the procurement of transplantable tissues, improved utilization rates, operating efficiency realization, and increased financial sustainability. The widespread adaptation of lamellar keratoplasty techniques also holds promise to improve corneal transplant success rates. The global ophthalmic community is now poised to scale up widespread access to corneal transplantation to meet the needs of the millions who are currently blind.

  12. Database of predicted SCAR markers in five fruit and three ...

    Indian Academy of Sciences (India)

    2016-03-04

    ; Paran and Michelmore 1993) markers were introduced to overcome the disadvantages of RAPD. It is easy to design SCAR primers if the target sequence is known. SCAR primers are longer (18–25 bases) than RAPD.

  13. Will stem cells bring hope to pathological skin scar treatment?

    Science.gov (United States)

    Li, Qiankun; Zhang, Cuiping; Fu, Xiaobing

    2016-08-01

    Pathological skin scars, such as keloids, aesthetically and psychosocially affect patients. The quest for scar reduction and the increasing recognition of patient satisfaction has led to the continued exploration of scar treatment. Stem cells are a promising source for tissue repair and regeneration. The multi-potency and secretory functions of these cells could offer possible treatments for pathological scars and have been examined in recent studies. Here, we analyze the factors that influence the formation of pathological skin scars, summarize recent research on pathological scar treatment with stem cells and elaborate on the possible mechanisms of this treatment. Additionally, other effects of stem cell treatments are also presented while evaluating potential side effects of stem cell-based pathological scar treatments. Thus, this review may provide meaningful guidance in the clinic for scar treatments with stem cells. Copyright © 2016. Published by Elsevier Inc.

  14. Before and After Photos: Treatment of Hypertrophic Scars

    Science.gov (United States)

    ... Hands Age Spots Aging Skin Birthmarks Burn Scars Cellulite Crow's Feet Droopy Eyelids Excess Fat Excessive Sweating ... Hands Age Spots Aging Skin Birthmarks Burn Scars Cellulite Crow's Feet Droopy Eyelids Excess Fat Excessive Sweating ...

  15. Changes of corneal biomechanics with keratoconus.

    Science.gov (United States)

    Wolffsohn, James S; Safeen, Saima; Shah, Sunil; Laiquzzaman, Mohammad

    2012-08-01

    To perform advanced analysis of the corneal deformation response to air pressure in keratoconics compared with age- and sex-matched controls. The ocular response analyzer was used to measure the air pressure-corneal deformation relationship of 37 patients with keratoconus and 37 age (mean 36 ± 10 years)- and sex-matched controls with healthy corneas. Four repeat air pressure-corneal deformation profiles were averaged, and 42 separate parameters relating to each element of the profiles were extracted. Corneal topography and pachymetry were performed with the Orbscan II. The severity of the keratoconus was graded based on a single metric derived from anterior corneal curvatures, difference in astigmatism in each meridian, anterior best-fit sphere, and posterior best-fit sphere. Most of the biomechanical characteristics of keratoconic eyes were significantly different from normal eyes (P corneal applanation. With increasing keratoconus severity, the cornea was thinner (r = -0.407, P corneal concave deformation past applanation was quicker (dive; r2 = -0.314, P = 0.01), and the tear film index was lower (r = -0.319, P = 0.01). The variance in keratoconus severity could be accounted for by the corneal curvature and central corneal thickness (r = 0.80) with biomechanical characteristics contributing an additional 4% (total r = 0.84). The area under the receiver operating characteristic curve was 0.919 ± 0.025 for keratometry alone, 0.965 ± 0.014 with the addition of pachymetry, and 0.972 ± 0.012 combined with ocular response analyzer biomechanical parameters. Characteristics of the air pressure-corneal deformation profile are more affected by keratoconus than the traditionally extracted corneal hysteresis and corneal resistance factors. These biomechanical metrics slightly improved the detection and severity prediction of keratoconus above traditional keratometric and pachymetric assessment of corneal shape.

  16. Short scar correction of the tuberous breast.

    Science.gov (United States)

    Ribeiro, Liacyr; Accorsi, Affonso; Buss, Affonso; Pessĵa, Marcelo Castro Marçal

    2002-07-01

    This article describes the author's technique-an alternative form of short scar correction of tuberous breast. The historical background that suports the technique is described as well as the surgical sequence. Illustrative cases and postoperative results reached by author's technique are shown.

  17. Recombinant human endostatin reduces hypertrophic scar ...

    African Journals Online (AJOL)

    Methods: Sixteen New Zealand white rabbits were used to establish HS models. Then, rabbit ears containing HS were randomly assigned to either the Endostar group or the control group. The changes of appearance and histology were evaluated using the naked eye, hematoxylin eosin staining, and a scar elevation index.

  18. Pulmonary scar carcinoma in South Africa

    African Journals Online (AJOL)

    of both fibrosis and cancer.[2,3]. The Western Cape Province of South Africa (SA) has one of the highest recorded incidences of pulmonary tuberculosis (TB) in the world, and also carries a high burden of smoking-related diseases including lung cancer.[4] However, the potential association between pulmonary scarring and ...

  19. An idiosyncratic history of burn scars.

    Science.gov (United States)

    Petro, Jane A

    2015-03-01

    The history of burn scars can best be found in military medical history. The care of wounded soldiers documented in the Illiad reflected the trauma of the weapons of war, arrow, spear, sword, and ax. The introduction of gunpowder in the 14th century, increasingly sophisticated explosives, and in modern times, petroleum-driven vehicles, including airplanes, created a new subset of wounds requiring attention and post-survival scars challenging the quality of survival. This article selects from among a myriad of examples of modern military treatments as they relate to those survivors. Larrey, with Napolean's Grand Army, Sir Harold Gilles during and following World War I, and the Boston area preparation and response to the Cocoanut Grove Fire in 1942 are the principle topics examined. Recent modern interventions, related to the survival of horrific blast and burn injuries, with modern wound care and scar manipulation techniques provide context to the current ability to modify healing and scars. ©2015 Frontline Medical Communications.

  20. 9 CFR 11.3 - Scar rule.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Scar rule. 11.3 Section 11.3 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ANIMAL... inflammation, and, other bilateral evidence of abuse indicative of soring including, but not limited to...

  1. "Scars" connect classical and quantum theory

    CERN Multimedia

    Monteiro, T

    1990-01-01

    Chaotic systems are unstable and extremely sensitive to initial condititions. So far, scientists have been unable to demonstrate that the same kind of behaviour exists in quantum or microscopic systems. New connections have been discovered though between classical and quantum theory. One is the phenomena of 'scars' which cut through the wave function of a particle (1 page).

  2. The clinical outcome of cesarean scar pregnancies implanted "on the scar" versus "in the niche".

    Science.gov (United States)

    Kaelin Agten, Andrea; Cali, Giuseppe; Monteagudo, Ana; Oviedo, Johana; Ramos, Joanne; Timor-Tritsch, Ilan

    2017-05-01

    The term cesarean scar pregnancy refers to placental implantation within the scar of a previous cesarean delivery. The rising numbers of cesarean deliveries in the last decades have led to an increased incidence of cesarean scar pregnancy. Complications of cesarean scar pregnancy include morbidly adherent placenta, uterine rupture, severe hemorrhage, and preterm labor. It is suspected that cesarean scar pregnancies that are implanted within a dehiscent scar ("niche") behave differently compared with those implanted on top of a well-healed scar. To date there are no studies that have compared pregnancy outcomes between cesarean scar pregnancies implanted either "on the scar" or "in the niche." The purpose of this study was to determine the pregnancy outcome of cesarean scar pregnancy implanted either "on the scar" or "in the niche." This was a retrospective 2-center study of 17 patients with cesarean scar pregnancy that was diagnosed from 5-9 weeks gestation (median, 8 weeks). All cesarean scar pregnancies were categorized as either implanted or "on the scar" (group A) or "in the niche" (group B), based on their first-trimester transvaginal ultrasound examination. Clinical outcomes based on gestational age at delivery, mode of delivery, blood loss at delivery, neonate weight and placental histopathologic condition were compared between the groups with the use of the Mann-Whitney U test. Myometrial thickness overlying the placenta was compared among all the patients who required hysterectomy and those who did not with the use of the Mann-Whitney U test. Myometrial thickness was also correlated with gestational age at delivery with the use of Spearman's correlation. Group A consisted of 6 patients; group B consisted of 11 patients. Gestational age at delivery was lower in group B (median, 34 weeks; range, 20-36 weeks) than in group A (median, 38 weeks; range, 37-39 weeks; P=.001). In group A, 5 patients were delivered via cesarean delivery (with normal placenta), and

  3. SCAR knockouts in Dictyostelium: WASP assumes SCAR's position and upstream regulators in pseudopods

    National Research Council Canada - National Science Library

    Veltman, Douwe M; King, Jason S; Machesky, Laura M; Insall, Robert H

    2012-01-01

    ...) assembles actin at clathrin-coated pits. We show that, unexpectedly, Dictyostelium discoideum SCAR knockouts could still spread, migrate, and chemotax using pseudopods driven by the Arp2/3 complex...

  4. Evaluation of corneal symmetry after UV corneal crosslinking for keratoconus.

    Science.gov (United States)

    Mofty, Hanan; Alzahrani, Khaled; Carley, Fiona; Harper, Sophie; Brahma, Arun; Au, Leon; Morley, Debbie; Hillarby, M Chantal

    2017-01-01

    The purpose of this study was to assess UV corneal crosslinking (CXL) treatment outcomes for keratoconus by evaluating the corneal regularity in patients through follow-up using the Oculus Pentacam. A total of 18 eyes from CXL patients with keratoconus were studied before and after CXL treatment, and six eyes from six patients who were not treated with CXL served as controls. Treated patients had Pentacam images taken before CXL treatment and regularly 3 months post treatment up to the 12th month. Controls were imaged during their first appointment and after 12 months. Symmetry and asphericity were evaluated and correlated with both best-corrected visual acuity (BCVA) and maximum K -readings. In the CXL-treated group, there was a significant improvement in the index of symmetrical variation (ISV) and keratoconus index (KI) at 3 months and in the index of height asymmetry (IHA) and minimum radius of curvature ( R min ) at 9 months post treatment. On the contrary, the untreated group's indices showed some significant worsening in ISV, KI, central keratoconus index (CKI), and R min . A novel finding in our study was a slight positive shift of anterior asphericity in the 6 mm, 7 mm, and 8 mm 3 months after treatment, which had a correlation with BCVA ( R 2 =0.390, p =0.053) and a strong correlation with maximum K -reading ( R 2 =0.690, p =0.005). However, the untreated group had no significant changes after 1 year. The corneal asymmetrical shape is associated with the spherical aberration alteration influenced by temporal evolution of surface ablation and increased corneal haze. However, insignificant changes in symmetry attest the stabilization effect on cornea postoperatively as compared with controls.

  5. Posterior corneal shape : Comparison of height data from 3 corneal topographers

    NARCIS (Netherlands)

    de Jong, Tim; Sheehan, Matthew T.; Koopmans, Steven A.; Jansonius, Nomdo M.

    Purpose: To compare the ability of 3 clinical corneal topographers to describe the posterior corneal shape. Setting: University Medical Center Groningen, the Netherlands. Design: Prospective observational study. Methods: Corneas of healthy participants were measured twice with a dual Scheimpflug

  6. The hidden cost of skin scars: quality of life after skin scarring.

    Science.gov (United States)

    Brown, B C; McKenna, S P; Siddhi, K; McGrouther, D A; Bayat, A

    2008-09-01

    Surprisingly little is known about how skin scars affect patients' lives, though specialist clinical impressions suggest their impact is related to both their physical and psychosocial effects. Facial scars have been shown to cause high levels of anxiety and self-consciousness, but further work has been neglected. We aimed to explore the influence of skin scars on patients' quality of life (QoL) and identify potential implications for clinical practice. We adopted a needs-based approach to QoL and conducted semi-structured interviews with scar patients at a specialist clinic. Transcribed data underwent interpretative phenomenological analysis to identify common themes in individuals' personal experiences. Thirty-four scar patients (24 women; aged 14-70 years, mean=35.7 years, SD=17.9 years) with a wide range of scar type, severity and onset were recruited. Five hundred and seventy-three statements were identified from interview transcripts relating to need impairment by skin scars. These were subsequently classified into 44 themes covering five main areas: physical comfort and functioning; acceptability to self and others; social functioning; confidence in the nature and management of the condition; emotional well-being. The majority of respondents were unhappy with their scar's appearance due to their perceived stigma and psychological associations, and thus adopted different coping behaviours to hide or compensate for them. Often this made them unsociable and interfered with their communication skills, personal relationships, work life and leisure activities. Concerns about the diagnosis and persistent nature of scars were common, whilst unempathic management by general physicians and frustrations of current treatment compounded distress. There are five main areas of impact on the needs of scar patients that should be addressed in their management, which are greater and more complex than previously considered. Support services should be made available, along with

  7. Combination therapy in the management of atrophic acne scars

    Directory of Open Access Journals (Sweden)

    Shilpa Garg

    2014-01-01

    Full Text Available Background: Atrophic acne scars are difficult to treat. The demand for less invasive but highly effective treatment for scars is growing. Objective: To assess the efficacy of combination therapy using subcision, microneedling and 15% trichloroacetic acid (TCA peel in the management of atrophic scars. Materials and Methods: Fifty patients with atrophic acne scars were graded using Goodman and Baron Qualitative grading. After subcision, dermaroller and 15% TCA peel were performed alternatively at 2-weeks interval for a total of 6 sessions of each. Grading of acne scar photographs was done pretreatment and 1 month after last procedure. Patients own evaluation of improvement was assessed. Results: Out of 16 patients with Grade 4 scars, 10 (62.5% patients improved to Grade 2 and 6 (37.5% patients improved to Grade 3 scars. Out of 22 patients with Grade 3 scars, 5 (22.7% patients were left with no scars, 2 (9.1% patients improved to Grade 1and 15 (68.2% patients improved to Grade 2. All 11 (100% patients with Grade 2 scars were left with no scars. There was high level of patient satisfaction. Conclusion: This combination has shown good results in treating not only Grade 2 but also severe Grade 4 and 3 scars.

  8. Prevalence of scar contractures after burn : A systematic review

    NARCIS (Netherlands)

    Oosterwijk, Anouk M; Mouton, Leonora J; Schouten, Hennie; Disseldorp, Laurien M; van der Schans, Cees P.; Nieuwenhuis, Marianne K

    OBJECTIVE: Burn scar contractures are the pathological outcome of excessive scarring and ongoing scar contraction. Impairment of joint range of motion is a threat to performing activities in daily living. To direct treatment strategies to prevent and/or correct such contractures, insight into the

  9. The Use of Silicone Adhesives for Scar Reduction.

    Science.gov (United States)

    Bleasdale, Benjamin; Finnegan, Simon; Murray, Kathyryn; Kelly, Sean; Percival, Steven L

    2015-07-01

    Significance: This article discusses the history and developments of silicone gel sheeting (SGS) scar therapy. Furthermore, we review a breadth of literature to gain an insight into how and why topical silicone gels remain the favored treatment of medical experts in scar management. We also analyze an ever increasing number of alternative therapies claiming to provide enhanced scar reduction performance. Recent Advances: Topical silicone gel treatments seem to remain the first point of clinical recommendation in scar management. SGS has been used in scar therapy for over 30 years, during which its efficacy has been the subject of numerous clinical evaluations. Critical Issues: While the exact mechanisms by which SGS improves hypertrophic scars, keloid development and recovery are yet to be fully agreed upon, its ability to do so remains largely undisputed at present. However, there still is ongoing deliberation over the exact mechanism of action of silicone in improving a scar. At present it is likely that through occlusion of the scar site and hydration of the wound bed, the overactivity of scar-related cells is suppressed, and their activity normalized. Future Direction: The clinical support of topical silicone gel products, relative to all alternative scar therapies, is considered the internationally recommended first-line form of scar management, and favored by consensus among healthcare professionals. However, there still remains the need for further clinical evidence and a better understanding of the mechanism behind the benefit of silicone gel for use in the prevention of abnormal scarring.

  10. Currently known risk factors for hypertrophic skin scarring : A review

    NARCIS (Netherlands)

    Butzelaar, L.; Ulrich, M. M W; Mink Van Der Molen, A. B.; Niessen, F. B.; Beelen, R. H J

    2016-01-01

    SummaryObjective The study aims to provide an overview of risk factors for hypertrophic scarring. Background Hypertrophic skin scarring remains a major concern in medicine and causes considerable morbidity. Despite extensive research on this topic, the precise mechanism of excessive scarring is

  11. The Use of Silicone Adhesives for Scar Reduction

    Science.gov (United States)

    Bleasdale, Benjamin; Finnegan, Simon; Murray, Kathyryn; Kelly, Sean; Percival, Steven L.

    2015-01-01

    Significance: This article discusses the history and developments of silicone gel sheeting (SGS) scar therapy. Furthermore, we review a breadth of literature to gain an insight into how and why topical silicone gels remain the favored treatment of medical experts in scar management. We also analyze an ever increasing number of alternative therapies claiming to provide enhanced scar reduction performance. Recent Advances: Topical silicone gel treatments seem to remain the first point of clinical recommendation in scar management. SGS has been used in scar therapy for over 30 years, during which its efficacy has been the subject of numerous clinical evaluations. Critical Issues: While the exact mechanisms by which SGS improves hypertrophic scar/span>s, keloid development and recovery are yet to be fully agreed upon, its ability to do so remains largely undisputed at present. However, there still is ongoing deliberation over the exact mechanism of action of silicone in improving a scar. At present it is likely that through occlusion of the scar site and hydration of the wound bed, the overactivity of scar-related cells is suppressed, and their activity normalized. Future Direction: The clinical support of topical silicone gel products, relative to all alternative scar therapies, is considered the internationally recommended first-line form of scar management, and favored by consensus among healthcare professionals. However, there still remains the need for further clinical evidence and a better understanding of the mechanism behind the benefit of silicone gel for use in the prevention of abnormal scarring. PMID:26155385

  12. Therapeutic Improvement of Scarring: Mechanisms of Scarless and Scar-Forming Healing and Approaches to the Discovery of New Treatments

    Directory of Open Access Journals (Sweden)

    Nick L. Occleston

    2010-01-01

    Full Text Available Scarring in the skin after trauma, surgery, burn or sports injury is a major medical problem, often resulting in loss of function, restriction of tissue movement and adverse psychological effects. Whilst various studies have utilised a range of model systems that have increased our understanding of the pathways and processes underlying scar formation, they have typically not translated to the development of effective therapeutic approaches for scar management. Existing treatments are unreliable and unpredictable and there are no prescription drugs for the prevention or treatment of dermal scarring. As a consequence, scar improvement still remains an area of clear medical need. Here we describe the basic science of scar-free and scar-forming healing, the utility of pre-clinical model systems, their translation to humans, and our pioneering approach to the discovery and development of therapeutic approaches for the prophylactic improvement of scarring in man

  13. Vertical scar versus the inverted-T scar reduction mammaplasty: a 10-year follow-up.

    Science.gov (United States)

    Bouwer, Lesley R; van der Biezen, Jan Jaap; Spronk, Cees A; van der Lei, Berend

    2012-10-01

    A retrospective study was undertaken to evaluate whether the initial outcome of two types of reduction mammaplasty techniques (vertical scar reduction mammaplasty vs. the inverted-T scar reduction mammaplasty) remains stable in the long term: Sixty-nine patients who had undergone breast reduction surgery in the period 1997-2000 at the Department of Reconstructive Plastic Surgery at the Medical Center of Leeuwarden were willing and able to participate in this study. A structured questionnaire was used to assess the degree of patient satisfaction. For subjective evaluation, the Strasser Grading System on photographs at the 3 months after surgery and after long-term follow-up (10 years) was used. The median general appreciation mark for the entire surgical procedure given by patients was 8 (1-10) on a scale from 1 to 10. Forty-six of the 69 patients could be scored according to Strasser: at 3 months in 17 patients (37%) the result was 'good', in 21 patients (46%) 'mediocre' and in eight patients (17%) 'poor'. After 10 years, in 37 of the patients (80%) the result was 'good', in six patients (13%) 'mediocre' and in three patients (7%) 'poor'. At 3 months, there was a higher incidence of bottoming out in the vertical scar group (one on two patients) as compared to the inverted-T scar group (one on 10 patients); however, at the 10-years follow-up bottoming out was 50% in the inverted-T scar group and 20% in the vertical scar group. Despite bottoming out, in both the vertical scar reduction mammaplasty technique and the inverted-T scar reduction mammaplasty technique, high patient satisfaction rates are achieved that remains for years. Copyright © 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  14. The relationship of graft survival and herpes simplex virus latency in recipient corneal buttons

    Directory of Open Access Journals (Sweden)

    Orhan Aydemir

    2007-10-01

    Full Text Available Orhan Aydemir1, Peykan Türkçüoglu1, Yasemin Bulut2, Ahmet Kalkan31Firat University School of Medicine, Department of Ophthalmology, Elazig, Turkey; 2Firat University School of Medicine, Department of Microbiology, Elazig, Turkey; 3Firat University School of Medicine, Department of Infectious Diseases, Elazig, TurkeyPurpose: To demonstrate relationship between herpes simplex virus (HSV corneal latency and graft survival.Methods: Prospective case control study. 28 recipient corneal buttons and donor cornea-scleral remnants were examined for HSV DNA with polymerase chain reaction (PCR. None of the recipient had a history of HSV infection. Serum samples of graft recipients were analyzed for the presence of anti-HSV IgG and IgM with enzyme-linked immunosorbent assay technique. All corneas were free of stromal scarring or epithelial defect before sampling and had an endothelial cell density of >2000 cells/mm2.Results: In twenty three patients (82% anti-HSV IgG was detected in serum. In none of the recipients anti-HSV IgM was positive. HSV DNA was positive in six out of twenty eight (21% of the recipient corneal buttons and none of the donor cornea-scleral remnants. In eighteen months follow-up period three out of six (50% HSV DNA positive and one out of twenty-two (4.5% HSV DNA negative patients experienced late endothelial failure that was statistically significantly different (p = 0.022. Conclusion: Even without a history of HSV keratitis, presence of latent HSV virus in recipient cornea is an important risk factor for subsequent graft survival.Keywords: herpes simplex virus, polymerase chain reaction, corneal latency, corneal graft survival

  15. Visual management of aphakia with concomitant severe corneal irregularity by mini-scleral design contact lenses.

    Science.gov (United States)

    Alipur, Fateme; Hosseini, Seyedeh Simindokht

    2016-03-01

    To evaluate visual results, comfort of use, safety, and efficacy of mini scleral contact lenses in optical management in patients with traumatic aphakia and severe concomitant irido-corneal injury. In a case series, eight eyes with post traumatic aphakia and severe concomitant irido-corneal injury that were evaluated at the Contact Lens Clinic of Farabi Eye Hospital, Tehran, Iran for contact lens fitting and could not be corrected with conventional corneal RGP contact lenses were fitted with miniscleral contact lenses. Uncorrected visual acuity (UCVA), best spectacle corrected visual acuity (BSCVA), and BCVA (Best corrected visual acuity) with miniscleral lens were recorded. Slit lamp examination, comfortable daily wearing time, and any contact lens-related complication were documented in each follow-up visit. The mean UCVA and BSCVA of the cases was >2.7 and 0.41 LogMAR, respectively (BSCVA could not be assessed in one case due to severe corneal irregularity). The mean final BCVA with the miniscleral lens was 0.05 LogMAR (range from 0.4 to -0.04 LogMAR). The mean follow-up period was 14.6 months. The mean comfortable daily wearing time (CDWT) was 11.6 h, ranging from 8 to 16 h. The only contact lens-related complication was mild redness and irritation that was observed in 2 patients during the follow-up visits. All patients were comfortable with handling these lenses. Miniscleral contact lenses can be considered a safe and effective option in aphakia patients with concurrent corneal scarring secondary to ocular injury for whom surgical intervention would be complicated.

  16. Altered corneal stromal matrix organization is associated with mucopolysaccharidosis I, III and VI.

    Science.gov (United States)

    Alroy, J; Haskins, M; Birk, D E

    1999-05-01

    The presence of cloudy corneas is a prominent feature of mucopolysaccharidosis (MPS) types I and VI, but not MPS IIIA or IIIB. The cause of corneal cloudiness in MPS I and VI is speculative. Transparency of the cornea is dependent on the uniform diameter and the regular spacing and arrangement of the collagen fibrils within the stroma. Alterations in the spacing of collagen fibrils in a variety of conditions including corneal edema, scars, and macular corneal dystrophy is clinically manifested as corneal opacity. The purpose of this study was to compare the structural organization of the stromal extracellular matrix of normal corneas with that of MPS corneas. The size and arrangement of collagen fibrils in cloudy corneas from patients with MPS I were examined. The alterations observed were an increased mean fibril diameter with a broader distribution in the MPS corneas. The MPS I corneas also had altered fibril spacing and more irregular packing compared with normal control corneas. The clear corneas of patients with MPS IIIA and IIIB also showed increases in mean fibril diameter and fibril spacing. However, there was less variation indicating more regularity than seen in MPS I. In addition, corneas from cat models of certain MPS were compared to the human corneas. Cats with MPS I and VI, as well as normal control cats, were examined. Structural alterations comparable to those seen in human MPS corneas were seen in MPS I and VI cats relative to normal clear corneas. The findings suggest that cloudy corneas in MPS I and VI are in part a consequence of structural alterations in the corneal stroma, including abnormal spacing, size, and arrangement of collagen fibrils. Copyright 1999 Academic Press.

  17. [Perioperative interstitial brachytherapy for recurrent keloid scars].

    Science.gov (United States)

    Rio, E; Bardet, E; Peuvrel, P; Martinet, L; Perrot, P; Baraer, F; Loirat, Y; Sartre, J-Y; Malard, O; Ferron, C; Dreno, B

    2010-01-01

    Evaluation of the results of perioperative interstitial brachytherapy with low dose-rate (LDR) Ir-192 in the treatment of keloid scars. We performed a retrospective analysis of 73 histologically confirmed keloids (from 58 patients) resistant to medicosurgical treated by surgical excision plus early perioperative brachytherapy. All lesions were initially symptomatic. Local control was evaluated by clinical evaluation. Functional and cosmetic results were assessed in terms of patient responses to a self-administered questionnaire. Median age was 28 years (range 13-71 years). Scars were located as follows: 37% on the face, 32% on the trunk or abdomen, 16% on the neck, and 15% on the arms or legs. The mean delay before loading was four hours (range, 1-6h). The median dose was 20Gy (range, 15-40Gy). Sixty-four scars (from 53 patients) were evaluated. Local control was 86% (follow-up, 44.5 months; range, 14-150 months). All relapses occurred early - within 2 years posttreatment. At 20 months, survival without recurrence was significantly lower when treated lengths were more than 6cm long. The rate was 100% for treated scars below 4.5cm in length, 95% (95% CI: 55-96) for those 4.5-6cm long, and 75% (95% CI: 56-88) beyond 6cm (p=0.038). Of the 35 scars (28 patients) whose results were reassessed, six remained symptomatic and the esthetic results were considered to be good in 51% (18/35) and average in 37% (13/35) (median follow-up, 70 months; range, 16-181 months). Early perioperative LDR brachytherapy delivering 20Gy at 5mm reduced the rate of recurrent keloids resistant to other treatments and gave good functional results. 2009 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

  18. Value of recombinant human epidermal growth factor in corneal wound repair after corneal foreign body elimination

    OpenAIRE

    Hong-Jie Han

    2013-01-01

    AIM: To investigate the repair efficacy of recombinant human epidermal growth factor on corneal epithelium after corneal foreign body eliminating operation. METHODS: There were 102 patients with corneal foreign body(188 affected eyes)chosen for the study. All patients were divided into treatment group and control group according to the random number table. Both groups received corneal foreign body elimination by slit lamp. Postoperatively, the treatment group was given eye drops containing ep...

  19. Corneal Toxicity Following Exposure to Asclepias Tuberosa

    DEFF Research Database (Denmark)

    Mikkelsen, Lauge Hjorth; Hamoudi, Hassan; Gül, Cigdem Altuntas

    2017-01-01

    PURPOSE: To present a case of corneal toxicity following exposure to milky plant latex from Asclepias tuberosa. METHODS: A 70-year-old female presented with blurred vision and pain in her left eye after handling an Ascepias tuberosa. Clinical examination revealed a corneal stromal oedema with small...... that inhibit the Na+/ K+-ATPase in the corneal endothelium. The oedema resolved after 96 hours. After nine months the best corrected visual acuity was 20/20. CONCLUSION: Corneal toxicity has previously been reported for plants of the Asclepias family. This is a rare case describing severe corneal toxicity...... caused by exposure to latex from Asclepias tuberosa. Handling of plants of the Asclepias family should be kept as a differential diagnosis in cases of acute corneal toxicity....

  20. Genetics Home Reference: lattice corneal dystrophy type I

    Science.gov (United States)

    ... corneal dystrophy type I lattice corneal dystrophy type I Printable PDF Open All Close All Enable Javascript ... expand/collapse boxes. Description Lattice corneal dystrophy type I is an eye disorder that affects the clear, ...

  1. Immunoglobulins in granular corneal dystrophy Groenouw type I

    DEFF Research Database (Denmark)

    Møller, H U; Bojsen-Møller, M; Schrøder, H D

    1993-01-01

    Three patients with granular corneal dystrophy Groenouw type I underwent corneal grafting, and cryostat sections of the corneal buttons were examined immunohistochemically for immunoglobulins. Positive results were obtained for IgG, Kappa-, and Lambda chains with immunofluorescence technique. The...

  2. Microkeratome-assisted superficial anterior lamellar keratoplasty for anterior stromal corneal opacities after penetrating keratoplasty.

    Science.gov (United States)

    Patel, Amit K; Scorcia, Vincenzo; Kadyan, Anju; Lapenna, Lucia; Ponzin, Diego; Busin, Massimo

    2012-01-01

    To describe the surgical technique and report the outcomes of patients treated with microkeratome-assisted superficial anterior lamellar keratoplasty for anterior stromal corneal opacities developing after penetrating keratoplasty (PK). All patients with post-penetrating keratoplasty anterior stromal opacities treated with microkeratome-assisted superficial anterior lamellar keratoplasty between July 2005 and June 2007 were reviewed. A 130-μm superficial keratectomy was performed, followed by the placement of an appropriately sized donor graft, which was secured with overlay sutures. Refraction, corneal topography, and uncorrected and best-corrected visual acuities (UCVA, BCVA, respectively) were noted at each examination. Nine eyes of 8 consecutive patients were identified. Causes of anterior stromal opacities included dystrophy recurrence (n = 3), post-photorefractive keratectomy haze (n = 2), and scarring after stromal melt (n = 4). BCVA improved in all 9 eyes at final follow-up, and 7 of 9 eyes achieved ≥20/40 within the first month. Average follow-up period was 28 ± 3.9 months. Refractive astigmatism also improved by an average of 0.7 diopters. Superficial anterior lamellar keratoplasty is a viable and effective alternative to repeat PK in treating anterior stromal scars. It avoids open-globe surgery and exposure to endothelial rejection associated with repeat PK, and visual rehabilitation is considerably quicker.

  3. Corneal epithelium in penetrating keratoplasty.

    Science.gov (United States)

    Meyer, R F; Bobb, K C

    1980-08-01

    We studied corneal epithelium in 66 patients with bullous keratopathy treated with penetrating keratoplasty using McCarey-Kaufman stored donor corneas. Epithelium was evaluated at times of storage, surgery, and postoperative dressing changes. Epithelium was intact in 43 of the donor corneas at storage, and 23 had 5 to 100% (median, 50%) epithelium missing. At the end of the keratoplasty procedure, 16 grafts had epithelium intact, and 50 had 5 to 100% (median, 20%) epithelium missing. Postoperative epithelial healing time ranged from one to 12 days, with a median of two days. Postoperative healing was significantly prolonged when donor corneal epithelium was missing at keratoplasty. As the amount of epithelium intact at the end of surgery decreased, the number of days to heal postoperatively increased. We found that donor corneas could be stored as long as 79 hours, with 63 hours in McCarey-Kaufman medium, and still have epithelium intact at the end of the keratoplasty procedure.

  4. Corneal astigmatism following cataract extraction.

    Science.gov (United States)

    Wishart, M S; Wishart, P K; Gregor, Z J

    1986-01-01

    The changes in corneal curvature in the first six months after cataract extraction were studied by performing sequential keratometry on a group of 57 patients. 8/0 Virgin silk interrupted sutures were used for the closure of corneoscleral incisions, and 10/0 monofilament tied in double running (bootlace) or single running (continuous) fashion was used for corneal wound closure. A high degree of with-the-rule astigmatism was evident in all patients two weeks postoperatively, but thereafter the character of the astigmatism produced by 8/0 virgin silk and 10/0 monofilament closure was quite different: in the 8/0 virgin silk group there was an early and pronounced shift in the axis of astigmatism to against-the-rule, whereas in the 10/0 monofilament group there was little further change in the astigmatism unless the sutures were removed. Wound compression and wound gape as factors responsible for these changes are discussed. PMID:3539177

  5. Glaucoma and Corneal Transplant Procedures

    Directory of Open Access Journals (Sweden)

    Ammar M. Al-Mahmood

    2012-01-01

    Full Text Available Glaucoma after corneal transplantation is a leading cause of ocular morbidity after penetrating keratoplasty. The incidence reported is highly variable and a number of etiologic factors have been identified. A number of treatment options are available; surgical intervention for IOP control is associated with a high incidence of graft failure. IOP elevation is less frequently seen following deep anterior lamellar keratoplasty. Descemet's striping-automated endothelial keratoplasty is also associated with postprocedure intraocular pressure elevation and secondary glaucoma and presents unique surgical challenges in patients with preexisting glaucoma surgeries. Glaucoma exists in up to three-quarters of patients who undergo keratoprosthesis surgery and the management if often challenging. The aim of this paper is to highlight the incidence, etiology, and management of glaucoma following different corneal transplant procedures. It also focuses on the challenges in the diagnosis of glaucoma and intraocular pressure monitoring in this group of patients.

  6. Corneal hemangiosarcoma in a cat.

    Science.gov (United States)

    Cazalot, G; Regnier, A; Deviers, A; Serra, F; Lucas, M N; Etienne, C L; Letron, I Raymond

    2011-09-01

    A 10 year-old castrated male Domestic Short-hair cat with a history of chronic bilateral keratitis was referred for assessment of a red, elevated mass involving the left cornea. The rapid growth of the mass, over a month period in combination with pronounced vascularization and invasion of the corneal surface suggested an aggressive inflammatory or neoplastic process. Following keratectomy, the lesion was diagnosed histopathologically as a hemangiosarcoma. The tumor recurred locally within 3 weeks and enucleation was performed. Histopathologic examination of the globe confirmed the diagnosis and did not reveal infiltration of the limbus and conjunctiva. No signs of local recurrence or metastatic disease have been observed 18 months following enucleation. To the authors' knowledge this is the first case of primary corneal hemangiosarcoma described in the feline species. © 2011 American College of Veterinary Ophthalmologists.

  7. Evaluation of corneal symmetry after UV corneal crosslinking for keratoconus

    Directory of Open Access Journals (Sweden)

    Mofty H

    2017-11-01

    Full Text Available Hanan Mofty,1,2 Khaled Alzahrani,2 Fiona Carley,3 Sophie Harper,3 Arun Brahma,3 Leon Au,3 Debbie Morley,3 M Chantal Hillarby2 1Optometry Department, College of Applied Medical Science, King Saud University, Riyadh, Kingdom of Saudi Arabia; 2Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, 3Manchester Royal Eye Hospital, Manchester, UK Purpose: The purpose of this study was to assess UV corneal crosslinking (CXL treatment outcomes for keratoconus by evaluating the corneal regularity in patients through follow-up using the Oculus Pentacam.Patients and methods: A total of 18 eyes from CXL patients with keratoconus were studied before and after CXL treatment, and six eyes from six patients who were not treated with CXL served as controls. Treated patients had Pentacam images taken before CXL treatment and regularly 3 months post treatment up to the 12th month. Controls were imaged during their first appointment and after 12 months. Symmetry and asphericity were evaluated and correlated with both best-corrected visual acuity (BCVA and maximum K-readings.Results: In the CXL-treated group, there was a significant improvement in the index of symmetrical variation (ISV and keratoconus index (KI at 3 months and in the index of height asymmetry (IHA and minimum radius of curvature (Rmin at 9 months post treatment. On the contrary, the untreated group’s indices showed some significant worsening in ISV, KI, central keratoconus index (CKI, and Rmin. A novel finding in our study was a slight positive shift of anterior asphericity in the 6 mm, 7 mm, and 8 mm 3 months after treatment, which had a correlation with BCVA (R2=0.390, p=0.053 and a strong correlation with maximum K-reading (R2=0.690, p=0.005. However, the untreated group had no significant changes after 1 year.Conclusion: The corneal asymmetrical shape is associated with the spherical aberration alteration

  8. Corneal Donor Tissue Preparation for Endothelial Keratoplasty

    OpenAIRE

    Woodward, Maria A.; Titus, Michael; Mavin, Kyle; Shtein, Roni M.

    2012-01-01

    Over the past ten years, corneal transplantation surgical techniques have undergone revolutionary changes1,2. Since its inception, traditional full thickness corneal transplantation has been the treatment to restore sight in those limited by corneal disease. Some disadvantages to this approach include a high degree of post-operative astigmatism, lack of predictable refractive outcome, and disturbance to the ocular surface. The development of Descemet's stripping endothelial keratoplasty (DSEK...

  9. Corneal Biomechanics Determination in Healthy Myopic Subjects

    OpenAIRE

    Kunliang Qiu; Xuehui Lu; Riping Zhang; Geng Wang; Mingzhi Zhang

    2016-01-01

    Purpose. To determine the corneal biomechanical properties by using the Ocular Response Analyzer? and to investigate potential factors associated with the corneal biomechanics in healthy myopic subjects. Methods. 135 eyes from 135 healthy myopic subjects were included in this cross-sectional observational study. Cornea hysteresis (CH), corneal resistance factor (CRF), cornea-compensated intraocular pressure (IOPcc), and Goldmann-correlated intraocular pressure (IOPg) were determined with the ...

  10. On the surgical treatment of hypertrophic scars: a comprehensive guideline for the surgical treatment of hypertrophic scars

    NARCIS (Netherlands)

    Stekelenburg, C.M.; van der Wal, M.B.A.; Middelkoop, E.; Niessen, F.B.; van Zuijlen, P.P.M.

    2012-01-01

    Background: Treating the hypertrophic scar remains a challenging problem. It often leaves the clinician with the questions whether, when and how to treat a hypertrophic scar. Methods: This review will focus on the surgical treatment of hypertrophic scars considering the latest research in this

  11. Differences in collagen architecture between keloid, hypertrophic scar, normotrophic scar, and normal skin: An objective histopathological analysis

    NARCIS (Netherlands)

    Verhaegen, P.D.; Zuijlen, van P.P.; Pennings, N.M.; Marle, van J.; Niessen, F.B.; Horst, C.; Middelkoop, E.

    2009-01-01

    Normotrophic, hypertrophic, and keloidal scars are different types of scar formation, which all need a different approach in treatment. Therefore, it is important to differentiate between these types of scar, not only clinically but also histopathologically. Differences were explored for collagen

  12. Efficacy and Safety of a Novel 100% Silicone Scar Gel Treatment for Early Intervention in Scar Management.

    Science.gov (United States)

    Goldberg, David J

    2016-12-01

    Objective: To evaluate the efficacy and safety of a new topical silicone gel for the early intervention in the management of scars. Design: In this 12-week, observational study, healthy subjects (n=15) with an accessible linear or hypertrophic scar were given the test product and instructed to apply twice daily. Subjects returned 14, 28, 56, and 84 days later for evaluation and recording of adverse events. Setting: Private practice of the author. Participants: Eligible subjects had a scar with a Vancouver Scar Scale total score ≥3 at baseline. Measurements: Improvement was evaluated by the Vancouver Scar Scale and Observer Scar Assessment Scale at baseline and at four follow-up visits. Results: The median total Vancouver Scar Scale score and median total Observer Scar Assessment Scale score decreased significantly from baseline at each visit, showing rapid and continuing improvement in the appearance of the scars. For Vancouver Scar Scale, significant differences of individual parameters from baseline began at 28 days for pliability and height, 56 days for vascularity, and 84 days for pigmentation. For Observer Scar Assessment Scale parameters, significant differences from baseline began at 14 days and continued until 84 days for vascularization, thickness, and pigmentation. Pain and pruritis scores were low at each visit. Overall, 84.6 percent of subjects rated the treatment as excellent, very good, or good after three months of treatment. No adverse events were reported. Conclusion: The test product improved the appearance of scars after three months of twice-daily treatment and without adverse events.

  13. Refractive surgery following corneal graft.

    Science.gov (United States)

    Alió, Jorge L; Abdou, Ahmed A; Abdelghany, Ahmed A; Zein, Ghassam

    2015-07-01

    To review the different surgical procedures for management of postkeratoplasty refractive errors after total suture removal. There are different surgical options to address residual refractive errors that frequently occur after corneal transplantation. The correction can be done on the corneal surface or intraocular with intraocular lens (IOL) implantation which requires complete tectonic and refractive stability after suture removal. The most commonly used procedures are photorefractive keratectomy, laser in-situ keratomileusis and Phakic IOLs. Keratoplasty has been profited by recent advances in refractive surgery. Custom excimer laser ablation is an alternative way to treat irregular errors. New IOL modalities are good practical options for a wide range of errors. Femtosecond laser, as a new option in the toolbox, can modify corneal grafting refractive results and assist corrective refractive procedures. Although being the most successful organ transplantation, keratoplasty is usually followed by significant ametropia. Different corrective modalities exist and the choice should fit ocular conditions, patient requirements, surgeon skills and the available technologies. Recent advances in ophthalmic surgery have improved the outcomes.

  14. Refractive surgery after corneal transplantation.

    Science.gov (United States)

    Chang, Daniel H; Hardten, David R

    2005-08-01

    Many patients who have undergone corneal transplantation are unable to achieve satisfactory visual acuity with spectacle and contact lens correction alone. For these patients, refractive surgery becomes a viable option to reduce the post-keratoplasty ametropia. With the many recent advances in refractive surgery for naturally occurring refractive error, new possibilities arise for application to this complicated set of patients. This review discusses key recent developments in refractive surgery after corneal transplantation. The biomechanical effects of incisional keratotomy on post-keratoplasty corneas continue to be studied, and these techniques remain a common and simple method of reducing astigmatism. Photorefractive keratectomy, previously problematic for regression and haze formation, is gaining new prominence as early experience with the adjunctive use of mitomycin C has demonstrated good results. Long-term studies with laser in-situ keratomileusis (LASIK) have continued to show good safety and efficacy. Modern developments in cataract surgery appear to have lower incidences of graft rejection and failure. Developments in lens implantation technology continue to offer expanding options for intraocular refractive surgery. Although visual rehabilitation after corneal transplantation remains a formidable challenge, developments in refractive surgery for naturally occurring ametropias directly translate into an improved ability to help these most challenging refractive cases. Continued research will bring about improved efficacy while maintaining a high level of safety.

  15. Obtaining corneal tissue for keratoplasty.

    Science.gov (United States)

    Navarro Martínez-Cantullera, A; Calatayud Pinuaga, M

    2016-10-01

    Cornea transplant is the most common tissue transplant in the world. In Spain, tissue donation activities depend upon transplant coordinator activities and the well-known Spanish model for organ and tissue donation. Tissue donor detection system and tissue donor evaluation is performed mainly by transplant coordinators using the Spanish model on donation. The evaluation of a potential tissue donor from detection until recovery is based on an exhaustive review of the medical and social history, physical examination, family interview to determine will of the deceased, and a laboratory screening test. Corneal acceptance criteria for transplantation have a wider spectrum than other tissues, as donors with active malignancies and infections are accepted for kearatoplasty in most tissue banks. Corneal evaluation during the whole process is performed to ensure the safety of the donor and the recipient, as well as an effective transplant. Last step before processing, corneal recovery, must be performed under standard operating procedures and in a correct environment. Copyright © 2016 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  16. Central corneal thickness in glaucoma.

    Science.gov (United States)

    Sng, Chelvin C A; Ang, Marcus; Barton, Keith

    2017-03-01

    The purpose of this review is to summarize the role of central corneal thickness (CCT) in the clinical management of a glaucoma patient. The prognostic value of CCT is well recognized in patients with ocular hypertension. However, its predictive value in other glaucoma suspects and patients with established glaucoma is less certain. Tonometry artefacts can result from variations in CCT. However, an adequately validated correction algorithm for Goldmann applanation tonometry measurements does not exist. Newer methods of tonometry are potentially less influenced by CCT but are limited in their clinical use. There may also be biological and genetic associations between corneal thickness and glaucoma. Demographics, environmental factors, glaucoma treatment and the measurement device used have a significant influence on CCT, and should be considered when interpreting the effect of cornea thickness in patients with glaucoma. New measurements of the biomechanical properties of the cornea are likely to be better approximations of the globe biomechanics than CCT, but these require further evaluation. The clinical significance of CCT is well recognized in the context of glaucoma diagnosis and management, though the extent of its importance remains debatable. Corneal biomechanical properties may be more significantly associated with glaucoma than CCT.

  17. Fractional Carbon Dioxide Laser in Treatment of Acne Scars

    OpenAIRE

    Andrej Petrov; Vesna Pljakovska

    2015-01-01

    BACKGROUND: Scars appear as a result of skin damage during the process of the skin healing. There are two types of acne scars, depending on whether there is a loss or accumulation of collagen: atrophic and hypertrophic. In 80-90% it comes to scars with loss of collagen compared to smaller number of hypertrophic scars and keloids. AIM: The aim of the study was to determine efficiency and safety of fractional carbon dioxide laser in the treatment of acne scars. MATERIAL AND METHODS: The...

  18. Relationship between Corneal Sensation, Blinking, and Tear Film Quality

    National Research Council Canada - National Science Library

    Nosch, Daniela Sonja; Pult, Heiko; Albon, Julie; Purslow, Christine; Murphy, Paul John

    2016-01-01

    PURPOSETo examine the possible role of corneal sensitivity and tear film quality in triggering a blink by investigating the relationship between blink rate, central corneal sensitivity threshold (CST...

  19. [Surgical strategy for postburn cervical scar contracture].

    Science.gov (United States)

    Feng, Shaoqing; Su, Weijie; Xi, Wenjing; Min, Peiru; Pu, Zheming; Zhang, Yan; Zhang, Yixin

    2015-08-01

    To explore the surgical strategy for postburn cervical scar contracture. Sixty-five patients with scar contracture as a result of burn injury in the neck were hospitalized from July 2013 to July 2014. Release of cervical scar contracture was conducted according to different demands of the 3 anatomic subunits of neck, i.e. lower lip vermilion border-supramaxillary region, submaxillary region, and anterior region of neck. After release of contracture, platysma was released. For some cases with chin retrusion, genioplasty with horizontal osteotomy was performed. The coverage of wound followed the principle of similarity, i.e. the skin tissue covering the wound in the neck should be similar to the characters of skin around the wound in terms of color, texture, and thickness. Based on this principle, except for the preschool children in whom skin grafting was performed, the wounds of the other patients were covered by local skin flaps, adjacent skin flaps, or free skin flaps. All patients underwent release of scar and platysma, while 9 patients underwent genioplasty with horizontal osteotomy. Wounds were covered with local skin flaps in 32 patients, with adjacent skin flaps in 7 patients, with free skin flaps in 11 patients, and with skin grafts in 15 patients. All skin grafts and flaps survived. Good range of motion was achieved in the neck of all patients, with the cervicomental angle after reconstruction ranging from 90 to 120°. All patients were followed up for 6 to 24 months. Six patients who had undergone skin grafting were found to have some degrees of skin contracture, while none of the patients who had undergone flap coverage showed any signs of contracture recurrence. Restoration of the cervicomental angle is critical in the treatment of postburn cervical scar contracture, and the release of scar contracture should conform to the subunit principle. The coverage of wound should be based on the principle of similarity, with repair by skin flaps as the first

  20. Effects of ethyl-cyanoacrylate and octyl-cyanoacrylate on experimental corneal lesions in rabbits Efeitos do etil-cianoacrilato ou do octil-cianoacrilato sobre lesões corneais experimentais em coelhos

    Directory of Open Access Journals (Sweden)

    V.T. Barbosa

    2009-10-01

    Full Text Available The use of ethyl-cyanoacrylate and octyl-cyanoacrylate were clinically and histopathologically compared on the corneas of 36 rabbits after lamellar keratectomy (standardized diameter and depth. The animals were distributed into two groups, one for each type of adhesive. From each group, six subgroups were histopathologically evaluated on the 3rd, 7th, 14th, 21st, 30th, and 60th day post-operative. General (daily and ophthalmic (days 0, 1, 3, 5, 7, 14, 21, 30, 44, and 60 evaluations clinically indicated that there were significant differences for the variables water intake, attitude, blepharitis, corneal edema, and fluorescein test. The adhesive permanence time for octyl-cyanoacrylate (17.22 days was greater than that for ethyl-cyanoacrylate (7.66 days. With respect to the histopathological evaluation, corneal epithelization and collagen organization occurred without severe complications. However, treatment with ethyl-cyanoacrylate led to a moderate inflammatory reaction in the initial phases. With octyl-cyanoacrylate, re-epithelization and collagen organization proceeded more slowly with a discrete inflammatory reaction in the initial phases. From clinical and histopathologic points of view, octyl-cyanoacrylate showed advantages over ethyl-cyanoacrylate, whereas wound healing was achieved in both groups without major complications.Comparou-se o uso do etil-cianoacrilato e do octil-cianoacrilato em córneas de 36 coelhos após ceratectomia lamelar (diâmetro e profundidade padronizados. Os animais foram distribuídos em dois grupos, segundo o tipo de adesivo, e redistribuídos em seis subgrupos com três animais cada, para as avaliações histológicas aos 3, 7, 14, 21, 30 e 60 dias de pós-operatório. As avaliações clínicas gerais (diárias e as oftálmicas (dias 0, 1, 3, 5, 7, 14, 21, 30, 44 e 60, indicaram diferença entre os dois grupos, quanto ao consumo de água, atitude, blefarite, edema da córnea e teste da fluoresceína. O Tempo de

  1. Suppressed inflammatory gene expression during human hypertrophic scar compared to normotrophic scar formation.

    Science.gov (United States)

    van den Broek, Lenie J; van der Veer, Willem M; de Jong, Etty H; Gibbs, Susan; Niessen, Frank B

    2015-08-01

    Hypertrophic scar formation is a result of adverse cutaneous wound healing. The pathogenesis of hypertrophic scar formation is still poorly understood. A problem next to the lack of suitable animal models is that often normal skin is compared to hypertrophic scar (HTscar) and not to normotrophic scar (NTscar) tissue. Another drawback is that often only one time period after wounding is studied, while scar formation is a dynamic process over a period of several months. In this study, we compared the expression of genes involved in inflammation, angiogenesis and extracellular matrix (ECM) formation and also macrophage infiltration in biopsies obtained before and up to 52 weeks after standard surgery in five patients who developed HTscar and six patients who developed NTscar. It was found that HTscar formation coincided with a prolonged decreased expression of inflammatory genes (TNFα, IL-1α, IL-1RN, CCL2, CCL3, CXCL2, CXCR2, C3 and IL-10) and an extended increased expression of ECM-related genes (PLAU, Col3A1, TGFβ3). This coincided with a delayed but prolonged infiltration of macrophages (type 2) in HTscar tissue compared to NTscar tissue. These findings were supported by immunohistochemical localization of proteins coding for select genes named above. Our study emphasizes that human cutaneous wound healing is a dynamic process that is needed to be studied over a period of time rather than a single point of time. Taken together, our results suggest innate immune stimulatory therapies may be a better option for improving scar quality than the currently used anti-inflammatory scar therapies. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Scar dechanneling: new method for scar-related left ventricular tachycardia substrate ablation.

    Science.gov (United States)

    Berruezo, Antonio; Fernández-Armenta, Juan; Andreu, David; Penela, Diego; Herczku, Csaba; Evertz, Reinder; Cipolletta, Laura; Acosta, Juan; Borràs, Roger; Arbelo, Elena; Tolosana, Jose María; Brugada, Josep; Mont, Lluis

    2015-04-01

    Ventricular tachycardia (VT) substrate ablation usually requires extensive ablation. Scar dechanneling technique may limit the extent of ablation needed. The study included 101 consecutive patients with left ventricular scar-related VT (75 ischemic patients; left ventricular ejection fraction, 36 ± 13%). Procedural end point was the elimination of all identified conducting channels (CCs) by ablation at the CC entrance followed by abolition of residual inducible VTs. By itself, scar dechanneling rendered noninducibility in 54.5% of patients; ablation of residual inducible VT increased noninducibility to 78.2%. Patients needing only scar dechanneling had a shorter procedure (213 ± 64 versus 244 ± 71 minutes; P = 0.027), fewer radiofrequency applications (19 ± 11% versus 27 ± 18%; P = 0.01), and external cardioversion/defibrillation shocks (20% versus 65.2%; P scar dechanneling alone had better event-free survival (80% versus 62%) and lower mortality (5% versus 11%). Incomplete CC-electrogram elimination was the only independent predictor (hazard ratio, 2.54 [1.06-6.10]) for the primary end point. Higher end point-free survival rates were observed in patients noninducible after scar dechanneling (log-rank P = 0.013) and those with complete CC-electrogram elimination (log-rank P = 0.013). The complications rate was 6.9%, with no deaths. Scar dechanneling alone results in low recurrence and mortality rates in more than half of patients despite the limited ablation extent required. Residual inducible VT ablation improves acute results, but patients who require it have worse outcomes. Recurrences are mainly related to incomplete CC-electrogram elimination. © 2015 American Heart Association, Inc.

  3. Femtosecond laser-assisted lamellar keratoplasty (FSLK) for anterior corneal stromal diseases.

    Science.gov (United States)

    Almousa, Radwan; Samaras, Konstantinos E; Khan, Saj; Lake, Damian B; Daya, Sheraz M

    2014-02-01

    Our objective was to study the outcome of femtosecond-assisted lamellar keratoplasty (FSLK) in stromal corneal diseases. This is a retrospective chart review of 17 patients (20 eyes) who underwent FSLK for anterior corneal pathologies. Main outcome measures were refractive results following FSLK, complications, and graft survival. Mean follow-up time was 42 ± 15 (7-58) months. Preoperative best spectacle-corrected visual acuity (BSCVA) was ≤20/40 in 17 eyes. Postoperative BSCVA ≥ 20/40 was achieved in 12/14 at 12 months, 11/12 at 24 months, and 10/12 eyes at 36 months; postoperative BSCVA ≥ 20/25 was achieved in 8/14, 8/12, and 5/12 eyes at 12, 24, and 36 months, respectively. One eye had vertical gas break through the epithelium during the FSLK. One eye had postoperative epithelial rejection and two eyes had stromal rejection treated successfully with topical steroids. Another eye had epithelial ingrowth that was not progressive; however, the same eye developed bacterial keratitis and scarred graft 32 months post-FSLK. One eye had graft dehiscence and one eye developed excessive interface fibrosis. Five out of 20 grafts failed due to the recurrence of the original disease (3), corneal scarring (1), and excessive interface fibrosis (1). FSLK provides many advantages over conventional PK and DALK, with faster visual rehabilitation and emmetropization of the manifest refraction rather than inducing ametropia and irregular astigmatism.

  4. Effect of lactated Ringer's solution and compound electrolyte solution on the corneal endothelium in phacoemulsification

    Directory of Open Access Journals (Sweden)

    Yang Xia

    2017-11-01

    Full Text Available AIM: To compare the effect of compound electrolyte solution and lactated Ringer's solution on corneal function in cataract phacoemulsification, and to provide scientific basis for clinical selection of appropriate perfusion fluid. METHODS: The patients with senile cataract were randomly divided into control group with lactated Ringer's solution as anterior chamber perfusion and experimental group with compound electrolyte as anterior chamber perfusion. Surgical removal of cataract and phacoemulsification with intraocular lens implantation were taken. The corneal endothelial cell density, central corneal thickness, hexagonal cell ratio and endothelial cell coefficient of variation were measured at preoperative and postoperative points. RESULTS: Totally 60 patients successfully completed all follow-ups, the experimental group of 30 cases, the control group of 30 cases. The density of corneal endothelial cells in experimental group was significantly higher than those in the lactated Ringer's solution group at 1 and 3d after operations(P=0.030, 0.046. The coefficient of variation of corneal endothelial cells in lactated Ringer's solution group was higher than that in compound electrolyte group at 1 and 14d after operation(P=0.025, 0.014. The visual acuity of the compound electrolyte group was better than that of the lactated Ringer's solution on the first day after operation(P=0.04. CONCLUSION: In the phacoemulsification of senile cataract, the compound electrolyte perfusion has better histocompatibility, which can maintain the stability of corneal endothelial cell structure and reduce corneal endothelial cell injury. The compound electrolyte perfusion solution is more suitable for senile cataract phacoemulsification surgery.

  5. Response of corneal hysteresis and central corneal thickness following clear corneal cataract surgery.

    Science.gov (United States)

    Kandarakis, Artemios; Soumplis, Vasileios; Karampelas, Michalis; Koutroumanos, Ioannis; Panos, Christos; Kandarakis, Stylianos; Karagiannis, Dimitrios

    2012-09-01

    To evaluate the effect of routine phacoemulsification in corneal viscoelastic properties determined by corneal hysteresis (CH) and central corneal thickness (CCT) and to explore the impact of phaco energy on the above parameters. Forty-one eyes of 41 patients undergoing cataract surgery were enrolled in this prospective study. CH and CCT were measured preoperatively, 1 day and 1 week postoperatively. CCT measurement was performed using a non-contact optical pachymeter followed by ocular response analyzer (ORA) examination. Intraoperatively ultrasound time, average phaco power and effective phaco time (EPT) were recorded. Mean CH was 10.05±1.86 mmHg preoperatively, 8.25±1.85 mmHg 1 day and 9.12±1.37 mmHg 1 week postoperatively (pcorneal alterations following cataract surgery resulted in a statistical change in CH and CCT. These two parameters responded in a different manner that clearly demarcates their different nature. On the first postoperative day, CCT increase was correlated at a statistically significant level with intraoperative EPT. This correlation was not found with CH reduction. Other factors, besides cornea oedema or phacoemulsification energy, could be responsible for this CH modification. © 2011 The Authors. Acta Ophthalmologica © 2011 Acta Ophthalmologica Scandinavica Foundation.

  6. Corneal donor tissue preparation for endothelial keratoplasty.

    Science.gov (United States)

    Woodward, Maria A; Titus, Michael; Mavin, Kyle; Shtein, Roni M

    2012-06-12

    Over the past ten years, corneal transplantation surgical techniques have undergone revolutionary changes. Since its inception, traditional full thickness corneal transplantation has been the treatment to restore sight in those limited by corneal disease. Some disadvantages to this approach include a high degree of post-operative astigmatism, lack of predictable refractive outcome, and disturbance to the ocular surface. The development of Descemet's stripping endothelial keratoplasty (DSEK), transplanting only the posterior corneal stroma, Descemet's membrane, and endothelium, has dramatically changed treatment of corneal endothelial disease. DSEK is performed through a smaller incision; this technique avoids 'open sky' surgery with its risk of hemorrhage or expulsion, decreases the incidence of postoperative wound dehiscence, reduces unpredictable refractive outcomes, and may decrease the rate of transplant rejection. Initially, cornea donor posterior lamellar dissection for DSEK was performed manually resulting in variable graft thickness and damage to the delicate corneal endothelial tissue during tissue processing. Automated lamellar dissection (Descemet's stripping automated endothelial keratoplasty, DSAEK) was developed to address these issues. Automated dissection utilizes the same technology as LASIK corneal flap creation with a mechanical microkeratome blade that helps to create uniform and thin tissue grafts for DSAEK surgery with minimal corneal endothelial cell loss in tissue processing. Eye banks have been providing full thickness corneas for surgical transplantation for many years. In 2006, eye banks began to develop methodologies for supplying precut corneal tissue for endothelial keratoplasty. With the input of corneal surgeons, eye banks have developed thorough protocols to safely and effectively prepare posterior lamellar tissue for DSAEK surgery. This can be performed preoperatively at the eye bank. Research shows no significant difference in

  7. Thermal and infrared-diode laser effects on indocyanine-green-treated corneal collagen

    Science.gov (United States)

    Timberlake, George T.; Patmore, Ann; Shallal, Assaad; McHugh, Dominic; Marshall, John

    1993-07-01

    It has been suggested that laser welds of collagenous tissues form by interdigitation and chemical bonding of thermally 'unraveled' collagen fibrils. We investigated this proposal by attempting to weld highly collagenous, avascular corneal tissue with an infrared (IR) diode laser as follows. First, the temperature at which corneal collagen shrinks and collagen fibrils 'split' into subfibrillary components was determined. Second, since use of a near-IR laser wavelength necessitated addition of an absorbing dye (indocyanine green (ICG) to the cornea, we measured absorption spectra of ICG-treated tissue to ensure that peak ICG absorbance did not change markedly when ICG was present in the cornea. Third, using gel electrophoresis of thermally altered corneal collagen, we searched for covalently crosslinked compounds predicted by the proposed welding mechanism. Finally, we attempted to weld partial thickness corneal incisions infused with ICG. Principal experimental findings were as follows: (1) Human corneal (type I) collagen splits into subfibrillary components at approximately 63 degree(s)C, the same temperature that produces collagen shrinkage. (2) Peak ICG absorption does not change significantly in corneal stroma or with laser heating. (3) No evidence was found for the formation of novel compounds or the loss of proteins as a result of tissue heating. All tissue treated with ICG, however, exhibited a novel 244 kD protein band indicating chemical activity between collagen and corneal stromal components. (4) Laser welding corneal incisions was unsuccessful possibly due to shrinkage of the sides of the incision, lack of incision compression during heating, or a less than optimal combination of ICG concentration and radiant exposure. In summary, these experiments demonstrate the biochemical and morphological complexity of ICG-enhanced IR laser-tissue welding and the need for further investigation of laser welding mechanisms.

  8. Corneal biomechanical changes after collagen cross-linking from porcine eye inflation experiments.

    Science.gov (United States)

    Kling, Sabine; Remon, Laura; Pérez-Escudero, Alfonso; Merayo-Lloves, Jesus; Marcos, Susana

    2010-08-01

    Understanding corneal biomechanics is important to refractive or therapeutic corneal treatments. The authors studied the corneal response to variable intraocular pressure (IOP) in porcines eyes after UV collagen cross-linking (CXL), in comparison with untreated eyes. Twenty-three enucleated eyes were treated with standard CXL conditions (365 nm, 3 mW, 30 minutes), and 15 contralateral eyes served as control. Eyes (within a humidity- and temperature-monitored wet chamber) were measured by Scheimpflug corneal three-dimensional topographer. Images were obtained automatically while IOP either remained constant (14 eyes) or increased (24 eyes) by 40 mm Hg and then decreased (4-mm Hg steps). Measurements were performed immediately after treatment and 24 hours later. Corneal geometry was analyzed as a function of IOP, and whole globe stress-strain curves were calculated. Instillation of riboflavin-dextran solution reduced corneal thickness (by 281 +/- 5 microm). Cross-linking produced a 1.54x reduction in corneal thinning and 2.8x reduction in corneal apical rise with increased IOP. Anterior and posterior cornea flattened with increased IOP (less flattening in CXL eyes) and became steeper with decreased IOP. The horizontal meridian flattened significantly (P Cross-linking stiffened porcine corneas significantly. Both experimental data and stress-strain analysis are valuable for finite element models to improve understanding of CXL and its predictability. Although differences are expected between human corneas in vivo and porcine corneas ex vivo, the results are consistent with clinical data found in patients. The apparent biomechanical anisotropy of pig corneas must be confirmed in humans.

  9. Perianal episiotomy scar endometrioma: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Wei Chiang; Kim, Kyo Nam; Kim, Soo Ah; Kim, Soon Yong [Sung Ae General Hospital, Seoul (Korea, Republic of)

    2000-09-01

    Endometrioma is a common clinical condition, but cases in which an episiotomy scaris present are, however, rare: only two cases have been reported in obstetric journals, and one other in a radiologic journal. All three were in English. We encountered a case in which a solitary endometrioma was present in the perineal region beneath an episiotomy scar. An irregularly marginated hypoechoic mass was revealed by US, and a discrete homogeneous enhancing mass by CT. (author)

  10. "Marriage" abdominoplasty: a short scar technique.

    Science.gov (United States)

    Shestak, Kenneth C; Walgenbach, Klaus J; Azari, Kodi

    2002-05-01

    Short scar abdominoplasty-that is, a marriage of aggressive superwet lipoplasty, rectus abdominis muscle plication, and excision of lower abdominal skin and excess adipose tissue-can be used as an alternative to conventional abdominoplasty in properly selected patients. According to the authors, this technique offers the advantages of less invasive surgery, decreased pain, and faster return to work. (Aesthetic Surg J 2002;22:294-301.).

  11. Optic disc planimetry, corneal hysteresis, central corneal thickness, and intraocular pressure as risk factors for glaucoma.

    Science.gov (United States)

    Carbonaro, Francis; Hysi, Pirro G; Fahy, Samantha J; Nag, Abhishek; Hammond, Christopher J

    2014-02-01

    To determine whether corneal hysteresis and central corneal thickness are independent risk factors for glaucoma. A cross-sectional population-based cohort study. Associations were tested between corneal hysteresis, measured in 1754 population-based subjects from the TwinsUK cohort, and glaucoma-related endophenotypes, including intraocular pressure (IOP), vertical cup-to-disc ratio, optic disc area, and optic disc cup area. Corneal hysteresis, IOP, and central corneal thickness (CCT) were measured; optic disc photographs were analyzed; and multivariable linear regression analysis was performed. Data were available on 1645 individuals. Multiple regression analysis showed corneal hysteresis to be significantly negatively associated with age (beta coefficient = -0.03, P Corneal hysteresis was also found to be associated with CCT (beta coefficient = 0.02, P corneal hysteresis and optic disc area (P = .6), cup area (P = .77), vertical cup-to-disc ratio (P = .51), or spherical equivalent (P = .08). CCT was also found to be significantly associated with IOP (beta coefficient = 3.3, P corneal hysteresis (beta coefficient = 9.4, P corneal hysteresis or CCT and quantitative measures of optic disc cupping, suggesting that corneal hysteresis and CCT are not independent risk factors for glaucoma. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Delayed corneal epithelial wound healing after penetrating keratoplasty in individuals with lattice corneal dystrophy.

    Science.gov (United States)

    Kawamoto, Koji; Morishige, Naoyuki; Yamada, Naoyuki; Chikama, Tai-Ichiro; Nishida, Teruo

    2006-07-01

    To investigate whether corneal epithelial cells of individuals with lattice corneal dystrophy (LCD) possess an intrinsic defect. Retrospective case-control study. The medical charts of nine individuals with LCD and those of 14 patients with keratoconus and 11 patients with corneal leukoma (controls), all of whom underwent penetrating keratoplasty (PKP) in one eye at Yamaguchi University Hospital between February 1998 and November 2001, were examined for the time for epithelial resurfacing after surgery. The time required for resurfacing of the corneal epithelium after PKP was significantly greater in LCD patients (8.56 +/- 4.95 days, mean +/- SD) than in patients with either keratoconus (1.71 +/- 0.91 days, P = .006) or corneal leukoma (3.00 +/- 1.95 days, P = .03). Corneal epithelial wound healing was delayed in LCD patients after PKP, suggesting that the keratoepithelin gene mutations responsible for this condition affect corneal epithelial cells.

  13. Association between corneal hysteresis and central corneal thickness in glaucomatous and non-glaucomatous eyes.

    Science.gov (United States)

    Mangouritsas, George; Morphis, George; Mourtzoukos, Spyridon; Feretis, Elias

    2009-11-01

    We aimed to determine corneal hysteresis values (CH) using the ocular response analyser (ORA) in non-glaucomatous and glaucomatous eyes and their relationship with central corneal thickness (CCT). Corneal hysteresis, intraocular pressure (IOP) as measured by Goldmann applanation tonometry (GAT) and CCT were prospectively evaluated in 74 non-glaucoma subjects with IOP Corneal hysteresis was significantly lower in eyes with treated POAG than in non-glaucomatous eyes. The corneal biomechanical response was strongly associated with CCT in non-glaucoma subjects, but only moderately so in glaucoma patients. It can be assumed that diverse structural factors, in addition to thickness, determine the differences in the corneal biomechanical profile between non-glaucomatous and glaucomatous eyes. Corneal hysteresis could be a useful tool in the diagnosis of glaucoma.

  14. Updated international clinical recommendations on scar management: part 2--algorithms for scar prevention and treatment.

    Science.gov (United States)

    Gold, Michael H; McGuire, Michael; Mustoe, Thomas A; Pusic, Andrea; Sachdev, Mukta; Waibel, Jill; Murcia, Crystal

    2014-08-01

    In 2002, an international advisory panel was convened to assess the scientific literature and develop evidence-based guidance for the prevention and treatment of pathologic scarring. Emerging clinical data, new treatment options, and technical advances warranted a renewed literature search and review of the initial advisory panel recommendations. To update the management algorithm for pathologic scarring to reflect best practice standards at present. Management recommendations were derived from clinical evidence amassed during a comprehensive literature search and from the clinical experience and consensus opinion of advisory panel members. A combination approach using multiple modalities provides the maximum potential for successful treatment of hypertrophic scars and keloids. The advisory panel advocates a move toward more aggressive initial management of keloids, including earlier application of 5-fluorouracil. A growing body of clinical research supports a place in therapy for newer agents (e.g., bleomycin, onion extract, imiquimod, mitomycin C) and laser therapy (pulsed-dye, fractional) for scar management. Prevention and treatment of pathologic scarring requires individualized care built upon the principles of evidence-based medicine and continues to evolve in step with technological and scientific advances.

  15. Utility of multiparametric MRI in Caesarean section scar characterization and preoperative prediction of scar dehiscence: a prospective study.

    Science.gov (United States)

    Kumar, Ishan; Verma, Ashish; Matah, Manjari; Satpathy, Gayatri

    2017-07-01

    Background Post-Caesarean uterine scar rupture during vaginal birth after Caesarean section (VBAC) is a potentially life-threatening complication. Prediction of scar dehiscence and scar rupture is vital in treatment planning and selecting candidates of trial of labor after a Caesarean section (CS). Purpose To assess the accuracy of magnetic resonance imaging (MRI) for evaluation of post-Caesarean uterine scar and to predict scar dehiscence during repeat CS. Material and Methods Thirty patients with a history of at least one previous CS underwent pelvic MRI for assessment of uterine scar during a subsequent gestation, all of whom underwent lower segment Caesarean section (LSCS) subsequently due to one of the established indications of CSs. Thickness, T1, T2 signal intensity ratio (SER), and apparent diffusion coefficient (ADC) value of scar site were charted. The lower uterine segment was assessed and graded intraoperatively and findings were correlated with MRI findings. Results A total of 30 participants were included in this study, of which nine were classified as having an abnormal scar (of various grades) based on surgical observations. T2 SER with a cutoff value of 0.935 showed the highest sensitivity of 100% and scar thickness value of 3.45 mm showed highest specificity of 91% in prediction of abnormal scar. On drawing a receiver operating characteristic (ROC) curve, T2 signal intensity ratio showed the highest area under the curve (AUC) closely followed by scar thickness values. Conclusion MRI derived parameters may be utilized for differentiation of an abnormal post-Caesarean uterine scar from a normal one. Both scar thickness and T2 SER measured on MRI can be used to predict scar dehiscence. However, T2 SER can serve as a more standardized and objective criterion.

  16. Finite element modeling of corneal strip extensometry

    CSIR Research Space (South Africa)

    Botha, N

    2012-12-01

    Full Text Available symmetric conicoid [19]: (x xo) 2+(y yo) 2+(1+Q)(z zo) 2 2R(z zo) 2 = 0; (2) c SACAM 2012 25 Top view Isometric view Initial corneal curvature z y x x y z Fig. 3: Finite element model of the vertical corneal strip, including the orthogonal...

  17. Corneal staining after treatment with topical tetracycline

    NARCIS (Netherlands)

    Lapid-Gortzak, Ruth; Nieuwendaal, Carla P.; Slomovic, Allan R.; Spanjaard, Lodewijk

    2006-01-01

    PURPOSE: The purpose of this paper is to report a case of corneal staining after treatment with topical tetracycline. METHODS: A patient with crystalline keratopathy caused by Streptococcus viridans after corneal transplantation was treated topically with tetracycline eye drops, based on results of

  18. Corynebacterium macginleyi isolated from a corneal ulcer

    Directory of Open Access Journals (Sweden)

    Kathryn Ruoff

    2010-02-01

    Full Text Available We report the isolation of Corynebacterium macginleyi from the corneal ulcer culture of a patient, later enrolled in the Steroids for Corneal Ulcer Trial (SCUT. To our knowledge this is the first published report from North America of the recovery of C. macginleyi from a serious ocular infection.

  19. Corneal hysteresis and its relevance to glaucoma

    Science.gov (United States)

    Deol, Madhvi; Taylor, David A.; Radcliffe, Nathan M.

    2015-01-01

    Purpose of review Glaucoma is a leading cause of irreversible blindness worldwide. It is estimated that roughly 60.5 million people had glaucoma in 2010 and that this number is increasing. Many patients continue to lose vision despite apparent disease control according to traditional risk factors. The purpose of this review is to discuss the recent findings with regard to corneal hysteresis, a variable that is thought to be associated with the risk and progression of glaucoma. Recent findings Low corneal hysteresis is associated with optic nerve and visual field damage in glaucoma and the risk of structural and functional glaucoma progression. In addition, hysteresis may enhance intraocular pressure (IOP) interpretation: low corneal hysteresis is associated with a larger magnitude of IOP reduction following various glaucoma therapies. Corneal hysteresis is dynamic and may increase in eyes after IOP-lowering interventions are implemented. Summary It is widely accepted that central corneal thickness is a predictive factor for the risk of glaucoma progression. Recent evidence shows that corneal hysteresis also provides valuable information for several aspects of glaucoma management. In fact, corneal hysteresis may be more strongly associated with glaucoma presence, risk of progression, and effectiveness of glaucoma treatments than central corneal thickness. PMID:25611166

  20. Corneal Biomechanics Determination in Healthy Myopic Subjects

    Science.gov (United States)

    Qiu, Kunliang; Lu, Xuehui; Zhang, Riping; Wang, Geng

    2016-01-01

    Purpose. To determine the corneal biomechanical properties by using the Ocular Response Analyzer™ and to investigate potential factors associated with the corneal biomechanics in healthy myopic subjects. Methods. 135 eyes from 135 healthy myopic subjects were included in this cross-sectional observational study. Cornea hysteresis (CH), corneal resistance factor (CRF), cornea-compensated intraocular pressure (IOPcc), and Goldmann-correlated intraocular pressure (IOPg) were determined with the Reichert Ocular Response Analyzer (ORA). Univariate and multivariate regression analyses were performed to investigate factors associated with corneal biomechanics. Results. The mean CH and CRF were 9.82 ± 1.34 mmHg and 9.64 ± 1.57 mmHg, respectively. In univariate regression analysis, CH was significantly correlated with axial length, refraction, central corneal thickness (CCT), and IOPg (r = −0.27, 0.23, 0.45, and 0.21, resp.; all with p ≤ 0.015), but not with corneal curvature or age; CRF was significantly correlated with CCT and IOPg (r = 0.52 and 0.70, resp.; all with p corneal curvature, or age. In multivariate regression analysis, axial length, IOPcc, and CCT were found to be independently associated with CH, while CCT and IOPg were associated with CRF. Conclusions. Both CH and CRF were positively correlated with CCT. Lower CH but not CRF was associated with increasing degree of myopia. Evaluation of corneal biomechanical properties should take CCT and myopic status into consideration. PMID:27525109

  1. Corneal hysteresis and its relevance to glaucoma.

    Science.gov (United States)

    Deol, Madhvi; Taylor, David A; Radcliffe, Nathan M

    2015-03-01

    Glaucoma is a leading cause of irreversible blindness worldwide. It is estimated that roughly 60.5 million people had glaucoma in 2010 and that this number is increasing. Many patients continue to lose vision despite apparent disease control according to traditional risk factors. The purpose of this review is to discuss the recent findings with regard to corneal hysteresis, a variable that is thought to be associated with the risk and progression of glaucoma. Low corneal hysteresis is associated with optic nerve and visual field damage in glaucoma and the risk of structural and functional glaucoma progression. In addition, hysteresis may enhance intraocular pressure (IOP) interpretation: low corneal hysteresis is associated with a larger magnitude of IOP reduction following various glaucoma therapies. Corneal hysteresis is dynamic and may increase in eyes after IOP-lowering interventions are implemented. It is widely accepted that central corneal thickness is a predictive factor for the risk of glaucoma progression. Recent evidence shows that corneal hysteresis also provides valuable information for several aspects of glaucoma management. In fact, corneal hysteresis may be more strongly associated with glaucoma presence, risk of progression, and effectiveness of glaucoma treatments than central corneal thickness.

  2. Inhibition of Corneal Neovascularization by Hydrazinocurcumin ...

    African Journals Online (AJOL)

    Purpose: To investigate the effect of hydrazinocurcumin on a human vascular endothelial growth factor (VEGF)-induced corneal neovascularization in rabbit model. Methods: Murine corneal neovascularization (CorNV) was induced via two intrastromal implantations of VEGF polymer 2 mm from the limbus.

  3. Corneal plaque containing levofloxacin in a dog.

    Science.gov (United States)

    Park, Young-Woo; Kang, Byung-Jae; Lim, Jae Hyun; Ahn, Jung-Mo; Lim, Hyun Sook

    2015-11-01

    A 13-year-old castrated male Yorkshire terrier developed a corneal ulcer 2 weeks after intracapsular lens extraction (ICLE) in the right eye. The corneal ulcer was treated with levofloxacin eye drops. A plaque with a white luster developed in the central cornea 2 weeks after treatment with levofloxacin eye drops. The corneal plaque was surgically removed under inhalant anesthesia. The corneal plaque displayed antimicrobial activity against Escherichia coli. Furthermore, levofloxacin content in the plaque was confirmed by matrix-assisted laser desorption/ionization time-of-flight/time-of-flight (MALDI-TOF/TOF) mass spectrometry (MS). The corneal ulcer completely resolved 2 weeks after the surgical removal of the corneal lesion and replacement of levofloxacin eye drops with tobramycin eye drops. Although the topical use of levofloxacin is unlikely to lead to corneal chemical deposits due to the high water solubility of the drug compared to other topical fluoroquinolones, this patient developed corneal plaque of the antibiotic drop. © 2015 American College of Veterinary Ophthalmologists.

  4. Corneal laceration caused by river crab

    Directory of Open Access Journals (Sweden)

    Vinuthinee N

    2015-01-01

    Full Text Available Naidu Vinuthinee,1,2 Anuar Azreen-Redzal,1 Jaafar Juanarita,1 Embong Zunaina2 1Department of Ophthalmology, Hospital Sultanah Bahiyah, Alor Setar, 2Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia Abstract: A 5-year-old boy presented with right eye pain associated with tearing and photophobia of 1-day duration. He gave a history of playing with a river crab when suddenly the crab clamped his fingers. He attempted to fling the crab off, but the crab flew and hit his right eye. Ocular examination revealed a right eye corneal ulcer with clumps of fibrin located beneath the corneal ulcer and 1.6 mm level of hypopyon. At presentation, the Seidel test was negative, with a deep anterior chamber. Culture from the corneal scrapping specimen grew Citrobacter diversus and Proteus vulgaris, and the boy was treated with topical gentamicin and ceftazidime eyedrops. Fibrin clumps beneath the corneal ulcer subsequently dislodged, and revealed a full-thickness corneal laceration wound with a positive Seidel test and shallow anterior chamber. The patient underwent emergency corneal toileting and suturing. Postoperatively, he was treated with oral ciprofloxacin 250 mg 12-hourly for 1 week, topical gentamicin, ceftazidime, and dexamethasone eyedrops for 4 weeks. Right eye vision improved to 6/9 and 6/6 with pinhole at the 2-week follow-up following corneal suture removal. Keywords: corneal ulcer, pediatric trauma, ocular injury

  5. Complications from Infective Corneal Conditions Treated by ...

    African Journals Online (AJOL)

    Background: Complications from infective corneal conditions are an important cause of blindness in adults and children. The eyelids play a major role in the pathogenesis of staphyloma and the perforation of descemetoceles. Tarsorrhaphy could, therefore, be beneficial in treating serious complications from infective corneal ...

  6. Facts about the Cornea and Corneal Disease

    Science.gov (United States)

    ... the Cornea and Corneal Disease Facts About the Cornea and Corneal Disease What is the cornea? The cornea is the eye’s outermost layer. It ... your vision. What are the parts of the cornea? Although the cornea may look clear and seem ...

  7. Corneal ulcers: For the general practitioner

    African Journals Online (AJOL)

    153 CME April 2013 Vol. 31 No. 4. Corneal ulcers: For the general practitioner. A corneal ulcer is a defect in the epithelial layer of the cornea. e general practitioner may play an important role in early management and appropriate referral. Incidence varies and depends on aetiology. S Ballim, MB ChB, Dip Ophth (SA), FC ...

  8. Inhibition of Corneal Neovascularization by Hydrazinocurcumin

    African Journals Online (AJOL)

    Purpose: To investigate the effect of hydrazinocurcumin on a human vascular endothelial growth factor. (VEGF)-induced corneal neovascularization in rabbit model. Methods: Murine corneal neovascularization (CorNV) was induced via two intrastromal implantations of. VEGF polymer 2 mm from the limbus.

  9. Laparoscopic Resection of Cesarean Scar Ectopic Pregnancy.

    Science.gov (United States)

    Ades, Alex; Parghi, Sneha

    To demonstrate a technique for the laparoscopic surgical management of cesarean section scar ectopic pregnancy. Step-by-step presentation of the procedure using video (Canadian Task Force classification III). Cesarean section scar ectopic pregnancy is a rare form of ectopic pregnancy with an incidence ranging from 1:1800 to 1:2216. Over the last decade, the incidence seems to be on the rise with increasing rates of cesarean deliveries and early use of Doppler ultrasound. These pregnancies can lead to life-threatening hemorrhage, uterine rupture, and hysterectomy if not managed promptly. Local or systemic methotrexate therapy has been used successfully but can result in prolonged hospitalization, requires long-term follow-up, and in some cases treatment can fail. In the hands of a trained operator, laparoscopic resection can be performed to manage this type of pregnancy. Consent was obtained from the patient, and exemption was granted from the local Internal Review Board (The Womens' Hospital, Parkville). In this video we describe our technique for laparoscopic management of a cesarean scar ectopic pregnancy. We present the case of a 34-year-old G4P2T1 with the finding of a live 8-week pregnancy embedded in the cesarean section scar. The patient had undergone 2 previous uncomplicated cesarean sections at term. On presentation her β-human chorionic gonadotropin (β-hCG) level was 52 405 IU/L. She was initially managed with an intragestational sac injection of potassium chloride and methotrexate, followed by 4 doses of intramuscular methotrexate. Despite these conservative measures, the level of β-hCG did not adequately fall and an ultrasound showed a persistent 4-cm mass. A decision was made to proceed with surgical treatment in the form of a laparoscopic resection of the ectopic pregnancy. The surgery was uneventful, and the patient was discharged home within 24 hours of her procedure. Her serial β-hCG levels were followed until complete resolution

  10. Management of slipped laser in situ keratomileusis flap following intrastromal corneal ring implantation in post-LASIK ectasia.

    Science.gov (United States)

    Abad, Juan-Carlos

    2008-12-01

    Two cases of intrastromal corneal ring (Intacs, Addition Technology) implantation to treat post-laser in situ keratomileusis (LASIK) ectasia developed progressive slippage of the flap over the stromal bed, resulting in progressive flattening of the affected meridian. The flattening was thought to have occurred because the poorly healed flap edge could not withstand the change in corneal shape induced by the ring segments. The flap was lifted, debris was removed, and the flap was sutured to the residual stromal bed using interrupted 10-0 nylon sutures passed through two thirds of the cornea. The sutures induced a localized area of scarring that acted as "welding spots" and prevented further flap slippage. Refractive stability after suture removal supports the hypothesis that a sutured flap restores (at least partially) the biomechanical strength of post-LASIK corneas.

  11. Update on scar management: guidelines for treating Asian patients.

    Science.gov (United States)

    Kim, Sukwha; Choi, Tae Hyun; Liu, Wei; Ogawa, Rei; Suh, Jeong Seok; Mustoe, Thomas A

    2013-12-01

    Following injury, Asian skin has a tendency towards hyper-pigmentation and scar formation, and therefore the prevention of scarring is particularly important in Asian patients. Since publication of an International Clinical Recommendation on Scar Management in 2002, there have been numerous publications in the field of scar management. Advances in understanding scar formation have also led to the introduction of new treatments as well as a better understanding of established therapeutic options. A literature search for abstracts, clinical trials and meta-analyses evaluating scar prevention and treatment was performed using PubMed and the Cochrane Database of Systematic Reviews. Based on this data a panel of experts formulated treatment recommendations for Asian patients. Following surgery, scar prevention should be initiated in all Asian patients due to the high risk of poor scars. There is strong evidence for the efficacy of silicone based products, and due to their ease of use, they can be considered first-line therapy. Silicone gel (versus silicone gel sheets) products have demonstrated efficacy. For patients who fail to respond to first-line therapy, intralesional steroid injections, radiation therapy, and intralesional 5-flourouracil injections have achieved widespread acceptance. Laser treatments have been increasingly used, although the evidence remains largely anecdotal without a clear consensus on optimal wavelength, or amount of energy. Surgical approaches have increased in sophistication with recognition of the impact that tension has on scar formation. Updated scar management recommendations will benefit practitioners making decisions regarding optimal, evidence-based treatment strategies for their patients.

  12. Molecular expression in transfected corneal endothelial cells

    Science.gov (United States)

    Wang, Fan; Miao, Zhuang; Lu, Chengwei; Hao, Jilong

    2017-10-01

    To investigate the capability of human corneal endothelial cells serving as immunological cells. Expression of HLA-DP, -DQ, -DR, CD40, CD80, and CD86 was determined by immunohistochemical methods. Meanwhile, purified peripheral blood mononuclear cells were cocultured with human corneal endothelial cells which were pre-treated with and without -IFN respectively, activation of lymphocytes was determined by FACS analysis. In coculture system, T lymphocyte was activated by corneal endothelial cells, HLA-DP, -DQ, -DR and CD40 expression were increased by - IFN induction. Costimulatory molecular CD80 was shown on the endothelial cells. Human corneal endothelial cells were assumed to be involved in the corneal transplantation rejection process as potential antigen presenting cells.

  13. Laser therapy for prevention and treatment of pathologic excessive scars.

    Science.gov (United States)

    Jin, Rui; Huang, Xiaolu; Li, Hua; Yuan, Yuwen; Li, Bin; Cheng, Chen; Li, Qingfeng

    2013-12-01

    The management of hypertrophic scars and keloids remains a therapeutic challenge. Treatment regimens are currently based on clinical experience rather than substantiated evidence. Laser therapy is an emerging minimally invasive treatment that has recently gained attention. A meta-analysis was conducted to evaluate the effectiveness of various laser therapies. The pooled response rate, pooled standardized mean difference of Vancouver Scar Scale scores, scar height, erythema, and pliability were reported. Twenty-eight well-designed clinical trials with 919 patients were included in the meta-analysis. The overall response rate for laser therapy was 71 percent for scar prevention, 68 percent for hypertrophic scar treatment, and 72 percent for keloid treatment. The 585/595-nm pulsed-dye laser and 532-nm laser subgroups yielded the best responses among all laser systems. The pooled estimates of hypertrophic scar studies also showed that laser therapy reduced total Vancouver Scar Scale scores, scar height, and scar erythema of hypertrophic scars. Regression analyses of pulsed-dye laser therapy suggested that the optimal treatment interval is 5 to 6 weeks. In addition, the therapeutic effect of pulsed-dye laser therapy is better on patients with lower Fitzpatrick skin type scores. This study presents the first meta-analysis to confirm the efficacy and safety of laser therapy in hypertrophic scar management. The level of evidence for laser therapy as a keloid treatment is low. Further research is required to determine the mechanism of action for different laser systems and to examine the efficacy in quantifiable parameters, such as scar erythema, scar texture, degrees of symptom relief, recurrence rates, and adverse effects.

  14. Variations in corneal wound healing after radial keratotomy: possible insights into mechanisms of clinical complications and refractive effects.

    Science.gov (United States)

    Jester, J V; Villaseñor, R A; Schanzlin, D J; Cavanagh, H D

    1992-05-01

    Ultrastructural and histopathologic analysis was performed on three human corneal specimens for variable and complicated refractive outcomes 1-2 years after radial keratotomy. Specimens were obtained immediately postsurgery after microkeratome resection with homoplastic lamellar keratoplasty (two cases) and penetrating keratoplasty (one case) for correction of glare, severe astigmatism, overcorrection, and/or double vision. All three cases showed variability of wound healing and delayed corneal wound healing sites; epithelial retention cysts, and/or absence of stromal scar collagen that was not dependent on the length of time after surgery. Two of the three radial keratotomy specimens also contained extensive duplication of the superficial corneal epithelial basal lamina. When present, the thickened basal lamina (3-6 microns in thickness) was seen between all incisions evaluated and appeared to extend from the central optical zone out to the periphery of the lamellar button. The one full-thickness keratoplasty specimen showed focal loss of underlying endothelial cells with occasional migrating cells seen by scanning electron microscopy. These data support previous findings that delayed corneal wound healing with epithelial retention cysts remains the most common histopathologic alteration after radial keratotomy. The effects of variations and delay in wound healing between individuals could explain the lack of predictability of refractive outcome and continuing refractive instability in long-term follow-up after single or repeat radial keratotomy surgeries.

  15. Corneal biomechanical properties in thyroid eye disease

    Directory of Open Access Journals (Sweden)

    Gamze Ozturk Karabulut

    2014-06-01

    Full Text Available The purpose of this study is to investigate the effect of thyroid eye disease (TED on the measurement of corneal biomechanical properties and the relationship between these parameters and disease manifestations. A total of 54 eyes of 27 individuals with TED and 52 eyes of 30 healthy control participants were enrolled. Thyroid ophthalmopathy activity was defined using the VISA (vision, inflammation, strabismus, and appearance/exposure classification for TED. The intraocular pressure (IOP measurement with Goldmann applanation tonometer (GAT, axial length (AL, keratometry, and central corneal thickness (CCT measurements were taken from each patient. Corneal biomechanical properties, including corneal hysteresis (CH and corneal resistance factor (CRF and noncontact IOP measurements, Goldmann-correlated IOP (IOPg and corneal-compensated IOP (IOPcc were measured with the Ocular Response Analyzer (ORA using the standard technique. Parameters such as best corrected visual acuity, axial length, central corneal thickness, and corneal curvature were not statistically significant between the two groups (p > 0.05. IOP measured with GAT was higher in participants with TED (p < 0.001. The CH of TED patients was significantly lower than that of the control group. There was no significant difference in the corneal resistance factor between groups. However, IOPg and IOPcc were significantly higher in TED patients. CH and VISA grading of TED patients showed a negative correlation (p = 0.007. In conclusion, TED affects the corneal biomechanical properties by decreasing CH. IOP with GAT and IOPg is found to be increased in these patients. As the severity of TED increases, CH decreases in these patients.

  16. Effect of chalazion excision on refractive error and corneal topography.

    Science.gov (United States)

    Bagheri, Abbas; Hasani, Hamid R; Karimian, Farid; Abrishami, Mohammad; Yazdani, Shahin

    2009-01-01

    To evaluate refractive and corneal topographic changes following excision of chalazia. This prospective noncomparative quasi-experimental clinical trial includes consecutive patients older than 7 years with chalazia of minimum duration of 1 month who underwent excision of the lesions by an internal or external approach. Overall, 253 lids from 228 eyes of 195 patients including 110 female subjects with mean age of 31-/+14 years (range 7-71) were studied. Mean duration of presenting symptoms was 4-/+2.8 months (range 1-24). Lesions were equally distributed in medial, central, and lateral areas of the eyelids. The chalazia were single in 172 (88.2%) and multiple in 23 (11.8%) patients. Mean change in best-corrected visual acuity, spherical equivalent refractive error, and difference of keratometry (corneal astigmatism) were 0.0004-/+0.007 logMAR (p=0.3), -0.06-/+0.6 D (p=0.1), and 0.34-/+0.35 (pChalazion excision can decrease corneal astigmatism and irregularity, which is more prominent in single, firm, and central upper lid lesions. These findings may have implications in pediatric patients at risk for amblyopia.

  17. Influence of corneal hydration on optical coherence elastography

    Science.gov (United States)

    Twa, Michael D.; Vantipalli, Srilatha; Singh, Manmohan; Li, Jiasong; Larin, Kirill V.

    2016-03-01

    Corneal biomechanical properties are influenced by several factors, including intraocular pressure, corneal thickness, and viscoelastic responses. Corneal thickness is directly proportional to tissue hydration and can influence corneal stiffness, but there is no consensus on the magnitude or direction of this effect. We evaluated the influence of corneal hydration on dynamic surface deformation responses using optical coherence elastography (OCE). Fresh rabbit eyes (n=10) were prepared by removing the corneal epithelium and dropping with 0.9% saline every 5 minutes for 1 hour, followed by 20% dextran solution every 5 minutes for one hour. Corneal thickness was determined from structural OCT imaging and OCE measurements were performed at baseline and every 20 minutes thereafter. Micron-scale deformations were induced at the apex of the corneal tissue using a spatially-focused (150μm) short-duration (corneal thickness due to hydration process. Corneal thickness rapidly increased and remained constant following epithelium removal and changed little thereafter. Likewise, corneal stiffness changed little over the first hour and then decreased sharply after Dextran application (thickness: -46% [-315/682 μm] RR: - 24% [-0.7/2.88 ms-1]; GV: -19% [-0.6/3.2 m/s]). Corneal thickness and corneal stiffness (RR) were well correlated (R2 = .66). Corneal biomechanical properties are highly correlated with tissue hydration over a wide range of corneal thickness and these changes in corneal stiffness are quantifiable using OCE.

  18. Corneal Regeneration by Deep Anterior Lamellar Keratoplasty (DALK Using Decellularized Corneal Matrix.

    Directory of Open Access Journals (Sweden)

    Yoshihide Hashimoto

    Full Text Available The purpose of this study is to demonstrate the feasibility of DALK using a decellularized corneal matrix obtained by HHP methodology. Porcine corneas were hydrostatically pressurized at 980 MPa at 10°C for 10 minutes to destroy the cells, followed by washing with EGM-2 medium to remove the cell debris. The HHP-treated corneas were stained with H-E to assess the efficacy of decellularization. The decellularized corneal matrix of 300 μm thickness and 6.0 mm diameter was transplanted onto a 6.0 mm diameter keratectomy wound. The time course of regeneration on the decellularized corneal matrix was evaluated by haze grading score, fluorescein staining, and immunohistochemistry. H-E staining revealed that no cell nuclei were observed in the decellularized corneal matrix. The decellularized corneal matrices were opaque immediately after transplantation, but became completely transparent after 4 months. Fluorescein staining revealed that initial migration of epithelial cells over the grafts was slow, taking 3 months to completely cover the implant. Histological sections revealed that the implanted decellularized corneal matrix was completely integrated with the receptive rabbit cornea, and keratocytes infiltrated into the decellularized corneal matrix 6 months after transplantation. No inflammatory cells such as macrophages, or neovascularization, were observed during the implantation period. The decellularized corneal matrix improved corneal transparency, and remodelled the graft after being transplanted, demonstrating that the matrix obtained by HHP was a useful graft for corneal tissue regeneration.

  19. High interocular corneal symmetry in average simulated keratometry, central corneal thickness, and posterior elevation.

    Science.gov (United States)

    Myrowitz, Elliott H; Kouzis, Anthony C; O'Brien, Terrence P

    2005-05-01

    The purpose of this study was to assess interocular corneal symmetry in average simulated keratometry, corneal thickness, and posterior corneal elevation. This retrospective analysis included data from scanning slit topography (Orbscan II; Bausch and Lomb, Rochester, NY) on 242 eyes from 121 consecutive patients undergoing standard evaluation for consideration of elective laser vision correction. The symmetry between the right and left eye in average simulated keratometry, minimum central corneal thickness, and posterior corneal elevation was assessed by comparative data analysis. Simulated keratometry ranged from 39.9 to 48.6 D. The interocular difference in average simulated keratometry was 0.47 D (standard deviation [SD] 0.43). The interocular Pearson correlation coefficient for average simulated keratometry was 0.90 (p central corneal thickness was 0.95 (p symmetry in all these parameters was very high in this group of consecutive patients. Asymmetry of these interocular parameters may warrant repeat clinical testing for accuracy and may predict corneal abnormalities. Normative data on posterior cornea elevation is presented. This study points out potentially clinically important high interocular corneal symmetry data in simulated keratometry, corneal thickness, and posterior corneal elevation.

  20. Ketamine/Xylazine-Induced Corneal Damage in Mice.

    Directory of Open Access Journals (Sweden)

    Demelza Koehn

    Full Text Available We have observed that the commonly used ketamine/xylazine anesthesia mix can induce a focally severe and permanent corneal opacity. The purpose of this study was to establish the clinical and histological features of this deleterious side effect, its sensitivity with respect to age and anesthesia protocol, and approaches for avoiding it.Young C57BL/6J, C57BLKS/J, and SJL/J mice were treated with permutations of anesthesia protocols and compared using slit-lamp exams, optical coherence tomography, histologic analyses, and telemetric measurements of body temperature.Ketamine/xylazine induces corneal damage in mice with a variable frequency. Among 12 experimental cohorts, corneal damage associated with ketamine/xylazine was observed in 9 of them. Despite various treatments to avoid corneal dehydration during anesthesia, the frequency of corneas experiencing damage among responding cohorts was 42% (26% inclusive of all cohorts, which is significantly greater than the natural prevalence (5%. The damage was consistent with band keratopathy. It appeared as a white or gray horizontal band located proximal to the pupil and was positive for subepithelial calcium deposition with von Kossa stain.The sum of our clinical and histological observations is consistent with ketamine/xylazine-induced band keratopathy in mice. This finding is relevant for mouse studies involving the eye and/or vision-dependent behavioral assays, which would both be prone to artifact without appreciation of the damage caused by ketamine/xylazine anesthesia. Use of yohimbine is suggested as a practical means of avoiding this complication.

  1. Insertion force in manual and robotic corneal suturing.

    Science.gov (United States)

    Yang, Yang; Xu, Cunliang; Deng, Shijing; Xiao, Jingjing

    2012-03-01

    Due to differences in corneal grafting microsurgery between manual and robotic suturing, new challenges have arisen in testing the insertion force and torque of corneal tissue acting on suturing needles in order to guarantee successful completion of surgical procedures. In order to measure the force during the insertion operation, from the needle entering the cornea through the entry point until the puncturing of the exit point along the circular trajectory, a force measurement system was established, including fresh porcine cornea, a corneal-suturing robot, a circular needle, a micro-forceps manipulator with a force transducer, a computer with a data acquisition board and a medical microscope. The force values in the needle coordinate frames were obtained on the basis of a sensor coordinate frame through D-H coordinate transformation, and an index is proposed here to evaluate the insertion performance. Experiments on both manual and robotic suturing were carried out for comparison. The scale and changes of the needle insertion force were obtained using two different suturing methods. The maximal tangent force in robotic suturing is a little larger than in manual suturing, and the maximal resultant force in robotic suturing is somewhat smaller. Although the difference is not very significant, robotic suturing performs in a more stable way. Moreover, the performance evaluation index M(dmax) (the maximum of square root of the quadratic sum of torque components M(OX) and M(OY)) in robotic suturing is much smaller than that in manual suturing. The force measurement system has been verified to be feasible through experimentation. Compared with conventional manual surgery, robotic suturing has some advantages: more stable suturing, smaller distortion torque and fewer invasions to the corneal tissue, showing that its application in minimally invasive surgery is practical. Copyright © 2011 John Wiley & Sons, Ltd.

  2. Cutaneous Scar Prevention and Management; Overview of current therapies

    Directory of Open Access Journals (Sweden)

    Sultan Al-Shaqsi

    2016-02-01

    Full Text Available Cutaneous scarring is common after trauma, surgery and infection and occurs when normal skin tissue is replaced by fibroblastic tissue during the healing process. The pathophysiology of scar formation is not yet fully understood, although the degree of tension across the wound edges and the speed of cell growth are believed to play central roles. Prevention of scars is essential and can be achieved by attention to surgical techniques and the use of measures to reduce cell growth. Grading and classifying scars is important to determine available treatment strategies. This article presents an overview of the current therapies available for the prevention and treatment of scars. It is intended to be a practical guide for surgeons and other health professionals involved with and interested in scar management.

  3. [Mechanism of scar formation and strategy of treatment].

    Science.gov (United States)

    Lu, Shu-liang

    2013-04-01

    So far, studies on the mechanism of scar formation have mainly focused on cells, cytokines and extracellular matrix. Some studies have shown that fibroblast is one of the most important element in the process of scar formation, while epidermal and endothelial cells exert synergistic effects as well. Genetic factor can not be ignored in scar formation, either. Recently, studies have shown decisively the loss or damage of the three-dimensional structure of dermal tissue is the initiator of scar formation. Thus, the defect of epidermis template is proposed as a theory in order to explain the mechanism of scar formation. There are various techniques for scar treatment. The commonly accepted methods are physical therapy, pressure therapy, pharmaceutical therapy, radiotherapy, etc.

  4. Prosthodontist contribution in treating post-burn hypertrophic facial scars

    Directory of Open Access Journals (Sweden)

    Padmanabhan T

    2010-01-01

    Full Text Available The formation of hypertrophic scars is common following healing of the burn wound, particularly in children. The face is one of the areas of the body most frequently affected by burns. Scar formation as a result of burn wounds leads to contraction of the formed granulation tissue, which causes both aesthetic and functional impairment for the patient. Scarring has major psychological and physical repercussions. Scarring on the face and visible regions of the body can be very distressing for the patient. Prevention of scars involves early and continuous use of a compressive orthesis. However, their efficacy is often limited to the facial region because of the contours of this area of body. This paper describes a clinical case of post-burn hypertrophic scars treated with silicone gel sheeting applied with pressure under custom made auto-polymerizing resin stent.

  5. Cesarean scar ectopic pregnancy. Laparoscopic resection and total scar dehiscence repair. A case report.

    Science.gov (United States)

    Mahgoub, Sara; Gabriele, Victor; Faller, Emilie; Langer, Bruno; Wattiez, Arnaud; Lecointre, Lise; Akladios, Cherif

    2017-02-04

    Illustrate laparoscopic technique for resection of cesarean scar ectopic pregnancy, associated with isthmocele repair. Case report SETTING: Tertiary referral centre in Strasbourg, France. The study was approved by the local IRB. Cesarean scar pregnancy is a rare form of ectopic pregnancy. The major risk of this type of pregnancy is the early uterine rupture with massive bleeding and maternal life-threatening. It is therefore crucial to manage actively these pregnancies as soon as they are diagnosed. Therapeutic options can be medical, surgical, or a combination of both. Many case reports or case series are found in the literature, but only few clinical studies, too difficult to carry out because of cases rarity and inconclusiveness. "Systematic review: What is the best first-line approach for cesarean section ectopic pregnancy?" is a meta-analysis that was published in 2016, and includes 194 studies between 1978 and 2014 (126 case reports, 45 cases series and 23 clinical studies). According to this systematic review, hysteroscopy or laparoscopic hysterotomy seems to be the best first-line approach to treat cesarean scar ectopic pregnancy. Uterine artery embolization seems to be reserved for significant bleeding and/or a high suspicion index for arteriovenous malformation. There is however no consensus on treatment of reference. The case concerns a 38-year-old primiparous women with cesarean section in 2010, who was diagnosed by US scan at 7 WG as cesarean scar ectopic pregnancy, confirmed by pelvic MRI. The patient has initially received medical treatment with two intramuscular injections of Methotrexate and one local intra-gestational injection of KCl. Initial rate of HCG was 82000 IU/L. Through a rigorous weekly biological and US scan monitoring, it has been observed an involution of the ectopic pregnancy at ultrasonography associated to HCG decreasing. No bleeding or infectious complications occurred during this period. After 10 weeks of monitoring, because of a

  6. Corneal epithelium following penetrating keratoplasty.

    Science.gov (United States)

    Tsubota, K; Mashima, Y; Murata, H; Yamada, M; Sato, N

    1995-03-01

    This study was designed to observe any changes to the corneal epithelium after penetrating keratoplasty. The corneal epithelia of 26 patients were observed by specular microscopy 1 week, 1 month, 3 months, and 6 months following penetrating keratoplasty. After re-epithelialisation was confirmed by biomicroscopy 1 week after surgery, specular microscopy revealed many abnormal cells, including spindle shaped cells, nucleated cells, large cells, as well as irregular cell configurations. Although these abnormal findings tended to decrease with time, they were still present in some cases as much as 6 months postoperatively. Computerised morphometric analysis yielded mean cell areas of 1121 (SD 168) microns 2, 1139 (675) microns 2, 1712 (496) microns 2, and 1400 (377) microns 2 at 1 week, 1 month, 3 months, and 6 months respectively, all significantly greater than that of age matched controls (710 (151) microns 2). The shape factor decreased with time, but was still greater than the control level at 6 months. This study demonstrates that epithelial abnormalities persist longer than expected after penetrating keratoplasty, and that these subtle changes can be detected by specular microscopic observation, potentially allowing for modification and enhancement of the wound healing process.

  7. [Infectious corneal ulcers--once with endophthalmitis--after photorefractive keratotomy with disposable contact lens].

    Science.gov (United States)

    Faschinger, C; Faulborn, J; Ganser, K

    1995-02-01

    Infections of the cornea with or without involvement of intraocular tissues are severe complications after photorefractive keratectomy. We report on three cases with ulcerative keratitis and one case with severe endophthalmitis, which developed some days after laser treatment. After 39 photo-therapeutic and 118 photo-refractive treatments without complications four young treated persons suffered from corneal infiltrations. Three of them developed severe corneal ulcerations, one a severe endophthalmitis. We used the laser machine of the company Schwind (193 nm wavelength, repetition rate 10 Hz, fluence 180-200 mJ/cm2). One part of the treatment which all patients had in common was the application of a disposable contact lens postoperatively, which was worn overnight. THERAPY AND FOLLOW-UP: Because all three patients with ulcerations revealed hyphen of fungi in their corneal-scratch material they were treated with antifungal agents locally and systemically. Due to the local and temporal connection the patient with the endophthalmitis was treated with antifungal agents, too. All corneal ulcerations healed with scars similar to a haze graded 3 to 4, the eye with the endophthalmitis healed almost completely. Probably the use of disposable contact lenses postoperatively, especially the overnight wear, during an extremely hot and humid summer lead to the described severe infections of the eyes after the "traumatisation" of the cornea by the excimer laser. A known higher concentration of Aspergillus in the air due to renovations of buildings in the clinical area might have been an additional negative effect. The avoidance of the use of disposable contact lenses postoperatively, especially the overnight wear, is emphasized.

  8. A novel instrument aimed at measuring hypertrophic scar formation

    Energy Technology Data Exchange (ETDEWEB)

    Ramella-Roman, J C; Nguyen, T A; Lemaillet, P [Department of Biomedical Engineering, Catholic University of America (United States); Pavlovich, A R; Jordan, M H; Shupp, J W, E-mail: ramella@cua.edu [Burn Center, Department of Surgery, Washington Hospital Center-MedStar Health Research Institute, Washington, DC (United States)

    2011-01-01

    Hypertrophic scaring is a condition that can occur after thermal trauma and can lead to loss of function and psyco-social complications. Assessment of the development of a hypertrophic scar currently relies on visual inspection and grading. In this paper we propose a system based on polarized illumination and collection capable of capturing images of scars and quantify their roughness. Models of rough surface roughness are ultimately used to quantify the level of roughness of scarred skin compared to normal skin.

  9. Numerical study of scars in a chaotic billiard

    CERN Document Server

    Li, B

    1997-01-01

    We study numerically the scaling properties of scars in stadium billiard. Using the semiclassical criterion, we have searched systematically the scars of the same type through a very wide range, from ground state to as high as the 1 millionth state. We have analyzed the integrated probability density along the periodic orbit. The numerical results confirm that the average intensity of certain types of scars is independent of $\\hbar$ rather than scales with (1989).

  10. Post herpes-zoster scar sarcoidosis with pulmonary involvement

    Directory of Open Access Journals (Sweden)

    Archana Singal

    2014-01-01

    Full Text Available Cutaneous sarcoidosis presents with a wide range of clinical presentations. An uncommon cutaneous manifestation is infiltration of old cutaneous scars with non-caseating granulomas known as scar sarcoidosis. Most of the patients with this clinical entity have other systemic manifestations, particularly pulmonary changes. We report a case of a 50 years old man, presenting with cutaneous sarcoidosis overlying scars of healed herpes zoster.

  11. Current treatment options for corneal ectasia.

    Science.gov (United States)

    Tan, Donald T H; Por, Yong-Ming

    2007-07-01

    The approach to the management of various forms of corneal ectasia is changing, with the advent of new surgical and nonsurgical options. The purpose of this review is to summarize and evaluate relevant studies on new treatments for keratoconus, postrefractive surgery keratectasia, and peripheral ectatic corneal disorders. Various alternatives to corneal transplantation for the management of keratoconus aim to enhance corneal rigidity by means of nonsurgical collagen cross-linking, or with the use of intrastromal corneal ring segments, and studies suggest that these treatments may reduce astigmatism or ectatic progression to varying degrees. Recent developments in anterior lamellar keratoplasty enable targeted replacement or augmentation of corneal stroma without replacement of endothelium, and include procedures such as deep anterior lamellar keratoplasty, microkeratome or laser-assisted anterior lamellar surgery, and peripheral tectonic lamellar keratoplasty procedures demonstrate successful reinforcement of peripheral stroma to reduce astigmatism. These new forms of surgery are viable alternatives to conventional penetrating keratoplasty and bring added safety profiles for long-term visual rehabilitation and restoration of tectonic integrity in central and peripheral forms of corneal ectasia.

  12. Factors Affecting Corneal Hysteresis in Taiwanese Adults.

    Science.gov (United States)

    Wang, Jia-Kang; Huang, Tzu-Lun; Pei-Yuan Su; Chang, Pei-Yao

    2015-09-01

    To investigate the correlation of various corneal hysteresis (CH) factors in Chinese adults. From January 2009 to November 2011, the healthy right eyes of a total of 292 adults were recruited into the study. Goldmann-correlated intraocular pressure (IOPG) and CH were measured using an ocular response analyzer (ORA). Central corneal thickness was measured using the ORA's integrated handheld ultrasonic pachymeter. The IOLMaster was used to obtain the ocular biometric measurements including axial length, anterior chamber depth, and keratometric values. The Pearson correlation coefficient was used to test correlations between CH and quantitative factors. The chi-square test was used to detect differences in categorical values. Longer axial length (P = 0.0001), lower IOPG (P = 0.03), older age (P = 0.003), and thinner central corneal thickness (P = 0.0001) were significantly associated with lower CH. The anterior chamber depth (P = 0.34), gender (P = 0.23), and corneal curvature (P = 0.18) had no relationship to CH. Various factors including axial length, intraocular pressure, age, and central corneal thickness can affect measurement of corneal biomechanical properties in Chinese adults. But the anterior chamber depth, gender, and corneal curvature were irrelevant to CH.

  13. Analysis of ethanol effects on corneal epithelium.

    Science.gov (United States)

    Oh, Joo Youn; Yu, Ji Min; Ko, Jung Hwa

    2013-06-04

    Ethanol is widely used in ocular surface surgeries and for the treatment of corneal diseases. However, ethanol is a toxic agent that is related to the development of a number of alcohol-related diseases. Despite the common use of ethanol for therapeutic purposes in ophthalmology, effects of ethanol on the ocular surface have been poorly defined. Hence, we performed this study to investigate effects of ethanol on corneal epithelium from various aspects. We exposed corneal epithelial cells in culture to different concentrations of ethanol for 30 seconds and evaluated the cells for toxicity, survival, and expression of cell-specific markers and inflammatory cytokines at 24, 48, and 72 hours after ethanol exposure. We found that ethanol markedly decreased the viability of cells in a concentration-dependent manner by causing cell lysis, suppressing proliferation, and inducing apoptosis. Also, expression of corneal epithelial cell-specific markers, both stem cell and differentiation markers, was significantly reduced by ethanol exposure. Expression of proinflammatory cytokines and chemokines was highly increased in corneal epithelial and stromal cells that were exposed to ethanol. Together, data suggest that brief exposure of the corneal surface to ethanol may have long-term effects by disrupting the integrity of corneal epithelium and generating inflammation, both of which are precursors to a number of ocular surface diseases.

  14. Electrospun Scaffolds for Corneal Tissue Engineering: A Review

    OpenAIRE

    Bin Kong; Shengli Mi

    2016-01-01

    Corneal diseases constitute the second leading cause of vision loss and affect more than 10 million people globally. As there is a severe shortage of fresh donated corneas and an unknown risk of immune rejection with traditional heterografts, it is very important and urgent to construct a corneal equivalent to replace pathologic corneal tissue. Corneal tissue engineering has emerged as a practical strategy to develop corneal tissue substitutes, and the design of a scaffold with mechanical pro...

  15. Interactive visualization for scar transmurality in cardiac resynchronization therapy

    Science.gov (United States)

    Reiml, Sabrina; Toth, Daniel; Panayiotou, Maria; Fahn, Bernhard; Karim, Rashed; Behar, Jonathan M.; Rinaldi, Christopher A.; Razavi, Reza; Rhode, Kawal S.; Brost, Alexander; Mountney, Peter

    2016-03-01

    Heart failure is a serious disease affecting about 23 million people worldwide. Cardiac resynchronization therapy is used to treat patients suffering from symptomatic heart failure. However, 30% to 50% of patients have limited clinical benefit. One of the main causes is suboptimal placement of the left ventricular lead. Pacing in areas of myocardial scar correlates with poor clinical outcomes. Therefore precise knowledge of the individual patient's scar characteristics is critical for delivering tailored treatments capable of improving response rates. Current research methods for scar assessment either map information to an alternative non-anatomical coordinate system or they use the image coordinate system but lose critical information about scar extent and scar distribution. This paper proposes two interactive methods for visualizing relevant scar information. A 2-D slice based approach with a scar mask overlaid on a 16 segment heart model and a 3-D layered mesh visualization which allows physicians to scroll through layers of scar from endocardium to epicardium. These complementary methods enable physicians to evaluate scar location and transmurality during planning and guidance. Six physicians evaluated the proposed system by identifying target regions for lead placement. With the proposed method more target regions could be identified.

  16. Management of Keloid and Hypertrophic Scar/span>s

    Science.gov (United States)

    Edriss, A.S.; Mesták, J.

    2005-01-01

    Summary Scar management for the prevention of excessive scar formation has always been important but never so important as it is today. Optimal management continues to be an enigma for surgeons, and the best modality of treatment has been debated for many years. However, most studies have unfortunately been either retrospective or case report descriptions. Advances in scar management have been hampered by confusing or ambiguous terminology. There is no consensus on what amount of post-traumatic skin scar formation is "normal" and what should be considered "hypertrophic". In the World Health Organization's ICD-9, there is no diagnostic code for hypertrophic scar - only keloid is listed. Yet the medical and scientific literature distinguishes them as different conditions. This confusion results in inappropriate management of scar formation, and occasionally contributes to decision making related to elective or cosmetic surgery. Our experience suggests that there is no single treatment for scars that is adequate and that clinical judgement is very important when considering treatment and balancing the potential benefits of the various treatments available. The goal of treating scars is to restore functionality, provide relief of symptoms, enhance cosmetics, and prevent recurrence. This article is based on our scientific and clinical experiences and focuses on over-the-counter options to manage keloid and hypertrophic scar/span>s. PMID:21991008

  17. Quantitative analysis of a scar's pliability, perfusion and metrology

    Science.gov (United States)

    Gonzalez, Mariacarla; Sevilla, Nicole; Chue-Sang, Joseph; Ramella-Roman, Jessica C.

    2017-02-01

    The primary effect of scarring is the loss of function in the affected area. Scarring also leads to physical and psychological problems that could be devastating to the patient's life. Currently, scar assessment is highly subjective and physician dependent. The examination relies on the expertise of the physician to determine the characteristics of the scar by touch and visual examination using the Vancouver scar scale (VSS), which categorizes scars depending on pigmentation, pliability, height and vascularity. In order to establish diagnostic guidelines for scar formation, a quantitative, accurate assessment method needs to be developed. An instrument capable of measuring all categories was developed; three of the aforementioned parameters will be explored. In order to look at pliability, a durometer which measures the amount of resistance a surface exerts to prevent the permanent indentation of the surface is used due to its simplicity and quantitative output. To look at height and vascularity, a profilometry system that collects the location of the scar in three-dimensions and laser speckle imaging (LSI), which shows the dynamic changes in perfusion, respectively, are used. Gelatin phantoms were utilized to measure pliability. Finally, dynamic changes in skin perfusion of volunteers' forearms undergoing pressure cuff occlusion were measured, along with incisional scars.

  18. Abnormal pigmentation within cutaneous scars: A complication of wound healing

    Directory of Open Access Journals (Sweden)

    Sarah Chadwick

    2012-01-01

    Full Text Available Abnormally pigmented scars are an undesirable consequence of cutaneous wound healing and are a complication every single individual worldwide is at risk of. They present a challenge for clinicians, as there are currently no definitive treatment options available, and render scars much more noticeable making them highly distressing for patients. Despite extensive research into both wound healing and the pigment cell, there remains a scarcity of knowledge surrounding the repigmentation of cutaneous scars. Pigment production is complex and under the control of many extrinsic and intrinsic factors and patterns of scar repigmentation are unpredictable. This article gives an overview of human skin pigmentation, repigmentation following wounding and current treatment options.

  19. Treating Scars on the Oral Mucosa.

    Science.gov (United States)

    Evans, Erik William

    2017-02-01

    Mucosal wounds tend to heal more rapidly than skin wounds and with minimal to no scar formation and hence have a minimal impact on function or aesthetics. This is likely due to differences in the magnitude and timing of the various factors that contribute to wound healing. Some examples of these differences are fibroblast proliferation, transforming growth factor-β, macrophages, neutrophils, and T cells. Other factors, such as the moist environment, contribute to the favorable wound-healing characteristics of mucosa. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Current concepts and techniques in corneal transplantation.

    Science.gov (United States)

    Laibson, Peter R

    2002-08-01

    The corneal endothelium is the most important single layer in corneal transplantation. In his Castroviejo Lecture, William Bourne, MD, summarizes his work on the corneal endothelium and its importance to corneal transplantation. Almost half the corneal transplants performed in the United States are done so because of malfunctioning, diseased, or absent endothelial cells. If just this layer could be transplanted, the long wait for better vision after keratoplasty (up to two years in some countries) can be eliminated, as well as the problems of epithelial and subepithelial graft rejection. The significant astigmatism after keratoplasty could also be reduced. Transplantation of the endothelium in deep lamellar keratoplasty is being done in limited fashion throughout the world and the first patients have now been done in the United States. In many countries where corneal tissue is difficult to obtain, keratoplasty is only performed on one eye, even though both eyes may need it. One article this year discusses binocular vision recovery in bilateral keratoplasty and the objective and subjective improvements after bilateral keratoplasty. Patients who are bilaterally blind from diseases such as Stevens-Johnson syndrome, and ocular pemphigoid have little hope of visual recovery from conventional corneal transplants. The use of a keratoprosthesis to bypass the totally abnormal conjunctival surface has helped many people in the past. The preoperative prognostic categories of patients who may benefit from keratoprosthesis has been carefully reviewed in a large number of keratoprosthesis patients and this information will help ophthalmologists decide who will benefit the most benefit from keratoprosthesis. This year, articles on corneal transplantation after conjunctival flaps, suture-related complications in keratoplasty, the implantation of an intraocular lens after penetrating keratoplasty, and long-term results of penetrating keratoplasty with glaucoma drainage tube

  1. Corneal Biomechanical Properties in Rheumatoid Arthritis.

    Science.gov (United States)

    Can, Mehmet Erol; Erten, Sukran; Can, Gamze Dereli; Cakmak, Hasan Basri; Sarac, Ozge; Cagil, Nurullah

    2015-11-01

    To investigate the variations in biomechanical properties of the cornea in rheumatoid arthritis (RA) patients. A total of 53 RA patients, and 25 healthy individuals (control group) were enrolled. Rheumatoid arthritis patients were classified as in active phase (group 1; n=24) or in remission phase (group 2; n=29). Corneal biomechanical parameters including corneal hysteresis (CH), corneal resistance factor (CRF), corneal compensated intraocular pressure (IOPcc), and Goldmann-correlated IOP (IOPg) were measured with the Reichert Ocular Response Analyzer. Topographical measurements, including central corneal thickness (CCT), anterior chamber depth, iridocorneal angle, and corneal volume were measured using a Sirius corneal topographer. The mean CH was 9.43±1.17 mm Hg in group 1, 9.42±1.84 mm Hg in group 2, and 10.47±1.68 mm Hg in the control group (P=0.03). The mean IOPcc was 17.85±3.2 mm Hg in group 1, 17.95±3.49 mm Hg in group 2, and 15.36±3.11 mm Hg in the control group (P=0.008). The CH showed a significant positive correlation with CRF (P=0.000, r=0.809) and CCT (P=0.000, r=0.461), and a significant negative correlation with IOPcc (P=0.000, r=-0.469). Decrease in the mean CH measurements indicates that ultrastructural changes in the cornea may occur in the active phase, and these changes persist in the remission period. In addition, IOPcc is significantly affected by the corneal biomechanical properties. In RA patients, it is important to control the corneal parameters and IOP measurements against the irreversible changes on the optic nerve.

  2. Human hypertrophic and keloid scar models: principles, limitations and future challenges from a tissue engineering perspective

    NARCIS (Netherlands)

    van den Broek, L.J.; Limandjaja, G.C.; Niessen, F.B.; Gibbs, S.

    2014-01-01

    Most cutaneous wounds heal with scar formation. Ideally, an inconspicuous normotrophic scar is formed, but an abnormal scar (hypertrophic scar or keloid) can also develop. A major challenge to scientists and physicians is to prevent adverse scar formation after severe trauma (e.g. burn injury) and

  3. Effects of nicotine on corneal wound healing following acute alkali burn.

    Science.gov (United States)

    Kim, Jong Won; Lim, Chae Woong; Kim, Bumseok

    2017-01-01

    Epidemiological studies have indicated that smoking is a pivotal risk factor for the progression of several chronic diseases. Nicotine, the addictive component of cigarettes, has powerful pathophysiological properties in the body. Although the effects of cigarette smoking on corneal re-epithelialization have been studied, the effects of nicotine on corneal wound healing-related neovascularization and fibrosis have not been fully demonstrated. The aim of this study was to evaluate the effects of chronic administration of nicotine on corneal wound healing following acute insult induced by an alkali burn. BALB/C female mice randomly received either vehicle (2% saccharin) or nicotine (100 or 200 μg/ml in 2% saccharin) in drinking water ad libitum. After 1 week, animals were re-randomized and the experimental group was subjected to a corneal alkali burn, and then nicotine was administered until day 14 after the alkali burn. A corneal alkali burn model was generated by placing a piece of 2 mm-diameter filter paper soaked in 1N NaOH on the right eye. Histopathological analysis and the expression level of the pro-angiogenic genes vascular endothelial growth factor (VEGF) and matrix metalloproteinase-9 (MMP9) revealed that chronic nicotine administration enhanced alkali burn-induced corneal neovascularization. Furthermore, the mRNA expression of the pro-fibrogenic factors α-smooth muscle actin (αSMA), transforming growth factor-β (TGF-β), and collagen α1 (Col1) was enhanced in the high-concentration nicotine-treated group compared with the vehicle group after corneal injury. Immunohistochemical analysis also showed that the αSMA-positive area was increased in chronic nicotine-treated mice after corneal alkali burn. An in vitro assay found that expression of the α3, α7, and β1 nicotinic acetylcholine receptor (nAChR) subunits was significantly increased by chemical injury in human corneal fibroblast cells. Moreover, alkali-induced fibrogenic gene expression and

  4. Psychometric properties of the Brisbane Burn Scar Impact Profile in adults with burn scars.

    Science.gov (United States)

    Tyack, Zephanie; Kimble, Roy; McPhail, Steven; Plaza, Anita; Simons, Megan

    2017-01-01

    The aim of the study was to determine the longitudinal validity, reproducibility, responsiveness and interpretability of the adult version of the Brisbane Burn Scar Impact Profile, a patient-report measure of health-related quality of life. A prospective longitudinal cohort study of patients with or at risk of burn scarring was conducted at three assessment points (at baseline around the time of wound healing, one to two weeks post-baseline and 1-month post-baseline). Participants attending a major metropolitan adult burn centre at baseline were recruited. Participants completed the Brisbane Burn Scar Impact Profile and the 36-item Short Form Health Survey and Patient Observer Scar Assessment Scale. Intraclass Correlation Coefficients (ICCs), smallest detectable change, percentage of those who improved, stayed the same or worsened and Area under the Receiver Operating Characteristic Curve (AUC) were used to test the aim. Data were included for 118 participants at baseline, 68 participants at one to two weeks and 57 participants at 1-month post-baseline. All groups of items had acceptable reproducibility, except for the overall impact of burn scars (ICC = 0.69), the impact of sensations which was not expected to be stable (ICC = 0.63), mobility and daily activities (ICC = 0.63, 0.67 respectively). The responsiveness of six out of seven groups of items able to be tested against external criterion was supported (AUC = 0.72-0.75). Hypothesised correlations of changes in the Brisbane Burn Scar Impact Profile items with changes in criterion measures generally supported longitudinal validity (e.g., nine out of thirteen hypotheses using the SF-36 as an external criterion were supported). Internal consistency estimates, item-total and inter-item correlations indicated there was likely redundancy of some groups of items, particularly in the relationships and social interaction, appearance and emotional reactions items (Chronbach's alpha range = 0.94-0.95). Support was found

  5. Psychometric properties of the Brisbane Burn Scar Impact Profile in adults with burn scars.

    Directory of Open Access Journals (Sweden)

    Zephanie Tyack

    Full Text Available The aim of the study was to determine the longitudinal validity, reproducibility, responsiveness and interpretability of the adult version of the Brisbane Burn Scar Impact Profile, a patient-report measure of health-related quality of life.A prospective longitudinal cohort study of patients with or at risk of burn scarring was conducted at three assessment points (at baseline around the time of wound healing, one to two weeks post-baseline and 1-month post-baseline. Participants attending a major metropolitan adult burn centre at baseline were recruited. Participants completed the Brisbane Burn Scar Impact Profile and the 36-item Short Form Health Survey and Patient Observer Scar Assessment Scale. Intraclass Correlation Coefficients (ICCs, smallest detectable change, percentage of those who improved, stayed the same or worsened and Area under the Receiver Operating Characteristic Curve (AUC were used to test the aim.Data were included for 118 participants at baseline, 68 participants at one to two weeks and 57 participants at 1-month post-baseline. All groups of items had acceptable reproducibility, except for the overall impact of burn scars (ICC = 0.69, the impact of sensations which was not expected to be stable (ICC = 0.63, mobility and daily activities (ICC = 0.63, 0.67 respectively. The responsiveness of six out of seven groups of items able to be tested against external criterion was supported (AUC = 0.72-0.75. Hypothesised correlations of changes in the Brisbane Burn Scar Impact Profile items with changes in criterion measures generally supported longitudinal validity (e.g., nine out of thirteen hypotheses using the SF-36 as an external criterion were supported. Internal consistency estimates, item-total and inter-item correlations indicated there was likely redundancy of some groups of items, particularly in the relationships and social interaction, appearance and emotional reactions items (Chronbach's alpha range = 0.94-0.95.Support

  6. Technology needs for corneal transplant surgery

    Science.gov (United States)

    Vaddavalli, Pravin K.; Yoo, Sonia H.

    2011-03-01

    Corneal transplant surgery has undergone numerous modifications over the years with improvements in technique, instrumentation and eye banking. The main goals of corneal transplantation are achieving excellent optical clarity with long-term graft survival. Penetrating, anterior and posterior lamellar surgery along with femtosecond laser technology have partially met these goals, but outcomes are often unpredictable and surgeon dependent. Technology to predictably separate stroma from Descemet's membrane, techniques to minimize endothelial cell loss, improvements in imaging technology and emerging techniques like laser welding that might replace suturing, eventually making corneal transplantation a refractively predictable procedure are on the wish list of the cornea surgeon.

  7. The Effect of Smoking on Corneal Biomechanics.

    Science.gov (United States)

    Kilavuzoglu, Ayse Ebru; Celebi, Ali Riza Cenk; Altiparmak, Ugur Emrah; Cosar, Cemile Banu

    2017-01-01

    To determine the effect of smoking on corneal biomechanical behavior. The medical records of consecutive patients that presented to the ophthalmology department were reviewed. History of smoking and ophthalmological examination findings were recorded. The smoking group met the following criteria: a clear history of and present smoking habit, negative history of corneal disease and surgery, ocular response analyzer measurement at the time of examination, and a waveform score ≥3.7. Nonsmokers (never smoked or quit smoking ≥6 months earlier) that met the same criteria constituted the control group. Corneal biomechanical parameters were measured using ocular response analyzer. Data were analyzed using Pearson's χ(2) test, Mann-Whitney U test, and Spearman's correlation coefficient. The smoking group included 166 eyes of 166 patients with a mean age of 38.7 ± 11.95 years, and the control group consisted of 170 eyes of 170 patients with a mean age of 38.40 ± 12.2 years. Mean cumulative smoking dose in the smoking group was 9.59 ± 11.87 pack-years (0.04- 75.00). There was no significant correlation between cumulative smoking dose and corneal hysteresis and corneal resistance factor (P = 0.382 and 0.074, respectively). There were no significant differences in corneal hysteresis or the corneal resistance factor between the two groups (P > 0.05). There was no significant difference in corneal hysteresis between those in the smoking group aged 18-44 years and those aged 45-64 years (P = 0.258), whereas in the control group mean corneal hysteresis was significantly lower in the 45-64 year olds than in the 18-44 year olds (P = 0.034). Although there was no significant difference in corneal biomechanics between smoking and control groups, the decrease in corneal hysteresis with aging was less apparent in the smoking group, which may be due to the potential changes in the cornea's microstructure induced by smoking during aging and the effect of smoking in aged corneal

  8. Should nylon corneal sutures be routinely removed?

    Science.gov (United States)

    Jackson, H.; Bosanquet, R.

    1991-01-01

    Three groups of patients who had undergone cataract extraction through a corneal incision closed with 10/0 nylon sutures one, two, and three years previously were recalled to determine the incidence of suture related complications. Broken corneal sutures were found in 87.5% of patients after two years and 90% after three years and were causing symptoms in over half the patients. It is recommended that 10/0 nylon corneal sutures be routinely removed no later than one year after surgery. Images PMID:1751460

  9. Clinical study on human lamellar keratoplasty for fungal corneal ulcers with porcine acellular corneal stroma

    OpenAIRE

    Fu-Hong Liao; Zi-Zhong Yu; Bin Hu

    2017-01-01

    AIM: To observe the transplantation of acellular porcine corneal stroma on the treatment of superficial keratitis by drug-resistant fungal. METHODS: We performed a retrospective analysis of 16 cases of fungal keratitis received the transplantation of acellular porcine corneal matrix from June 2015 to March 2016 with a follow-up of 6mo. We analyzed on items as postoperative visual acuity, corneal graft status, postoperative recurrence and postoperative complications. RESULTS: We observed a hea...

  10. Corneal-Wavefront guided transepithelial photorefractive keratectomy after corneal collagen cross linking in keratoconus

    OpenAIRE

    Camellin, Massimo; Guidotti, Jacopo Maria; Arba Mosquera, Samuel

    2016-01-01

    Purpose To evaluate the efficacy and safety of Corneal-Wavefront guided transepithelial photorefractive keratectomy (TransPRK) after corneal collagen cross linking (CXL) in keratoconic patients. Methods In this retrospective, non-comparative, consecutive case series, 39 keratoconic eyes underwent Corneal-Wavefront guided TransPRK for the correction of aberrations at least 4 months after conventional CXL at SEKAL Rovigo Microsurgery Centre, Rovigo, Italy. Two eyes (5%) underwent a secondary la...

  11. Role of Corneal Epithelium in Riboflavin/Ultraviolet-A Mediated Corneal Cross-Linking Treatment in Rabbit Eyes

    OpenAIRE

    Xiangchen Tao; Haiqun Yu; Yong Zhang; Zhiwei Li; Vishal Jhanji; Shouxiang Ni; Ya Wang; Guoying Mu

    2013-01-01

    Purpose. To evaluate the role of corneal epithelium in riboflavin/ultraviolet-A (UVA) mediated corneal collagen cross-linking treatment. Methods. Fifty New Zealand rabbits were divided into 5 groups: UVA treatment with or without corneal epithelium, UVA+riboflavin treatment with or without corneal epithelium, and control without any treatment. All rabbits were sacrificed after irradiation and subsequently 4?mm???10?mm corneal strips were harvested for biomechanical evaluation. Results. UVA ir...

  12. Clinical assessment of the soft corneal contact lens on corneal epithelium defect after vitrectomy

    Directory of Open Access Journals (Sweden)

    Meng-Su Tang

    2017-03-01

    Full Text Available AIM: To investigate the effect of soft corneal contact lens on the recovery of corneal epithelial defects and the comfort in patients with diabetic retinopathy after vitrectomy. METHODS: Twenty patients(20 eyeswith diabetic retinopathy whose corneal epithelium defected after vitrectomy were randomly divided into 2 groups. The trial group(10 eyesreceived the combination treatment of wearing soft corneal contact lenses and eyedrops to promote corneal epithelial repair, and the control group(10 eyesonly received eyedrops. The corneal epithelial healing time was observed postoperatively. And the scores of the comfort in patients between two groups were compared. RESULTS: The average duration of corneal epithelial defects was 4.1±1.20d in the trial group, and 14.2±6.07d in the control group, which was statistically significant different between the two groups(PP>0.05. CONCLUSION: The soft corneal contact lens could effectively treat patients with corneal epithelial defects after vitrectomy, and improve their comfort.

  13. Correlation of both corneal surfaces in corneal ectasia after myopic LASIK.

    Science.gov (United States)

    Peinado, Teresa Fernández; Piñero, David P; López, Ignacio Alcaraz; Alio, Jorge L

    2011-04-01

    We report a case of corneal ectasia in a 25-year-old man after myopic laser in situ keratomileusis in which a complete characterization of the corneal structure was performed by means of a Scheimpflug photography-based system. The patient presented in the ectatic eye with a subjective refraction of +0.50 to 6.00 × 100°, which with correction gave a visual acuity of 20/25. With the topographic analysis, corneal shapes from both corneal surfaces at the four different quadrants were found to be complementary, maintaining the meniscus-shaped profile of the cornea. This correlation between the anterior and posterior corneal surfaces was also confirmed with an optical tomography evaluation. Corneal biomechanics was also evaluated by means of the Ocular Response Analyzer (Reichert), which confirmed the biomechanical alteration. In summary, biomechanical changes leading to corneal ectasia in this case affected the global corneal structure, inducing alterations in the shape of both anterior and posterior corneal surfaces.

  14. [The effect of cataract and vitreoretinal surgery on central corneal thickness and corneal hysteresis].

    Science.gov (United States)

    Hager, A; Loge, K; Kutschan, A; Wiegand, W

    2008-03-01

    Intraocular irrigating solutions remain for several hours beyond the actual time of surgery in the eye. The irrigating solution ought to resemble biochemically aqueous humor and vitreous and offer protection for sensitive structures of the eye, such as the corneal endothelium. Impairment of the corneal endothelium may lead to corneal oedema and biomechanical alterations of the cornea. 54 eyes after pars-plana vitrectomy (PPV) in elective macular surgery were evaluated by measuring corneal thickness (CCT) using ultrasound pachymetry (20 MHz) and corneal hysteresis (CH) using the ocular response analyser (Reichert Ophthalmic Instruments, Buffalo, NY, USA). Measurements were performed not earlier than 2 weeks prior to surgery and 1 to 3 days after surgery. Results were compared to a control group (n = 39) and to 101 eyes after clear cornea cataract extraction (KAT). The two groups (PPV and KAT) did not differ with respect to age (p = 0.555). Corneal thickness has increased significantly in both groups (p corneal hysteresis decreased significantly postoperatively (p corneal thickness but also by biomechanical parameters such as corneal hysteresis.

  15. Corneal hysteresis, resistance factor, topography, and pachymetry after corneal lamellar flap.

    Science.gov (United States)

    Gatinel, Damien; Chaabouni, Slim; Adam, Pierre-Alexandre; Munck, Jacques; Puech, Michel; Hoang-Xuan, Thanh

    2007-01-01

    To measure prospectively the early changes in corneal hysteresis, topography, and pachymetry after the creation of a stromal flap cut without laser photoablation. A 37-year-old man was referred for a bioptic procedure to correct for compound myopic astigmatism in the left eye. A 159-microm-thick 8x8.5-mm superior hinged flap was created with a mechanical microkeratome in the left cornea. Changes in the corneal hysteresis, corneal resistance factor, Goldmann correlated intraocular pressure (lOP), corneal compensated IOP, anterior and posterior topography, and optical and ultrasound pachymetry were monitored prospectively before and at 1 hour, 1 day, 5 days, and 25 days after flap creation. The right eye served as a control. In the left eye, corneal hysteresis and corneal resistance factor decreased immediately after the flap cut and remained lower than preoperatively at 1 hour, 1 day, 5 days, and 25 days. Corneal compensated IOP varied significantly less than Goldmann correlated IOP in both eyes. Central flattening of the horizontal meridians was observed on the difference topography maps. The values of the left eye posterior best fit sphere increased after the flap cut. Increased central corneal thickness occurred immediately after the flap cut and decreased over time without returning to its preoperative value. The creation of a stromal flap can modify the biomechanical properties of the cornea, including a reduction in corneal hysteresis. The topographic changes were consistent with previously reported cases of flap cut in normal corneas.

  16. Repair of corneal ulcer or perforation using the corneal stromal lenticule

    Directory of Open Access Journals (Sweden)

    Xiao-Feng Hao

    2018-01-01

    Full Text Available AIM: To describe the outcomes of corneal stromal lenticules in repairing of corneal ulcer and/or perforation. METHODS: This was a retrospective chart review of 6 eyes of 6 patients from January to June 2017,who underwent corneal ulcer repair with the corneal, stromal lenticules harvested from femtosecond laser refractive surgery and kept in pure glycerin for use. Three cases of infectious corneal ulcers were bacterial, fungal, and infection with foreign bodies in corneal deep layer, one each. The other 3 were corneal ulcer perforation. Making sure no air bubble between donor graft and Descemet membrane. The mean follow-up time was 3.71±1.56mo(range 1-6mo. RESULTS: All eyes were successfully treated under control of infection without intra-operative complications, and early postoperative evaluation showed a clear graft in all cases. The last follow-up visit showed the mean best corrected visual acuity(VAsignificantly improved after surgery. There was significant difference from 0.48±0.12 to 1.50±0.08(PCONCLUSION: The preliminary results suggest that the use of corneal stromal lenticules may be a safe and effective surgical alternative for corneal ulcer, even though the long-term outcome of the graft needs to be further observed.

  17. Semiclassical quantization of highly excited scar states

    Science.gov (United States)

    Vergini, Eduardo G.

    2017-04-01

    The semiclassical quantization of Hamiltonian systems with classically chaotic dynamics is restricted to low excited states, close to the ground state, because the number of required periodic orbits grows exponentially with energy. Nevertheless, here we demonstrate that it is possible to find eigenenergies of highly excited states scarred by a short periodic orbit. Specifically, by using 18146 homoclinic orbits (HO)s of the shortest periodic orbit of the hyperbola billiard, we find eigenenergies of the strongest scars over a range which includes 630 even eigenfunctions. The analysis of data reveals that the used semiclassical formula presents two regimes. First, when all HOs with excursion time smaller than the Heisenberg time t H are included, the error is around 3.3% of the mean level spacing. Second, in the energy region defined by \\tilde{t}/ tH > 0.13 , where \\tilde{t} is the maximum excursion time included in the calculation, the error is around 15% of the mean level spacing.

  18. Standardised antibacterial Manuka honey in the management of persistent post-operative corneal oedema: a case series.

    Science.gov (United States)

    Albietz, Julie M; Lenton, Lee M

    2015-09-01

    Corneal oedema is a common post-operative problem that delays or prevents visual recovery from ocular surgery. Honey is a supersaturated solution of sugars with an acidic pH, high osmolarity and low water content. These characteristics inhibit the growth of micro-organisms, reduce oedema and promote epithelialisation. This clinical case series describes the use of a regulatory approved Leptospermum species honey ophthalmic product, in the management of post-operative corneal oedema and bullous keratopathy. A retrospective review of 18 consecutive cases (30 eyes) with corneal oedema persisting beyond one month after single or multiple ocular surgical procedures (phacoemulsification cataract surgery and additional procedures) treated with Optimel Antibacterial Manuka Eye Drops twice to three times daily as an adjunctive therapy to conventional topical management with corticosteroid, aqueous suppressants, hypertonic sodium chloride five per cent, eyelid hygiene and artificial tears. Visual acuity and central corneal thickness were measured before and at the conclusion of Optimel treatment. A temporary reduction in corneal epithelial oedema lasting up to several hours was observed after the initial Optimel instillation and was associated with a reduction in central corneal thickness, resolution of epithelial microcysts, collapse of epithelial bullae, improved corneal clarity, improved visualisation of the intraocular structures and improved visual acuity. Additionally, with chronic use, reduction in punctate epitheliopathy, reduction in central corneal thickness and improvement in visual acuity were achieved. Temporary stinging after Optimel instillation was experienced. No adverse infectious or inflammatory events occurred during treatment with Optimel. Optimel was a safe and effective adjunctive therapeutic strategy in the management of persistent post-operative corneal oedema and warrants further investigation in clinical trials. © 2015 The Authors. Clinical and

  19. Reliable scar scoring system to assess photographs of burn patients.

    Science.gov (United States)

    Mecott, Gabriel A; Finnerty, Celeste C; Herndon, David N; Al-Mousawi, Ahmed M; Branski, Ludwik K; Hegde, Sachin; Kraft, Robert; Williams, Felicia N; Maldonado, Susana A; Rivero, Haidy G; Rodriguez-Escobar, Noe; Jeschke, Marc G

    2015-12-01

    Several scar-scoring scales exist to clinically monitor burn scar development and maturation. Although scoring scars through direct clinical examination is ideal, scars must sometimes be scored from photographs. No scar scale currently exists for the latter purpose. We modified a previously described scar scale (Yeong et al., J Burn Care Rehabil 1997) and tested the reliability of this new scale in assessing burn scars from photographs. The new scale consisted of three parameters as follows: scar height, surface appearance, and color mismatch. Each parameter was assigned a score of 1 (best) to 4 (worst), generating a total score of 3-12. Five physicians with burns training scored 120 representative photographs using the original and modified scales. Reliability was analyzed using coefficient of agreement, Cronbach alpha, intraclass correlation coefficient, variance, and coefficient of variance. Analysis of variance was performed using the Kruskal-Wallis test. Color mismatch and scar height scores were validated by analyzing actual height and color differences. The intraclass correlation coefficient, the coefficient of agreement, and Cronbach alpha were higher for the modified scale than those of the original scale. The original scale produced more variance than that in the modified scale. Subanalysis demonstrated that, for all categories, the modified scale had greater correlation and reliability than the original scale. The correlation between color mismatch scores and actual color differences was 0.84 and between scar height scores and actual height was 0.81. The modified scar scale is a simple, reliable, and useful scale for evaluating photographs of burn patients. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Association between culture results of corneal scrapings and culture and histopathology results of corneal tissues in therapeutic keratoplasty.

    Science.gov (United States)

    Das, Sujata; Sharma, Savitri; Priyadarshini, Omega; Sahu, Srikant K; Kar, Sarita; Vemuganti, Geeta K

    2011-09-01

    To correlate the culture results of corneal scrapings with culture and histopathology results of corneal tissues in therapeutic keratoplasty. A retrospective analysis of the culture results of corneal scrapings and corneal tissues of eyes that received therapeutic penetrating keratoplasty at a tertiary eye care center between December 2006 and November 2008 was conducted. As per the preferred practice, those cases that did not respond to appropriate antimicrobial therapy and/or presented with a large infiltrate/perforation received therapeutic keratoplasty. The microbiology and histopathology findings of the corneal tissues were compared. Thirty-eight therapeutic keratoplasties were performed on 36 patients. Although all cases had histopathology and culture of the corneal tissue, corneal scrapings were not performed in 4 cases. Corneal scrapings and corneal tissues were culture-positive in 76% (26 of 34) and 60% (23 of 38) of cases, respectively. In 8 cases, the corneal scrapings and corneal tissues yielded identical organisms, whereas different organisms grew in 4 cases. In 6 cases, the corneal tissues were culture-positive but the corneal scrapings were sterile. In 20 cases, the corneal tissues were culture-positive for fungus and also showed fungal filaments in their corresponding histopathology specimens. Corneal tissue culture can provide additional information in cases undergoing therapeutic keratoplasty. It helps to determine the management of patients after keratoplasty.

  1. Thrombomodulin promotes corneal epithelial wound healing

    National Research Council Canada - National Science Library

    Huang, Yi-Hsun; I, Ching-Chang; Kuo, Cheng-Hsiang; Hsu, Yun-Yan; Lee, Fang-Tzu; Shi, Guey-Yueh; Tseng, Sung-Huei; Wu, Hua-Lin

    2015-01-01

    To determine the role of thrombomodulin (TM) in corneal epithelial wound healing, and to investigate whether recombinant TM epidermal growth factor-like domain plus serine/threonine-rich domain (rTMD23...

  2. Femtosecond Lasers and Corneal Surgical Procedures.

    Science.gov (United States)

    Marino, Gustavo K; Santhiago, Marcony R; Wilson, Steven E

    2017-01-01

    Our purpose is to present a broad review about the principles, early history, evolution, applications, and complications of femtosecond lasers used in refractive and nonrefractive corneal surgical procedures. Femtosecond laser technology added not only safety, precision, and reproducibility to established corneal surgical procedures such as laser in situ keratomileusis (LASIK) and astigmatic keratotomy, but it also introduced new promising concepts such as the intrastromal lenticule procedures with refractive lenticule extraction (ReLEx). Over time, the refinements in laser optics and the overall design of femtosecond laser platforms led to it becoming an essential tool for corneal surgeons. In conclusion, femtosecond laser is a heavily utilized tool in refractive and nonrefractive corneal surgical procedures, and further technological advances are likely to expand its applications. Copyright 2017 Asia-Pacific Academy of Ophthalmology.

  3. Clear corneal incision in cataract surgery.

    Science.gov (United States)

    Al Mahmood, Ammar M; Al-Swailem, Samar A; Behrens, Ashley

    2014-01-01

    Since the introduction of sutureless clear corneal cataract incisions, the procedure has gained increasing popularity worldwide because it offers several advantages over the traditional sutured scleral tunnels and limbal incisions. Some of these benefits include lack of conjunctival trauma, less discomfort and bleeding, absence of suture-induced astigmatism, and faster visual rehabilitation. However, an increasing incidence of postoperative endophthalmitis after clear corneal cataract surgery has been reported. Different authors have shown a significant increase up to 15-fold in the incidence of endophthalmitis following clear corneal incision compared to scleral tunnels. The aim of this report is to review the advantages and disadvantages of clear corneal incisions in cataract surgery, emphasizing on wound construction recommendations based on published literature.

  4. Corneal biomechanical properties in thyroid eye disease

    National Research Council Canada - National Science Library

    Karabulut, Gamze Ozturk; Kaynak, Pelin; Altan, Cıgdem; Ozturker, Can; Aksoy, Ebru Funda; Demirok, Ahmet; Yılmaz, Omer Faruk

    2014-01-01

    The purpose of this study is to investigate the effect of thyroid eye disease (TED) on the measurement of corneal biomechanical properties and the relationship between these parameters and disease manifestations...

  5. Conjunctival intraepithelial neoplasia with corneal furrow degeneration

    Directory of Open Access Journals (Sweden)

    Pukhraj Rishi

    2014-01-01

    Full Text Available A 68-year-old man presented with redness of left eye since six months. Examination revealed bilateral corneal furrow degeneration. Left eye lesion was suggestive of conjunctival squamous cell carcinoma, encroaching on to cornea. Anterior segment optical coherence tomography (AS-OCT confirmed peripheral corneal thinning. Fluorescein angiography confirmed intrinsic vascularity of lesion. Patient was managed with "no touch" surgical excision, dry keratectomy without alcohol, cryotherapy, and primary closure. Pathologic examination of removed tissue confirmed clinical diagnosis. Management of this particular case required modification of standard treatment protocol. Unlike the alcohol-assisted technique of tumor dissection described, ethyl alcohol was not used for risk of corneal perforation due to underlying peripheral corneal thinning. Likewise, topical steroids were withheld in the post-operative period. Three weeks post-operatively, left eye was healing well. Hence, per-operative usage of absolute alcohol and post-operative use of topical steroids may be best avoided in such eyes.

  6. Surgical compensation of presbyopia with corneal inlays.

    Science.gov (United States)

    Konstantopoulos, Aris; Mehta, Jodhbir S

    2015-05-01

    Presbyopia, the physiological change in near vision that develops with ageing, gradually affects individuals older than 40 years and is a growing cause of visual disability due to ageing demographics of the global population. The routine use of computers and 'smartphones', combined with the affluence of the 'baby boomers' generation has set high standards for near vision correction. Corneal inlays are a relatively new treatment modality that is effective at compensating for presbyopia. The dimensions of these devices vary from 2 to 3.8 mm in diameter and 5 to 32 μm in thickness. They are implanted in the anterior corneal stroma of the non-dominant eye, most commonly, in a femtosecond laser created corneal pocket. They improve near vision by increasing the depth of focus, creating a hyper-prolate region of increased central cornea power or providing a refractive add power. This article reviews the literature on the efficacy and safety of corneal inlays.

  7. IOL Power Calculation after Corneal Refractive Surgery

    OpenAIRE

    Maddalena De Bernardo; Luigi Capasso; Luisa Caliendo; Francesco Paolercio; Nicola Rosa

    2014-01-01

    Purpose. To describe the different formulas that try to overcome the problem of calculating the intraocular lens (IOL) power in patients that underwent corneal refractive surgery (CRS). Methods. A Pubmed literature search review of all published articles, on keyword associated with IOL power calculation and corneal refractive surgery, as well as the reference lists of retrieved articles, was performed. Results. A total of 33 peer reviewed articles dealing with methods that try to overcome the...

  8. Corneal collagen crosslinking for keratoconus. A review

    OpenAIRE

    M. M. Bikbov; V. K. Surkova

    2014-01-01

    Photochemical crosslinking is widely applied in ophthalmology. Its biochemical effect is due to the release of singlet oxygen that promotes anaerobic photochemical reaction. Keratoconus is one of the most common corneal ectasia affecting 1 in 250 to 250 000 persons. Currently, the rate of iatrogenic ectasia following eximer laser refractive surgery increases due to biomechanical weakening of the cornea. Morphologically and biochemically, ectasia is characterized by corneal layers thinning, co...

  9. Corneal biomechanical properties of patients with acromegaly.

    Science.gov (United States)

    Ozkok, Ahmet; Hatipoglu, Esra; Tamcelik, Nevbahar; Balta, Burcu; Gundogdu, Ahmet Sadi; Ozdamar, Mehmet Akif; Kadioglu, Pinar

    2014-05-01

    Growth hormone (GH) and insulin-like growth factor-1 (IGF-1) excess in acromegaly have various effects on many organs. The ophthalmologic effects of GH and IGF-1 excess have not yet been investigated in detail. The aim of the current study is to compare the corneal biomechanical properties of patients with acromegaly and those of healthy subjects. 45 patients with acromegaly (F/M=27/18) and 42 age-matched and gender-matched healthy individuals (F/M=24/18) were enrolled in this cross-sectional study. Central corneal thickness (CCT), corneal resistance factor (CRF), corneal hysteresis (CH), corneal compensated intraocular pressure (IOPcc) and Goldmann correlated IOPG were measured in patients with acromegaly and in healthy individuals using the Ocular Response Analyser (ORA). GH and IGF1 values were also determined in the study group. The mean CH and CRF values were higher in acromegalic patients (12.1±2.2 and 12.3±2.4, respectively) than in healthy subjects (11.0±1.6 and 10.8±1.5, respectively; for CH, p=0.014; for CRF, p=0.001). Mean IOPG measurement was higher in the acromegaly group than in the control group (p=0.017). There was no statistically significant difference in measured CCT (p=0.117) and IOPcc (p=0.594) values between acromegalic patients and healthy subjects. These findings indicate that acromegaly has target organ effects on the eye. Consequently, it can change corneal biomechanical properties such as corneal hysteresis and the CRF. Corneal biomechanical properties are known to affect the accuracy of IOP measurements. These findings should be taken into account when measuring IOP values in acromegaly patients, as IOP readings may be overestimated.

  10. Corneal Biomechanics Determination in Healthy Myopic Subjects

    Directory of Open Access Journals (Sweden)

    Kunliang Qiu

    2016-01-01

    Full Text Available Purpose. To determine the corneal biomechanical properties by using the Ocular Response Analyzer™ and to investigate potential factors associated with the corneal biomechanics in healthy myopic subjects. Methods. 135 eyes from 135 healthy myopic subjects were included in this cross-sectional observational study. Cornea hysteresis (CH, corneal resistance factor (CRF, cornea-compensated intraocular pressure (IOPcc, and Goldmann-correlated intraocular pressure (IOPg were determined with the Reichert Ocular Response Analyzer (ORA. Univariate and multivariate regression analyses were performed to investigate factors associated with corneal biomechanics. Results. The mean CH and CRF were 9.82±1.34 mmHg and 9.64±1.57 mmHg, respectively. In univariate regression analysis, CH was significantly correlated with axial length, refraction, central corneal thickness (CCT, and IOPg (r=-0.27, 0.23, 0.45, and 0.21, resp.; all with p≤0.015, but not with corneal curvature or age; CRF was significantly correlated with CCT and IOPg (r=0.52 and 0.70, resp.; all with p<0.001, but not with axial length/refraction, corneal curvature, or age. In multivariate regression analysis, axial length, IOPcc, and CCT were found to be independently associated with CH, while CCT and IOPg were associated with CRF. Conclusions. Both CH and CRF were positively correlated with CCT. Lower CH but not CRF was associated with increasing degree of myopia. Evaluation of corneal biomechanical properties should take CCT and myopic status into consideration.

  11. Corneal hysteresis in mucopolysaccharidosis I and VI.

    Science.gov (United States)

    Fahnehjelm, Kristina Teär; Chen, Enping; Winiarski, Jacek

    2012-08-01

    High intraocular pressure (IOP) and glaucoma are often suspected in patients with mucopolysaccharidosis (MPS). To determine corneal hysteresis (CH) and IOP in children with mucopolysaccharidosis I-Hurler (MPS I-H) and MPS VI. Clinical measurements with ocular response analyzer (ORA). In seven patients, five with MPS I-H treated with stem cell transplantation (SCT), and two with MPS VI, one treated with SCT and the other with enzyme therapy, the IOP was examined with ORA. Ocular response analyzer measurements were made at a median age of 8.7 years in the patients with MPS I-H and at a median age of 9.3 years in the patients with MPS VI. Earlier measurements had raised suspicion of high IOP in one patient. The ORA showed an increased CH and a falsely high IOP values in all 14 eyes. The recalculated IOPs were normal in all 14 eyes. Mild to severe corneal opacities were present in all 14 eyes. Optic disc areas, borders and cupping were clinically normal in the 12 of 14 eyes that were possible to examine. Severe corneal opacities hampered optic disc evaluation in the older patient with MPS VI. Three eyes in two patients had normal thickness of the retinal nerve fibre layer measured with scanning laser polarimetry with corneal compensation (GDx VCC). No patient was diagnosed or treated for glaucoma. The IOPs are often falsely high because of an increased resistance of the cornea and correlate to the extent of corneal clouding. In this small, cross-sectional study, it appears that corneal resistance is directly correlated with corneal clouding, although a longitudinal study that evaluates resistance as the cornea clears with treatment would provide more direct evidence that corneal deposits are directly related to resistance. A correct measured IOP can avoid unnecessary medical or surgical hypotensive treatment. © 2011 The Authors. Acta Ophthalmologica © 2011 Acta Ophthalmologica Scandinavica Foundation.

  12. Corneal topography and soft contact lens fit.

    Science.gov (United States)

    Young, Graeme; Schnider, Cristina; Hunt, Chris; Efron, Suzanne

    2010-05-01

    To determine which ocular topography variables affect soft contact lens fit. Fifty subjects each wore three pairs of soft lenses in random succession (Vistakon Acuvue 2, Vistakon Acuvue Advance, Ciba Vision Night & Day), and various aspects of lens fit were evaluated. The steeper base curves of each type were worn in one eye and the flatter base curves in the other eye. Corneal topography data were collected using a Medmont E300 corneal topographer (Camberwell, Australia). Corneal curvature, shape factor (SF), and corneal height were measured over a 10 mm chord and also over the maximum measurable diameter. These were measured in the horizontal, vertical, steepest, and flattest meridians. With each lens type, the steeper base curve provided the best fit on the greatest proportion of eyes and the significant differences in various aspects of fit were noted between base curves. For each lens type, there was no significant difference in mean K-reading between those eyes best fit with the steeper base curve and those eyes best fit with the flatter base curve. Two of the lenses showed a positive correlation between centration and horizontal corneal height (maximum), whereas one lens showed a negative correlation between centration and horizontal SF (SF = e). Several lenses showed a positive correlation between post-blink movement and horizontal or vertical corneal SF. The measurement of corneal topography using current Placido disc instrumentation allows a better prediction of soft lens fit than by keratometry, but it is not reliable enough to enable accurate selection of the best fitting base curve. Some correlations are evident between corneal measurements; however, trial fitting remains the method of choice for selection of soft lens base curve.

  13. Corneal Collagen Cross-Linking Outcomes: Review

    OpenAIRE

    Jankov II,Mirko R.; Jovanovic,Vesna; Delevic, Sladjana; Coskunseven, Efekan

    2011-01-01

    Keratoconus is a condition characterized by biomechanical instability of the cornea, presenting in a progressive, asymmetric and bilateral way. Corneal collagen cross-linking with riboflavin and UVA (CXL) is a new technique of corneal tissue strengthening that combines the use of riboflavin as a photo sensitizer and UVA irradiation. The studies showed that CXL was effective in halting the progression of keratoconus over a period of up to four years. The published studies also revealed a reduc...

  14. Assessment of the ex vivo biomechanical properties of porcine cornea with inflation test for corneal xenotransplantation.

    Science.gov (United States)

    Bao, F; Jiang, L; Wang, X; Zhang, D; Wang, Q; Zeng, Y

    2012-01-01

    This study aims to obtain the biomechanical properties of porcine cornea so as to provide necessary biomechanical experimental basis for pig-to-human corneal xenotransplantation. Seventeen fresh porcine corneal specimens obtained from pigs aged 4-6 months were examined under inflation conditions to determine the constitutive relationships of the material through dynamic loading conditions (pressure range: 1.47-42.66 mmHg). The forward deflection of porcine anterior corneal apex was measured by the laser displacement sensor. The pressure deformation results were analysed on the basis of shell theory to estimate Young's modulus of the cornea and derive its relationship with intraocular pressure (IOP). The porcine corneas showed a nonlinear corneal forward displacement/IOP and stress/strain relationship with an initial low stiffness stage and a later high stiffness stage. In spite of the nonlinearity between the internal pressure and apex forward deflection, the relationship between the Young's modulus and the IOP was almost linear. Compared with human corneas, porcine corneas exhibited a similar nonlinear behaviour but lower stiffness values. The biomechanical parameters of porcine cornea obtained from this test could be applied to numerical simulations of refractive surgery procedures and lay a foundation for pig-to-human corneal xenotransplantation. Copyright © 2012 Informa UK, Ltd.

  15. [Relationship between corneal neovascularization and various relevant biological factors in surrounding cornea stroma of rats].

    Science.gov (United States)

    Wang, Ting; Shi, Wei-yun; Li, Su-xia; Liu, Ming-na

    2009-02-01

    To study the relationship between corneal neovascularization and various biological factors in corneal stroma of rats. It was an experimental study. Corneal neovascularization was induced by alkali burn in 40 rats. Transforming growth factor-beta1 (TGF-beta1), alpha-smooth muscle actin (alpha-SMA) and fibroblast activation protein (FAP) in the stroma surrounding corneal neovascularization were detected by immunohistochemical studies on day 1, 3 and 7 after chemical burn. Platelet-endothelial cell adhesion molecule-1 (CD31) was used to identify the vascular endothelial cells. RT-PCR was used to identify FAP in the cornea 3 and 7 days after chemical burn. Picrosirius staining and polarization microscopy were used to detect changes of collagen types I and III in the cornea. After alkali burn, TGF-beta1 was first expressed in the cornea stroma. Then, some stroma cells expressed both alpha-SMA and FAP. The FAP(+) keratocytes were found surrounding the CD31(+) endothelium of angiogenesis. RT-PCR study showed that FAP mRNA was only present in neovascularized cornea and not in normal cornea. Polarization microscopy revealed that the collagen types I and III were rearranged in neovascularized cornea. Various biological factors in corneal stroma are changed when the cornea shows neovascularization. FAP(+) keratocytes are present in the stroma, and the appearance of these cells parallels the growth of vascular endothelial cells. Collagen types I and III are rearranged during the process of angiogenesis.

  16. Cellular and nerve regeneration within a biosynthetic extracellular matrix for corneal transplantation

    Science.gov (United States)

    Li, Fengfu; Carlsson, David; Lohmann, Chris; Suuronen, Erik; Vascotto, Sandy; Kobuch, Karin; Sheardown, Heather; Munger, Rejean; Nakamura, Masatsugu; Griffith, May

    2003-12-01

    Our objective was to determine whether key properties of extracellular matrix (ECM) macromolecules can be replicated within tissue-engineered biosynthetic matrices to influence cellular properties and behavior. To achieve this, hydrated collagen and N-isopropylacrylamide copolymer-based ECMs were fabricated and tested on a corneal model. The structural and immunological simplicity of the cornea and importance of its extensive innervation for optimal functioning makes it an ideal test model. In addition, corneal failure is a clinically significant problem. Matrices were therefore designed to have the optical clarity and the proper dimensions, curvature, and biomechanical properties for use as corneal tissue replacements in transplantation. In vitro studies demonstrated that grafting of the laminin adhesion pentapeptide motif, YIGSR, to the hydrogels promoted epithelial stratification and neurite in-growth. Implants into pigs' corneas demonstrated successful in vivo regeneration of host corneal epithelium, stroma, and nerves. In particular, functional nerves were observed to rapidly regenerate in implants. By comparison, nerve regeneration in allograft controls was too slow to be observed during the experimental period, consistent with the behavior of human cornea transplants. Other corneal substitutes have been produced and tested, but here we report an implantable matrix that performs as a physiologically functional tissue substitute and not simply as a prosthetic device. These biosynthetic ECM replacements should have applicability to many areas of tissue engineering and regenerative medicine, especially where nerve function is required. regenerative medicine | tissue engineering | cornea | implantation | innervation

  17. Database of predicted SCAR markers in five fruit and three ...

    Indian Academy of Sciences (India)

    Database of predicted. SCAR markers in five fruit and three vegetable crops. Balakrishnan. V asanthakumari. Premkrishnan and. V adivel. Arunachalam. J. Genet. 95. ,. 171–175. Figure. 1 . Multiplex. PCR with. SCAR primer designed based on. OPJ-04 along with. 16S. rRNA- specific primers with genomic. DNA of banana.

  18. Managing Caesarean Scar Pregnancy in low Resource Settings: 2 ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    Mots-clés: grossesse de la cicatrice césarienne, approche chirurgicale guidée de l'échographie transrectale. Introduction. Caesarean scar pregnancy (CSP) occurs when an embryo implants in a previous caesarean section scar. It has a reported incidence of 1 in 18001 and was first reported by Larson and Solomon in ...

  19. External charring and fire scarring in three western conifers

    Science.gov (United States)

    E. K. Sutherland; Josh Farella; David K Wright; Ian Hyp; K. T. Smith; Donald A. Falk; Estelle Arbellay; Markus Stoffel

    2013-01-01

    Fires that injure but do not kill trees cause scars used as proxies for the reconstruction of wildfire history. Understanding about these wildfires - and their relationship to vegetation dynamics and climate - has profoundly affected wildfire and land management policy globally. To better understand scarring in the context of wildfire behavior, landscape and biological...

  20. NEDD4-1 and PTEN expression in keloid scarring

    National Research Council Canada - National Science Library

    Sang, P F; Wang, H; Wang, M; Hu, C; Zhang, J S; Li, X J; Zhu, F

    2015-01-01

    Keloid scarring remains a major problem in plastic surgery. The aim of this study was to determine the expression of the PTEN tumor suppressor and NEDD4-1 genes in keloid tissue and explore their effect on the formation of such scarring...