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Sample records for schnyder crystalline corneal

  1. Distrofia corneal de Schnyder

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    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.

  2. Crystalline Subtype of Pre-Descemetic Corneal Dystrophy

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    Rosa Dolz-Marco

    2014-01-01

    Full Text Available Purpose: To report corneal findings in a familial case of the crystalline subtype of pre- Descemetic corneal dystrophy. Case Report: A 19-year-old girl and her 44-year-old mother were found to have asymptomatic, bilateral, punctiform and multi-colored crystalline opacities across the whole posterior layer of the corneas. Endothelial specular microscopy revealed the presence of white round flecks located at different levels anterior to the endothelium. No systemic abnormalities or medications could be related to account for these findings. Conclusion: To the best of our knowledge, this is the third familial report of this rare corneal disorder. Differential diagnosis may include Schnyder corneal dystrophy, cystinosis, Bietti΄s dystrophy and monoclonal gammopathy.

  3. Crystalline Subtype of Pre-Descemetic Corneal Dystrophy

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    Dolz-Marco, Rosa; Gallego-Pinazo, Roberto; Pinazo-Durán, María Dolores; Díaz-Llopis, Manuel

    2014-01-01

    Purpose To report corneal findings in a familial case of the crystalline subtype of pre-Descemetic corneal dystrophy. Case Report A 19-year-old girl and her 44-year-old mother were found to have asymptomatic, bilateral, punctiform and multi-colored crystalline opacities across the whole posterior layer of the corneas. Endothelial specular microscopy revealed the presence of white round flecks located at different levels anterior to the endothelium. No systemic abnormalities or medications could be related to account for these findings. Conclusion To the best of our knowledge, this is the third familial report of this rare corneal disorder. Differential diagnosis may include Schnyder corneal dystrophy, cystinosis, Bietti´s dystrophy and monoclonal gammopathy. PMID:25279130

  4. UBIAD1 mutation alters a mitochondrial prenyltransferase to cause Schnyder corneal dystrophy.

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    Michael L Nickerson

    2010-05-01

    Full Text Available Mutations in a novel gene, UBIAD1, were recently found to cause the autosomal dominant eye disease Schnyder corneal dystrophy (SCD. SCD is characterized by an abnormal deposition of cholesterol and phospholipids in the cornea resulting in progressive corneal opacification and visual loss. We characterized lesions in the UBIAD1 gene in new SCD families and examined protein homology, localization, and structure.We characterized five novel mutations in the UBIAD1 gene in ten SCD families, including a first SCD family of Native American ethnicity. Examination of protein homology revealed that SCD altered amino acids which were highly conserved across species. Cell lines were established from patients including keratocytes obtained after corneal transplant surgery and lymphoblastoid cell lines from Epstein-Barr virus immortalized peripheral blood mononuclear cells. These were used to determine the subcellular localization of mutant and wild type protein, and to examine cholesterol metabolite ratios. Immunohistochemistry using antibodies specific for UBIAD1 protein in keratocytes revealed that both wild type and N102S protein were localized sub-cellularly to mitochondria. Analysis of cholesterol metabolites in patient cell line extracts showed no significant alteration in the presence of mutant protein indicating a potentially novel function of the UBIAD1 protein in cholesterol biochemistry. Molecular modeling was used to develop a model of human UBIAD1 protein in a membrane and revealed potentially critical roles for amino acids mutated in SCD. Potential primary and secondary substrate binding sites were identified and docking simulations indicated likely substrates including prenyl and phenolic molecules.Accumulating evidence from the SCD familial mutation spectrum, protein homology across species, and molecular modeling suggest that protein function is likely down-regulated by SCD mutations. Mitochondrial UBIAD1 protein appears to have a highly

  5. Distrofia de Schnyder

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    Zaadia Pérez Parra

    Full Text Available Entre las distrofias estromales encontramos la distrofia de Schnyder, que se caracteriza por ser bilateral y progresiva. Su diagnóstico es relativamente sencillo cuando se presenta con cristales de colesterol y fosfolípidos. El estudio histológico y la microscopia confocal confirman el diagnóstico. Presentamos dos casos clínicos de distrofia de Schnyder, en pacientes del sexo femenino, quienes acudieron a la consulta y refirieron disminución de la visión y cambio de coloración de los ojos. Los hallazgos clínicos y la microscopia confocal confirman el diagnóstico de distrofia de Schnyder, la cual se caracteriza por la presencia de cristales en el estroma anterior central de distribución anular o disciforme, asociado a arco lipoide y haze en la media periferia. La fotoqueratectomía con excímer láser cuando la afección se limita al estroma anterior, o la queratoplastia penetrante en casos más avanzados, constituyen el arsenal terapéutico en esta afección.

  6. Punctiform and Polychromatophilic Dominant Pre-Descemet Corneal Dystrophy.

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    Lagrou, Lisa; Midgley, Julian; Romanchuk, Kenneth Gerald

    2016-04-01

    To describe the slit-lamp appearance and corneal confocal microscopy of autosomal dominant punctiform and polychromatophilic pre-Descemet corneal dystrophy in 3 members of the same family. Slit-lamp examination of a 9-year-old boy showed bilateral polychromatophilic corneal opacities in a pre-Descemet membrane location evenly deposited limbus to limbus, both horizontally and vertically, with an intervening clear cornea. The corneal endothelium was normal on corneal confocal microscopy, with hyperreflective opacities of various sizes located pre-Descemet membrane. Slit-lamp examination of the patient's father and brother revealed identical crystalline deposition in the pre-Descemet corneal stroma. The remainders of the eye examinations were otherwise normal in all 3 individuals, and all were asymptomatic. The general physical examination and laboratory investigations of the patient were all normal, as were the laboratory investigations of the other 2 family members. There was no progression in the corneal findings over 6 months of follow-up. These patients likely illustrate a rare autosomal dominant pre-Descemet crystalline keratopathy that has been reported only once previously.

  7. Infectious crystalline keratopathy caused by Cladosporium sp. after penetrating keratoplasty: a case report

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    Stock RA

    2016-08-01

    Full Text Available Ricardo Alexandre Stock,1 Elcio Luiz Bonamigo,2 Emeline Cadore,3 Rafael Allan Oechsler4 1Corneal Transplant Section, Santa Terezinha University Hospital, 2Department of Ophthalmology and Bioethics, 3University of Western Santa Catarina, Joaçaba, 4Cornea Department, Oftalmo Center Blumenau, Blumenau, Santa Catarina, Brazil Background: Infectious crystalline keratopathy is a rare, progressive infection characterized by the insidious progression of branches and crystalline corneal opacities with minimal or no inflammation. This case report describes the evolution of an infectious crystalline keratopathy caused by Cladosporium sp., which developed after tectonic keratoplasty in a patient with a history of ocular trauma.Case presentation: A 40-year-old Brazilian male was the victim of firework-induced trauma to the left eye, which resulted in a corneal laceration that could not be sutured as well as a severe traumatic cataract. The patient underwent penetrating keratoplasty and phacoemulsification. During postoperative follow-up, another therapeutic keratoplasty was required because unresponsive infectious keratitis was observed. The infiltrate’s characteristics were suggestive of infectious crystalline keratopathy; in particular, the infiltrate was insidious and progressive, and grayish-white branches appeared in the anterior corneal stroma. As different therapies were administered, inflammatory reactions ranging from mild to severe were observed. The infection was unresponsive to typical antifungal drugs. This lack of response most likely occurred due to steroid treatment and the diffuse corneal spread of an atypical microorganism, which was subsequently identified in culture as Cladosporium sp. After the second therapeutic keratoplasty, the patient’s eye integrity was successfully reestablished.Conclusion: This study likely provides the first report describing a case of infectious crystalline keratopathy caused by Cladosporium sp. This case

  8. Crystalline lens power and refractive error.

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    Iribarren, Rafael; Morgan, Ian G; Nangia, Vinay; Jonas, Jost B

    2012-02-01

    To study the relationships between the refractive power of the crystalline lens, overall refractive error of the eye, and degree of nuclear cataract. All phakic participants of the population-based Central India Eye and Medical Study with an age of 50+ years were included. Calculation of the refractive lens power was based on distance noncycloplegic refractive error, corneal refractive power, anterior chamber depth, lens thickness, and axial length according to Bennett's formula. The study included 1885 subjects. Mean refractive lens power was 25.5 ± 3.0 D (range, 13.9-36.6). After adjustment for age and sex, the standardized correlation coefficients (β) of the association with the ocular refractive error were highest for crystalline lens power (β = -0.41; P lens opacity grade (β = -0.42; P lens power (β = -0.95), lower corneal refractive power (β = -0.76), higher lens thickness (β = 0.30), deeper anterior chamber (β = 0.28), and less marked nuclear lens opacity (β = -0.05). Lens thickness was significantly lower in eyes with greater nuclear opacity. Variations in refractive error in adults aged 50+ years were mostly influenced by variations in axial length and in crystalline lens refractive power, followed by variations in corneal refractive power, and, to a minor degree, by variations in lens thickness and anterior chamber depth.

  9. Corneal Laceration

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

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    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.

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

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    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.

  12. Corneal Laceration

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  13. Mitochondrial damage and cholesterol storage in human hepatocellular carcinoma cells with silencing of UBIAD1 gene expression

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    Carlos R. Morales

    2014-01-01

    Full Text Available Heterozygous mutations in the UBIAD1 gene cause Schnyder corneal dystrophy characterized by abnormal cholesterol and phospholipid deposits in the cornea. Ubiad1 protein was recently identified as Golgi prenyltransferase responsible for biosynthesis of vitamin K2 and CoQ10, a key protein in the mitochondrial electron transport chain. Our study shows that silencing UBIAD1 in cultured human hepatocellular carcinoma cells causes dramatic morphological changes and cholesterol storage in the mitochondria, emphasizing an important role of UBIAD1 in mitochondrial function.

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

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    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.

  15. Corneal densitometry and its correlation with age, pachymetry, corneal curvature, and refraction.

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    Garzón, Nuria; Poyales, Francisco; Illarramendi, Igor; Mendicute, Javier; Jáñez, Óscar; Caro, Pedro; López, Alfredo; Argüeso, Francisco

    2017-12-01

    To determine normative corneal densitometry values in relation to age, sex, refractive error, corneal thickness, and keratometry, measured using the Oculus Pentacam system. Three hundred and thirty-eight healthy subjects (185 men; 153 women) with no corneal disease underwent an exhaustive ocular examination. Corneal densitometry was expressed in standardized grayscale units (GSU). The mean corneal densitometry over the total area was 16.46 ± 1.85 GSU. The Pearson correlation coefficient for total densitometry was r = 0.542 (p  0.05). This is the first report of normative corneal densitometry values in relation to keratometry, corneal thickness, and spherical equivalent measured with the latest Oculus Pentacam software. Corneal densitometry increases with age, but corneal keratometry and refractive parameters do not affect light scattering in the human cornea.

  16. 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.

  17. Intraocular pressure, corneal thickness, and corneal hysteresis in Steinert's myotonic dystrophy

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    Carlos Alexandre de A. Garcia Filho

    2011-06-01

    Full Text Available PURPOSE: Low intraocular pressure (IOP measured by Goldmann applanation tonometry (GAT is one of the ocular manifestations of Steinert's myotonic dystrophy. The goal of this study was to evaluate the corneal-compensated IOP as well as corneal properties (central corneal thickness and corneal hysteresis in patients with myotonic dystrophy. METHODS: A total of 12 eyes of 6 patients with Steinert's myotonic dystrophy (dystrophy group and 12 eyes of 6 age-, race-, and gender-matched healthy volunteers (control group were included in the study. GAT, Dynamic Contour Tonometry (DCT-Pascal and Ocular Response Analyzer (ORA were used to assess the IOP. Central corneal thickness was obtained by ultrasound pachymetry, and corneal hysteresis was analyzed using the ORA device. In light of the multiplicity of tests performed, the significance level was set at 0.01 rather than 0.05. RESULTS: The mean (standard deviation [SD] GAT, DCT, and corneal-compensated ORA IOP in the dystrophy group were 5.4 (1.4 mmHg, 9.7 (1.5 mmHg, and 10.1 (2.6 mmHg, respectively. The mean (SD GAT, DCT, and corneal-compensated ORA IOP in the control group was 12.6 (2.9 mmHg, 15.5 (2.7 mmHg, and 15.8 (3.4 mmHg, respectively. There were significant differences in IOP values between dystrophy and control groups obtained by GAT (mean, -7.2 mmHg; 99% confidence interval [CI], -10.5 to -3.9 mmHg; P<0.001, DCT (mean, -5.9 mmHg; 99% CI, -8.9 to -2.8 mmHg; P<0.001, and corneal-compensated ORA measurements (mean, -5.7 mmHg; 99% CI, -10.4 to -1.0 mmHg; P=0.003. The mean (SD central corneal thickness was similar in the dystrophy (542 [31] µm and control (537 [11] µm groups (P=0.65. The mean (SD corneal hysteresis in the dystrophy and control groups were 11.2 (1.5 mmHg and 9.7 (1.2 mmHg, respectively (P=0.04. CONCLUSIONS: Patients with Steinert's myotonic dystrophy showed lower Goldmann and corneal-compensated IOP in comparison with healthy individuals. Since central corneal thickness and

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

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    2009-01-01

    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: SafetyCorneal Surface Topographic Effects:Effects on corneal surface remodellingImpact of these changes on subsequent interventions, particularly corneal transplantation (penetrating keratoplasty [PKP])Visual AcuityRefractive OutcomesVISUAL QUALITY (SYMPTOMS): such as contrast vision or decreased visual symptoms (halos, fluctuating vision)Contact lens toleranceFunctional visual rehabilitation and quality of lifePatient satisfaction:Disease Process:Impact on corneal thinning processEffect on delaying or deferring the need for corneal transplantation 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 occurs when the normally round dome-shaped cornea

  19. Intraoperative corneal thickness measurements during corneal collagen cross-linking with isotonic riboflavin solution without dextran in corneal ectasia.

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    Cınar, Yasin; Cingü, Abdullah Kürşat; Sahin, Alparslan; Türkcü, Fatih Mehmet; Yüksel, Harun; Caca, Ihsan

    2014-03-01

    Abstract Objective: To monitor the changes in corneal thickness during the corneal collagen cross-linking procedure by using isotonic riboflavin solution without dextran in ectatic corneal diseases. The corneal thickness measurements were obtained before epithelial removal, after epithelial removal, following the instillation of isotonic riboflavin solution without dextran for 30 min, and after 10 min of ultraviolet A irradiation. Eleven eyes of eleven patients with progressive keratoconus (n = 10) and iatrogenic corneal ectasia (n = 1) were included in this study. The mean thinnest pachymetric measurements were 391.82 ± 30.34 µm (320-434 µm) after de-epithelialization of the cornea, 435 ± 21.17 µm (402-472 µm) following 30 min instillation of isotonic riboflavin solution without dextran and 431.73 ± 20.64 µm (387-461 µm) following 10 min of ultraviolet A irradiation to the cornea. Performing corneal cross-linking procedure with isotonic riboflavin solution without dextran might not induce corneal thinning but a little swelling throughout the procedure.

  20. 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....... Medical and surgical treatments are now directed towards elimination of fungal and bacterial infections, reduction and replacement of diseased corneal stroma, and suppression of iridocyclitis. If the abscess and anterior uveitis do not respond satisfactorily to medical therapy, full thickness or split...

  1. Dynamic corneal deformation response and integrated corneal tomography

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    Marcella Q Salomão

    2018-01-01

    Full Text Available Measuring corneal biomechanical properties is still challenging. There are several clinical applications for biomechanical measurements, including the detection of mild or early forms of ectatic corneal diseases. This article reviews clinical applications for biomechanical measurements provided by the Corvis ST dynamic non contact tonometer

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

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    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.

  3. Efficacy of Tectonic Corneal Patch Graft for Progressive Peripheral Corneal Thinning

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    Cafer Tanrıverdio

    2014-12-01

    Full Text Available Objectives: To report the results of tectonic corneal patch graft (TCPG in patients with progressive peripheral corneal thinning (PCT. Materials and Methods: In this study, we included 8 patients who underwent TCPG for PCT or perforated corneal ulceration at Ankara Training and Research Hospital. Results: We performed TCPG in 7 patients for PCT and in 1 patient for perforated corneal ulceration. Mean age was 57.2±16.7 (38- 82 years. Postoperative follow-up time ranged from 6 to 24 months (mean 13.9±6.7. Possible etiologies leading to progressive PCT were trachoma, infectious corneal ulcer, and rheumatoid arthritis-severe dry eye in 2 patients each. Other 2 patients had a progressive PCT following ocular surgery. One of the patients with infectious corneal ulcer also had a trauma caused by a scissor. Amnion membrane transplantation was performed in 3 patients prior to TCPG. While the anatomic success was achieved in all 8 patients, best-corrected visual acuity (BCVA was 0.1 or better in 4 patients (50%. Postoperative BCVA was better than preoperative BCVA in 6 patients (75%. Local peripheral anterior synechiae developed in two eyes. Conclusion: TCPG is a useful therapeutic option in selected cases of corneal thinning and perforations because it effectively restores the integrity of the globe and allows acceptable visual results. (Turk J Ophthalmol 2014; 44: 440-4

  4. Construction of a human corneal stromal equivalent with non-transfected human corneal stromal cells and acellular porcine corneal stromata.

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    Diao, Jin-Mei; Pang, Xin; Qiu, Yue; Miao, Ying; Yu, Miao-Miao; Fan, Ting-Jun

    2015-03-01

    A tissue-engineered human corneal stroma (TE-HCS) has been developed as a promising equivalent to the native corneal stroma for replacement therapy. However, there is still a crucial need to improve the current approaches to render the TE-HCS equivalent more favorable for clinical applications. At the present study, we constructed a TE-HCS by incubating non-transfected human corneal stromal (HCS) cells in an acellular porcine corneal stromata (aPCS) scaffold in 20% fetal bovine serum supplemented DMEM/F12 (1:1) medium at 37 °C with 5% CO2in vitro. After 3 days of incubation, the constructed TE-HCS had a suitable tensile strength for transplantation, and a transparency that is comparable to native cornea. The TE-HCS had a normal histological structure which contained regularly aligned collagen fibers and differentiated HCS cells with positive expression of marker and functional proteins, mimicking a native HCS. After transplantation into rabbit models, the TE-HCS reconstructed normal corneal stroma in vivo and function well in maintaining corneal clarity and thickness, indicating that the completely biological TE-HCS could be used as a HCS equivalent. The constructed TE-HCS has promising potentials in regenerative medicine and treatment of diseases caused by corneal stromal disorders. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Corneal Laceration

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  6. Keratocyte apoptosis and corneal antioxidant enzyme activities after refractive corneal surgery.

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    Bilgihan, K; Bilgihan, A; Adiguzel, U; Sezer, C; Yis, O; Akyol, G; Hasanreisoglu, B

    2002-01-01

    Refractive corneal surgery induces keratocyte apoptosis and generates reactive oxygen radicals (ROS) in the cornea. The purpose of the present study is to evaluate the correlation between keratocyte apoptosis and corneal antioxidant enzyme activities after different refractive surgical procedures in rabbits. Rabbits were divided into six groups. All groups were compared with the control group (Group 1), after epithelial scraping (Group 2), epithelial scrape and photorefractive keratectomy (PRK) (traditional PRK: Group 3), transepithelial PRK (Group 4), creation of a corneal flap with microkeratome (Group 5) and laser-assisted in situ keratomileusis (LASIK, Group 6). Terminal deoxyribonucleotidyl transferase-mediated dUTP-digoxigenin nick-end labelling assay (to detect DNA fragmentation in situ) and light microscopy were used to detect apoptosis in rabbit eyes. Glutathione peroxidase (Gpx) and superoxide dismutase (SOD) activities of the corneal tissues were measured with spectrophotometric methods. Corneal Gpx and SOD activities decreased significantly in all groups when compared with the control group (P<0.05) and groups 2, 3 and 6 showed a significantly higher amount of keratocyte apoptosis (P<0.05). Not only a negative correlation was observed between corneal SOD activity and keratocyte apoptosis (cc: -0.3648) but Gpx activity also showed negative correlation with keratocyte apoptosis (cc: -0.3587). The present study illustrates the negative correlation between keratocyte apoptosis and corneal antioxidant enzyme activities. This finding suggests that ROS may be partly responsible for keratocyte apoptosis after refractive surgery.

  7. Corneal tissue welding with infrared laser irradiation after clear corneal incision.

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    Rasier, Rfat; Ozeren, Mediha; Artunay, Ozgür; Bahçecioğlu, Halil; Seçkin, Ismail; Kalaycoğlu, Hamit; Kurt, Adnan; Sennaroğlu, Alphan; Gülsoy, Murat

    2010-09-01

    The aim of this study was to investigate the potential of infrared lasers for corneal welding to seal corneal cuts done in an experimental animal model. Full-thickness corneal cuts on freshly enucleated bovine eyes were irradiated with infrared (809-nm diode, 980-nm diode, 1070-nm YLF, and 1980-nm Tm:YAP) lasers to get immediate laser welding. An 809-nm laser was used with the topical application of indocyanine green to enhance the photothermal interaction at the weld site. In total, 60 bovine eyes were used in this study; 40 eyes were used in the first part of the study for the determination of optimal welding parameters (15 eyes were excluded because of macroscopic carbonization, opacification, or corneal shrinkage; 2 eyes were used for control), and 20 eyes were used for further investigation of more promising lasers (YLF and Tm:YAP). Laser wavelength, irradiating power, exposure time, and spot size were the dose parameters, and optimal dose for immediate closure with minimal thermal damage was estimated through histological examination of welded samples. In the first part of the study, results showed that none of the applications was satisfactory. Full-thickness success rates were 28% (2 of 7) for 809-nm and for 980-nm diode lasers and 67% (2 of 3) for 1070-nm YLF and (4 of 6) for 1980-nm Tm:YAP lasers. In the second part of the study, YLF and Tm:YAP lasers were investigated with bigger sample size. Results were not conclusive but promising again. Five corneal incisions were full-thickness welded out of 10 corneas with 1070-nm laser, and 4 corneal incisions were partially welded out of 10 corneas with 1980-nm laser in the second part of the study. Results showed that noteworthy corneal welding could be obtained with 1070-nm YLF laser and 1980-nm Tm:YAP laser wavelengths. Furthermore, in vitro and in vivo studies will shed light on the potential usage of corneal laser welding technique.

  8. 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

  9. Neurotrophic corneal and conjunctival xerosis

    Directory of Open Access Journals (Sweden)

    Svetlana Gennadyevna Zhurova

    2014-03-01

    Full Text Available Purpose: to develop a method of surgical treatment of patients with corneal ulcers of xerotic etiology and evaluate its efficacy in different time periods after operation. Materials and methods: 68 patients (86 eyes with severe dry eye syndrome complicated by xerotic corneal ulcers were examined. In all patients, the ulcer defect was covered with conjunctiva and amniotic membrane. The operation was combined with an outer tarsorrhaphy and temporary blepharorraphy. Results: All 86 eyes (100% achieved total closure of the ulcer defect, sealing of any perforation and maintaining of corneal transparency beyond the ulcer defect. Conclusion: Surgical closure of corneal ulcers with conjunctiva is an effective method of treatment of xerotic corneal ulcers. It could be recommended in patients with corneal perforation and tendency of descemetocele formation.

  10. Corneal markers of diabetic neuropathy.

    Science.gov (United States)

    Pritchard, Nicola; Edwards, Katie; Shahidi, Ayda M; Sampson, Geoff P; Russell, Anthony W; Malik, Rayaz A; Efron, Nathan

    2011-01-01

    Diabetic neuropathy is a significant clinical problem that currently has no effective therapy, and in advanced cases, leads to foot ulceration and lower limb amputation. The accurate detection, characterization and quantification of this condition are important in order to define at-risk patients, anticipate deterioration, monitor progression, and assess new therapies. This review evaluates novel corneal methods of assessing diabetic neuropathy. Two new noninvasive corneal markers have emerged, and in cross-sectional studies have demonstrated their ability to stratify the severity of this disease. Corneal confocal microscopy allows quantification of corneal nerve parameters and noncontact corneal esthesiometry, the functional correlate of corneal structure, assesses the sensitivity of the cornea. Both these techniques are quick to perform, produce little or no discomfort for the patient, and are suitable for clinical settings. Each has advantages and disadvantages over traditional techniques for assessing diabetic neuropathy. Application of these new corneal markers for longitudinal evaluation of diabetic neuropathy has the potential to reduce dependence on more invasive, costly, and time-consuming assessments, such as skin biopsy.

  11. Topical thrombin-related corneal calcification.

    Science.gov (United States)

    Kiratli, Hayyam; Irkeç, Murat; Alaçal, Sibel; Söylemezoğlu, Figen

    2006-09-01

    To report a highly unusual case of corneal calcification after brief intraoperative use of topical thrombin. A 44-year-old man underwent sclerouvectomy for ciliochoroidal leiomyoma, during which 35 UNIH/mL lyophilized bovine thrombin mixed with 9 mL of diluent containing 1500 mmol/mL calcium chloride was used. From the first postoperative day, corneal and anterior lenticular capsule calcifications developed, and corneal involvement slightly enlarged thereafter. A year later, 2 corneal punch biopsies confirmed calcification mainly in the Bowman layer. Topical treatment with 1.5% ethylenediaminetetraacetic acid significantly restored corneal clarity. Six months later, a standard extracapsular cataract extraction with intraocular lens placement improved visual acuity to 20/60. This case suggests that topical thrombin drops with elevated calcium concentrations may cause acute corneal calcification in Bowman layer and on the anterior lens capsule.

  12. Corneal Transplantation

    DEFF Research Database (Denmark)

    Hjortdal, Jesper Østergaard

    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...... and to assist fellows and corneal surgeons in their advice and selection of patients for the best surgical procedure considering benefi ts and risks....

  13. Applications of corneal topography and tomography: a review.

    Science.gov (United States)

    Fan, Rachel; Chan, Tommy Cy; Prakash, Gaurav; Jhanji, Vishal

    2018-03-01

    Corneal imaging is essential for diagnosing and management of a wide variety of ocular diseases. Corneal topography is used to characterize the shape of the cornea, specifically, the anterior surface of the cornea. Most corneal topographical systems are based on Placido disc that analyse rings that are reflected off the corneal surface. The posterior corneal surface cannot be characterized using Placido disc technology. Imaging of the posterior corneal surface is useful for diagnosis of corneal ectasia. Unlike corneal topographers, tomographers generate a three-dimensional recreation of the anterior segment and provide information about the corneal thickness. Scheimpflug imaging is one of the most commonly used techniques for corneal tomography. The cross-sectional images generated by a rotating Scheimpflug camera are used to locate the anterior and posterior corneal surfaces. The clinical uses of corneal topography include, diagnosis of corneal ectasia, assessment of corneal astigmatism, and refractive surgery planning. This review will discuss the applications of corneal topography and tomography in clinical practice. © 2017 Royal Australian and New Zealand College of Ophthalmologists.

  14. A medieval fallacy: the crystalline lens in the center of the eye

    Directory of Open Access Journals (Sweden)

    Leffler CT

    2016-04-01

    Full Text Available Christopher T Leffler,1 Tamer M Hadi,2 Akrithi Udupa,1 Stephen G Schwartz,3 Daniel Schwartz1 1Department of Ophthalmology, Virginia Commonwealth University, Richmond, VA, 2Graduate School of Medicine, University of Tennessee Medical Center, Knoxville, TN, 3Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA Objective: To determine whether, as most modern historians have written, ancient Greco-Roman authors believed the crystalline lens is positioned in the center of the eye. Background: Historians have written that statements about cataract couching by Celsus, or perhaps Galen of Pergamon, suggested a centrally located lens. Celsus specifically wrote that a couching needle placed intermediate between the corneal limbus and the lateral canthus enters an empty space, presumed to represent the posterior chamber. Methods: Ancient ophthalmic literature was analyzed to understand where these authors believed the crystalline lens was positioned. In order to estimate where Celsus proposed entering the eye during couching, we prospectively measured the distance from the temporal corneal limbus to the lateral canthus in 30 healthy adults. Results: Rufus of Ephesus and Galen wrote that the lens is anterior enough to contact the iris. Galen wrote that the lens equator joins other ocular structures at the corneoscleral junction. In 30 subjects, half the distance from the temporal corneal limbus to the lateral canthus was a mean of 4.5 mm (range: 3.3–5.3 mm. Descriptions of couching by Celsus and others are consistent with pars plana entry of the couching needle. Anterior angulation of the needle would permit contact of the needle with the lens. Conclusion: Ancient descriptions of anatomy and couching do not establish the microanatomic relationships of the ciliary region with any modern degree of accuracy. Nonetheless, ancient authors, such as Galen and Rufus, clearly understood that the lens is located anteriorly

  15. Effects of artificial tear treatment on corneal epithelial thickness and corneal topography findings in dry eye patients.

    Science.gov (United States)

    Çakır, B; Doğan, E; Çelik, E; Babashli, T; Uçak, T; Alagöz, G

    2018-05-01

    To investigate the effects of artificial tear treatment on central corneal epithelial thickness, and central, mid-peripheral and peripheral corneal thicknesses in patients with dry eye disease (DED). Patients with DED underwent ocular examinations, including Schirmer-2 test, slit lamp examination for tear break-up time (BUT), corneal topography (CT) for measuring mean central, mid-peripheral and peripheral corneal thickness values and anterior segment optic coherence tomography (AS-OCT) for obtaining central corneal epithelial thickness. After artificial tear treatment (carboxymethylcellulose and sodium hyaluronate formulations) for one month, patients were examined again at a second visit and the results were compared. Sixty-one eyes of 33 female dry eye patients (mean age: 38.3±5.7 years) were enrolled. The mean follow-up time was 36.4±3.3 days. The mean tear BUT and Schirmer-1 tests revealed significant improvement after treatment (P=0.000, P=0.000, respectively). Central corneal epithelium and mean mid-peripheral corneal thicknesses measured significantly higher after treatment (P=0.001, P=0.02). Changes in central and peripheral corneal thicknesses were not statistically significant. Artificial tear treatment in dry eye patients seems to increase central corneal epithelial and mid-peripheral corneal thicknesses. Measurement of corneal epithelial thickness can be a useful tool for evaluation of treatment response in dry eye patients. Further long-term prospective studies are needed to investigate this item. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  16. A medieval fallacy: the crystalline lens in the center of the eye.

    Science.gov (United States)

    Leffler, Christopher T; Hadi, Tamer M; Udupa, Akrithi; Schwartz, Stephen G; Schwartz, Daniel

    2016-01-01

    To determine whether, as most modern historians have written, ancient Greco-Roman authors believed the crystalline lens is positioned in the center of the eye. Historians have written that statements about cataract couching by Celsus, or perhaps Galen of Pergamon, suggested a centrally located lens. Celsus specifically wrote that a couching needle placed intermediate between the corneal limbus and the lateral canthus enters an empty space, presumed to represent the posterior chamber. Ancient ophthalmic literature was analyzed to understand where these authors believed the crystalline lens was positioned. In order to estimate where Celsus proposed entering the eye during couching, we prospectively measured the distance from the temporal corneal limbus to the lateral canthus in 30 healthy adults. Rufus of Ephesus and Galen wrote that the lens is anterior enough to contact the iris. Galen wrote that the lens equator joins other ocular structures at the corneoscleral junction. In 30 subjects, half the distance from the temporal corneal limbus to the lateral canthus was a mean of 4.5 mm (range: 3.3-5.3 mm). Descriptions of couching by Celsus and others are consistent with pars plana entry of the couching needle. Anterior angulation of the needle would permit contact of the needle with the lens. Ancient descriptions of anatomy and couching do not establish the microanatomic relationships of the ciliary region with any modern degree of accuracy. Nonetheless, ancient authors, such as Galen and Rufus, clearly understood that the lens is located anteriorly. There is little reason to believe that Celsus or other ancient authors held a variant understanding of the anatomy of a healthy eye. The notion of the central location of the lens seems to have arisen with Arabic authors in 9th century Mesopotamia, and lasted for over 7 centuries.

  17. Topical Drug Formulations for Prolonged Corneal Anesthesia

    Science.gov (United States)

    Wang, Liqiang; Shankarappa, Sahadev A.; Tong, Rong; Ciolino, Joseph B.; Tsui, Jonathan H.; Chiang, Homer H.; Kohane, Daniel S.

    2013-01-01

    Purpose Ocular local anesthetics (OLA’s) currently used in routine clinical practice for corneal anesthesia are short acting and their ability to delay corneal healing makes them unsuitable for long-term use. In this study, we examined the effect on the duration of corneal anesthesia of the site-1 sodium channel blocker tetrodotoxin (TTX), applied with either proparacaine or the chemical permeation enhancer OTAB. The effect of test solutions on corneal healing was also studied. Methods Solutions of TTX, proparacaine, and OTAB, singly or in combination were applied topically to the rat cornea. The blink response, an indirect measure of corneal sensitivity, was recorded using a Cochet-Bonnet esthesiometer, and the duration of corneal anesthesia calculated. The effect of test compounds on the rate of corneal epithelialization was studied in vivo following corneal debridement. Results Combination of TTX and proparacaine resulted in corneal anesthesia that was 8–10 times longer in duration than that from either drug administered alone, while OTAB did not prolong anesthesia. The rate of corneal healing was moderately delayed following co-administration of TTX and proparacaine. Conclusion Co-administration of TTX and proparacaine significantly prolonged corneal anesthesia but in view of delayed corneal re-epithelialization, caution is suggested in use of the combination. PMID:23615270

  18. Evaluation of intraocular pressure according to corneal thickness before and after excimer laser corneal ablation for myopia.

    Science.gov (United States)

    Hamed-Azzam, Shirin; Briscoe, Daniel; Tomkins, Oren; Shehedeh-Mashor, Raneen; Garzozi, Hanna

    2013-08-01

    Intraocular pressure is affected by corneal thickness and biomechanics. Following ablative corneal refractive surgery, corneal structural changes occur. The purpose of the study is to determine the relationship between the mean central corneal thickness (CCT) and the change in intraocular pressure measurements following various corneal ablation techniques, using different measurement methods. Two hundred myopic eyes undergoing laser in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK) were enrolled into a prospective, non-randomized study. Corneal parameters examined included full ocular examination, measurement of CCT, corneal topography, corneal curvature and ocular refractivity. Intraocular pressure measurements were obtained using three different instruments-non-contact tonometer, Goldmann applanation tonometer and TonoPen XL (TonoPen-Central and TonoPen-Peripheral). All measurements were performed pre-operatively and 4 months post-operatively. Post-operative intraocular pressure was significantly lower than pre-operative values, with all instruments (p value tonometer and non-contact tonometer (p value < 0.001, ANOVA). Intraocular pressure readings are significantly reduced following corneal ablation surgery. We determined in our myopic patient cohort that the TonoPen XL intraocular pressure measurement method is the least affected following PRK and LASIK as compared to other techniques.

  19. Trifluoperazine: corneal endothelial phototoxicity

    International Nuclear Information System (INIS)

    Hull, D.S.; Csukas, S.; Green, K.

    1983-01-01

    Trifluoperazine is used for the treatment of psychiatric disorders. Perfusion of corneal endothelial cells with trifluoperazine-HC1 concurrent with exposure to long wavelength ultraviolet light resulted in a corneal swelling rate greater than that found in perfused corneas not exposed to ultraviolet light. Exposure of endothelial cells to 25 W incandescent light during perfusion with trifluoperazine-HC1 did not result in a higher corneal swelling rate compared to those perfused in the dark. The increased corneal swelling rate could be produced by pre-exposure of the trifluoperazine-HC1 perfusing solution to ultraviolet light suggesting the production of toxic photoproducts during exposure of trifluoperazine-HC1 to ultraviolet light. Perfusion of corneal endothelial cells with non-ultraviolet illuminated trifluoperazine-HC1 had no effect on endothelial cell membranes or ultrastructure. This is in contrast to cells perfused with trifluoperazine-HC1 that had been exposed to ultraviolet light in which there was an alteration of mitochondria and a loss of cytoplasmic homogeneity. The data imply that the trifluoperazine-HC1 photoproduct had an adverse effect on cellular transport mechanisms. The study also further demonstrates the value of the corneal endothelial cell model for identifying the physiological and anatomical changes occuring in photo-induced toxic reactions. (author)

  20. Corneal surface temperature change as the mode of stimulation of the non-contact corneal aesthesiometer.

    Science.gov (United States)

    Murphy, P J; Morgan, P B; Patel, S; Marshall, J

    1999-05-01

    The non-contact corneal aesthesiometer (NCCA) assesses corneal sensitivity by using a controlled pulse of air, directed at the corneal surface. The purpose of this paper was to investigate whether corneal surface temperature change was a component in the mode of stimulation. Thermocouple experiment: A simple model corneal surface was developed that was composed of a moistened circle of filter paper placed on a thermocouple and mounted on a glass slide. The temperature change produced by different stimulus pressures was measured for five different ambient temperatures. Thermal camera experiment: Using a thermal camera, the corneal surface temperature change was measured in nine young, healthy subjects after exposure to different stimulus air pulses. Pulse duration was set at 0.9 s but was varied in pressure from 0.5 to 3.5 millibars. Thermocouple experiment: An immediate drop in temperature was detected by the thermocouple as soon as the air flow was incident on the filter paper. A greater temperature change was produced by increasing the pressure of the incident air flow. A relationship was found and a calibration curve plotted. Thermal camera experiment: For each subject, a drop in surface temperature was detected at each stimulus pressure. Furthermore, as the stimulus pressure increased, the induced reduction in temperature also increased. A relationship was found and a calibration curve plotted. The NCCA air-pulse stimulus was capable of producing a localized temperature change on the corneal surface. The principal mode of corneal nerve stimulation, by the NCCA air pulse, was the rate of temperature change of the corneal surface.

  1. 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.

  2. Correlations between corneal and total wavefront aberrations

    Science.gov (United States)

    Mrochen, Michael; Jankov, Mirko; Bueeler, Michael; Seiler, Theo

    2002-06-01

    Purpose: Corneal topography data expressed as corneal aberrations are frequently used to report corneal laser surgery results. However, the optical image quality at the retina depends on all optical elements of the eye such as the human lens. Thus, the aim of this study was to investigate the correlations between the corneal and total wavefront aberrations and to discuss the importance of corneal aberrations for representing corneal laser surgery results. Methods: Thirty three eyes of 22 myopic subjects were measured with a corneal topography system and a Tschernig-type wavefront analyzer after the pupils were dilated to at least 6 mm in diameter. All measurements were centered with respect to the line of sight. Corneal and total wavefront aberrations were calculated up to the 6th Zernike order in the same reference plane. Results: Statistically significant correlations (p the corneal and total wavefront aberrations were found for the astigmatism (C3,C5) and all 3rd Zernike order coefficients such as coma (C7,C8). No statistically significant correlations were found for all 4th to 6th order Zernike coefficients except for the 5th order horizontal coma C18 (p equals 0.003). On average, all Zernike coefficients for the corneal aberrations were found to be larger compared to Zernike coefficients for the total wavefront aberrations. Conclusions: Corneal aberrations are only of limited use for representing the optical quality of the human eye after corneal laser surgery. This is due to the lack of correlation between corneal and total wavefront aberrations in most of the higher order aberrations. Besides this, the data present in this study yield towards an aberration balancing between corneal aberrations and the optical elements within the eye that reduces the aberration from the cornea by a certain degree. Consequently, ideal customized ablations have to take both, corneal and total wavefront aberrations, into consideration.

  3. Corneal Toxicity Following Exposure to Asclepias Tuberosa.

    Science.gov (United States)

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

    2017-01-01

    To present a case of corneal toxicity following exposure to milky plant latex from Asclepias tuberosa. 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 epithelial defects. The corneal endothelium was intact and folds in Descemets membrane were observed. The oedema was treated with chloramphenicol, dexamethasone and scopolamine. The corneal oedema had appeared after corneal exposure to the plant, Asclepias tuberosa , whose latex contains cardenolides 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. 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.

  4. Anterior corneal profile with variable asphericity.

    Science.gov (United States)

    Rosales, Marco A; Juárez-Aubry, Montserrat; López-Olazagasti, Estela; Ibarra, Jorge; Tepichín, Eduardo

    2009-12-10

    We present a corneal profile in which the eccentricity, e(Q=-e(2)), has a nonlinear continuous variation from the center outwards. This nonlinear variation is intended to fit and reproduce our current experimental data in which the anterior corneal surface of the human eye exhibits different values of e at different diameters. According to our clinical data, the variation is similar to an exponential decay. We propose a linear combination of two exponential functions to describe the variation of e. We then calculate the corneal sagittal height by substituting e in the first-order aspherical surface equation to obtain the corneal profile. This corneal profile will be used as a reference to analyze the resultant profiles of the customized corneal ablation in refractive surgery.

  5. 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.

  6. Glaucoma after corneal replacement.

    Science.gov (United States)

    Baltaziak, Monika; Chew, Hall F; Podbielski, Dominik W; Ahmed, Iqbal Ike K

    Glaucoma is a well-known complication after corneal transplantation surgery. Traditional corneal transplantation surgery, specifically penetrating keratoplasty, has been slowly replaced by the advent of new corneal transplantation procedures: primarily lamellar keratoplasties. There has also been an emergence of keratoprosthesis implants for eyes that are high risk of failure with penetrating keratoplasty. Consequently, there are different rates of glaucoma, pathogenesis, and potential treatment in the form of medical, laser, or surgical therapy. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. 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.

  8. Analysis of the horizontal corneal diameter, central corneal thickness, and axial length in premature infants

    Directory of Open Access Journals (Sweden)

    Ozdemir Ozdemir

    2014-08-01

    Full Text Available Purpose: To determine the horizontal corneal diameter, central corneal thickness, and axial length in premature infants. Methods: Infants with a birth weight of less than 2,500 g or with a gestation period of less than 36 weeks were included in the study. Infants with retinopathy of prematurity (ROP were allocated to Group 1 (n=138, while those without ROP were allocated to Group 2 (n=236. All infants underwent a complete ophthalmologic examination, including corneal diameter measurements, pachymetry, biometry, and fundoscopy. Between-group comparisons of horizontal corneal diameter, central corneal thickness, and axial lengths were performed. Independent sample t-tests were used for statistical analysis. Results: Data was obtained from 374 eyes of 187 infants (102 female, 85 male. The mean gestational age at birth was 30.7 ± 2.7 weeks (range 25-36 weeks, the mean birth weight was 1,514 ± 533.3 g (range 750-1,970 g, and the mean postmenstrual age at examination was 40.0 ± 4.8 weeks. The mean gestational age and the mean birth weight of Group 1 were statistically lower than Group 2 (p0.05. Conclusions: The presence of ROP in premature infants does not alter the horizontal corneal diameter, central corneal thickness, or axial length.

  9. 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...... epithelial defects. The corneal endothelium was intact and folds in Descemets membrane were observed. The oedema was treated with chloramphenicol, dexamethasone and scopolamine. RESULTS: The corneal oedema had appeared after corneal exposure to the plant, Asclepias tuberosa, whose latex contains cardenolides...... 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...

  10. Instillation of Sericin Enhances Corneal Wound Healing through the ERK Pathway in Rat Debrided Corneal Epithelium

    Directory of Open Access Journals (Sweden)

    Noriaki Nagai

    2018-04-01

    Full Text Available Sericin is a major constituent of silk produced by silkworms. We previously found that the instillation of sericin enhanced the proliferation of corneal epithelial cells, and acted to promote corneal wound healing in both normal and diabetic model rats. However, the mechanisms by which sericin promotes the proliferation of corneal cells have not been established. In this study, we investigated the effects of sericin on Akt and ERK activation in a human corneal epithelial cell line (HCE-T cells and rat debrided corneal epithelium. Although Akt phosphorylation was not detected following the treatment of HCE-T cells with sericin, ERK1/2 phosphorylation was enhanced. The growth of HCE-T cells treated with sericin was significantly increased, with the cell growth of sericin-treated HCE-T cells being 1.7-fold higher in comparison with vehicle-treated HCE-T cells. On the other hand, both of an ERK inhibitor U0126 (non-specific specific inhibitor and SCH772984 (specific inhibitor attenuated the enhanced cell growth by sericin, and the growth level in the case of co-treatment with sericin and ERK1/2 inhibitor was similar to that of cells treated with ERK1/2 inhibitor alone. In an in vivo study using rat debrided corneal epithelium, the corneal wound healing rate was enhanced by the instillation of sericin, and this enhancement was also attenuated by the instillation of U0126. In addition, the corneal wound healing rate in rats co-instilled with sericin and U0126 was similar to that following the instillation of U0126 alone. In conclusion, we found that the instillation of sericin enhanced cell proliferation via the activation of the MAPK/ERK pathway, resulting in the promotion of corneal wound healing in rat eyes. These findings provide significant information for designing further studies to develop potent corneal wound-healing drugs.

  11. Human corneal epithelial subpopulations

    DEFF Research Database (Denmark)

    Søndergaard, Chris Bath

    2013-01-01

    Corneal epithelium is being regenerated throughout life by limbal epithelial stem cells (LESCs) believed to be located in histologically defined stem cell niches in corneal limbus. Defective or dysfunctional LESCs result in limbal stem cell deficiency (LSCD) causing pain and decreased visual acuity...... 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...

  12. Corneal collagen crosslinking and pigment dispersion syndrome.

    Science.gov (United States)

    LaHood, Benjamin R; Moore, Sacha

    2017-03-01

    We describe the case of a keratoconus patient with pigment dispersion syndrome (PDS) who was treated for progressive corneal ectasia with corneal collagen crosslinking (CXL). Pigment dispersion syndrome has been shown to have associated morphologic changes of the corneal endothelium. Corneal CXL has the potential to cause toxicity to the corneal endothelium, and adjacent pigment might increase the likelihood of damage. In this case, the presence of PDS had no detrimental effect on the outcome of treatment, and no complications were observed at 12 months follow-up, indicating that it may be safe to perform corneal CXL in the setting of PDS. This is an important observation as the number of indications for corneal CXL grows. Copyright © 2017 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  13. Corneal melanosis successfully treated using topical mitomycin-C and alcohol corneal epitheliectomy: a 3-year follow-up case report

    Directory of Open Access Journals (Sweden)

    Mehmet Balcı

    2015-08-01

    Full Text Available ABSTRACTWe report a case of primary acquired corneal melanosis without atypia associated with corneal haze in a patient with a history of limbal malignant melanoma and the effect of mitomycin-C. A 75-year-old woman with a history of limbal malignant melanoma presented with loss of vision in right eye. Corneal examination showed a patchy melanotic pigmentation with a central haze. Topical mitomycin-C improved visual acuity and corneal haze. However, the pigmented lesions persisted, and they were removed with alcohol corneal epitheliectomy. Histopathological examination demonstrated primary acquired melanosis without atypia. The lesions were successfully removed, and there were no recurrences during the follow-up period of 36 months. The association of conjunctival and corneal melanosis without atypia is a rare condition. In addition, co-existence of central corneal haze and melanosis may decrease visual acuity. Topical mitomycin-C and alcohol corneal epitheliectomy can be useful treatments in this condition.

  14. Healed corneal ulcer with keloid formation.

    Science.gov (United States)

    Alkatan, Hind M; Al-Arfaj, Khalid M; Hantera, Mohammed; Al-Kharashi, Soliman

    2012-04-01

    We are reporting a 34-year-old Arabic white female patient who presented with a white mass covering her left cornea following multiple ocular surgeries and healed corneal ulcer. The lesion obscured further view of the iris, pupil and lens. The patient underwent penetrating keratoplasty and the histopathologic study of the left corneal button showed epithelial hyperplasia, absent Bowman's layer and subepithelial fibrovascular proliferation. The histopathologic appearance was suggestive of a corneal keloid which was supported by further ultrastructural study. The corneal graft remained clear 6 months after surgery and the patient was satisfied with the visual outcome. Penetrating keratoplasty may be an effective surgical option for corneal keloids in young adult patients.

  15. Current status of accelerated corneal cross-linking

    Directory of Open Access Journals (Sweden)

    Michael Mrochen

    2013-01-01

    Full Text Available Corneal cross-linking with riboflavin is a technique to stabilize or reduce corneal ectasia, in diseases such as keratoconus and post-laser-assisted in situ keratomileusis (LASIK ectasia. There is an interest by patient as well as clinicians to reduce the overall treatment time. Especially, the introduction of corneal cross-linking in combination with corneal laser surgery demands a shorter treatment time to assure a sufficient patient flow. The principles and techniques of accelerated corneal cross-linking is discussed.

  16. Corneal Regeneration After Photorefractive Keratectomy: A Review

    Directory of Open Access Journals (Sweden)

    Javier Tomás-Juan

    2015-07-01

    Full Text Available 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.

  17. Evaluation of subbasal nerve morphology and corneal sensation after accelerated corneal collagen cross-linking treatment on keratoconus.

    Science.gov (United States)

    Ozgurhan, Engin Bilge; Celik, Ugur; Bozkurt, Ercument; Demirok, Ahmet

    2015-05-01

    The aim of this study was to report on the evaluation of corneal nerve fiber density and corneal sensation after accelerated corneal collagen cross-linking on keratoconus patients. The study was performed on 30 keratoconus eyes (30 participants: 16 M, 14 F; 17-32 years old) treated with accelerated collagen cross-linking for disease stabilization. Mean outcome measures were corneal sensation evaluation by Cochet-Bonnet esthesiometry and subbasal nerve fiber density assessment by corneal in vivo confocal microscopy. All corneal measurements were performed using scanning slit confocal microscopy (ConfoScan 4, Nidek Technologies, Padova, Italy). The accelerated corneal collagen cross-linking procedure was performed on 30 eyes of 30 patients (19 right, 63.3%; 11 left, 27.7%). The mean age was 23.93 ± 4. The preoperative mean keratometry, apex keratometry and pachymetry values were 47.19 ± 2.82 D, 56.79 ± 5.39 and 426.1 ± 25.6 μm, respectively. Preoperative mean corneal sensation was 56.3 ± 5.4 mm (with a range from 40 to 60 mm), it was significantly decreased at 1st and 3rd month visit and increased to preoperative values after 6th month visit. Preoperative mean of subbasal nerve fiber density measurements was 22.8 ± 9.7 nerve fiber/mm(2) (with a range of 5-45 mm), it was not still at the preoperative values at 6th month (p = 0.0001), however reached to the preoperative values at 12th month (p = 0.914). Subbasal nerve fibers could reach the preoperative values at the 12th month after accelerated corneal collagen cross-linking treatment although the corneal sensation was improved at 6th month. These findings imply that the subjective healing process is faster than the objective evaluation of the keratoconus patients' cornea treated with accelerated corneal collagen cross-linking.

  18. Corneal Reinnervation and Sensation Recovery in Patients With Herpes Zoster Ophthalmicus: An In Vivo and Ex Vivo Study of Corneal Nerves.

    Science.gov (United States)

    Cruzat, Andrea; Hamrah, Pedram; Cavalcanti, Bernardo M; Zheng, Lixin; Colby, Kathryn; Pavan-Langston, Deborah

    2016-05-01

    To study corneal reinnervation and sensation recovery in Herpes zoster ophthalmicus (HZO). Two patients with HZO were studied over time with serial corneal esthesiometry and laser in vivo confocal microscopy (IVCM). A Boston keratoprosthesis type 1 was implanted, and the explanted corneal tissues were examined by immunofluorescence histochemistry for βIII-tubulin to stain for corneal nerves. The initial central corneal IVCM performed in each patient showed a complete lack of the subbasal nerve plexus, which was in accordance with severe loss of sensation (0 of 6 cm) measured by esthesiometry. When IVCM was repeated 2 years later before undergoing surgery, case 1 showed a persistent lack of central subbasal nerves and sensation (0 of 6). In contrast, case 2 showed regeneration of the central subbasal nerves (4786 μm/mm) with partial recovery of corneal sensation (2.5 of 6 cm). Immunostaining of the explanted corneal button in case 1 showed no corneal nerves, whereas case 2 showed central and peripheral corneal nerves. Eight months after surgery, IVCM was again repeated in the donor tissue around the Boston keratoprosthesis in both patients to study innervation of the corneal transplant. Case 1 showed no nerves, whereas case 2 showed new nerves growing from the periphery into the corneal graft. We demonstrate that regaining corneal innervation and corneal function are possible in patients with HZO as shown by corneal sensation, IVCM, and ex vivo immunostaining, indicating zoster neural damage is not always permanent and it may recover over an extended period of time.

  19. 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.

  20. 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

  1. Visual outcome after corneal transplantation for corneal perforation and iris prolapse in 37 horses

    DEFF Research Database (Denmark)

    Henriksen, Michala de Linde; Plummer, C. E.; Mangan, B.

    2012-01-01

    We wanted to investigate the visual outcome of horses presented with iris prolapse and treated with corneal transplantation.......We wanted to investigate the visual outcome of horses presented with iris prolapse and treated with corneal transplantation....

  2. Corneal iron ring after conductive keratoplasty.

    Science.gov (United States)

    Kymionis, George D; Naoumidi, Tatiana L; Aslanides, Ioannis M; Pallikaris, Ioannis G

    2003-08-01

    To report formation of corneal iron ring deposits after conductive keratoplasty. Observational case report. Case report. A 54-year-old woman underwent conductive keratoplasty for hyperopia. One year after conductive keratoplasty, iron ring pattern pigmentation was detected at the corneal epithelium of both eyes. This is the first report of the appearance of corneal iron ring deposits following conductive keratoplasty treatment in a patient. It is suggested that alterations in tear film stability, resulting from conductive keratoplasty-induced changes in corneal curvature, constitute the contributory factor for these deposits.

  3. Explore the full thick layer of corneal transplantation in the treatment of pseudomonas aeruginosa corneal ulcer infection

    Directory of Open Access Journals (Sweden)

    Xin Wang

    2015-02-01

    Full Text Available AIM: To explore the feasibility, safety and effect of the full-thickness lamellar keratoplasty for the treatment of pseudomonas aeruginosa corneal ulcer. METHODS: Based on a retrospective non-controlled study, 25 patients were given the full-thickness lamellar keratoplasty for clinical diagnosis of pseudomonas aeruginosa infection and corneal ulcer medication conventional anti-gram-negative bacteria. Routine follow-up were carried out at postoperative 1wk; 1, 3, 6, 12, 18mo to observe the situation of corneal epithelial healing, recurrent infection, immune rejection, graft transparency and best corrected visual acuity, etc. At the 6 and 12mo postoperative, corneal endothelial cell density was reexamined.RESULTS: No patients because of Descemet's membrane rupture underwent penetrating keratoplasty surgery: One only in cases of bacterial infection after 1mo, once again did not cultivate a culture of bacteria pseudomonas aeruginosa, and the remaining 24 cases average follow-up 14±6mo, corneal graft were transparent, the cure rate was 96%. At the sixth month after surgery, there were 16 cases of eye surgery best corrected visual acuity ≥4.5, of which 3 cases ≥4.8. At the sixth month after surgery, the average corneal endothelial cell density 2 425±278/mm2; At 12mo postoperatively, it was 2 257± 326/mm2.CONCLUSION: Full-thickness lamellar keratoplasty is an effective method of pseudomonas aeruginosa infection in the treatment of corneal ulcers, corneal drying material glycerol can be achieved by visual effects.

  4. Contact Lens Related Corneal Ulcer

    OpenAIRE

    Loh, KY; Agarwal, P

    2010-01-01

    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. Th...

  5. Riboflavin for corneal cross-linking.

    Science.gov (United States)

    O'Brart, D P S

    2016-06-01

    Corneal collagen cross-linking (CXL) with riboflavin and ultraviolet A (UVA) radiation is the first therapeutic modality that appears to arrest the progression of keratoconus and other corneal ectasias. Riboflavin is central to the process, acting as a photosensitizer for the production of oxygen singlets and riboflavin triplets. These free radicals drive the CXL process within the proteins of the corneal stroma, altering its biomechanical properties. Riboflavin also absorbs the majority of the UVA radiation, which is potentially cytotoxic and mutagenic, within the anterior stroma, preventing damage to internal ocular structures, such as the corneal endothelium, lens and retina. Clinical studies report cessation of ectatic progression in over 90% of cases and the majority document significant improvements in visual, keratometric and topographic parameters. Clinical follow-up is limited to 5-10 years, but suggests sustained stability and enhancement in corneal shape. Sight-threatening complications are rare. The optimal stromal riboflavin dosage for CXL is as yet undetermined. Copyright 2016 Prous Science, S.A.U. or its licensors. All rights reserved.

  6. Chlorpromazine-induced corneal endothelial phototoxicity

    International Nuclear Information System (INIS)

    Hull, D.S.; Csukas, S.; Green, K.

    1982-01-01

    Chlorpromazine, which has been used extensively for the treatment of psychiatric disorders, is known to accumulate in the posterior corneal stroma, lens, and uveal tract. Because it is a phototoxic compound, the potential exists for it to cause cellular damage after light exposure. Specular microscopic perfusion of corneal endothelial cells in darkness with 0.5 mM chlorpromazine HCl resulted in a swelling rate of 18 +/- 2 micrometer/hr, whereas corneas exposed to long-wavelength ultraviolet light for 3 min in the presence of 0.5 mM chlorpromazine swelled at 37 +/- 9 micrometer/hr (p less than 0.01). Preirradiation of 0.5 mM chlorpromazine solution with ultraviolet light for 30 min and subsequent corneal perfusion with the solution resulted in a corneal swelling rate of 45 +/- 19 micrometer/hr. Cornea endothelial cells perfused with 0.5 mM chlorpromazine that was preirradiated with ultraviolet light showed marked swelling on scanning electron microscopic examination, whereas those perfused with nonirradiated chlorpromazine were flat and showed a normal mosaic pattern. Combining either 500 U/ml catalase or 290 U/ml superoxide dismutase with chlorpromazine did not alter photoinduction of corneal swelling. The data suggest that corneal endothelial chlorpromazine phototoxicity is secondary to cytotoxic products resulting from the photodynamically induced decomposition of chlorpromazine and is not caused by hydrogen peroxide or superoxide anion generated during the phototoxic reaction

  7. Corneal Neurotoxicity Due to Topical Benzalkonium Chloride

    OpenAIRE

    Sarkar, Joy; Chaudhary, Shweta; Namavari, Abed; Ozturk, Okan; Chang, Jin-Hong; Yco, Lisette; Sonawane, Snehal; Khanolkar, Vishakha; Hallak, Joelle; Jain, Sandeep

    2012-01-01

    Topical application of benzalkonium chloride (BAK) to the eye causes dose-related corneal neurotoxicity. Corneal inflammation and reduction in aqueous tear production accompany neurotoxicity. Cessation of BAK treatment leads to recovery of corneal nerve density.

  8. Long-term outcomes of wedge resection at the limbus for high irregular corneal astigmatism after repaired corneal laceration

    Directory of Open Access Journals (Sweden)

    Jun Du

    2016-06-01

    Full Text Available AIM: To evaluate the clinical value of wedge resection at corneal limbus in patients with traumatic corneal scarring and high irregular astigmatism. METHODS: Patients with traumatic corneal astigmatism received wedge resection at least 6mo after suture removal from corneal wound. The uncorrected distance visual acuities (UCVA and best corrected distance visual acuities (BCVA, pre- and post-operation astigmatism, spherical equivalent (SE, safety and complications were evaluated. RESULTS: Ten eyes (10 patients were enrolled in this study. Mean follow-up time after wedge resection was 37.8±15.4mo (range, 20-61mo. The mean UCVA improved from +1.07±0.55 logMAR to +0.43±0.22 logMAR (P=0.000 and the mean BCVA from +0.50±0.30 logMAR to +0.15±0.17 logMAR (P=0.000. The mean astigmatism power measured by retinoscopy was -2.03±2.27 D postoperatively and -2.83±4.52 D preoperatively (P=0.310. The mean SE was -0.74±1.61 D postoperatively and -0.64±1.89 D preoperatively (P=0.601. Two cases developed mild pannus near the sutures. No corneal perforation, infectious keratitis or wound gape occurred. CONCLUSION: Corneal-scleral limbal wedge resection with compression suture is a safe, effective treatment for poor patients with high irregular corneal astigmatism after corneal-scleral penetrating injury. Retinoscopy can prove particularly useful for high irregular corneal astigmatism when other measurements are not amenable.

  9. Induction of corneal collagen cross-linking in experimental corneal alkali burns in rabbits

    Directory of Open Access Journals (Sweden)

    Marcello Colombo-Barboza

    2014-10-01

    Full Text Available Objective: To evaluate the effect of riboflavin-ultraviolet-A-induced cross-linking (CXL following corneal alkali burns in rabbits. Methods: The right corneas and limbi of ten rabbits were burned using a 1N solution of NaOH and the animals were then divided into two groups: a control group submitted to clinical treatment alone and an experimental group that was treated 1 h after injury with CXL, followed by the same clinical treatment as administered to the controls. Clinical parameters were evaluated post-injury at 1, 7, 15, and 30 days by two independent observers. Following this evaluation, the corneas were excised and examined histologically. Results: There were no statistically significant differences in clinical parameters, such as hyperemia, corneal edema, ciliary injection, limbal ischemia, secretion, corneal neovascularization, symblepharon, or blepharospasm, at any of the time-points evaluated. However, the size of the epithelial defect was significantly smaller in the CXL group (p<0.05 (day 15: p=0.008 and day 30: p=0.008 and the extent of the corneal injury (opacity lesion was also smaller (day 30: p=0.021. Histopathology showed the presence of collagen bridges linking the collagen fibers in only the CXL group. Conclusions: These results suggest that the use of CXL may improve the prognosis of acute corneal alkali burns.

  10. Construction of Anterior Hemi-Corneal Equivalents Using Nontransfected Human Corneal Cells and Transplantation in Dog Models.

    Science.gov (United States)

    Xu, Bin; Song, Zhan; Fan, Tingjun

    2017-11-01

    Tissue-engineered human anterior hemi-cornea (TE-aHC) is a promising equivalent for treating anterior lamellar keratopathy to surmount the severe shortage of donated corneas. This study was intended to construct a functional TE-aHC with nontransfected human corneal stromal (ntHCS) and epithelial (ntHCEP) cells using acellular porcine corneal stromata (aPCS) as a carrier scaffold, and evaluate its biological functions in a dog model. To construct a TE-aHC, ntHCS cells were injected into an aPCS scaffold and cultured for 3 days; then, ntHCEP cells were inoculated onto the Bowman's membrane of the scaffold and cultured for 5 days under air-liquid interface condition. After its morphology and histological structure were characterized, the constructed TE-aHC was transplanted into dog eyes via lamellar keratoplasty. The corneal transparency, thickness, intraocular pressure, epithelial integrity, and corneal regeneration were monitored in vivo, and the histological structure and histochemical property were examined ex vivo 360 days after surgery, respectively. The results showed that the constructed TE-aHC was highly transparent and composed of a corneal epithelium of 7-8 layer ntHCEP cells and a corneal stroma of regularly aligned collagen fibers and well-preserved glycosaminoglycans with sparsely distributed ntHCS cells, mimicking a normal anterior hemi-cornea (aHC). Moreover, both ntHCEP and ntHCS cells maintained positive expression of their marker and functional proteins. After transplantation into dog eyes, the constructed TE-aHC acted naturally in terms of morphology, structure and inherent property, and functioned well in maintaining corneal clarity, thickness, normal histological structure, and composition in dog models by reconstructing a normal aHC, which could be used as a promising aHC equivalent in corneal regenerative medicine and aHC disorder therapy. © 2017 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  11. Corneal Toxicity Following Exposure to Asclepias Tuberosa

    OpenAIRE

    Mikkelsen, Lauge Hjorth; Hamoudi, Hassan; G?l, Cigdem Altuntas; Heegaard, Steffen

    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 epithelial defects. The corneal endothelium was intact and folds in Descemets membrane were observed. The oedema was treated with chloramphenicol, dexamethasone and scopolamine.RESULTS: The corneal ...

  12. Corneal hydrops induced by Bell’s paralysis in a case of corneal ectasia

    Directory of Open Access Journals (Sweden)

    Lokman Aslan

    2017-09-01

    Full Text Available An 18-year-old male patient presented with suddenly decreased vision, itching, corneal edema and an inability to close the left eye. They had left Bell’s paralysis for two weeks and had used high diopter glasses for five years. The best corrected visual acuity was 0.4 in their right eye and counting fingers in the left eye. Biomicroscopic examination revealed thinning and steepening of the cornea in the right eye and anterior protrusion of the cornea, stromal edema and punctate disruption of the epithelium in the left eye. Topographic image of the right eye was consistent with keratoconus. Six months later, stromal edema gradually regressed and a corneal scar ensued. This case presentation emphasizes that Bell’s palsy may induce disease progression in a patient with preexisting corneal ectasia and results in corneal hydrops. [Arch Clin Exp Surg 2017; 6(3.000: 165-167

  13. Corneal modeling for analysis of photorefractive keratectomy

    Science.gov (United States)

    Della Vecchia, Michael A.; Lamkin-Kennard, Kathleen

    1997-05-01

    Procedurally, excimer photorefractive keratectomy is based on the refractive correction of composite spherical and cylindrical ophthalmic errors of the entire eye. These refractive errors are inputted for correction at the corneal plane and for the properly controlled duration and location of laser energy. Topography is usually taken to correspondingly monitor spherical and cylindrical corneorefractive errors. While a corneal topographer provides surface morphologic information, the keratorefractive photoablation is based on the patient's spherical and cylindrical spectacle correction. Topography is at present not directly part of the procedural deterministic parameters. Examination of how corneal curvature at each of the keratometric reference loci affect the shape of the resultant corneal photoablated surface may enhance the accuracy of the desired correction. The objective of this study was to develop a methodology to utilize corneal topography for construction of models depicting pre- and post-operative keratomorphology for analysis of photorefractive keratectomy. Multiple types of models were developed then recreated in optical design software for examination of focal lengths and other optical characteristics. The corneal models were developed using data extracted from the TMS I corneal modeling system (Computed Anatomy, New York, NY). The TMS I does not allow for manipulation of data or differentiation of pre- and post-operative surfaces within its platform, thus models needed to be created for analysis. The data were imported into Matlab where 3D models, surface meshes, and contour plots were created. The data used to generate the models were pre- and post-operative curvatures, heights from the corneal apes, and x-y positions at 6400 locations on the corneal surface. Outlying non-contributory points were eliminated through statistical operations. Pre- and post- operative models were analyzed to obtain the resultant changes in the corneal surfaces during PRK

  14. Pigment dispersion syndrome associated with spontaneous subluxation of crystalline lens

    Directory of Open Access Journals (Sweden)

    Vikas Veerwal

    2017-01-01

    Full Text Available Pigment dispersion syndrome (PDS is an ocular condition characterized by a dispersion of iris pigment throughout the eye. This pigment is deposited in a characteristic manner on the corneal endothelium as Krukenberg's spindle, anterior surface of the iris, in the trabecular meshwork, on the lens and zonule and occasionally on the anterior hyaloid face. Even with deposition of pigment on zonular fibers, no zonular weakness, or zonular dehiscence has been reported in these cases. We report a unique case of PDS with bilateral spontaneous subluxation of crystalline lens. With characteristic findings of pigment distribution in both his eyes, the patient had concave iris configuration with heavily pigmented trabecular meshwork confirming the diagnosis of PDS. The patient had bilateral 180° temporal subluxation of crystalline lens in both his eyes. The usual cause of lens subluxation such as Marfan's Syndrome and Ehler's Danlos Syndrome was ruled out. The patient underwent right eye followed by left eye intracapsular cataract extraction with ab-interno technique with postoperative best-corrected visual acuity (BCVA of 6/9 in both eyes. Spontaneous subluxation of crystalline lens in isolated PDS is not known to occur and has been reported by means of this case. We recommend a thorough assessment of zonular status in all cases of PDS.

  15. Pigment dispersion syndrome associated with spontaneous subluxation of crystalline lens.

    Science.gov (United States)

    Veerwal, Vikas; Goyal, Jawahar Lal; Jain, Parul; Arora, Ritu

    2017-01-01

    Pigment dispersion syndrome (PDS) is an ocular condition characterized by a dispersion of iris pigment throughout the eye. This pigment is deposited in a characteristic manner on the corneal endothelium as Krukenberg's spindle, anterior surface of the iris, in the trabecular meshwork, on the lens and zonule and occasionally on the anterior hyaloid face. Even with deposition of pigment on zonular fibers, no zonular weakness, or zonular dehiscence has been reported in these cases. We report a unique case of PDS with bilateral spontaneous subluxation of crystalline lens. With characteristic findings of pigment distribution in both his eyes, the patient had concave iris configuration with heavily pigmented trabecular meshwork confirming the diagnosis of PDS. The patient had bilateral 180° temporal subluxation of crystalline lens in both his eyes. The usual cause of lens subluxation such as Marfan's Syndrome and Ehler's Danlos Syndrome was ruled out. The patient underwent right eye followed by left eye intracapsular cataract extraction with ab-interno technique with postoperative best-corrected visual acuity (BCVA) of 6/9 in both eyes. Spontaneous subluxation of crystalline lens in isolated PDS is not known to occur and has been reported by means of this case. We recommend a thorough assessment of zonular status in all cases of PDS.

  16. Late onset corneal ectasia after LASIK surgery.

    Science.gov (United States)

    Said, Ashraf; Hamade, Issam H; Tabbara, Khalid F

    2011-07-01

    To report late onset corneal ectasia following myopic LASIK. A retrospective cohort case series. Nineteen patients with late onset corneal ectasia following LASIK procedure were examined at The Eye Center, Riyadh, Saudi Arabia. Patients underwent LASIK for myopia with spherical equivalent ranging from -1.4 to -13.75 diopters. Age and gender, history of systemic or local diseases, and time of onset of corneal ectasia were recorded. Eye examination and corneal topographical analyses were done before and after LASIK surgery. Nineteen patients (29 eyes) with late onset corneal ectasia were identified from 1998 to 2008 in 13 male and six female patients. The mean follow-up period was 108 ± 23 months (range 72-144 months). No patient had pre-operative identifiable risk factors for corneal ectasia and the mean time of onset was 57 ± 24 months (range 24-120 months after LASIK). The pre-operative values included mean central pachymetry 553 ± 25 μm, mean keratometry reading of 42.9 ± 1.5 diopters, average oblique cylinder of 1.4 ± 1.2 diopters, posterior surface elevation of 26 ± 2.1 diopters, corneal flap thickness of 160 μm, mean spherical equivalent of -5.6 ± 3.6 diopters, and calculated residual corneal stromal bed thickness was 288 ± 35 μm. Three (5 eyes) patients developed ectasia after pregnancy. Three (4 eyes) patients developed corneal ectasia following severe adenoviral keratoconjunctivitis and had positive PCR for adenovirus type 8. Corneal ectasia may develop many years after LASIK surgery and symptoms could go undetected for some time. Pregnancy and adenoviral keratoconjunctivitis occurred post-operatively in six patients.

  17. Designing Hydrogel Adhesives for Corneal Wound Repair

    Science.gov (United States)

    Grinstaff, Mark W.

    2013-01-01

    Today, corneal wounds are repaired using nylon sutures. Yet there are a number of complications associated with suturing the cornea, and thus there is interest in an adhesive to replace or supplement sutures in the repair of corneal wounds. We are designing and evaluating corneal adhesives prepared from dendrimers – single molecular weight, highly branched polymers. We have explored two strategies to form these ocular adhesives. The first involves a photocrosslinking reaction and the second uses a peptide ligation reactions to couple the individual dendrimers together to from the adhesive. These adhesives were successfully used to repair corneal perforations, close the flap produced in a LASIK procedure, and secure a corneal transplant. PMID:17889330

  18. Granular corneal dystrophy Groenouw type I (GrI) and Reis-Bücklers' corneal dystrophy (R-B). One entity?

    Science.gov (United States)

    Møller, H U

    1989-12-01

    This paper maintains that Reis-Bücklers' corneal dystrophy and granular corneal dystrophy Groenouw type I are one and the same disease. Included are some of the technically best photographs of Reis-Bücklers' dystrophy found in the literature, and these are compared with photographs from patients with granular corneal dystrophy examined by the author. It is argued that most of the histological and ultrastructural findings on Reis Bücklers' dystrophy described in the literature are either congruent with what is found in granular corneal dystrophy or unspecific.

  19. Using corneal confocal microscopy to track changes in the corneal layers of dry eye patients after autologous serum treatment.

    Science.gov (United States)

    Mahelkova, Gabriela; Jirsova, Katerina; Seidler Stangova, Petra; Palos, Michalis; Vesela, Viera; Fales, Ivan; Jiraskova, Nada; Dotrelova, Dagmar

    2017-05-01

    In vivo corneal confocal microscopy allows the examination of each layer of the cornea in detail and the identification of pathological changes at the cellular level. The purpose of this study was to identify the possible effects of a three-month treatment with autologous serum eye-drops in different corneal layers of patients with severe dry eye disease using corneal confocal microscopy. Twenty-six patients with dry eye disease were included in the study. Corneal fluorescein staining was performed. The corneas of the right eyes were examined using in vivo corneal confocal microscopy before and after a three-month treatment with autologous serum drops. The densities of superficial and basal epithelial cells, Langerhans cells, the keratocytes and activated keratocytes, the density of endothelial cells and the status of the sub-basal nerve plexus fibres were evaluated. A significant decrease in corneal fluorescein staining was found after the three-month autologous serum treatment (p = 0.0006). The basal epithelial cell density decreased significantly (p = 0.001), while the density of superficial epithelial cells did not change significantly (p = 0.473) nor did the number of Langerhans cells or activated keratocytes (p = 0.223; p = 0.307, respectively). There were no differences in the other corneal cell layers or in the status of the nerve fibres. The results demonstrate the ability of corneal confocal microscopy to evaluate an improvement in the basal epithelial cell layer of the cornea after autologous serum treatment in patients with dry eye disease. More studies with longer follow-up periods are needed to elucidate the suitability of corneal confocal microscopy to follow the effect of autologous serum treatment on nerve fibres or other corneal layers in dry eye disease patients. © 2016 Optometry Australia.

  20. Queratopatía cristalina: diagnóstico clínico y microbiológico de una infección corneal infrecuente causada por el grupo Streptococcus mitis

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    Gustavo J Galperín

    2011-09-01

    Full Text Available El objetivo del presente informe es describir un caso de queratopatía cristalina causada por microorganismos pertenecientes al grupo Streptococcus mitis en una paciente que concurrió a la consulta oftalmológica por molestias en su ojo derecho. Al examen oftalmológico presentó un punto de sutura interrumpida de nylon 10-0 sin tensión y con secreciones mucosas adheridas. El punto flojo fue retirado bajo normas de asepsia. Se indicó colirio de moxifloxacina al 0,5 %; el ojo tuvo una evolución adecuada, con una correcta epitelización. Sin embargo, luego de 15 días desarrolló un infiltrado blanquecino arboriforme. Se tomó una muestra en el quirófano, enhebrando el trayecto intraestromal de la sutura retirada con sutura de vicryl 7-0. Se indicaron colirios de vancomicina con 50 mg/ml. El infiltrado se mantuvo estable durante 45 días, luego se incrementó el tamaño y se produjo necrosis tisular con peligro de perforación corneal. Se realizó un recubrimiento conjuntival bipediculado. La paciente evolucionó favorablemente y luego de la retracción espontánea del recubrimiento, se observó leucoma cicatrizal y neovasos corneales.Crystalline keratopathy: an infrequent corneal infection produced by the Streptococcus mitis group. The objective of this report is to describe a case of crystalline keratopathy caused by the Streptococcus mitis group corresponding to a patient who attended hospital for discomfort in his right eye. The ophthalmological examination showed an interrupted stitch of 10-0 nylon suture without tension and with attached mucus secretions. The loose suture was removed under aseptic conditions. Moxifloxacin 0.5 % eye drops were topically indicated. The treated eye successfully epithelialized and evolved favorably. However, after 15 days, a white tree-shaped infiltrate developed. A corneal sample was taken in the operating room, threading the intrastromal path of the removed stitch with a 7-0 vicryl suture. Vancomycin 50

  1. Anatomical characterization of central, apical and minimal corneal thickness

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    Federico Saenz-Frances

    2014-08-01

    Full Text Available AIM: To anatomically locate the points of minimum corneal thickness and central corneal thickness (pupil center in relation to the corneal apex.METHODS: Observational, cross-sectional study, 299 healthy volunteers. Thickness at the corneal apex (AT, minimum corneal thickness (MT and corneal thickness at the pupil center (PT were determined using the pentacam. Distances from the corneal apex to MT (MD and PT (PD were calculated and their quadrant position (taking the corneal apex as the reference determined:point of minimum thickness (MC and point of central thickness (PC depending on the quadrant position. Two multivariate linear regression models were constructed to examine the influence of age, gender, power of the flattest and steepest corneal axes, position of the flattest axis, corneal volume (determined using the Pentacam and PT on MD and PD. The effects of these variables on MC and PC were also determined in two multinomial regression models.RESULTS: MT was located at a mean distance of 0.909 mm from the apex (79.4% in the inferior-temporal quadrant. PT was located at a mean distance of 0.156 mm from the apex. The linear regression model for MD indicated it was significantly influenced by corneal volume (B=-0.024; 95%CI:-0.043 to -0.004. No significant relations were identified in the linear regression model for PD or the multinomial logistic regressions for MC and PC.CONCLUSION: MT was typically located at the inferior-temporal quadrant of the cornea and its distance to the corneal apex tended to decrease with the increment of corneal volume.

  2. 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

  3. Preliminary study of the correlation between refractive error and corneal refractive power, corneal asphericity in myopic eye

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    Qi-Chao Han

    2014-05-01

    Full Text Available AIM: To investigate the correlation between myopic refractive error and relative factors, including the corneal refractive power, posterior refractive power, axial length, corneal asphericity coefficient Q value, central cornea thickness(CCTand intraocular pressure(IOP. METHODS:According to the degree of myopia measured by subjective refraction, 138 myopia patients were divided into three subgroups: mild group(-1.00D--3.00D, moderate group(-3.25D--6.00D, high group(>6.00D. The Pentacam anterior segment tomographer(Germany, Oculus Companywas used to measure the corneal refractive power, posterior refractive power, and corneal asphericity in the right eye. IOP, CCT and axial length were measured by a non-contact tonometer and A-scan ultrasonic, respectively. The data was analyzed with a Pearson correlation analysis and one-way ANOVA. RESULTS: The myopic refractive error was negatively correlated with the axial length(r=-0.682, Pr=0.009, P=0.925. The axial length was negatively correlated with corneal refractive power(r=-0.554, Pr=0.674, Pr=-0.375, P=0.01. There was no significantly correlation between the myopic refractive error and CCT, IOP(r=-0.138, P=0.141; r=-0.121, P=0.157. CONCLUSION:The corneal refractive power plays the role of emmetropization during the development of myopia. There is clinic significance for the correlation between Q value and refractive error, IOP to guide the corneal refractive surgery.

  4. Application of Novel Drugs for Corneal Cell Regeneration

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    Sang Beom Han

    2018-01-01

    Full Text Available Corneal transplantation has been the only treatment method for corneal blindness, which is the major cause of reversible blindness. However, despite the advancement of surgical techniques for corneal transplantation, demand for the surgery can never be met due to a global shortage of donor cornea. The development of bioengineering and pharmaceutical technology provided us with novel drugs and biomaterials that can be used for innovative treatment methods for corneal diseases. In this review, the authors will discuss the efficacy and safety of pharmacologic therapies, such as Rho-kinase (ROCK inhibitors, blood-derived products, growth factors, and regenerating agent on corneal cell regeneration. The promising results of these agents suggest that these can be viable options for corneal reconstruction and visual rehabilitation.

  5. Generation of corneal epithelial cells from induced pluripotent stem cells derived from human dermal fibroblast and corneal limbal epithelium.

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    Ryuhei Hayashi

    Full Text Available Induced pluripotent stem (iPS cells can be established from somatic cells. However, there is currently no established strategy to generate corneal epithelial cells from iPS cells. In this study, we investigated whether corneal epithelial cells could be differentiated from iPS cells. We tested 2 distinct sources: human adult dermal fibroblast (HDF-derived iPS cells (253G1 and human adult corneal limbal epithelial cells (HLEC-derived iPS cells (L1B41. We first established iPS cells from HLEC by introducing the Yamanaka 4 factors. Corneal epithelial cells were successfully induced from the iPS cells by the stromal cell-derived inducing activity (SDIA differentiation method, as Pax6(+/K12(+ corneal epithelial colonies were observed after prolonged differentiation culture (12 weeks or later in both the L1B41 and 253G1 iPS cells following retinal pigment epithelial and lens cell induction. Interestingly, the corneal epithelial differentiation efficiency was higher in L1B41 than in 253G1. DNA methylation analysis revealed that a small proportion of differentially methylated regions still existed between L1B41 and 253G1 iPS cells even though no significant difference in methylation status was detected in the specific corneal epithelium-related genes such as K12, K3, and Pax6. The present study is the first to demonstrate a strategy for corneal epithelial cell differentiation from human iPS cells, and further suggests that the epigenomic status is associated with the propensity of iPS cells to differentiate into corneal epithelial cells.

  6. Corneal topography with an aberrometry-topography system.

    Science.gov (United States)

    Mülhaupt, Michael; Dietzko, Sven; Wolffsohn, James; Bandlitz, Stefan

    2018-05-07

    To investigate the agreement between the central corneal radii and corneal eccentricity measurements generated by the new Wave Analyzer 700 Medica (WAV) compared to the Keratograph 4 (KER) and to test the repeatability of the instruments. 20 subjects (10 male, mean age 29.1 years, range 21-50 years) were recruited from the students and staff of the Cologne School of Optometry. Central corneal radii for the flat (r c/fl ) and steep (r c/st ) meridian as well as corneal eccentricity for the nasal (e nas ), temporal (e temp ), inferior (e inf ) and superior (e sup ) directions were measured using WAV and KER by one examiner in a randomized order. Central radii of the flat (r c/fl ) and steep (r c/st ) meridian measured with both instruments were statically significantly correlated (r = 0.945 and r = 0.951; p  0.05). Limits of agreement (LoA) indicate a better repeatability for the KER compared to WAV. Corneal topography measurements captured with the WAV were strongly correlated with the KER. However, due to the differences in measured corneal radii and eccentricities, the devices cannot be used interchangeably. For corneal topography the KER demonstrated better repeatability. Copyright © 2018 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  7. Rechazo y retrasplante corneal Corneal rejection and re-transplantation

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    Miguel O Mokey Castellanos

    2007-06-01

    Full Text Available Se efectuó una investigación observacional análítica retrospectiva, sobre los transplantes corneales efectuados en el Servicio de Oftalmología del Hospital "Hermanos Ameijeiras. Rechazaron 76 pacientes, que se compararon con un control de 89 pacientes, que en un período similar no tuvieron rechazo. El queratocono fue la afección corneal que predominó. El primer lugar en los rechazos correspondió a queratoherpes (43,5 %. El menor índice de rechazo fue para el queratocono (8,8 %. Se analizó la multiplicidad de rechazos; y fue frecuente que se presentara un solo rechazo, aunque sí hubo congruencia entre el número de rechazos y la necesidad de retrasplantes. Se encontró que los resultados de la conducta médica o quirúrgica se relacionaban con la causa. Se calcula un índice de supervivencia (Kaplan-Meier, que concluye que en los primeros dos años existe menos posibilidad de aparición de rechazoAn retrospective observational analytical research was conducted on corneal transplants performed at Ophthalmological Service in “Hermanos Ameijeiras” hospital . Seventy six patients had graft rejection and were compared to a control group of 89 patients that did not present rejection in the same period of time. Keratoconus was the prevailing corneal problem. The highest rejection rate corresponded to keratoherpes (43,5% whereas the lowest rate was for keratoconus (8,8%. Multiplicity of rejections was analyzed and it was found that mostly one graft rejection occured, but number of rejections was associated with the need of re-transplantation. It was found that the results of medical or surgical performance were related to the cause of graft rejection. A survival index (Kaplan-Meier was estimated, which showed that occurence of graf rejection is less probable in the first two years

  8. Granular corneal dystrophy

    OpenAIRE

    Castillo Pérez, Alexeide de la C; Vilches Lescaille, Daysi; Noriega, Justo Luis; Martínez Balido, Daneel; León Balbón, Bárbaro Ramón; León Bernal, Danysleidi

    2015-01-01

    Las distrofias corneales constituyen un conjunto de enfermedades que presentan, en su mayoría, una baja incidencia y se caracterizan por acúmulo de material hialino o amiloide que disminuyen la transparencia corneal. La distrofia granular es una enfermedad autosómica dominante que presenta opacidades grises en el estroma superficial central de la córnea y se hacen visibles en la primera y segunda décadas de la vida, lo que provoca disminución de la visión más significativa cerca de los 40 año...

  9. Prevalence and causes of corneal blindness.

    Science.gov (United States)

    Wang, Haijing; Zhang, Yaoguang; Li, Zhijian; Wang, Tiebin; Liu, Ping

    2014-04-01

    The study aimed to assess the prevalence and causes of corneal blindness in a rural northern Chinese population. Cross-sectional study. The cluster random sampling method was used to select the sample. This population-based study included 11 787 participants of all ages in rural Heilongjiang Province, China. These participants underwent a detailed interview and eye examination that included the measurement of visual acuity, slit-lamp biomicroscopy and direct ophthalmoscopy. An eye was considered to have corneal blindness if the visual acuity was blindness and low vision. Among the 10 384 people enrolled in the study, the prevalence of corneal blindness is 0.3% (95% confidence interval 0.2-0.4%). The leading cause was keratitis in childhood (40.0%), followed by ocular trauma (33.3%) and keratitis in adulthood (20.0%). Age and illiteracy were found to be associated with an increased prevalence of corneal blindness. Blindness because of corneal diseases in rural areas of Northern China is a significant public health problem that needs to be given more attention. © 2013 Royal Australian and New Zealand College of Ophthalmologists.

  10. Two cases of corneal perforation after oral administration of nonsteroidal anti-inflammatory drugs: oral NSAID-induced corneal damage.

    Science.gov (United States)

    Masuda, Ikuya; Matsuo, Toshihiko; Okamoto, Kazuo; Matsushita, Kyoko; Ohtsuki, Hiroshi

    2010-01-01

    To report 2 cases of corneal perforation associated with the use of oral nonsteroidal anti-inflammatory drugs (NSAIDs). In a 62-year-old woman and a 79-year-old woman, corneal perforation occurred after 7 days and 5 months of oral NSAIDs administration, respectively. After NSAIDs were discontinued, the cornea epithelialized and the anterior chamber formed within 14 and 10 days, respectively. It is well known that topical NSAIDs cause corneal perforation. Observations in the present cases suggest that the oral administration of NSAIDs may also cause corneal damage, and hence, medical professionals should consider the risk of damage to the cornea when administering these drugs orally.

  11. Applanation optical coherence elastography: noncontact measurement of intraocular pressure, corneal biomechanical properties, and corneal geometry with a single instrument

    Science.gov (United States)

    Singh, Manmohan; Han, Zhaolong; Nair, Achuth; Schill, Alexander; Twa, Michael D.; Larin, Kirill V.

    2017-02-01

    Current clinical tools provide critical information about ocular health such as intraocular pressure (IOP). However, they lack the ability to quantify tissue material properties, which are potent markers for ocular tissue health and integrity. We describe a single instrument to measure the eye-globe IOP, quantify corneal biomechanical properties, and measure corneal geometry with a technique termed applanation optical coherence elastography (Appl-OCE). An ultrafast OCT system enabled visualization of corneal dynamics during noncontact applanation tonometry and direct measurement of micro air-pulse induced elastic wave propagation. Our preliminary results show that the proposed Appl-OCE system can be used to quantify IOP, corneal biomechanical properties, and corneal geometry, which builds a solid foundation for a unique device that can provide a more complete picture of ocular health.

  12. Risk factors for corneal ectasia after LASIK.

    Science.gov (United States)

    Tabbara, Khalid F; Kotb, Amgad A

    2006-09-01

    To establish a grading system that helps identify high-risk individuals who may experience corneal ectasia after LASIK. Retrospective, comparative, interventional case series. One hundred forty-eight consecutive patients (148 eyes) were included in this study. Thirty-seven patients who underwent LASIK at other refractive centers experienced corneal ectasia in 1 eye after LASIK. One hundred eleven eyes of 111 patients who underwent successful LASIK during the same period were age and gender matched and served as controls. All patients underwent preoperative and postoperative topographic analysis of the cornea. The follow-up period in both groups of patients ranged from 2 to 5 years, with a mean follow-up of 3.6 years. All patients underwent LASIK for myopia (spherical equivalent, -4.00 to -8.00 diopters). Corneal keratometry, oblique cylinder, pachymetry, posterior surface elevation, difference between the inferior and superior corneal diopteric power, and posterior best sphere fit (BSF) over anterior BSF were given a grade of 1 to 3 each. An ectasia grading system was established, and the cumulative risk score was assessed. Patients who had a grade of 7 or less showed no evidence of corneal ectasia, whereas 16 (59%) of 27 patients who had a grade of 8 to 12 had corneal ectasia. Twenty-one (100%) of 21 patients with a grade of more than 12 had corneal ectasia after LASIK (P<0.0001). A risk score may help in the prediction of patients who are at risk of experiencing corneal ectasia after LASIK. A prospective clinical study is needed to assess the validity of these risk factors.

  13. 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

  14. Pharmacologic strategies in the prevention and treatment of corneal transplant rejection.

    Science.gov (United States)

    Tabbara, Khalid F

    2008-06-01

    Corneal transplantation remains one of the most successful organ transplantation procedures in humans. The unique structure of the cornea, with its absence of blood vessels and corneal lymphatic, allows the survival of corneal allograft. Recent advances in sutures, storage media, microsurgical instrumentation, and new pharmacological strategies have greatly improved the success of corneal transplantation and the prevention of corneal allograft rejection. Our strategies in the management and prevention of corneal graft rejection can modify and improve the survival of corneal allografts. Preoperative evaluation, understanding the risk factors, and management of ocular surface disorders may greatly improve the survival of the corneal transplant. Early recognition of corneal allograft rejection and aggressive treatment may improve the survival of the corneal graft. Furthermore, patients who undergo corneal transplantation should be maintained under close ophthalmic surveillance and patients should be informed to report immediately whenever symptoms of corneal graft rejection occur. The mainstay of therapy is topical corticosteroids. In severe cases, periocular, intravenous, and oral corticosteroids therapy can be rendered. New therapeutic modalities such as cyclosporine, tacrolimus, daclizumab, mycophenolate mofetil, leflunomide, rapamycin, and others may prove to be of help in the prevention and treatment of corneal graft rejection. Early recognition of corneal graft rejection and prompt treatment are mandatory for the successful survival of the corneal allograft.

  15. Study on the establishment of corneal alkali chemical injury on rats

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    Nan Hu

    2013-06-01

    Full Text Available AIM:To investigate the appropriate methods to establish corneal alkali chemical injury on rats. METHODS:The rats(n=87were randomly divided into three groups. Corneal alkali injury was induced by placing 1mol/L NaOH soaked filter paper on the limbus of right cornea for 20 seconds(group A, n=34or 40 seconds(group B, n=23, and on the central axis of the right cornea for 40 seconds(group C, n=30respectively. Corneal transparency, corneal ulceration, and corneal neovascularization were observed and recorded under slit- lamp biomicroscope on day 7 post-operation. RESULTS: Incidence of corneal ulceration, corneal perforation and positive rate of corneal fluorescein staining in limbal corneal injury groups(group A and Bwere significantly higher than that of central corneal injury group(group C(P<0.05. Incidence of corneal ulceration and corneal perforation in group B was significantly higher than group A(P<0.05. Corneal neovascularization was observed in all three groups. CONCLUSION: Corneal alkali burns induced by 3mm diameter central cornea injury are fit for the study of corneal neovascularization, while those induced by limbus injury for 20 seconds are fit for the study on limbal stem cells deficiency.

  16. Recovery of Corneal Endothelial Cells from Periphery after Injury.

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    Sang Ouk Choi

    Full Text Available Wound healing of the endothelium occurs through cell enlargement and migration. However, the peripheral corneal endothelium may act as a cell resource for the recovery of corneal endothelium in endothelial injury.To investigate the recovery process of corneal endothelial cells (CECs from corneal endothelial injury.Three patients with unilateral chemical eye injuries, and 15 rabbit eyes with corneal endothelial chemical injuries were studied. Slit lamp examination, specular microscopy, and ultrasound pachymetry were performed immediately after chemical injury and 1, 3, 6, and 9 months later. The anterior chambers of eyes from New Zealand white rabbits were injected with 0.1 mL of 0.05 N NaOH for 10 min (NaOH group. Corneal edema was evaluated at day 1, 7, and 14. Vital staining was performed using alizarin red and trypan blue.Specular microscopy did not reveal any corneal endothelial cells immediately after injury. Corneal edema subsided from the periphery to the center, CEC density increased, and central corneal thickness decreased over time. In the animal study, corneal edema was greater in the NaOH group compared to the control at both day 1 and day 7. At day 1, no CECs were detected at the center and periphery of the corneas in the NaOH group. Two weeks after injury, small, hexagonal CECs were detected in peripheral cornea, while CECs in mid-periphery were large and non-hexagonal.CECs migrated from the periphery to the center of the cornea after endothelial injury. The peripheral corneal endothelium may act as a cell resource for the recovery of corneal endothelium.

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

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    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

  18. Corneal Collagen Crosslinking Combined with Phototherapeutic Keratectomy and Photorefractive Keratectomy for Corneal Ectasia after Laser in situ Keratomileusis.

    Science.gov (United States)

    Zhu, Wei; Han, Yunfei; Cui, Changxia; Xu, Wenwen; Wang, Xuan; Dou, Xiaoxiao; Xu, Linlin; Xu, Yanyun; Mu, Guoying

    2018-01-01

    The aim of this study was to analyze the effects of corneal crosslinking (CXL) combined with phototherapeutic keratectomy (PTK) and photorefractive keratectomy (PRK) in halting the progression and improving the visual function of corneal ectasia after laser in situ keratomileusis (LASIK). PTK-PRK-CXL was performed on 14 eyes of 14 patients who developed corneal ectasia after LASIK. The visual acuity, spherical refraction and cylinder, corneal topography indices, thinnest corneal thickness (TCT), and endothelial cell count were evaluated at baseline and at 1, 3, 6, and 12 months postoperatively. The mean uncorrected visual acuity improved significantly from 0.64 ± 0.36 logMAR preoperatively to 0.19 ± 0.12 logMAR at 12 months of follow-up (p 0.05) beyond 6 months after treatment. PTK-PRK-CXL is a promising procedure to halt the progression of post-LASIK keratectasia with significant visual quality improvement. © 2018 S. Karger AG, Basel.

  19. Self-assembled liquid crystalline nanoparticles as a novel ophthalmic delivery system for dexamethasone: Improving preocular retention and ocular bioavailability.

    Science.gov (United States)

    Gan, Li; Han, Shun; Shen, Jinqiu; Zhu, Jiabi; Zhu, Chunliu; Zhang, Xinxin; Gan, Yong

    2010-08-30

    The object of this study was to design novel self-assembled liquid crystalline nanoparticles (cubosomes) as an ophthalmic delivery system for dexamethasone (DEX) to improve its preocular retention and ocular bioavailability. DEX cubosome particles were produced by fragmenting a cubic crystalline phase of monoolein and water in the presence of stabilizer Poloxamer 407. Small angle X-ray diffraction (SAXR) profiles revealed its internal structure as Pn3m space group, indicating the diamond cubic phase. In vitro, the apparent permeability coefficient of DEX administered in cubosomes exhibited a 4.5-fold (F1) and 3.5-fold (F2) increase compared to that of Dex-Na phosphate eye drops. Preocular retention studies revealed that the retention of cubosomes was significantly longer than that of solution and carbopol gel, with AUC(0-->180min) of Rh B cubosomes being 2-3-fold higher than that of the other two formulations. In vivo pharmacokinetics in aqueous humor was evaluated by microdialysis, which indicated a 1.8-fold (F1) increase in AUC(0-->240min) of DEX administered in cubosomes relative to that of Dex-Na phosphate eye drops, with about an 8-fold increase compared to that of DEX suspension. Corneal cross-sections after incubation with DEX cubosomes demonstrated an unaffected corneal structure and tissue integrity, which indicated the good biocompatibility of DEX cubosomes. In conclusion, self-assembled liquid crystalline nanoparticles might represent a promising vehicle for effective ocular drug delivery. Crown Copyright 2010. Published by Elsevier B.V. All rights reserved.

  20. Research on mouse model of grade II corneal alkali burn

    Directory of Open Access Journals (Sweden)

    Jun-Qiang Bai

    2016-04-01

    Full Text Available AIM: To choose appropriate concentration of sodium hydroxide (NaOH solution to establish a stable and consistent corneal alkali burn mouse model in grade II. METHODS: The mice (n=60 were randomly divided into four groups and 15 mice each group. Corneal alkali burns were induced by placing circle filter paper soaked with NaOH solutions on the right central cornea for 30s. The concentrations of NaOH solutions of groups A, B, C, and D were 0.1 mol/L, 0.15 mol/L , 0.2 mol/L, and 1.0 mol/L respectively. Then these corneas were irrigated with 20 mL physiological saline (0.9% NaCl. On day 7 postburn, slit lamp microscope was used to observe corneal opacity, corneal epithelial sodium fluorescein staining positive rate, incidence of corneal ulcer and corneal neovascularization, meanwhile pictures of the anterior eyes were taken. Cirrus spectral domain optical coherence tomography was used to scan cornea to observe corneal epithelial defect and corneal ulcer. RESULTS: Corneal opacity scores ( were not significantly different between the group A and group B (P=0.097. Incidence of corneal ulcer in group B was significantly higher than that in group A (P=0.035. Incidence of corneal ulcer and perforation rate in group B was lower than that in group C. Group C and D had corneal neovascularization, and incidence of corneal neovascularization in group D was significantly higher than that in group C (P=0.000. CONCLUSION: Using 0.15 mol/L NaOH can establish grade II mouse model of corneal alkali burns.

  1. Corneal Laceration

    Medline Plus

    Full Text Available ... to Full Corneal Transplantation Nov 29, 2016 Follow The Academy Professionals: Education Guidelines News Multimedia Public & Patients: Contact Us About the Academy Jobs at the Academy Financial Relationships with Industry ...

  2. Using corneal topography design personalized cataract surgery programs

    Directory of Open Access Journals (Sweden)

    Jin-Ou Huang

    2014-08-01

    Full Text Available AIM:To investigate how to design personalized cataract surgery programs to achieve surgical correction of preoperative corneal astigmatism with surgical astigmatism under the guidance of corneal topography, improve postoperative visual quality and reduce the cost of treatment. METHODS: Totally 202 cases(226 eyescataract patients were divided into randomized treatment group and individualized treatment group. According to the method and location of the incision, randomized treatment group were divided into 8 groups. Surgical astigmatism after different incision were calculated with the use of preoperative and postoperative corneal astigmatism through vector analysis method. Individualized treatment groups were designed personably for surgical method with reference of every surgically induced astigmatism, the surgical method chooses the type of surgical incision based on close link between preoperative corneal astigmatism and surgically induced astigmatism, and the incision was located in the steep meridian. The postoperative corneal astigmatism of individualized treatment group was observed. RESULTS: Postoperative corneal astigmatism of individualized treatment group were lower than that of 3.0mm clear corneal tunnel incision in the randomized treatment group, there were statistically significance difference, while with 3.0mm sclera tunnel incision group there were no statistically significance difference. After 55.8% of patients with the use of individualized surgical plan could undergo the operation of extracapsular cataract extraction with relatively low cost and rigid intraocular lens implantation, the per capita cost of treatment could be reduced. CONCLUSION: Personalized cataract surgery programs are designed to achieve surgical correction of preoperative corneal astigmatism under the use of corneal topography, improve postoperative visual quality and reduce the cost of treatment.

  3. Crystalline-Like Keratopathy after Intravenous Immunoglobulin Therapy with Incomplete Kawasaki Disease: Case Report and Literature Review

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    Elif Erdem

    2013-01-01

    Full Text Available A 7-year-old girl had presented with high body temperature and joint pain which continued for 3 days. Because of the prolonged history of unexplained fever, rash, bilateral nonpurulent conjunctival injection, oropharyngeal erythema, strawberry tongue, and extreme of age, incomplete Kawasaki disease was considered and started on an intravenous immunoglobulin infusion. Six days after this treatment, patient was referred to eye clinic with decreased vision and photophobia. Visual acuity was reduced to 20/40 in both eyes. Slit-lamp examination revealed bilateral diffuse corneal punctate epitheliopathy and anterior stromal haze. Corneal epitheliopathy seemed like crystal deposits. One day after presentation, mild anterior uveitis was added to clinical picture. All ocular findings disappeared in one week with topical steroid and unpreserved artificial tear drops. We present a case who was diagnosed as incomplete Kawasaki disease along with bilateral diffuse crystalline-like keratopathy. We supposed that unusual ocular presentation may be associated with intravenous immunoglobulin treatment.

  4. Topical Ranibizumab as a Treatment of Corneal Neovascularization

    Science.gov (United States)

    Ferrari, Giulio; Dastjerdi, Mohammad H.; Okanobo, Andre; Cheng, Sheng-Fu; Amparo, Francisco; Nallasamy, Nambi; Dana, Reza

    2014-01-01

    Purpose To examine the effect of topical ranibizumab on clinically stable corneal neovascularization (NV). Methods This was a prospective, open-label, monocentric, uncontrolled, non-comparative study. Ten eyes of 9 patients with corneal NV received topical ranibizumab (1%) 4 times a day for 3 weeks with a follow-up of 16 weeks. The main corneal neovascularization outcome measures were: neovascular area (NA), the area occupied by the corneal neovessels; vessel caliber (VC), the mean diameter of the corneal neovessels; and invasion area (IA), the fraction of the total cornea area covered by the vessels. This study was conducted at the Massachusetts Eye and Ear Infirmary, Boston, MA, USA. Results Statistically significant decreases in NA (55.3%, P<0.001), which lasted through 16 weeks, and VC (59%, P<0.001), which continued to improve up to week 16, were observed after treatment. No significant decrease was observed in IA (12.3%, P=0.49). There was no statistically significant change in visual acuity or intraocular pressure. No adverse events ascribed to the treatment were noted. Conclusions Topical application of ranibizumab is effective in reducing the severity of corneal NV in the context of established corneal NV, mostly through decrease in VC rather than IA. PMID:23407316

  5. Corneal changes with accommodation using dual Scheimpflug photography.

    Science.gov (United States)

    Sisó-Fuertes, Irene; Domínguez-Vicent, Alberto; del Águila-Carrasco, Antonio; Ferrer-Blasco, Teresa; Montés-Micó, Robert

    2015-05-01

    To assess whether corneal parameters and aberrations are affected by accommodation. Optics Department, University of Valencia, Valencia, Spain. Prospective cross-sectional study. The Galilei G4 dual Scheimpflug device was used to obtain data on the anterior and posterior axial curvatures, total corneal power (TCP), and corneal pachymetry from 3 corneal zones (central: 0.0 up to 4.0 mm; paracentral or mid: 4.0 up to 7.0 mm; peripheral: 7.0 up to 10.0 mm) in young emmetropic eyes in the unaccommodated and 4 accommodated states (from -1.0 to -4.0 diopters [D] in 1.0 D steps). The 2nd-, 3rd-, and 4th-order aberrations as well as the root mean square (RMS) were also determined for the entire cornea at the same accommodative demands. The study evaluated 7 subjects (12 eyes). No significant changes in any measured parameter were found during accommodation for any corneal zone (P > .05). Statistically significant differences were found in the various corneal zones when it was assumed they were constant with accommodation (P the high standard deviation values. Different parameters in various zones of the cornea as well as corneal aberrations were stable during accommodation. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

  6. Corneal Biomechanics in Ectatic Diseases: Refractive Surgery Implications

    Science.gov (United States)

    Ambrósio, Jr, Renato; Correia, Fernando Faria; Lopes, Bernardo; Salomão, Marcella Q.; Luz, Allan; Dawson, Daniel G.; Elsheikh, Ahmed; Vinciguerra, Riccardo; Vinciguerra, Paolo; Roberts, Cynthia J.

    2017-01-01

    Background: Ectasia development occurs due to a chronic corneal biomechanical decompensation or weakness, resulting in stromal thinning and corneal protrusion. This leads to corneal steepening, increase in astigmatism, and irregularity. In corneal refractive surgery, the detection of mild forms of ectasia pre-operatively is essential to avoid post-operative progressive ectasia, which also depends on the impact of the procedure on the cornea. Method: The advent of 3D tomography is proven as a significant advancement to further characterize corneal shape beyond front surface topography, which is still relevant. While screening tests for ectasia had been limited to corneal shape (geometry) assessment, clinical biomechanical assessment has been possible since the introduction of the Ocular Response Analyzer (Reichert Ophthalmic Instruments, Buffalo, USA) in 2005 and the Corvis ST (Oculus Optikgeräte GmbH, Wetzlar, Germany) in 2010. Direct clinical biomechanical evaluation is recognized as paramount, especially in detection of mild ectatic cases and characterization of the susceptibility for ectasia progression for any cornea. Conclusions: The purpose of this review is to describe the current state of clinical evaluation of corneal biomechanics, focusing on the most recent advances of commercially available instruments and also on future developments, such as Brillouin microscopy. PMID:28932334

  7. Corneal biomechanical properties in healthy children measured by corneal visualization scheimpflug technology.

    Science.gov (United States)

    He, Miao; Ding, Hui; He, Hong; Zhang, Chi; Liu, Liangping; Zhong, Xingwu

    2017-05-17

    The aim of this study was to evaluate corneal biomechanical properties in a population of healthy children in China using corneal visualization Scheimpflug technology (CST). All children underwent complete bi-ocular examinations. CST provided intraocular pressure (IOP) and corneal biomechanical parameters, including time, velocity, length and deformation amplitude at first applanation (A1T, A1V, A1L, A1DA), at second applanation (A2T, A2V, A2L, A2DA), highest concavity time (HCT), maximum deformation amplitude (MDA), peak distance (PD), and radius of curvature (RoC). Pearson correlation analysis was used to assess the impacts of demographic factors, central corneal thickness (CCT), spherical equivalent (SE), and IOP on corneal biomechanics. One hundred eight subjects (32 girls and 76 boys) with the mean age of 10.80 ± 4.13 years (range 4 to18 years) were included in the final analyses. The right and left eyes were highly symmetrical in SE (p = 0.082), IOP (p = 0.235), or CCT (p = 0.210). Mean A1T of the right eyes was 7.424 ± 0.340 ms; the left eyes 7.451 ± 0.365 ms. MDA was 0.993 ± 0.102 mm in the right eyes and 0.982 ± 0.100 mm in the left eyes. Mean HCT of the right eyes was 16.675 ± 0.502 ms; the left eyes 16.735 ± 0.555 ms. All CST parameters of both eye were remarkably symmetrical with the exception of A2L (p = 0.006), A1DA (p = 0.025). The majority of CST parameters of both eyes were significantly correlated with CCT and IOP (p children eyes. Several CST biomechanical parameters in children are modified by CCT and IOP.

  8. 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 ...

  9. In Vivo Corneal Biomechanical Properties with Corneal Visualization Scheimpflug Technology in Chinese Population

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    Ying Wu

    2016-01-01

    Full Text Available Purpose. To determine the repeatability of recalculated corneal visualization Scheimpflug technology (CorVis ST parameters and to study the variation of biomechanical properties and their association with demographic and ocular characteristics. Methods. A total of 783 healthy subjects were included in this study. Comprehensive ophthalmological examinations were conducted. The repeatability of the recalculated biomechanical parameters with 90 subjects was assessed by the coefficient of variation (CV and intraclass correlation coefficient (ICC. Univariate and multivariate linear regression models were used to identify demographic and ocular factors. Results. The repeatability of the central corneal thickness (CCT, deformation amplitude (DA, and first/second applanation time (A1/A2-time exhibited excellent repeatability (CV% ≤ 3.312% and ICC ≥ 0.929 for all measurements. The velocity in/out (Vin/out, highest concavity- (HC- radius, peak distance (PD, and DA showed a normal distribution. Univariate linear regression showed a statistically significant correlation between Vin, Vout, DA, PD, and HC-radius and IOP, CCT, and corneal volume, respectively. Multivariate analysis showed that IOP and CCT were negatively correlated with Vin, DA, and PD, while there was a positive correlation between Vout and HC-radius. Conclusion. The ICCs of the recalculated parameters, CCT, DA, A1-time, and A2-time, exhibited excellent repeatability. IOP, CCT, and corneal volume significantly influenced the biomechanical properties of the eye.

  10. Alloimmunity and Tolerance in Corneal Transplantation.

    Science.gov (United States)

    Amouzegar, Afsaneh; Chauhan, Sunil K; Dana, Reza

    2016-05-15

    Corneal transplantation is one of the most prevalent and successful forms of solid tissue transplantation. Despite favorable outcomes, immune-mediated graft rejection remains the major cause of corneal allograft failure. Although low-risk graft recipients with uninflamed graft beds enjoy a success rate ∼90%, the rejection rates in inflamed graft beds or high-risk recipients often exceed 50%, despite maximal immune suppression. In this review, we discuss the critical facets of corneal alloimmunity, including immune and angiogenic privilege, mechanisms of allosensitization, cellular and molecular mediators of graft rejection, and allotolerance induction. Copyright © 2016 by The American Association of Immunologists, Inc.

  11. Corneal thickness: measurement and implications.

    Science.gov (United States)

    Ehlers, Niels; Hjortdal, Jesper

    2004-03-01

    The thickness of the cornea was reported in more than 100-year-old textbooks on physiological optics (Helmholtz, Gullstrand). Physiological interest was revived in the 1950s by David Maurice, and over the next 50 years, this 'simple' biological parameter has been studied extensively. Several techniques for its measurement have been described and physiological and clinical significance have been studied. In this review, the different methods and techniques of measurement are briefly presented (optical, ultrasound). While the corneal thickness of many animals are the same over a considerable part of the surface, in the human cornea anterior and posterior curvature are not concentric giving rise to a problem of definition. Based on this the precision and accuracy of determining the central corneal thickness are discussed. Changes in corneal thickness reflects changes in function of the boundary layers, in particular the endothelial barrier. The absolute value of thickness is of importance for the estimation of IOP but also in diagnosis of corneal and systemic disorders. Finally it is discussed to what extent the thickness is a biometric parameter of significance, e.g. in the progression of myopia or in the development of retinal detachment.

  12. Generation of Femtosecond Laser-Cut Decellularized Corneal Lenticule Using Hypotonic Trypsin-EDTA Solution for Corneal Tissue Engineering

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    Man-Il Huh

    2018-01-01

    Full Text Available Purpose. To establish an optimized and standardized protocol for the development of optimal scaffold for bioengineering corneal substitutes, we used femtosecond laser to process human corneal tissue into stromal lenticules and studied to find the most efficient decellularization method among various reagents with different tonicities. Methods. The decellularization efficacy of several agents (0.1%, 0.25%, and 0.5% of Triton X-100, SDS, and trypsin-EDTA (TE, resp. with different tonicities was evaluated. Of all protocols, the decellularization methods, which efficiently removed nuclear materials examined as detected by immunofluorescent staining, were quantitatively tested for sample DNA and glycosaminoglycan (GAG contents, recellularization efficacy, and biocompatibilities. Results. 0.5% SDS in hypertonic and isotonic buffer, 0.25% TE in hypotonic buffer, and 0.5% TE in all tonicities completely decellularized the corneal lenticules. Of the protocols, decellularization with hypotonic 0.25 and 0.5% TE showed the lowest DNA contents, while the GAG content was the highest. Furthermore, the recellularization efficacy of the hypotonic TE method was better than that of the SDS-based method. Hypotonic TE-treated decellularized corneal lenticules (DCLs were sufficiently transparent and biocompatible. Conclusion. We generated an ideal protocol for DCLs using a novel method. Furthermore, it is possible to create a scaffold using a bioengineered corneal substitute.

  13. Treatment Results of Corneal Collagen Cross-Linking Combined with Riboflavin and 440 Nm Blue Light for Bacterial Corneal Ulcer in Rabbits.

    Science.gov (United States)

    Wei, Shufang; Zhang, Cuiying; Zhang, Shaoru; Xu, Yanyun; Mu, Guoying

    2017-10-01

    To study the treatment effect of corneal collagen cross-linking (CXL) combined with 440 nm blue light and riboflavin on bacterial corneal ulcer using animal experiments. A total of 21 New Zealand white rabbits that developed Staphylococcus aureus corneal ulcer were randomly divided into three groups. Seven rabbits were used as blank control groups; seven rabbits were treated with CXL combined with riboflavin and 440 nm blue light; and seven rabbits were treated with CXL combined with riboflavin and 370 nm ultraviolet A light. Necrotic tissues or secretions from the ulcer surface, eye secretions, conjunctival hyperemia, hypopyon, corneal infiltration, and pathological changes of the cornea were all observed. The 1st, 3th, and 7th day after CXL treatment, a statistically significant difference was found among the inflammation scores of the three groups. The scores of 440 and 370 groups decreased gradually, significantly lower than that of the control group. Bacterial cultures of 440 and 370 groups turned to be negative while that of the control group remained positive. After 1 day of CXL treatment, pathology pictures of the three groups all showed loss of corneal epithelia with many inflammatory cells in deep stroma. After 7 days of CXL treatment, abscess formed in almost all corneal area in the control group, while in 440 and 370 groups, multilayer healing of corneal epithelia, neovascularization, and many inflammatory cells within ulcers and proliferation of a small amount of fibroblast were seen. CXL combined with riboflavin and 440 nm blue light is effective in treating S. aureus corneal ulcer.

  14. Human tears reveal insights into corneal neovascularization.

    Science.gov (United States)

    Zakaria, Nadia; Van Grasdorff, Sigi; Wouters, Kristien; Rozema, Jos; Koppen, Carina; Lion, Eva; Cools, Nathalie; Berneman, Zwi; Tassignon, Marie-José

    2012-01-01

    Corneal neovascularization results from the encroachment of blood vessels from the surrounding conjunctiva onto the normally avascular cornea. The aim of this study is to identify factors in human tears that are involved in development and/or maintenance of corneal neovascularization in humans. This could allow development of diagnostic tools for monitoring corneal neovascularization and combination monoclonal antibody therapies for its treatment. In an observational case-control study we enrolled a total of 12 patients with corneal neovascularization and 10 healthy volunteers. Basal tears along with reflex tears from the inferior fornix, superior fornix and using a corneal bath were collected along with blood serum samples. From all patients, ocular surface photographs were taken. Concentrations of the pro-angiogenic cytokines interleukin (IL)-6, IL-8, Vascular Endothelial Growth Factor (VEGF), Monocyte Chemoattractant Protein 1 (MCP-1) and Fas Ligand (FasL) were determined in blood and tear samples using a flow cytometric multiplex assay. Our results show that the concentration of pro-angiogenic cytokines in human tears are significantly higher compared to their concentrations in serum, with highest levels found in basal tears. Interestingly, we could detect a significantly higher concentration of IL- 6, IL-8 and VEGF in localized corneal tears of patients with neovascularized corneas when compared to the control group. This is the first study of its kind demonstrating a significant difference of defined factors in tears from patients with neovascularized corneas as compared to healthy controls. These results provide the basis for future research using animal models to further substantiate the role of these cytokines in the establishment and maintenance of corneal neovascularization.

  15. Clinical Validation of Point-Source Corneal Topography in Keratoplasty

    NARCIS (Netherlands)

    Vrijling, A C L; Braaf, B.; Snellenburg, J.J.; de Lange, F.; Zaal, M.J.W.; van der Heijde, G.L.; Sicam, V.A.D.P.

    2011-01-01

    Purpose. To validate the clinical performance of point-source corneal topography (PCT) in postpenetrating keratoplasty (PKP) eyes and to compare it with conventional Placido-based topography. Methods. Corneal elevation maps of the anterior corneal surface were obtained from 20 post-PKP corneas using

  16. Corneal donations in South Africa: A 15-year review.

    Science.gov (United States)

    York, Nicholas J; Tinley, Christopher

    2017-07-28

    Corneal pathology is one of the leading causes of preventable blindness in South Africa (SA). A corneal transplant can restore or significantly improve vision in most cases. However, in SA there is a gross shortage of corneal tissue available to ophthalmologists. Little has been published describing the magnitude of the problem. To describe trends in the number of corneal donors per year in SA, the number of corneal transplants performed each year, the origin of donors, the allocation of corneas to the public or private sector, and the demographics of donors. This was a retrospective review of all corneal donations to SA eye banks over the 15-year period 1 January 2002 - 31 December 2016. There was a progressive year-on-year decline in corneal donors over the study period, from 565 per year in 2002 to 89 in 2016. As a direct result, there has been an 85.5% decrease in the number of corneal transplants performed per year using locally donated corneas, from 1 049 in 2002 to 152 in 2016. Of the donors, 48.8% originated from mortuaries, 39.0% from private hospitals and 12.2% from government hospitals; donors from mortuaries showed the most significant decline over the 15-year period, decreasing by 94.8%. Of donated corneas, 79.3% were allocated to the private sector and 21.7% to the public sector. Males comprised 69.1% of donors, while 77.2% were white, 14.0% coloured, 6.3% black and 2.5% Indian/Asian. Donor age demonstrated a bimodal peak at 25 and 55 years. The number of corneal donations in SA has declined markedly, causing the burden of corneal disease requiring transplantation to rise steadily. Population groups with a low donor rate may have cultural and other objections to corneal donation, which should be a major focus of future research and initiatives aimed at reversing the current trends.

  17. Effect of Cycloplegia on Corneal Biometrics and Refractive State.

    Science.gov (United States)

    Bagheri, Abbas; Feizi, Mohadeseh; Shafii, Aliakbar; Faramarzi, Amir; Tavakoli, Mehdi; Yazdani, Shahin

    2018-01-01

    To determine changes in refractive state and corneal parameters after cycloplegia with cyclopentolate hydrochloride 1% using a dual Scheimpflug imaging system. In this prospective cross-sectional study patients aged 10 to 40 years who were referred for optometric evaluation enrolled and underwent autorefraction and corneal imaging with the Galilei dual Scheimpflug system before and 30 minutes after twice instillation of medication. Changes in refraction and astigmatism were investigated. Corneal biometrics including anterior and posterior corneal curvatures, total corneal power and corneal pachymetry were compared before and after cycloplegia. Two hundred and twelve eyes of 106 subjects with mean age of 28 ± 5 years including 201 myopic and 11 hyperopic eyes were evaluated. Mean spherical equivalent refractive error before cycloplegia was -3.4 ± 2.6 D. A mean hyperopic shift of 0.4 ± 0.5 D occurred after cycloplegia ( P biometrics should be considered before cataract and refractive surgeries.

  18. Surgically induced astigmatism after phacoemulsification by temporal clear corneal and superior clear corneal approach: a comparison

    Directory of Open Access Journals (Sweden)

    Nikose AS

    2018-01-01

    Full Text Available Archana Sunil Nikose, Dhrubojyoti Saha, Pradnya Mukesh Laddha, Mayuri Patil Department of Ophthalmology, N.K.P. Salve Institute and LMH, Nagpur, Maharashtra, India Introduction: Cataract surgery has undergone various advances since it was evolved from ancient couching to the modern phacoemulsification cataract surgery. Surgically induced astigmatism (SIA remains one of the most common complications. The introduction of sutureless clear corneal incision has gained increasing popularity worldwide because it offers several advantages over the traditional sutured limbal incision and scleral tunnel. A clear corneal incision has the benefit of being bloodless and having an easy approach, but SIA is still a concern.Purpose: In this study, we evaluated the SIA in clear corneal incisions with temporal approach and superior approach phacoemulsification. Comparisons between the two incisions were done using keratometric readings of preoperative and postoperative refractive status.Methodology: It was a hospital-based prospective interventional comparative randomized control trial of 261 patients conducted in a rural-based tertiary care center from September 2012 to August 2014. The visual acuity and detailed anterior segment and posterior segment examinations were done and the cataract was graded according to Lens Opacification Classification System II. Patients were divided for phacoemulsification into two groups, group A and group B, who underwent temporal and superior clear corneal approach, respectively. The patients were followed up on day 1, 7, 30, and 90 postoperatively. The parameters recorded were uncorrected visual acuity, best-corrected visual acuity, slit lamp examination, and keratometry. The mean difference of SIA between 30th and 90th day was statistically evaluated using paired t-test, and all the analyses were performed using SPSS 18.0 (SPSS Inc. software.Results: The mean postoperative SIA in group A was 0.998 D on the 30th day, which

  19. Depósitos corneales de ciprofloxacino Corneal deposits of ciprofloxacin

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    Taimi Cárdenas Díaz

    2010-01-01

    Full Text Available Las fluoroquinolonas son ampliamente utilizadas para el tratamiento de infecciones oculares bacterianas, ya que tienen actividad tanto para grampositivos, como para gramnegativos. Son fármacos seguros, pero se han descrito depósitos blancos cristalinianos en pacientes con administración frecuente y prolongada;en la mayoría de los casos, ellos resuelven de forma lenta al interrumpir el tratamiento. Si esto no ocurre, los depósitos se deben desbridar. Se ilustran 3 casos operados de catarata que llevaron tratamiento con ciprofloxacino en el posoperatorio, en los cuales se presentaron depósitos corneales y aunque disminuyó la agudeza visual, esta se recuperó después de la queratectomía.Fluoroquinolones are broadly used for the treatment of bacterial ocular infections, since they can act upon both grampositive and gramnegative bacteria. They are safe drugs, but white corneal deposits have been described in patients who frequently take this drug for a long period of time. In most of the cases, the deposits disappear slowly after the treatment is interrupted. If this does not happen, the deposits should be eliminated. Three cases operated on from cataract were presented, who had been taken ciprofloxacin in the postoperative stage and had corneal deposits. Although their visual acuity decreased, it recovered after keratectomy.

  20. Effects of two different incision phacoemulsification on corneal astigmatism

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    Lu Huo

    2014-12-01

    Full Text Available AIM:To compare the effect of different incision in corneal astigmatism after phacoemulsification. METHODS: Totally 88 cases(122 eyeswith pure cataract were randomly divided into two groups. Forty cases(60 eyeswere clarity corneal incision in group A, and 48 cases(62 eyeswere sclera tunnel incision in group B. Mean corneal astigmatism, surgically induced astigmatism(SIA, uncorrected visual acuity(UCVAand best correct vision acuity(BCVAwere observed in pre- and post-operation at 1d; 1wk; 1mo.RESULTS: The mean astigmatism had statistically significant difference between two groups at 1d; 1wk; 1mo after operation(PPP>0.05. UCVA≥0.5 and BCVA≥0.8 had statistically significant difference at 1d; 1wk(PP>0.05.CONCLUSION: Phacoemulsification with scleral tunnel incision remove combined intraocular lens(IOLimplantation has small changes to corneal astigmatism. By selecting personalized corneal incision according to the corneal topography might be more beneficial.

  1. Effects of genipin corneal crosslinking in rabbit corneas.

    Science.gov (United States)

    Avila, Marcel Y; Narvaez, Mauricio; Castañeda, Juan P

    2016-07-01

    To evaluate the effect of genipin, a natural crosslinking agent, in rabbit eyes. Department of Ophthalmology, Universidad Nacional de Colombia Centro de Tecnologia Oftalmica, Bogotá, Colombia. Experimental study. Ex vivo rabbit eyes (16; 8 rabbits) were treated with genipin 1.00%, 0.50%, and 0.25% for 5 minutes with a vacuum device to increase corneal permeability. Penetration was evaluated using Scheimpflug pachymetry (Pentacam). In the in vivo model (20 rabbits; 1 eye treated, 1 eye with vehicle), corneas were crosslinked with genipin as described. Corneal curvature, corneal pachymetry, and intraocular pressure (IOP) assessments as well as slitlamp examinations were performed 0, 7, 30, and 60 days after treatment. In the ex vivo model, Scheimpflug pachymetry showed deep penetration in the rabbit corneas with an increase in corneal density and a dose-dependent relationship. Corneal flattening was observed in treated eyes (mean 4.4 diopters ± 0.5 [SD]) compared with the control eyes. Pachymetry and IOP were stable in all evaluations. No eye showed toxicity in the anterior chamber or in the lens. Corneal crosslinking induced by genipin produced significant flattening of the cornea with no toxicity in rabbit eyes. This crosslinking could be useful in the treatment of corneal ectasia and in the modification of corneal curvature. None of the authors has a financial or proprietary interest in any material or method mentioned. Copyright © 2016 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  2. 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.

  3. Changes in corneal endothelial cell density and the cumulative risk of corneal decompensation after Ahmed glaucoma valve implantation.

    Science.gov (United States)

    Kim, Kyoung Nam; Lee, Sung Bok; Lee, Yeon Hee; Lee, Jong Joo; Lim, Hyung Bin; Kim, Chang-Sik

    2016-07-01

    To evaluate changes in the corneal endothelial cell density (ECD) and corneal decompensation following Ahmed glaucoma valve (AGV) implantation. This study was retrospective and observational case series. Patients with refractory glaucoma who underwent AGV implantation and were followed >5 years were consecutively enrolled. We reviewed the medical records, including the results of central corneal specular microscopy. Of the 127 enrolled patients, the annual change in ECD (%) was determined using linear regression for 72 eyes evaluated at least four times using serial specular microscopic examination and compared with 31 control eyes (fellow glaucomatous eyes under medical treatment). The main outcome measures were cumulative risk of corneal decompensation and differences in the ECD loss rates between subjects and controls. The mean follow-up after AGV implantation was 43.1 months. There were no cases of postoperative tube-corneal touch. The cumulative risk of corneal decompensation was 3.3%, 5 years after AGV implantation. There was a more rapid loss of ECD in the 72 subject eyes compared with the 31 controls (-7.0% and -0.1%/year, respectively; p<0.001). However, the rate of loss decreased over time and statistical significance compared with control eyes disappeared after 2 years postoperatively: -10.7% from baseline to 1 year (p<0.01), -7.0% from 1 year to 2 years (p=0.037), -4.2% from 2 years to 3 years (p=0.230) and -2.7% from 3 years to the final follow-up (p=0.111). In case of uncomplicated AGV implantation, the cumulative risk of corneal decompensation was 3.3%, 5 years after the operation. The ECD loss was statistically greater in eyes with AGV than in control eyes without AGV, but the difference was significant only up to 2 years post surgery. 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/.

  4. Corneal manifestations in systemic diseases

    OpenAIRE

    Zarranz-Ventura, J.; Nova, E. De; Moreno-Montañés, J.

    2008-01-01

    Un gran número de enfermedades sistémicas presentan manifestaciones corneales dentro de su espectro de enfermedad. El estudio detallado de todos los cuadros que asocian patología corneal resulta inabarcable, por ello se presentan las enfermedades más prevalentes o características. Este estudio contempla las enfermedades pulmonares y conectivopatías (colagenosis, enfermedades reumatológicas y enfermedades inflamatorias idiopáticas), las enfermedades dermatológicas, cardiovasculares, hematológi...

  5. 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.

  6. Spontaneous Healing of Corneal Perforation after Temporary Discontinuation of Erlotinib Treatment

    Directory of Open Access Journals (Sweden)

    Naoyuki Morishige

    2014-01-01

    Full Text Available Purpose: To report a case of corneal perforation associated with oral administration of erlotinib and its spontaneous healing after temporary discontinuation of drug treatment. Case Report: A 65-year-old man with metastatic lung cancer was treated with erlotinib (150 mg/day, a specific tyrosine kinase inhibitor of the epidermal growth factor receptor. He was referred to our corneal service for the treatment of bilateral corneal disorders, diagnosed with mild aqueous-deficient dry eye, and treated by insertion of punctal plugs. His corneal epithelial disorders initially improved, but subsequently worsened, as manifested by the development of bilateral corneal ulceration with corneal perforation in the right eye. The oral administration of erlotinib was interrupted in preparation for tectonic keratoplasty, but 2 days later the corneal perforation of the right eye and the bilateral epithelial defects had healed spontaneously. Treatment with erlotinib was resumed at half the initial dose, and the cornea of both eyes has remained apparently healthy. Discussion: Erlotinib may be secreted into tear fluid and thereby adversely affect the corneal epithelium. The development of corneal epithelial disorders in patients receiving this drug may be reversed by reducing its dose.

  7. 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

  8. Impact of Facial Conformation on Canine Health: Corneal Ulceration

    Science.gov (United States)

    Packer, Rowena M. A.; Hendricks, Anke; Burn, Charlotte C.

    2015-01-01

    Concern has arisen in recent years that selection for extreme facial morphology in the domestic dog may be leading to an increased frequency of eye disorders. Corneal ulcers are a common and painful eye problem in domestic dogs that can lead to scarring and/or perforation of the cornea, potentially causing blindness. Exaggerated juvenile-like craniofacial conformations and wide eyes have been suspected as risk factors for corneal ulceration. This study aimed to quantify the relationship between corneal ulceration risk and conformational factors including relative eyelid aperture width, brachycephalic (short-muzzled) skull shape, the presence of a nasal fold (wrinkle), and exposed eye-white. A 14 month cross-sectional study of dogs entering a large UK based small animal referral hospital for both corneal ulcers and unrelated disorders was carried out. Dogs were classed as affected if they were diagnosed with a corneal ulcer using fluorescein dye while at the hospital (whether referred for this disorder or not), or if a previous diagnosis of corneal ulcer(s) was documented in the dogs’ histories. Of 700 dogs recruited, measured and clinically examined, 31 were affected by corneal ulcers. Most cases were male (71%), small breed dogs (mean± SE weight: 11.4±1.1 kg), with the most commonly diagnosed breed being the Pug. Dogs with nasal folds were nearly five times more likely to be affected by corneal ulcers than those without, and brachycephalic dogs (craniofacial ratio dogs. A 10% increase in relative eyelid aperture width more than tripled the ulcer risk. Exposed eye-white was associated with a nearly three times increased risk. The results demonstrate that artificially selecting for these facial characteristics greatly heightens the risk of corneal ulcers, and such selection should thus be discouraged to improve canine welfare. PMID:25969983

  9. Study on phototherapeutic keratotomy for bacterial corneal lesions in rabbit

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    Xin Zhou

    2018-05-01

    Full Text Available AIM: To study the effect of phototherapeutic keratectomy(PTKon rabbit bacterial corneal ulcer model and explore the clinical potential of this method. METHODS: Totally 48 eyes from all the 24 New Zealand rabbits were inoculated with Staphylococcus aureus and bacterial corneal ulcer model was established successfully. At 1d after inoculation, 48 eyes were given levofloxacin eye drops when corneal ulcer was confirmed. Then slit lamp inspection and optical coherence tomography(OCTwere performed to measure the central corneal ulcer depth. All the rabbits right eyes were treated with PTK, as an observation group, left eyes were not treated as a control group. The eye section were observed by slit lamp and central thickness of corneal ulcer was measured by OCT at 3 and 7d after this operation. Rabbits were sacrificed and the cornea was removed for pathological section 7d later. RESULTS: The corneal ulcers in both groups had a tendency to heal, showing a decrease in ulcer area and smoothness of the surface. There was no significant difference in the depth of corneal ulcer between the observation group and the control group before PTK(t=0.706, P=0.484. The difference between the two groups of eyes at 3 and 7d after PTK was obviously(PCONCLUSION: PTK can effectively cure rabbit Staphylococcus aureus corneal ulcer and promote ulcer wound healing, which may be used for clinical treatment of patients with bacterial corneal lesions.

  10. Crosslinking and corneal cryotherapy in acanthamoeba keratitis -- a histological study.

    Science.gov (United States)

    Hager, Tobias; Hasenfus, A; Stachon, T; Seitz, B; Szentmáry, N

    2016-01-01

    Acanthamoeba keratitis is rare, but difficult to treat. Penetrating keratoplasty is performed in therapy-resistant cases. Nevertheless, subsequent recurrences occur in 40 % of the cases. In addition to triple-topical therapy (polyhexamid, propamidinisoethionat, neomycin), treatment alternatives are corneal cryotherapy and/or crosslinking (CXL). The aim of our present histological study was to analyze the persistence of acanthamoebatrophozoites and cysts, the persistence of bacteria, and activation of keratocytes in corneas of acanthamoeba keratitis patients following corneal cryotherapy and/or CXL. We analyzed histologically corneal buttons (from penetrating keratoplasties) of nine patients with acanthamoeba keratitis, following corneal cryotherapy (two patients) or a combination of crosslinking and corneal cryotherapy (seven patients), using haematoxilin–eosin, periodic acid Schiff (PAS), Gram and alpha-smooth muscle actin (alpha-SMA) stainings. Acanthamoeba trophozoites persisted in three corneas after cryotherapy and CXL. Cysts persisted in one of two corneas following corneal cryotherapy and in six of seven corneas after a combination of CXL and cryotherapy. One cornea showed positive Gram staining, but there were no alpha-SMA positive keratocytes in any of the corneas. Crosslinking and corneal cryotherapy have only limited impact on killing of acanthamoeba trophozoites, cysts, or bacteria. Corneal cryotherapy and CXL did not stimulate myofibroblastic transformation of keratocytes.

  11. Corneal topography

    DEFF Research Database (Denmark)

    Andersen, J.; Koch-Jensen, P.; Østerby, Ole

    1993-01-01

    The central corneal zone is depicted on keratoscope photographs using a small target aperture and a large object distance. Information on the peripheral area is included by employing a hemispherical target with a dense circular and radial pattern. On a 16 mm (R = 8 mm) reference steel sphere the ...

  12. Intracapsular lens extraction for the treatment of pupillary block glaucoma associated with anterior subluxation of the crystalline lens.

    Science.gov (United States)

    Kim, Yong Joon; Ha, Seung Joo

    2013-01-01

    To report a case of pupillary block glaucoma associated with spontaneous crystalline lens subluxation into the anterior chamber in a 34-year-old man. Dry vitrectomy was performed for securing enough retrolental space, and an intracapsular lens extraction was then performed via a corneolimbal incision. Additional endothelial cell damage was avoided with an injection of viscoelastics and gentle extraction of the crystalline lens. After deepening of the anterior chamber, scleral fixation of the intraocular lens was performed with an ab externo technique. Two months after the operation, a well-fixated intraocular lens was observed and intraocular pressure was stable. The postoperative corneal astigmatism was -3.5 dpt, and the patient had a best-corrected visual acuity of 20/25. Postoperative complications included decreased endothelial cell count and sector iris paralysis near the incision site. An anteriorly subluxated crystalline lens can cause pupillary block glaucoma in healthy young adults. To prevent intraoperative complications, intracapsular lens extraction with dry vitrectomy can be a good surgical option. The endothelial cell density should be closely monitored after surgery.

  13. Prevalence and associated factors of corneal blindness in Ningxia in northwest China

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    Xun-Lun Sheng

    2014-06-01

    Full Text Available AIM:To describe the prevalence and demographic characteristics of corneal blindness in an urban and rural region of Ningxia, located in the northwest part of China.METHODS:A stratified, randomized sampling procedure was employed in the study, including urban and rural area of all age group. Visual acuity, anterior segment and ocular fundus were checked. Related factor of corneal disease, including age, gender, education status, ethnic group, location and occupation, were identified according to uniform customized protocol. An eye was defined to be corneal blindness if the visual acuity was <20/400 due to a corneal disease.RESULTS:Three thousand individuals (1290 from urban area and 1710 from rural area participated in the investigation, with a response rate of 80.380%. The prevalence of corneal blindness was 0.023% in both eyes and 0.733% in at least one eye. The blindness in at least one eye with varied causes was present in 106 participants (3.533% and in bilateral eyes in 34 participants (1.133%. The corneal diseases accounted for 20.754% of blindness in at least one eye and 20.588% of bilateral blindness. The prevalence of corneal disease was higher in older and Han ethnic group, especially those who occupied in agriculture and outdoor work. People with corneal blindness were more likely to be older and lower education. Rural population were more likely to suffer from bilateral corneal blindness than the urban population in ≥59-year group (χ2=6.716, P=0.019. Infectious, trauma and immune corneal disease were the three leading causes of corneal disease. Trauma corneal disease was more likely leading to blindness in one eye. However, infectious and immune corneal diseases make more contribution to the bilateral corneal blindness.CONCLUSION: Corneal blindness is a significant burden of in Ningxia population, encompassing a variety of corneal infections and trauma; the majority of those were avoidable. Health promotion strategies and good

  14. Corneal Biomechanical Properties after FS-LASIK with Residual Bed Thickness Less Than 50% of the Original Corneal Thickness

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    Haixia Zhang

    2018-01-01

    Full Text Available Background. The changes in corneal biomechanical properties after LASIK remain an unknown but important topic for surgical design and prognostic evaluation. This study aims to observe the postoperative corneal biomechanical properties one month after LASIK with amount of corneal cutting (ACC greater than 50% of the central corneal thickness (CCT. Methods. FS-LASIK was performed in 10 left rabbit eyes with ACC being 60% (L60 and 65% (L65 of the CCT, while the right eyes (R were the control. After 4 weeks, rabbits were executed and corneal strip samples were prepared for uniaxial tensile tests. Results. At the same strain, the stresses of L65 and L60 were larger than those of R. The elastic moduli of L60 and L65 were larger than those of R when the stress was 0.02 MPa, while they began to be less than those of R when stress exceeds the low-stress region. After 10 s relaxation, the stress of specimens L65, L60, and R increased in turn. Conclusion. The elastic moduli of the cornea after FS-LASIK with ACC greater than 50% of the CCT do not become less under normal rabbit IOP. The limit stress grows with the rise of ACC when relaxation becomes stable.

  15. Temporary corneal stem cell dysfunction after radiation therapy

    International Nuclear Information System (INIS)

    Hiroshi, Fujishima; Kazuo, Tsubota

    1996-01-01

    Radiation therapy can cause corneal and conjuctival abnormalities that sometimes require surgical treatment. Corneal stem cell dysfunction is described, which recovered after the cessation of radiation. Methods - A 44-year-old man developed a corneal epithelial abnormality associated with conjuctival and corneal inflammation following radiation therapy for maxillary cancer. Examination of brush cytology samples showed goblet cells in the upper and lower parts of the cornea, which showed increased fluorescein permeability, and intraepithelial lymphocytes. Impression cytology showed goblet cells in the same part of the cornea. Specular microscopy revealed spindle type epithelial cells. Patient follow up included artificial tears and an antibiotic ophthalmic ointment. The corneal abnormalities resolved after 4 months with improved visual acuity without any surgical intervention, but the disappearance of the palisades of Vogt did not recover at 1 year after radiation. Radiation therapy in this patient caused temporary stem cell dysfunction which resulted in conjunctivalisation in a part of the cornea. Although limbal stem cell function did not fully recover, this rare case suggested that medical options should be considered before surgery. (Author)

  16. Effects of Silicone Hydrogel Contact Lens Application on Corneal High-order Aberration and Visual Guality in Patients with Corneal Opacities

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    Sevda Aydın Kurna

    2012-03-01

    Full Text Available Pur po se: Evaluation of the corneal high-order aberrations and visual quality changes after application of silicone hydrogel contact lenses in patients with corneal opacities due to various etiologies. Ma te ri al and Met hod: Fifteen eyes of 13 patients with corneal opacities were included in the study. During the ophthalmologic examination before and after contact lens application, visual acuity was measured with Snellen acuity chart and contrast sensitivity - with Bailey-Lowie Charts in letters. Aberrations were measured with corneal aberrometer (NIDEK Magellan Mapper under a naturally dilated pupil. Spherical aberration, coma, trefoil, irregular astigmatism and total high-order root mean square (RMS values were recorded. Measurements were repeated with balafilcon A lenses (PureVision 2 HD, B&L on all patients. Re sults: Patient age varied between 23 and 50 years. Two eyes had subepithelial infiltrates due to adenoviral keratitis, 1 had nebulae due to previous infections or trauma, and 2 had Salzmann’s nodular degeneration. We observed a mean increase of 1 line in visual acuity and 5 letters in contrast sensitivity with contact lenses versus glasses in the patients. Mean RMS values of spherical aberration, irregular astigmatism and total high-order aberrations decreased significantly with contact lenses. Dis cus si on: Silicone hydrogel soft contact lenses may improve visual quality by decreasing the corneal aberrations in patients with corneal opacities. (Turk J Ophthalmol 2012; 42: 97-102

  17. Altered corneal biomechanical properties in children with osteogenesis imperfecta.

    Science.gov (United States)

    Lagrou, Lisa M; Gilbert, Jesse; Hannibal, Mark; Caird, Michelle S; Thomas, Inas; Moroi, Sayoko E; Bohnsack, Brenda L

    2018-04-07

    To evaluate biomechanical corneal properties in children with osteogenesis imperfecta (OI). A prospective, observational, case-control study was conducted on children 6-19 years of age diagnosed with OI. Patients with OI and healthy control subjects underwent complete ophthalmic examinations. Additional tests included Ocular Response Analyzer (ORA) and ultrasonic pachymetry. Primary outcomes were central corneal thickness (CCT), corneal hysteresis (CH), and corneal resistance factor (CRF). Intraocular pressure (IOP) was measured directly by either iCare or Goldmann applanation and indirectly by the ORA (Goldmann-correlated and corneal-compensated IOP). Statistically significant differences between OI and control groups were determined using independent samples t test. A total of 10 of 18 OI cases (mean age, 13 ± 4.37 years; 8 males) and 30 controls (mean age, 12.76 ± 2.62 years; 16 males) were able to complete the corneal biomechanics and pachymetry testing. Children with OI had decreased CH (8.5 ± 1.0 mm Hg vs 11.6 ± 1.2 mm Hg [P < 0.001]), CRF (9.0 ± 1.9 mm Hg vs 11.5 ± 1.5 [P < 0.001]) and CCT (449.8 ± 30.8 μm vs 568 ± 47.6 μm [P < 0.001]) compared to controls. The corneal-compensated IOP was significantly higher in OI cases (18.8 ± 3.1 mm Hg) than in controls (15.0 ± 1.6 mm Hg, P < 0.004), but there was no significant difference in Goldmann-correlated IOP (16.3 ± 4.2 mm Hg vs 15.8 ± 2.2 mm Hg). Collagen defects in OI alter corneal structure and biomechanics. Children with OI have decreased CH, CRF, and CCT, resulting in IOPs that are likely higher than measured by tonometry. These corneal alterations are present at a young age in OI. Affected individuals should be routinely screened for glaucoma and corneal pathologies. Copyright © 2018 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

  18. Regulation of corneal stroma extracellular matrix assembly.

    Science.gov (United States)

    Chen, Shoujun; Mienaltowski, Michael J; Birk, David E

    2015-04-01

    The transparent cornea is the major refractive element of the eye. A finely controlled assembly of the stromal extracellular matrix is critical to corneal function, as well as in establishing the appropriate mechanical stability required to maintain corneal shape and curvature. In the stroma, homogeneous, small diameter collagen fibrils, regularly packed with a highly ordered hierarchical organization, are essential for function. This review focuses on corneal stroma assembly and the regulation of collagen fibrillogenesis. Corneal collagen fibrillogenesis involves multiple molecules interacting in sequential steps, as well as interactions between keratocytes and stroma matrix components. The stroma has the highest collagen V:I ratio in the body. Collagen V regulates the nucleation of protofibril assembly, thus controlling the number of fibrils and assembly of smaller diameter fibrils in the stroma. The corneal stroma is also enriched in small leucine-rich proteoglycans (SLRPs) that cooperate in a temporal and spatial manner to regulate linear and lateral collagen fibril growth. In addition, the fibril-associated collagens (FACITs) such as collagen XII and collagen XIV have roles in the regulation of fibril packing and inter-lamellar interactions. A communicating keratocyte network contributes to the overall and long-range regulation of stromal extracellular matrix assembly, by creating micro-domains where the sequential steps in stromal matrix assembly are controlled. Keratocytes control the synthesis of extracellular matrix components, which interact with the keratocytes dynamically to coordinate the regulatory steps into a cohesive process. Mutations or deficiencies in stromal regulatory molecules result in altered interactions and deficiencies in both transparency and refraction, leading to corneal stroma pathobiology such as stromal dystrophies, cornea plana and keratoconus. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. Dextran Preserves Native Corneal Structure During Decellularization.

    Science.gov (United States)

    Lynch, Amy P; Wilson, Samantha L; Ahearne, Mark

    2016-06-01

    Corneal decellularization has become an increasingly popular technique for generating scaffolds for corneal regeneration. Most decellularization procedures result in tissue swelling, thus limiting their application. Here, the use of a polysaccharide, dextran, to reduce swelling and conserve the native corneal structure during decellularization was investigated. Corneas were treated with 1% Triton X-100, 0.5% sodium dodecyl sulfate, and nucleases under constant rotation followed by extensive washing. To reduce swelling, decellularization solutions were supplemented with 5% dextran either throughout the whole decellularization process or during the washing cycles only. Quantitative analysis of DNA content showed a 96% reduction after decellularization regardless of the addition of dextran. Dextran resulted in a significant reduction in swelling from 3.85 ± 0.43 nm without to 1.94 ± 0.29-2.01 ± 0.37 nm (p dextran must be present throughout the decellularization protocol to preserve the native corneal architecture, anisotropy analysis demonstrated comparable results (0.22 ± 0.03) to the native cornea (0.24 ± 0.02), p > 0.05. Dextran can counteract the detrimental effects of decellularizing agents on the biomechanical properties of the tissue resulting in similar compressive moduli (mean before decellularization: 5.40 ± 1.18 kPa; mean after decellularization with dextran: 5.64 ± 1.34 kPa, p > 0.05). Cells remained viable in the presence of decellularized scaffolds. The findings of this study indicate that dextran not only prevents significant corneal swelling during decellularization but also enhances the maintenance of the native corneal ultrastructure.

  20. Comparison of the Keratometric Corneal Astigmatic Power after Phacoemulsification: Clear Temporal Corneal Incision versus Superior Scleral Tunnel Incision

    Directory of Open Access Journals (Sweden)

    Yongqi He

    2009-01-01

    Full Text Available Objective. This is prospective randomized control trial to compare the mean keratometric corneal astigmatism diopter power (not surgical induced astigmatism among preop and one-month and three-month postop phacoemulcification of either a clear temporal corneal incision or a superior scleral tunnel Incision, using only keratometric astigmatic power reading to evaluate the difference between the two cataract surgery incisions. Methods. 120 patients (134 eyes underwent phacoemulcification were randomly assigned to two groups: Group A, the clear temporal corneal incision group, and Group B, the superior scleral tunnel incision group. SPSS11.5 Software was used for statistical analysis to compare the postsurgical changes of cornea astigmatism on keratometry. Results. The changes of corneal astigmatic diopter in Groups A and B after 3 month postop from keratometric reading were 1.04 + 0.76 and 0.94 + 0.27, respectively (=.84>.05, which showed no statistic significance difference. Conclusion. The incision through either temporal clear cornea or superior scleral tunnel in phacoemulcification shows no statistic difference in astigmatism change on keratometry 3-month postop.

  1. Analysis of corneal topography in patients with pure microphthalmia in Eastern China.

    Science.gov (United States)

    Hu, Pei-Hong; Gao, Gui-Ping; Yu, Yao; Pei, Chong-Gang; Zhou, Qiong; Huang, Xin; Zhang, Ying; Shao, Yi

    2015-12-01

    To determine the typical corneal changes in pure microphthalmia using a corneal topography system and identify characteristics that may assist in early diagnosis. Patients with pure microphthalmia and healthy control subjects underwent corneal topography analysis (Orbscan IIZ® Corneal Topography System; Bausch and Lomb, Bridgewater, NJ, USA) to determine degree of corneal astigmatism (mean A), simulation of corneal astigmatism (sim A), mean keratometry (mean K), simulated keratometry (sim K), irregularities in the 3 - and 5-mm zone, and mean thickness of nine distinct corneal regions. Patients with pure microphthalmia (n = 12) had significantly higher mean K, sim K, mean A, sim A, 3.0 mm irregularity and 5.0 mm irregularity, and exhibited significantly more false keratoconus than controls (n = 12). There was a significant between-group difference in the morphology of the anterior corneal surface and the central curvature of the cornea. Changes in corneal morphology observed in this study could be useful in borderline situations to confirm the diagnosis of pure microphthalmia. © The Author(s) 2015.

  2. Congenital Corneal Anesthesia and Neurotrophic Keratitis: Diagnosis and Management

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    Flavio Mantelli

    2015-01-01

    Full Text Available Neurotrophic keratitis (NK is a rare degenerative disease of the cornea caused by an impairment of corneal sensory innervation, characterized by decreased or absent corneal sensitivity resulting in epithelial keratopathy, ulceration, and perforation. The aetiopathogenesis of corneal sensory innervation impairment in children recognizes the same range of causes as adults, although they are much less frequent in the pediatric population. Some extremely rare congenital diseases could be considered in the aetiopathogenesis of NK in children. Congenital corneal anesthesia is an extremely rare condition that carries considerable diagnostic and therapeutic problems. Typically the onset is up to 3 years of age and the cornea may be affected in isolation or the sensory deficit may exist as a component of a congenital syndrome, or it may be associated with systemic somatic anomalies. Accurate diagnosis and recognition of risk factors is important for lessening long-term sequelae of this condition. Treatment should include frequent topical lubrication and bandage corneal or scleral contact lenses. Surgery may be needed in refractory cases. The purpose of this review is to summarize and update data available on congenital causes and treatment of corneal hypo/anesthesia and, in turn, on congenital NK.

  3. Analysis of corneal esthesia in patients undergoing photorefractive keratectomy

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    Elmar Torres Neto

    2015-12-01

    Full Text Available ABSTRACT Purpose: To quantitatively analyze corneal esthesia in patients undergoing photorefractive keratectomy (PRK surgery. Methods: Forty-five patients selected for PRK in one eye underwent corneal esthesia using a Cochet-Bonnet esthesiometer preoperatively and 30 and 90 days postoperatively. Patients with a refractive diopter error of 4 or greater received intraoperative 0.02% mitomycin C for 20 s. Results: Twenty-four (53.3% of the 45 eyes received intraoperative 0.02% mitomycin. Decreased sensitivity was observed on postoperative day 30. By postoperative day 90, corneal esthesia had normalized but remained 14.9% lower than preoperative levels. In the mitomycin group, no recovery of corneal esthesia to normal sensitivity levels was observed. The mean esthesiometer level was 39.2 mm on postoperative day 90 (P<0.001. Conclusions: The results of the present study demonstrate recovery of corneal esthesia to normal levels at 90 days postoperatively in patients who did not receive mitomycin C. In patients administered mitomycin C, a 23.59% reduction in the corneal touch threshold was observed compared with preoperative levels indicating a failure of recovery to normal levels.

  4. Corneal conjunctivalization management with high Dk RGP contact lenses.

    Science.gov (United States)

    Martin, Raul

    2009-06-01

    To describe the management of corneal conjunctivalization with a high Dk RGP contact lens (CL) fitting. A high Dk RGP CL (Menicon Z-alpha Dk=189, Japan) was fitted, after temporary suspension of CL wear (6 months and 3 weeks), in two patients (a 36-year-old female and a 38-year-old male) who had corneal conjunctivalization secondary to low Dk soft CL wear. Both patients had worn their soft CLs 12-14 h per day without symptoms for the previous 18-20 years. After 9-15 months of high Dk RGP wear, all signs of corneal conjunctivalization had disappeared (corneal vascularization, late fluorescein stain, etc.) and patients wore their RGP CL comfortably. Corneal conjunctivalization was resolved with non-invasive procedures (temporary discontinuation, preservative-free artificial tears and high Dk RGP CL fitting) and thus other treatments (topical or surgical treatments such as limbus transplantation, amniotic membrane transplant or others) were not necessary. Short temporary suspension of CL wear (3 weeks), preservative-free artificial tears and refitting with high oxygen permeability RGP CL may be an alternative for the management of corneal conjunctivalization secondary to CL wear.

  5. Bioactive self-assembled peptide nanofibers for corneal stroma regeneration.

    Science.gov (United States)

    Uzunalli, G; Soran, Z; Erkal, T S; Dagdas, Y S; Dinc, E; Hondur, A M; Bilgihan, K; Aydin, B; Guler, M O; Tekinay, A B

    2014-03-01

    Defects in the corneal stroma caused by trauma or diseases such as macular corneal dystrophy and keratoconus can be detrimental for vision. Development of therapeutic methods to enhance corneal regeneration is essential for treatment of these defects. This paper describes a bioactive peptide nanofiber scaffold system for corneal tissue regeneration. These nanofibers are formed by self-assembling peptide amphiphile molecules containing laminin and fibronectin inspired sequences. Human corneal keratocyte cells cultured on laminin-mimetic peptide nanofibers retained their characteristic morphology, and their proliferation was enhanced compared with cells cultured on fibronectin-mimetic nanofibers. When these nanofibers were used for damaged rabbit corneas, laminin-mimetic peptide nanofibers increased keratocyte migration and supported stroma regeneration. These results suggest that laminin-mimetic peptide nanofibers provide a promising injectable, synthetic scaffold system for cornea stroma regeneration. Copyright © 2013 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

  6. 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.

  7. Corneal iron ring after hyperopic photorefractive keratectomy.

    Science.gov (United States)

    Bilgihan, K; Akata, F; Gürelik, G; Adigüzel, U; Akpinar, M; Hasanreisoğlu, B

    1999-05-01

    To report the incidence and course of corneal iron deposition after hyperopic photorefractive keratectomy (PRK). Gazi University, Medical School, Department of Ophthalmology, Ankara, Turkey. Between January 1995 and December 1997, 62 eyes had PRK to correct hyperopia. Nine eyes developed corneal iron ring 5 to 8 months (mean 6.25 months +/- 1.3 [SD]) after PRK for hyperopia. The rings persisted during the mean follow-up of 19 +/- 11.09 months. The ring-shaped iron deposition after PRK for hyperopia must be differentiated from the Fleischer ring. Our results suggest that the slitlamp findings of peripheral corneal iron deposition in hyperopic PRK patients correlate with achieved correction.

  8. Corneal collagen crosslinking for keratoconus. A review

    Directory of Open Access Journals (Sweden)

    M. M. Bikbov

    2014-10-01

    Full Text Available 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, contact between the stroma and epithelium resulting from Bowman’s membrane rupture, chromatin fragmentation in keratocyte nuclei, phagocytosis, abnormal staining and arrangement of collagen fibers, enzyme system disorders, and keratocyte apoptosis. In corneal ectasia, altered enzymatic processes result in the synthesis of abnormal collagen. Collagen packing is determined by the activity of various extracellular matrix enzymes which bind amines and aldehydes of collagen fiber amino acids. In the late stage, morphological changes of Descemet’s membrane (i.e., rupture and detachment develop. Abnormal hexagonal-shaped keratocytes and their apoptosis are the signs of endothelial dystrophy. The lack of analogs in domestic ophthalmology encouraged the scientists of Ufa Eye Research Institute to develop a device for corneal collagen crosslinking. The parameters of ultraviolet (i.e., wavelength, exposure time, power to achieve the desired effect were identified. The specifics of some photosensitizers in the course of the procedure were studied. UFalink, a device for UV irradiation of cornea, and photosensitizer Dextralink were developed and adopted. Due to the high risk of endothelial damage, this treatment is contraindicated in severe keratoconus (CCT less than 400 microns. Major effects of corneal collagen crosslinking are the following: Young’s modulus (modulus of elasticity increase by 328.9 % (on average, temperature tolerance increase by 5

  9. [The status quo and expectation of corneal research in China].

    Science.gov (United States)

    Shi, Weiyun; Xie, Lixin

    2014-09-01

    In China, corneal disease is currently the second leading cause of blindness. Severe donor shortage, insufficient technique supports and promotion, and the lack of corneal disease specialists due to poor systematic training are all urgent problems to be resolved. The last 5 years have witnessed a considerable progress in basic and clinical researches of corneal disease. Investigations on the pathogenesis and treatment of fungal keratitis have won an international reputation. Results from the study of corneal reconstruction with tissue-engineered and acellular matrix corneas have been tested in clinical trials with good preliminary performance. Moreover, the clinical researches of corneal refractive surgery have kept pace with the latest international progresses. However, Descemet's membrane endothelial keratoplasty needs further promotion, and the development and application of keratoprosthesis remains a blank. Although keratoprosthesis and corneal collagen cross-linking have been widely applied in Europe with satisfactory clinical efficacy, they are still under assessment by China Food and Drug Administration for approval of use.

  10. 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.

  11. 21 CFR 886.4070 - Powered corneal burr.

    Science.gov (United States)

    2010-04-01

    ...) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4070 Powered corneal burr. (a) Identification. A powered corneal burr is an AC-powered or battery-powered device that is a motor and drilling tool intended to remove rust rings from the cornea of the eye. (b) Classification. Class I (general controls). When...

  12. Comparative analysis of corneal morphological changes after transversal and torsional phacoemulsification through 2.2 mm corneal incision.

    Science.gov (United States)

    Assaf, Ahmed; Roshdy, Maged Maher

    2013-01-01

    This paper compares and evaluates the corneal morphological changes occurring after cataract surgery through a 2.2 mm corneal incision. We use two platforms for comparison and evaluation, transversal and torsional phacoemulsification. This study includes 139 consecutive cataractous eyes (nuclear color 2-4, according to the Lens Opacities Classification System III [LOCSIII]) of 82 patients undergoing cataract surgery through a 2.2 mm corneal incision. Two different phacoemulsification platforms were used and assigned randomly: we used the WhiteStar Signature(®) system with the Ellips™ FX transversal continuous ultrasound (US) mode for group I (mean age: 65.33 ± 6.97 years), and we used the Infiniti(®) system with the OZil(®) Intelligent Phaco (IP) torsional US mode for group II (mean age: 64.02 ± 7.55 years). The corneal endothelium and pachymetry were evaluated preoperatively and at 1 month postoperatively. Incision size changes were also evaluated. All surgeries were uneventful. Before intraocular lens implantation, the mean incision size was 2.24 ± 0.06 mm in both groups (P = 0.75). In terms of corneal endothelial cell density, neither preoperative (I vs II: 2304.1 ± 122.5 cell/mm(2) vs 2315.6 ± 83.1 cell/mm(2), P = 0.80) nor postoperative (I vs II: 2264.1 ± 124.3 cell/mm(2) vs 2270.3 ± 89.9 cell/mm(2), P = 0.98) differences between the groups were statistically significant. The mean endothelial cell density loss was 1.7% ± 1.6% and 2.0% ± 1.4% in groups I and II, respectively. Furthermore, no significant differences between groups I and II were found preoperatively (P = 0.40) and postoperatively (P = 0.68) in central pachymetry. With surgery, the mean increase in central pachymetry was 28.1 ± 23.6 μm and 24.0 ± 24.0 μm in groups I and II, respectively (P = 0.1). Ellips™ FX transversal and OZil(®) IP torsional phacoemulsification modes are safe for performing cataract surgery, inducing minimal corneal thickness and endothelial changes.

  13. Topical administration of orbital fat-derived stem cells promotes corneal tissue regeneration.

    Science.gov (United States)

    Lin, Ko-Jo; Loi, Mei-Xue; Lien, Gi-Shih; Cheng, Chieh-Feng; Pao, Hsiang-Yin; Chang, Yun-Chuang; Ji, Andrea Tung-Qian; Ho, Jennifer Hui-Chun

    2013-06-14

    Topical administration of eye drops is the major route for drug delivery to the cornea. Orbital fat-derived stem cells (OFSCs) possess an in vitro corneal epithelial differentiation capacity. Both the safety and immunomodulatory ability of systemic OFSC transplantation were demonstrated in our previous work. In this study, we investigated the safety, therapeutic effect, and mechanism(s) of topical OFSC administration in an extensive alkali-induced corneal wound. Corneal injury was created by contact of a piece of 0.5 N NaOH-containing filter paper on the corneal surface of a male Balb/c mouse for 30 s. The area of the filter paper covered the central 70% or 100% of the corneal surface. OFSCs (2 × 10(5)) in 5 μl phosphate-buffered saline (PBS) were given by topical administration (T) twice a day or by two intralimbal (IL) injections in the right cornea, while 5 μl of PBS in the left cornea served as the control. Topical OFSCs promoted corneal re-epithelialization of both the limbal-sparing and limbal-involved corneal wounds. In the first three days, topical OFSCs significantly reduced alkali-induced corneal edema and stromal infiltration according to a histopathological examination. Immunohistochemistry and immunofluorescence staining revealed that transplanted cells were easily detectable in the corneal epithelium, limbal epithelium and stroma, but only some of transplanted cells at the limbal epithelium had differentiated into cytokeratin 3-expressing cells. OFSCs did not alter neutrophil (Ly6G) levels in the cornea, but significantly reduced macrophage (CD68) infiltration and inducible nitrous oxide synthetase (iNOS) production during acute corneal injury as quantified by a Western blot analysis. Continuous topical administration of OFSCs for seven days improved corneal transparency, and this was accompanied by diffuse stromal engraftment of transplanted cells and differentiation into p63-expressing cells at the limbal area. The therapeutic effect of the

  14. Topical administration of orbital fat-derived stem cells promotes corneal tissue regeneration

    Science.gov (United States)

    2013-01-01

    Introduction Topical administration of eye drops is the major route for drug delivery to the cornea. Orbital fat-derived stem cells (OFSCs) possess an in vitro corneal epithelial differentiation capacity. Both the safety and immunomodulatory ability of systemic OFSC transplantation were demonstrated in our previous work. In this study, we investigated the safety, therapeutic effect, and mechanism(s) of topical OFSC administration in an extensive alkali-induced corneal wound. Methods Corneal injury was created by contact of a piece of 0.5 N NaOH-containing filter paper on the corneal surface of a male Balb/c mouse for 30 s. The area of the filter paper covered the central 70% or 100% of the corneal surface. OFSCs (2 × 105) in 5 μl phosphate-buffered saline (PBS) were given by topical administration (T) twice a day or by two intralimbal (IL) injections in the right cornea, while 5 μl of PBS in the left cornea served as the control. Results Topical OFSCs promoted corneal re-epithelialization of both the limbal-sparing and limbal-involved corneal wounds. In the first three days, topical OFSCs significantly reduced alkali-induced corneal edema and stromal infiltration according to a histopathological examination. Immunohistochemistry and immunofluorescence staining revealed that transplanted cells were easily detectable in the corneal epithelium, limbal epithelium and stroma, but only some of transplanted cells at the limbal epithelium had differentiated into cytokeratin 3-expressing cells. OFSCs did not alter neutrophil (Ly6G) levels in the cornea, but significantly reduced macrophage (CD68) infiltration and inducible nitrous oxide synthetase (iNOS) production during acute corneal injury as quantified by a Western blot analysis. Continuous topical administration of OFSCs for seven days improved corneal transparency, and this was accompanied by diffuse stromal engraftment of transplanted cells and differentiation into p63-expressing cells at the limbal area. The

  15. The Correlation Analysis between Corneal Biomechanical Properties and the Surgically Induced Corneal High-Order Aberrations after Small Incision Lenticule Extraction and Femtosecond Laser In Situ Keratomileusis

    Directory of Open Access Journals (Sweden)

    Wenjing Wu

    2015-01-01

    Full Text Available Background. To investigate the correlation between corneal biomechanics and the surgically induced corneal high-order aberrations (HOAs after small incision lenticule extraction (SMILE and femtosecond laser in situ keratomileusis (FS-LASIK. Methods. A total of 150 right myopic eyes that underwent SMILE or FS-LASIK surgery were included in this retrospective study, 75 eyes in each group. The corneal hysteresis (CH and the corneal resistance factor (CRF with the corneal HOAs of the anterior, posterior, and total cornea were assessed preoperatively and three months postoperatively. Multivariate linear regression was applied to determine the correlations. Results. The preoperative CRF was significantly correlated with the induced 3rd–6th-order HOAs and spherical aberration of the anterior surface and the total cornea after SMILE and FS-LASIK surgeries (P<0.05, postoperatively. The CRF was significantly correlated with the induced vertical coma of the anterior and posterior surfaces and the total cornea after SMILE surgery (P<0.05. There was a significant correlation between the CRF and the induced posterior corneal horizontal coma after FS-LASIK surgery (P=0.013. Conclusions. The corneal biomechanics affect the surgically induced corneal HOAs after SMILE and FS-LASIK surgery, which may be meaningful for screening the patients preoperatively and optimizing the visual qualities postoperatively.

  16. Corneal graft reversal: Histopathologic report of two cases

    OpenAIRE

    Qahtani, Abdullah A.; Alkatan, Hind M.

    2014-01-01

    Graft reversal is a rare cause for failed PKP. In this case report we are presenting 2 graft failure cases in which the corneal grafts were reversed unintentionally. The onset of signs of graft failure, however was variable. We have included their clinical course and the histopathologic findings of the removed corneal grafts. A total of 6 cases including ours have been reported so far. The aim of this report is to attract the attention of corneal surgeons to an additional rare cause for faile...

  17. Contact lens rehabilitation following repaired corneal perforations

    Science.gov (United States)

    Titiyal, Jeewan S; Sinha, Rajesh; Sharma, Namrata; Sreenivas, V; Vajpayee, Rasik B

    2006-01-01

    Background Visual outcome following repair of post-traumatic corneal perforation may not be optimal due to presence of irregular keratometric astigmatism. We performed a study to evaluate and compare rigid gas permeable contact lens and spectacles in visual rehabilitation following perforating corneal injuries. Method Eyes that had undergone repair for corneal perforating injuries with or without lens aspiration were fitted rigid gas permeable contact lenses. The fitting pattern and the improvement in visual acuity by contact lens over spectacle correction were noted. Results Forty eyes of 40 patients that had undergone surgical repair of posttraumatic corneal perforations were fitted rigid gas permeable contact lenses for visual rehabilitation. Twenty-four eyes (60%) required aphakic contact lenses. The best corrected visual acuity (BCVA) of ≥ 6/18 in the snellen's acuity chart was seen in 10 (25%) eyes with spectacle correction and 37 (92.5%) eyes with the use of contact lens (p < 0.001). The best-corrected visual acuity with spectacles was 0.20 ± 0.13 while the same with contact lens was 0.58 ± 0.26. All the patients showed an improvement of ≥ 2 lines over spectacles in the snellen's acuity chart with contact lens. Conclusion Rigid gas permeable contact lenses are better means of rehabilitation in eyes that have an irregular cornea due to scars caused by perforating corneal injuries. PMID:16536877

  18. 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.

  19. Clinical correlates of common corneal neovascular diseases:a literature review

    Directory of Open Access Journals (Sweden)

    Nizar Saleh Abdelfattah

    2015-02-01

    Full Text Available A large subset of corneal pathologies involves the formation of new blood and lymph vessels (neovascularization, leading to compromised visual acuity. This article aims to review the clinical causes and presentations of corneal neovascularization (CNV by examining the mechanisms behind common CNV-related corneal pathologies, with a particular focus on herpes simplex stromal keratitis, contact lenses-induced keratitis and CNV secondary to keratoplasty. Moreover, we reviewed CNV in the context of different types of corneal transplantation and keratoprosthesis, and summarized the most relevant treatments available so far.

  20. The Steroids for Corneal Ulcers Trial

    Science.gov (United States)

    Srinivasan, Muthiah; Mascarenhas, Jeena; Rajaraman, Revathi; Ravindran, Meenakshi; Lalitha, Prajna; Glidden, David V.; Ray, Kathryn J.; Hong, Kevin C.; Oldenburg, Catherine E.; Lee, Salena M.; Zegans, Michael E.; McLeod, Stephen D.; Lietman, Thomas M.; Acharya, Nisha R.

    2013-01-01

    Objectives To provide comprehensive trial methods and baseline data for the Steroids for Corneal Ulcers Trial and to present epidemiological characteristics such as risk factors, causative organisms, and ulcer severity. Methods Baseline data from a 1:1 randomized, placebo-controlled, double-masked clinical trial comparing prednisolone phosphate, 1%, with placebo as adjunctive therapy for the treatment of bacterial corneal ulcers. Eligible patients had a culture-positive bacterial corneal ulcer and had been taking moxifloxacin for 48 hours. The primary outcome for the trial is best spectacle-corrected visual acuity at 3 months from enrollment. This report provides comprehensive baseline data, including best spectacle-corrected visual acuity, infiltrate size, microbio-logical results, and patient demographics, for patients enrolled in the trial. Results Of 500 patients enrolled, 97% were in India. Two hundred twenty patients (44%) were agricultural workers. Median baseline visual acuity was 0.84 logMAR (Snellen, 20/125) (interquartile range, 0.36-1.7; Snellen, 20/50 to counting fingers). Baseline visual acuity was not significantly different between the United States and India. Ulcers in India had larger infiltrate/scar sizes (P=.04) and deeper infiltrates (P=.04) and were more likely to be localized centrally (P=.002) than ulcers enrolled in the United States. Gram-positive bacteria were the most common organisms isolated from the ulcers (n=366, 72%). Conclusions The Steroids for Corneal Ulcers Trial will compare the use of a topical corticosteroid with placebo as adjunctive therapy for bacterial corneal ulcers. Patients enrolled in this trial had diverse ulcer severity and on average significantly reduced visual acuity at presentation. PMID:21987581

  1. Corneal graft reversal: Histopathologic report of two cases.

    Science.gov (United States)

    Qahtani, Abdullah A; Alkatan, Hind M

    2014-10-01

    Graft reversal is a rare cause for failed PKP. In this case report we are presenting 2 graft failure cases in which the corneal grafts were reversed unintentionally. The onset of signs of graft failure, however was variable. We have included their clinical course and the histopathologic findings of the removed corneal grafts. A total of 6 cases including ours have been reported so far. The aim of this report is to attract the attention of corneal surgeons to an additional rare cause for failed penetrating keratoplasty (PKP) which is donor graft reversal.

  2. Fluorouracil as a treatment for corneal papilloma in a Malayan tapir.

    Science.gov (United States)

    Karpinski, Lorraine G; Miller, Christine L

    2002-09-01

    A 26-year-old, wild caught, male Malayan tapir at the Miami Metrozoo with bilateral corneal papillomas was serially immobilized and given subconjunctival injections of fluorouracil. Over the course of 17 weeks five bilateral injections of 25 mg fluorouracil were given. This treatment caused regression of the corneal lesions as evidenced by decreased lesion diameter, decreased corneal vascularity, increased corneal clarity, and improved visual function. No adverse drug effects were observed.

  3. Evaluation of corneal higher order aberrations in normal topographic patterns

    Directory of Open Access Journals (Sweden)

    Ali Mirzajani

    2016-06-01

    Conclusions: Based on results in this study, there were a good correlation between corneal topographic pattern and corneal HOAs in normal eyes. These results indicate that the corneal HOAs values are largely determined by the topographic patterns. A larger sample size would perhaps have been beneficial to yield in more accurate outcomes.

  4. Algorithm for Correcting the Keratometric Error in the Estimation of the Corneal Power in Keratoconus Eyes after Accelerated Corneal Collagen Crosslinking

    Directory of Open Access Journals (Sweden)

    David P. Piñero

    2017-01-01

    Full Text Available Purpose. To analyze the errors associated to corneal power calculation using the keratometric approach in keratoconus eyes after accelerated corneal collagen crosslinking (CXL surgery and to obtain a model for the estimation of an adjusted corneal refractive index nkadj minimizing such errors. Methods. Potential differences (ΔPc among keratometric (Pk and Gaussian corneal power (PcGauss were simulated. Three algorithms based on the use of nkadj for the estimation of an adjusted keratometric corneal power (Pkadj were developed. The agreement between Pk1.3375 (keratometric power using the keratometric index of 1.3375, PcGauss, and Pkadj was evaluated. The validity of the algorithm developed was investigated in 21 keratoconus eyes undergoing accelerated CXL. Results. Pk1.3375 overestimated corneal power between 0.3 and 3.2 D in theoretical simulations and between 0.8 and 2.9 D in the clinical study (ΔPc. Three linear equations were defined for nkadj to be used for different ranges of r1c. In the clinical study, differences between Pkadj and PcGauss did not exceed ±0.8 D nk=1.3375. No statistically significant differences were found between Pkadj and PcGauss (p>0.05 and Pk1.3375 and Pkadj (p<0.001. Conclusions. The use of the keratometric approach in keratoconus eyes after accelerated CXL can lead to significant clinical errors. These errors can be minimized with an adjusted keratometric approach.

  5. Ultraviolet induced lysosome activity in corneal epithelium

    International Nuclear Information System (INIS)

    Cullen, A.P.

    1980-01-01

    A 5.000 W Xe-Hg high pressure lamp and a double monochromator were used to produce a 3.3 nm half-bandpass ultraviolet radiation at 295 nm. Pigmented rabbit eyes were irradiated with radiant exposures from 140 Jm -2 to 10.000 Jm -2 and evaluated by slit-lamp biomicroscopy, light and electron microscopy. Corneal threshold (Hsub(c) was 200 Jm -2 and lens threshold (Hsub(L)) was 7.500 Jm -2 . The most repeatable and reliable corneal response to these levels of UV was the development of corneal epithelial granules. Histological changes included a loss of superficial epithelial cells and selective UV induced autolysis of the wing cells. It is suggested that the biomicroscopically observed granules are the clinical manifestation of the secondary lysosomes revealed by light and electron microscopy. It is proposed that UV breaks down the primary lysosome membranes to release hydrolytic enzymes which in turn form the secondary lysosomes during autolysis. Extreme levels of radiant exposure at 295 nm result in indiscriminate destruction of all layers of the corneal epithelium, but the posterior cornea was spared. (orig.) [de

  6. Alteraciones corneales en pacientes diabéticos

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    Iraisi Hormigó Puertas

    Full Text Available La diabetes mellitus, afección frecuente a nivel mundial, tiene gran impacto en la sociedad no solo por su alta prevalencia, sino por sus complicaciones crónicas y su alta mortalidad. Afecta a unos 180 millones de personas en el mundo. La prevalencia de la diabetes (tipos I y II se estima en el 13 % en pacientes mayores de 60 años. La estructura corneal sufre modificaciones en los pacientes diabéticos; la hiperglucemia afecta la hidratación de la córnea, y con esto varía el espesor corneal y aparecen cambios queratométricos visibles mediante topografía corneal. Las córneas de los pacientes con diabetes presentan alteraciones epiteliales, estromales y endoteliales. Además, existe una disminución de la permeabilidad endotelial durante la fase de hipoxia, que relacionan estos efectos de la diabetes en las células endoteliales. El objetivo de nuestro estudio es abordar las diferentes alteraciones corneales en los pacientes diabéticos.

  7. Effect of Viscous Agents on Corneal Density in Dry Eye Disease.

    Science.gov (United States)

    Wegener, Alfred R; Meyer, Linda M; Schönfeld, Carl-Ludwig

    2015-10-01

    To investigate the effect of the viscous agents, hydroxypropyl methylcellulose (HPMC), carbomer, povidone, and a combination of HPMC and povidone on corneal density in patients with dry eye disease. In total, 98 eyes of 49 patients suffering from dry eye and 65 eyes of 33 healthy age-matched individuals were included in this prospective, randomized study. Corneal morphology was documented with Scheimpflug photography and corneal density was analyzed in 5 anatomical layers (epithelium, bowman membrane, stroma, descemet's membrane, and endothelium). Corneal density was evaluated for the active ingredients HPMC, carbomer, povidone, and a combination of HPMC and povidone as the viscous agents contained in the artificial tear formulations used by the dry eye patients. Data were compared to the age-matched healthy control group without medication. Corneal density in dry eye patients was reduced in all 5 anatomical layers compared to controls. Corneal density was highest and very close to control in patients treated with HPMC containing ocular lubricants. Patients treated with lubricants, including carbomer as the viscous agent displayed a significant reduction of corneal density in layers 1 and 2 compared to control. HPMC containing ocular lubricants can help to maintain physiological corneal density and may be beneficial in the treatment of dry eye disease.

  8. Healed corneal ulcer with keloid formation

    OpenAIRE

    Alkatan, Hind M.; Al-Arfaj, Khalid M.; Hantera, Mohammed; Al-Kharashi, Soliman

    2012-01-01

    We are reporting a 34-year-old Arabic white female patient who presented with a white mass covering her left cornea following multiple ocular surgeries and healed corneal ulcer. The lesion obscured further view of the iris, pupil and lens. The patient underwent penetrating keratoplasty and the histopathologic study of the left corneal button showed epithelial hyperplasia, absent Bowman’s layer and subepithelial fibrovascular proliferation. The histopathologic appearance was suggestive of a co...

  9. Corneal thickness changes during corneal collagen cross-linking with UV-A irradiation and hypo-osmolar riboflavin in thin corneas

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    Belquiz Amaral Nassaralla

    2013-06-01

    Full Text Available PURPOSE: To evaluate the thinnest corneal thickness changes during and after corneal collagen cross-linking treatment with ultraviolet-A irradiation, using hypo-osmolar riboflavin solution in thin corneas. METHODS: Eighteen eyes of 18 patients were included in this study. After epithelium removal, iso-osmolar 0.1% riboflavin solution was instilled to the cornea every 3 minutes for 30 minutes. Hypo-osmolar 0.1% riboflavin solution was then applied every 20 seconds for 5 minutes or until the thinnest corneal thickness reached 400 µm. Ultraviolet-A irradiation was performed for 30 minutes. During irradiation, iso-osmolar 0.1% riboflavin drops were applied every 5 minutes. Ultrasound pachymetry was performed at approximately the thinnest point of the cornea preoperatively, after epithelial removal, after iso-osmolar riboflavin instillation, after hypo-osmolar riboflavin instillation, after ultraviolet-A irradiation, and at 1, 6 and 12 months after treatment. RESULTS: Mean preoperative thinnest corneal thickness was 380 ± 11 µm. After epithelial removal it decreased to 341 ± 11 µm, and after 30 minutes of iso-osmolar 0.1% riboflavin drops, to 330 ± 7.6 µm. After hypo-osmolar 0.1% riboflavin drops, mean thinnest corneal thickness increased to 418 ± 11 µm. After UVA irradiation, it was 384 ± 10 µm. At 1, 6 and 12 months after treatment, it was 372 ± 10 µm, 381 ± 12.7, and 379 ± 15 µm, respectively. No intraoperative, early postoperative, or late postoperative complications were noted. CONCLUSIONS: Hypo-osmolar 0.1% riboflavin solution seems to be effective for swelling thin corneas. The swelling effect is transient and short acting. Corneal thickness should be monitored throughout the procedure. Larger sample sizes and longer follow-up are required in order to make meaningful conclusions regarding safety.

  10. CD147 required for corneal endothelial lactate transport.

    Science.gov (United States)

    Li, Shimin; Nguyen, Tracy T; Bonanno, Joseph A

    2014-06-26

    CD147/basigin is a chaperone for lactate:H(+) cotransporters (monocarboxylate transporters) MCT1 and MCT4. We tested the hypothesis that MCT1 and -4 in corneal endothelium contribute to lactate efflux from stroma to anterior chamber and that silencing CD147 expression would cause corneal edema. CD147 was silenced via small interfering ribonucleic acid (siRNA) transfection of rabbit corneas ex vivo and anterior chamber lenti-small hairpin RNA (shRNA) pseudovirus in vivo. CD147 and MCT expression was examined by Western blot, RT-PCR, and immunofluorescence. Functional effects were examined by measuring lactate-induced cell acidification, corneal lactate efflux, [lactate], central cornea thickness (CCT), and Azopt (a carbonic anhydrase inhibitor) sensitivity. In ex vivo corneas, 100 nM CD147 siRNA reduced CD147, MCT1, and MCT4 expression by 85%, 79%, and 73%, respectively, while MCT2 expression was unaffected. CD147 siRNA decreased lactate efflux from 3.9 ± 0.81 to 1.5 ± 0.37 nmol/min, increased corneal [lactate] from 19.28 ± 7.15 to 56.73 ± 8.97 nmol/mg, acidified endothelial cells (pHi = 6.83 ± 0.07 vs. 7.19 ± 0.09 in control), and slowed basolateral lactate-induced acidification from 0.0034 ± 0.0005 to 0.0012 ± 0.0005 pH/s, whereas apical acidification was unchanged. In vivo, CD147 shRNA increased CCT by 28.1 ± 0.9 μm at 28 days; Azopt increased CCT to 24.4 ± 3.12 vs. 12.0 ± 0.48 μm in control, and corneal [lactate] was 47.63 ± 6.29 nmol/mg in shCD147 corneas and 17.82 ± 4.93 nmol/mg in paired controls. CD147 is required for the expression of MCT1 and MCT4 in the corneal endothelium. Silencing CD147 slows lactate efflux, resulting in stromal lactate accumulation and corneal edema, consistent with lactate efflux as a significant component of the corneal endothelial pump. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

  11. Case Report: Corneal Pyogenic Granuloma: Rare Complication of ...

    African Journals Online (AJOL)

    Slit lamp examination showed vascularized central corneal mass with surrounding stromal infiltrates. The mass was excised, and histopathological examination confirmed pyogenic granuloma of the cornea. Conclusion: Corneal pyogenic granuloma could be a rare complication of infectious keratitis. Therefore, it should be ...

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

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    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.

  13. Alternatives to eye bank native tissue for corneal stromal replacement.

    Science.gov (United States)

    Brunette, Isabelle; Roberts, Cynthia J; Vidal, François; Harissi-Dagher, Mona; Lachaine, Jean; Sheardown, Heather; Durr, Georges M; Proulx, Stéphanie; Griffith, May

    2017-07-01

    Corneal blindness is a major cause of blindness in the world and corneal transplantation is the only widely accepted treatment to restore sight in these eyes. However, it is becoming increasingly difficult for eye banks to meet the increasing demand for transplantable tissue, which is in part due to population aging. Donor tissue shortage is therefore a growing concern globally and there is a need for alternatives to human donor corneas. Biosynthetic corneal substitutes offer several significant advantages over native corneas: Large-scale production offers a powerful potential solution to the severe shortage of human donor corneas worldwide; Good manufacturing practices ensure sterility and quality control; Acellular corneal substitutes circumvent immune rejection induced by allogeneic cells; Optical and biomechanical properties of the implants can be adapted to the clinical need; and finally these corneal substitutes could benefit from new advances in biomaterials science, such as surface coating, functionalization and nanoparticles. This review highlights critical contributions from laboratories working on corneal stromal substitutes. It focuses on synthetic inert prostheses (keratoprostheses), acellular scaffolds with and without enhancement of endogenous regeneration, and cell-based replacements. Accent is put on the physical properties and biocompatibility of these biomaterials, on the functional and clinical outcome once transplanted in vivo in animal or human eyes, as well as on the main challenges of corneal stromal replacement. Regulatory and economic aspects are also discussed. All of these perspectives combined highlight the founding principles of the clinical application of corneal stromal replacement, a concept that has now become reality. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Excimer laser corneal surgery and free oxygen radicals.

    Science.gov (United States)

    Bilgihan, K; Bilgihan, A; Akata, F; Hasanreisoğlu, B; Türközkan, N

    1996-01-01

    Corneal photoablation with 193 nm argon fluoride excimer laser is a new technique for the treatment of refractive errors and for removing corneal opacities and irregularities. Ultraviolet radiation and thermal injury induce free radical formation in the tissues. The aim of this study was to confirm the production of free radicals by excimer laser photoablation in rabbits. The thermal changes of the posterior corneal surface were recorded during excimer laser photoablation. The lipid peroxide (LPO) levels and superoxide dismutase (SOD) activities of aqueous humour were measured after excimer laser keratectomy. The aqueous LPO levels were not changed after excimer laser ablation, but both the thermal increase in the cornea during the photoablation and the decreased aqueous SOD activities suggest that free radicals are formed in the cornea during excimer laser keratectomy, and that they may be responsible for some of the complications of excimer laser corneal surgery.

  15. Distrofia corneal granular

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    Alexeide de la C Castillo Pérez

    Full Text Available Las distrofias corneales constituyen un conjunto de enfermedades que presentan, en su mayoría, una baja incidencia y se caracterizan por acúmulo de material hialino o amiloide que disminuyen la transparencia corneal. La distrofia granular es una enfermedad autosómica dominante que presenta opacidades grises en el estroma superficial central de la córnea y se hacen visibles en la primera y segunda décadas de la vida, lo que provoca disminución de la visión más significativa cerca de los 40 años de edad. Presentamos dos casos clínicos de distrofia granular en pacientes hermanos de diferentes sexos, quienes acudieron a la consulta y refirieron visión nublada. El estudio de la historia familiar nos ayuda en el correcto diagnóstico y la biomicroscopia constituye el elemento más importante.

  16. The theory and art of corneal cross-linking.

    Science.gov (United States)

    McQuaid, Rebecca; Cummings, Arthur B; Mrochen, Michael

    2013-08-01

    Before the discovery of corneal cross-linking (CXL), patients with keratoconus would have had to undergo corneal transplantation, or wear rigid gas permeable lenses (RGPs) that would temporarily flatten the cone, thereby improving the vision. The RGP contact lens (CL) would not however alter the corneal stability and if the keratoconus was progressive, the continued steepening of the cone would occur under the RGP CL. To date, the Siena Eye has been the largest study to investigate long term effects of standard CXL. Three hundred and sixty-three eyes were treated and monitored over 4 years, producing reliable long-term results proving long-term stability of the cornea by halting the progression of keratoconus, and proving the safety of the procedure. Traditionally, CXL requires epithelial removal prior to corneal soakage of a dextran-based 0.1% riboflavin solution, followed by exposure of ultraviolet-A (UV-A) light for 30 min with an intensity of 3 mW/cm2. A series of in vitro investigations on human and porcine corneas examined the best treatment parameters for standard CXL, such as riboflavin concentration, intensity, wavelength of UV-A light, and duration of treatment. Photochemically, CXL is achieved by the generation of chemical bonds within the corneal stroma through localized photopolymerization, strengthening the cornea whilst minimizing exposure to the surrounding structures of the eye. In vitro studies have shown that CXL has an effect on the biomechanical properties of the cornea, with an increased corneal rigidity of approximately 70%. This is a result of the creation of new chemical bonds within the stroma.

  17. Comparison of parametric methods for modeling corneal surfaces

    Science.gov (United States)

    Bouazizi, Hala; Brunette, Isabelle; Meunier, Jean

    2017-02-01

    Corneal topography is a medical imaging technique to get the 3D shape of the cornea as a set of 3D points of its anterior and posterior surfaces. From these data, topographic maps can be derived to assist the ophthalmologist in the diagnosis of disorders. In this paper, we compare three different mathematical parametric representations of the corneal surfaces leastsquares fitted to the data provided by corneal topography. The parameters obtained from these models reduce the dimensionality of the data from several thousand 3D points to only a few parameters and could eventually be useful for diagnosis, biometry, implant design etc. The first representation is based on Zernike polynomials that are commonly used in optics. A variant of these polynomials, named Bhatia-Wolf will also be investigated. These two sets of polynomials are defined over a circular domain which is convenient to model the elevation (height) of the corneal surface. The third representation uses Spherical Harmonics that are particularly well suited for nearly-spherical object modeling, which is the case for cornea. We compared the three methods using the following three criteria: the root-mean-square error (RMSE), the number of parameters and the visual accuracy of the reconstructed topographic maps. A large dataset of more than 2000 corneal topographies was used. Our results showed that Spherical Harmonics were superior with a RMSE mean lower than 2.5 microns with 36 coefficients (order 5) for normal corneas and lower than 5 microns for two diseases affecting the corneal shapes: keratoconus and Fuchs' dystrophy.

  18. Unilateral corneal leukoplakia without limbal involvement

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    Hirano K

    2015-05-01

    Full Text Available Koji Hirano,1 Mihoko Koide,2 Yoshikazu Mizoguchi,3 Yasuhiro Osakabe,4 Kaoru-Araki Sasaki5 1Department of Ophthalmology, Ban Buntane Hotokukai Hospital, School of Medicine, Fujita Health University, Nagoya, Japan; 2Koide Internal Medicine and Eye Clinic, Nagoya, Japan; 3Department of Pathology, Ban Buntane Hotokukai Hospital, School of Medicine, Fujita Health University, Nagoya, Japan; 4Department of Molecular Pathology, Tokyo Medical University, Tokyo, Japan; 5Department of Ophthalmology, Japan Health Care Organization, Hoshigaoka Medical Center, Hirakata, Japan Purpose: Leukoplakia is the term given to a white patch or plaque that is found mainly on the oral mucus membrane. It can occasionally be seen on the corneal surface. We report our clinical and histopathological findings in a case of unilateral corneal leukoplakia. Methods: A 26-year-old woman was referred to our hospital because of a white patch on her right cornea that continued to expand. She first noticed the white patch when she was 20 years old, and the white patch had expanded to cover the pupillary area affecting her vision. After plastic surgery on both eyelids for bilateral entropion to alleviate the pain caused by the eyelashes rubbing the cornea, the white corneal patch decreased in size. Because of this reduction, we performed surgery to remove the patch with microforceps under topical anesthesia. The plaque was removed easily and completely, and submitted for histopathological examination. Results: Histopathological examination showed that the specimen had characteristics of epidermis with a basal cell layer, spinous cell layer, granular cell layer, and horny layer with hyperkeratosis. She was diagnosed with leukoplakia of the corneal surface. The basic structure of the squamous cell layer was preserved, and there were no signs of metaplasia. Six months after the removal of the leukoplakia, no recurrence was seen and her corrected decimal visual acuity recovered to 1

  19. Influence of eye biometrics and corneal micro-structure on noncontact tonometry.

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    Danilo A Jesus

    Full Text Available Tonometry is widely used as the main screening tool supporting glaucoma diagnosis. Still, its accuracy could be improved if full knowledge about the variation of the corneal biomechanical properties was available. In this study, Optical Coherence Tomography (OCT speckle statistics are used to infer the organisation of the corneal micro-structure and hence, to analyse its influence on intraocular pressure (IOP measurements.Fifty-six subjects were recruited for this prospective study. Macro and micro-structural corneal parameters as well as subject age were considered. Macro-structural analysis included the parameters that are associated with the ocular anatomy, such as central corneal thickness (CCT, corneal radius, axial length, anterior chamber depth and white-to-white corneal diameter. Micro-structural parameters which included OCT speckle statistics were related to the internal organisation of the corneal tissue and its physiological changes during lifetime. The corneal speckle obtained from OCT was modelled with the Generalised Gamma (GG distribution that is characterised with a scale parameter and two shape parameters.In macro-structure analysis, only CCT showed a statistically significant correlation with IOP (R2 = 0.25, p<0.001. The scale parameter and the ratio of the shape parameters of GG distribution showed statistically significant correlation with IOP (R2 = 0.19, p<0.001 and R2 = 0.17, p<0.001, respectively. For the studied group, a weak, although significant correlation was found between age and IOP (R2 = 0.053, p = 0.04. Forward stepwise regression showed that CCT and the scale parameter of the Generalised Gamma distribution can be combined in a regression model (R2 = 0.39, p<0.001 to study the role of the corneal structure on IOP.We show, for the first time, that corneal micro-structure influences the IOP measurements obtained from noncontact tonometry. OCT speckle statistics can be employed to learn about the corneal micro

  20. Influence of eye biometrics and corneal micro-structure on noncontact tonometry.

    Science.gov (United States)

    Jesus, Danilo A; Majewska, Małgorzata; Krzyżanowska-Berkowska, Patrycja; Iskander, D Robert

    2017-01-01

    Tonometry is widely used as the main screening tool supporting glaucoma diagnosis. Still, its accuracy could be improved if full knowledge about the variation of the corneal biomechanical properties was available. In this study, Optical Coherence Tomography (OCT) speckle statistics are used to infer the organisation of the corneal micro-structure and hence, to analyse its influence on intraocular pressure (IOP) measurements. Fifty-six subjects were recruited for this prospective study. Macro and micro-structural corneal parameters as well as subject age were considered. Macro-structural analysis included the parameters that are associated with the ocular anatomy, such as central corneal thickness (CCT), corneal radius, axial length, anterior chamber depth and white-to-white corneal diameter. Micro-structural parameters which included OCT speckle statistics were related to the internal organisation of the corneal tissue and its physiological changes during lifetime. The corneal speckle obtained from OCT was modelled with the Generalised Gamma (GG) distribution that is characterised with a scale parameter and two shape parameters. In macro-structure analysis, only CCT showed a statistically significant correlation with IOP (R2 = 0.25, p<0.001). The scale parameter and the ratio of the shape parameters of GG distribution showed statistically significant correlation with IOP (R2 = 0.19, p<0.001 and R2 = 0.17, p<0.001, respectively). For the studied group, a weak, although significant correlation was found between age and IOP (R2 = 0.053, p = 0.04). Forward stepwise regression showed that CCT and the scale parameter of the Generalised Gamma distribution can be combined in a regression model (R2 = 0.39, p<0.001) to study the role of the corneal structure on IOP. We show, for the first time, that corneal micro-structure influences the IOP measurements obtained from noncontact tonometry. OCT speckle statistics can be employed to learn about the corneal micro-structure and

  1. Successful transplantation of in vitro expanded human corneal endothelial precursors to corneal endothelial surface using a nanocomposite sheet

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    Parikumar P

    2011-01-01

    Full Text Available Background: Though the transplantation of in vitro expanded human corneal endothelial precursors in animal models of endothelial damage by injecting into the anterior chamber has been reported, the practical difficulties of accomplishing such procedure in human patients have been a hurdle to clinical translation. Here we report the successful transplantation of in vitro expanded human corneal precursor cells to an animal eye using a transparent Nano-composite sheet and their engraftment.Materials and Methods: Human Corneal endothelial cells (HCEC were isolated from human cadaver eyes with informed consent and expanded in the lab using a sphere forming assay in a novel Thermoreversible Gelation Polymer (TGP for 26 days. HCEC obtained by sphere forming assay were seeded in a novel Nano-composite sheet, which was made of PNIPA-NC gels by in-situ, free-radical polymerization of NIPA monomer in the presence of exfoliated clay (synthetic hectorite “Laponite XLG” uniformly dispersed in aqueous media. After a further seven days in vitro culture of HCEC in the Nano-composite sheet, cells were harvested and transplanted on cadaver-bovine eyes (n=3. The cells were injected between the corneal endothelial layer and the Nano-composite sheet that had been placed prior to the injection in close proximity to the endothelial layer. After three hours, the transplanted Nano-composite sheets were removed from the bovine eyes and subjected to microscopic examination. The corneas were subjected to Histo-pathological studies along with controls. Results: HCEC formed sphere like colonies in TGP which expressed relevant markers as confirmed by RT-PCR. Microscopic studies of the Nanosheets and histopathological studies of the cornea of the Bull’s eye revealed that the HCEC got engrafted to the corneal endothelial layer of the bovine eyes with no remnant cells in the Nanosheet. Conclusion: Transplantation of in vitro expanded donor human corneal endothelial cells

  2. Corneal elastosis within lattice dystrophy lesions.

    Science.gov (United States)

    Pe'er, J; Fine, B S; Dixon, A; Rothberg, D S

    1988-01-01

    Corneal buttons of two patients with lattice corneal dystrophy were studied by light and electron microscopy. They showed elastotic degeneration within the amyloid deposits. The amyloid deposits displayed characteristic staining; the elastotic material (elastin) within the deposits stained positive with Verhoeff-van Gieson and Movat pentachrome stains and showed autofluorescence. The characteristic ultrastructural findings of amyloid and elastotic material were also demonstrated. The possibility of the associations of these two materials in the cornea is discussed. Images PMID:3258531

  3. Do topical antibiotics help corneal epithelial trauma?

    OpenAIRE

    King, J. W.; Brison, R. J.

    1993-01-01

    Topical antibiotics are routinely used in emergency rooms to treat corneal trauma, although no published evidence supports this treatment. In a noncomparative clinical trial, 351 patients with corneal epithelial injuries were treated without antibiotics. The infection rate was 0.7%, suggesting that such injuries can be safely and effectively managed without antibiotics. A comparative clinical trial is neither warranted nor feasible.

  4. Applications of biomaterials in corneal wound healing

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    I-Lun Tsai

    2015-04-01

    Full Text Available Disease affecting the cornea is a common cause of blindness worldwide. To date, the amniotic membrane (AM is the most widely used clinical method for cornea regeneration. However, donor-dependent differences in the AM may result in variable clinical outcomes. To overcome this issue, biomaterials are currently under investigation for corneal regeneration in vitro and in vivo. In this article, we highlight the recent advances in hydrogels, bioengineered prosthetic devices, contact lenses, and drug delivery systems for corneal regeneration. In clinical studies, the therapeutic effects of biomaterials, including fibrin and collagen-based hydrogels and silicone contact lenses, have been demonstrated in damaged cornea. The combination of cells and biomaterials may provide potential treatment in corneal wound healing in the future.

  5. Comparative analysis of corneal morphological changes after transversal and torsional phacoemulsification through 2.2 mm corneal incision

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    Assaf A

    2013-01-01

    Full Text Available Ahmed Assaf, Maged Maher RoshdyOphthalmology Department, Ain Shams University, Cairo, EgyptPurpose: This paper compares and evaluates the corneal morphological changes occurring after cataract surgery through a 2.2 mm corneal incision. We use two platforms for comparison and evaluation, transversal and torsional phacoemulsification.Patients and methods: This study includes 139 consecutive cataractous eyes (nuclear color 2–4, according to the Lens Opacities Classification System III [LOCSIII] of 82 patients undergoing cataract surgery through a 2.2 mm corneal incision. Two different phacoemulsification platforms were used and assigned randomly: we used the WhiteStar Signature® system with the Ellips™ FX transversal continuous ultrasound (US mode for group I (mean age: 65.33 ± 6.97 years, and we used the Infiniti® system with the OZil® Intelligent Phaco (IP torsional US mode for group II (mean age: 64.02 ± 7.55 years. The corneal endothelium and pachymetry were evaluated preoperatively and at 1 month postoperatively. Incision size changes were also evaluated.Results: All surgeries were uneventful. Before intraocular lens implantation, the mean incision size was 2.24 ± 0.06 mm in both groups (P = 0.75. In terms of corneal endothelial cell density, neither preoperative (I vs II: 2304.1 ± 122.5 cell/mm2 vs 2315.6 ± 83.1 cell/mm2, P = 0.80 nor postoperative (I vs II: 2264.1 ± 124.3 cell/mm2 vs 2270.3 ± 89.9 cell/mm2, P = 0.98 differences between the groups were statistically significant. The mean endothelial cell density loss was 1.7% ± 1.6% and 2.0% ± 1.4% in groups I and II, respectively. Furthermore, no significant differences between groups I and II were found preoperatively (P = 0.40 and postoperatively (P = 0.68 in central pachymetry. With surgery, the mean increase in central pachymetry was 28.1 ± 23.6 µm and 24.0 ± 24.0 µm in groups I and II, respectively (P = 0.1.Conclusion: Ellips™ FX transversal and OZil® IP torsional

  6. Inhibition of Corneal Neovascularization by Topical and Subconjunctival Tigecycline

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    Sertan Goktas

    2014-01-01

    Full Text Available Objective. To investigate the effects of topical and subconjunctival tigecycline on the prevention of corneal neovascularization. Materials and Methods. Following chemical burn, thirty-two rats were treated daily with topical instillation of 1 mg/mL tigecycline (group 1 or subconjunctival instillation of 1 mg/mL tigecycline (group 3 for 7 days. Control rats received topical (group 2 or subconjunctival (group 4 0.9% saline. Digital photographs of the cornea were taken on the eighth day after treatment and analyzed to determine the percentage area of the cornea covered by neovascularization. Corneal sections were analyzed histopathologically. Results. The median percentages of corneal neovascularization in groups 1 and 3 were 48% (95% confidence interval (CI, 44.2–55.8% and 33.5% (95% CI, 26.6–39.2%, respectively. The median percentages of corneal neovascularization of groups 1 and 3 were significantly lower than that of the control group (P=0.03 and P<0.001, resp.. Histologic examination of samples from groups 1 and 3 showed lower vascularity than that of control groups. Conclusion. Topical and subconjunctival administration of tigecycline seems to be showing promising therapeutic effects on the prevention of corneal neovascularization. Furthermore, subconjunctival administration of tigecycline is more potent than topical administration in the inhibition of corneal neovascularization.

  7. Thick keratoconic cornea associated with posterior polymorphous corneal dystrophy.

    Science.gov (United States)

    Zaarour, K; Slim, E; Antoun, J; Waked, N

    2017-03-01

    We herein report a case of bilateral unusually thick non-edematous keratoconic corneas with associated endothelial features of posterior polymorphous corneal dystrophy (PPCD). We report the case of a 27-year-old myopic woman who presented for refractive surgery. Slit lamp exam showed bilateral corneal protrusion with diffuse deep stromal and endothelial vesicular opacities and small paracentral bands. Topography showed generalized advanced corneal steepening in both eyes with increased anterior and posterior central corneal elevations in comparison to the best fit sphere. Ultrasound pachymetry showed central corneal thickness of 605μm (RE) and 612μm (LE). On specular biomicroscopy, cell density of 2503 cells/mm 2 RE and 1526 cells/mm 2 LE with significant cellular pleomorphism and polymegathism were noted. Clinical and paraclinical findings together suggest the presence of simultaneous keratoconus and PPCD. The literature has suggested an association between PPCD and steep cornea. Moreover, many reports have also described cases of associated PPCD and keratoconus with characteristic thinning and ectasia, in comparison to the unusual thick corneas noted in our patient, despite the absence of edema. Identification of genetics factors is further needed to clarify this association. This case describes a patient whose corneas present features of both keratoconus and PPCD and is unique due to the presence of increased corneal thickness despite the absence of edema. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  8. Influence of different phacoemulsification incision on postoperative corneal astigmatism for cataract patients

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    Zhao-Rong Zeng

    2014-05-01

    Full Text Available AIM: To compare the effect of different phacoemulsification incision on postoperative corneal astigmatism for cataract patients. METHODS: The cataract patients were selected in our hospital. The patients were divided into control group(corneal limbus opposite curved scleral tunnel incision groupand observation group(above the top of cornea or temporal transparent corneal incision grouprandomly. At 1wk; 1 and 3mo after surgery, the change of corneal astigmatism and vision of the patients in two groups were compared and analyzed. RESULTS:Compared with control group, 1wk; 1 and 3mo after surgery, the average corneal astigmatism and surgically induced corneal astigmatism of the patients in observation group were decreased significantly. The visual acuity and corrected visual acuity were increased significantly. There was statistically significant(PPCONCLUSION: Center distance and small incision corneal phacoemulsification can reduce postoperative astigmatism and improve postoperative visual acuity for cataract patients. It provides guarantee for further strengthen the clinical treated effect for cataract patients.

  9. An experimental model of mycobacterial infection under corneal flaps

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    C.B.D. Adan

    2004-07-01

    Full Text Available In order to develop a new experimental animal model of infection with Mycobacterium chelonae in keratomileusis, we conducted a double-blind prospective study on 24 adult male New Zealand rabbits. One eye of each rabbit was submitted to automatic lamellar keratotomy with the automatic corneal shaper under general anesthesia. Eyes were immunosuppressed by a single local injection of methyl prednisolone. Twelve animals were inoculated into the keratomileusis interface with 1 µl of 10(6 heat-inactivated bacteria (heat-inactivated inoculum controls and 12 with 1 µl of 10(6 live bacteria. Trimethoprim drops (0.1%, w/v were used as prophylaxis for the surgical procedure every 4 h (50 µl, qid. Animals were examined by 2 observers under a slit lamp on the 1st, 3rd, 5th, 7th, 11th, 16th, and 23rd postoperative days. Slit lamp photographs were taken to document clinical signs. Animals were sacrificed when corneal disease was detected and corneal samples were taken for microbiological analysis. Eleven of 12 experimental rabbits developed corneal disease, and M. chelonae could be isolated from nine rabbits. Eleven of the 12 controls receiving a heat-inactivated inoculum did not develop corneal disease. M. chelonae was not isolated from any of the control rabbits receiving a heat-inactivated inoculum, or from the healthy cornea of control rabbits. Corneal infection by M. chelonae was successfully induced in rabbits submitted to keratomileusis. To our knowledge, this is the first animal model of M. chelonae infection following corneal flaps for refractive surgery to be described in the literature and can be used for the analysis of therapeutic responses.

  10. The Favorable Effect of Mesenchymal Stem Cell Treatment on the Antioxidant Protective Mechanism in the Corneal Epithelium and Renewal of Corneal Optical Properties Changed after Alkali Burns

    Science.gov (United States)

    Cejka, Cestmir; Holan, Vladimir; Trosan, Peter; Zajicova, Alena; Javorkova, Eliska; Cejkova, Jitka

    2016-01-01

    The aim of this study was to examine whether mesenchymal stem cells (MSCs) and/or corneal limbal epithelial stem cells (LSCs) influence restoration of an antioxidant protective mechanism in the corneal epithelium and renewal of corneal optical properties changed after alkali burns. The injured rabbit corneas (with 0.25 N NaOH) were untreated or treated with nanofiber scaffolds free of stem cells, with nanofiber scaffolds seeded with bone marrow MSCs (BM-MSCs), with adipose tissue MSCs (Ad-MSCs), or with LSCs. On day 15 following the injury, after BM-MSCs or LSCs nanofiber treatment (less after Ad-MSCs treatment) the expression of antioxidant enzymes was restored in the regenerated corneal epithelium and the expressions of matrix metalloproteinase 9 (MMP9), inducible nitric oxide synthase (iNOS), α-smooth muscle actin (α-SMA), transforming growth factor-β1 (TGF-β1), and vascular endothelial factor (VEGF) were low. The central corneal thickness (taken as an index of corneal hydration) increased after the injury and returned to levels before the injury. In injured untreated corneas the epithelium was absent and numerous cells revealed the expressions of iNOS, MMP9, α-SMA, TGF-β1, and VEGF. In conclusion, stem cell treatment accelerated regeneration of the corneal epithelium, restored the antioxidant protective mechanism, and renewed corneal optical properties. PMID:27057279

  11. The Favorable Effect of Mesenchymal Stem Cell Treatment on the Antioxidant Protective Mechanism in the Corneal Epithelium and Renewal of Corneal Optical Properties Changed after Alkali Burns.

    Science.gov (United States)

    Cejka, Cestmir; Holan, Vladimir; Trosan, Peter; Zajicova, Alena; Javorkova, Eliska; Cejkova, Jitka

    2016-01-01

    The aim of this study was to examine whether mesenchymal stem cells (MSCs) and/or corneal limbal epithelial stem cells (LSCs) influence restoration of an antioxidant protective mechanism in the corneal epithelium and renewal of corneal optical properties changed after alkali burns. The injured rabbit corneas (with 0.25 N NaOH) were untreated or treated with nanofiber scaffolds free of stem cells, with nanofiber scaffolds seeded with bone marrow MSCs (BM-MSCs), with adipose tissue MSCs (Ad-MSCs), or with LSCs. On day 15 following the injury, after BM-MSCs or LSCs nanofiber treatment (less after Ad-MSCs treatment) the expression of antioxidant enzymes was restored in the regenerated corneal epithelium and the expressions of matrix metalloproteinase 9 (MMP9), inducible nitric oxide synthase (iNOS), α-smooth muscle actin (α-SMA), transforming growth factor-β1 (TGF-β1), and vascular endothelial factor (VEGF) were low. The central corneal thickness (taken as an index of corneal hydration) increased after the injury and returned to levels before the injury. In injured untreated corneas the epithelium was absent and numerous cells revealed the expressions of iNOS, MMP9, α-SMA, TGF-β1, and VEGF. In conclusion, stem cell treatment accelerated regeneration of the corneal epithelium, restored the antioxidant protective mechanism, and renewed corneal optical properties.

  12. The Favorable Effect of Mesenchymal Stem Cell Treatment on the Antioxidant Protective Mechanism in the Corneal Epithelium and Renewal of Corneal Optical Properties Changed after Alkali Burns

    Directory of Open Access Journals (Sweden)

    Cestmir Cejka

    2016-01-01

    Full Text Available The aim of this study was to examine whether mesenchymal stem cells (MSCs and/or corneal limbal epithelial stem cells (LSCs influence restoration of an antioxidant protective mechanism in the corneal epithelium and renewal of corneal optical properties changed after alkali burns. The injured rabbit corneas (with 0.25 N NaOH were untreated or treated with nanofiber scaffolds free of stem cells, with nanofiber scaffolds seeded with bone marrow MSCs (BM-MSCs, with adipose tissue MSCs (Ad-MSCs, or with LSCs. On day 15 following the injury, after BM-MSCs or LSCs nanofiber treatment (less after Ad-MSCs treatment the expression of antioxidant enzymes was restored in the regenerated corneal epithelium and the expressions of matrix metalloproteinase 9 (MMP9, inducible nitric oxide synthase (iNOS, α-smooth muscle actin (α-SMA, transforming growth factor-β1 (TGF-β1, and vascular endothelial factor (VEGF were low. The central corneal thickness (taken as an index of corneal hydration increased after the injury and returned to levels before the injury. In injured untreated corneas the epithelium was absent and numerous cells revealed the expressions of iNOS, MMP9, α-SMA, TGF-β1, and VEGF. In conclusion, stem cell treatment accelerated regeneration of the corneal epithelium, restored the antioxidant protective mechanism, and renewed corneal optical properties.

  13. Dynamic Corneal Surface Mapping with Electronic Speckle Pattern Interferometry

    Science.gov (United States)

    Iqbal, S.; Gualini, M. M. S.

    2013-06-01

    In view of the fast advancement in ophthalmic technology and corneal surgery, there is a strong need for the comprehensive mapping and characterization techniques for corneal surface. Optical methods with precision non-contact approaches have been found to be very useful for such bio measurements. Along with the normal mapping approaches, elasticity of corneal surface has an important role in its characterization and needs to be appropriately measured or estimated for broader diagnostics and better prospective surgical results, as it has important role in the post-op corneal surface reconstruction process. Use of normal corneal topographic devices is insufficient for any intricate analysis since these devices operate at relatively moderate resolution. In the given experiment, Pulsed Electronic Speckle Pattern Interferometry has been utilized along with an excitation mechanism to measure the dynamic response of the sample cornea. A Pulsed ESPI device has been chosen for the study because of its micron-level resolution and other advantages in real-time deformation analysis. A bovine cornea has been used as a sample in the subject experiment. The dynamic response has been taken on a chart recorder and it is observed that it does show a marked deformation at a specific excitation frequency, which may be taken as a characteristic elasticity parameter for the surface of that corneal sample. It was seen that outside resonance conditions the bovine cornea was not that much deformed. Through this study, the resonance frequency and the corresponding corneal deformations are mapped and plotted in real time. In these experiments, data was acquired and processed by FRAMES plus computer analysis system. With some analysis of the results, this technique can help us to refine a more detailed corneal surface mathematical model and some preliminary work was done on this. Such modelling enhancements may be useful for finer ablative surgery planning. After further experimentation

  14. Ultraviolet induced lysosome activity in corneal epithelium

    Energy Technology Data Exchange (ETDEWEB)

    Cullen, A.P.

    1980-01-01

    A 5.000 W Xe-Hg high pressure lamp and a double monochromator were used to produce a 3.3 nm half-bandpass ultraviolet radiation at 295 nm. Pigmented rabbit eyes were irradiated with radiant exposures from 140 Jm/sup -2/ to 10.000 Jm/sup -2/ and evaluated by slit-lamp biomicroscopy, light and electron microscopy. Corneal threshold (Hsub(c) was 200 Jm/sup -2/ and lens threshold (Hsub(L)) was 7.500 Jm/sup -2/. The most repeatable and reliable corneal response to these levels of UV was the development of corneal epithelial granules. Histological changes included a loss of superficial epithelial cells and selective UV induced autolysis of the wing cells. It is suggested that the biomicroscopically observed granules are the clinical manifestation of the secondary lysosomes revealed by light and electron microscopy. It is proposed that UV breaks down the primary lysosome membranes to release hydrolytic enzymes which in turn form the secondary lysosomes during autolysis. Extreme levels of radiant exposure at 295 nm result in indiscriminate destruction of all layers of the corneal epithelium, but the posterior cornea was spared.

  15. The theory and art of corneal cross-linking

    Directory of Open Access Journals (Sweden)

    Rebecca McQuaid

    2013-01-01

    Full Text Available Before the discovery of corneal cross-linking (CXL, patients with keratoconus would have had to undergo corneal transplantation, or wear rigid gas permeable lenses (RGPs that would temporarily flatten the cone, thereby improving the vision. The RGP contact lens (CL would not however alter the corneal stability and if the keratoconus was progressive, the continued steepening of the cone would occur under the RGP CL. To date, the Siena Eye has been the largest study to investigate long term effects of standard CXL. Three hundred and sixty-three eyes were treated and monitored over 4 years, producing reliable long-term results proving long-term stability of the cornea by halting the progression of keratoconus, and proving the safety of the procedure. Traditionally, CXL requires epithelial removal prior to corneal soakage of a dextran-based 0.1% riboflavin solution, followed by exposure of ultraviolet-A (UV-A light for 30 min with an intensity of 3 mW/cm2. A series of in vitro investigations on human and porcine corneas examined the best treatment parameters for standard CXL, such as riboflavin concentration, intensity, wavelength of UV-A light, and duration of treatment. Photochemically, CXL is achieved by the generation of chemical bonds within the corneal stroma through localized photopolymerization, strengthening the cornea whilst minimizing exposure to the surrounding structures of the eye. In vitro studies have shown that CXL has an effect on the biomechanical properties of the cornea, with an increased corneal rigidity of approximately 70%. This is a result of the creation of new chemical bonds within the stroma.

  16. Effect of corneal cross-linking on contact lens tolerance in keratoconus.

    Science.gov (United States)

    Ünlü, Metin; Yüksel, Erdem; Bilgihan, Kamil

    2017-07-01

    The aim was to investigate changes in corneal sensation and rigid gas-permeable (RGP) contact lens tolerance after corneal cross-linking (CXL) on patients with keratoconus. Thirty eyes of 30 patients, who were RGP lens intolerant, were treated with CXL. The main outcome measures were corneal sensation evaluation by Cochet-Bonnet esthesiometry, sub-basal nerve fibre assessment by corneal in vivo confocal microscopy and RGP contact lens tolerance evaluation with the Likert scale and wearing time. All eyes were evaluated preoperatively and post-operatively at one, three and six months after CXL procedure. The mean age was 25.3 ± 6.2 years. Preoperatively, the maximum keratometry (Kmax) in study eyes was 56.89 ± 4.60 D. Six months after CXL, it reduced to 56.03 ± 4.85 D (p = 0.01). Preoperative mean corneal sensation was 0.44 ± 0.05 g/mm 2 , (range: 0.40 to 0.55); it was significantly decreased at the first month and increased to preoperative values after six months. The sub-basal nerve plexus could not be visualised in 90 per cent of the patients by confocal microscopy at one month post-operatively. Gradual restoration of corneal innervation with almost similar preoperative levels at post-operative month six was noted. There were significant differences in Likert scores between preoperative and third and sixth months after CXL. Likert scale scores correlated significantly with corneal sensitivity. It can be concluded that increased RGP contact lens tolerance after CXL may be associated with the potential role of decreased corneal sensitivity and corneal flattening after CXL. © 2016 Optometry Australia.

  17. Transepithelial Riboflavin Absorption in an Ex Vivo Rabbit Corneal Model.

    Science.gov (United States)

    Gore, Daniel M; O'Brart, David; French, Paul; Dunsby, Chris; Allan, Bruce D

    2015-07-01

    To measure depth-specific riboflavin concentrations in corneal stroma using two-photon fluorescence microscopy and compare commercially available transepithelial corneal collagen cross-linking (CXL) protocols. Transepithelial CXL riboflavin preparations--MedioCross TE, Ribocross TE, Paracel plus VibeX Xtra, and iontophoresis with Ricrolin+--were applied to the corneal surface of fresh postmortem rabbit eyes in accordance with manufacturers' recommendations for clinical use. Riboflavin 0.1% (VibeX Rapid) was applied after corneal epithelial debridement as a positive control. After riboflavin application, eyes were snap frozen in liquid nitrogen. Corneal cross sections 35-μm thick were cut on a cryostat, mounted on a slide, and imaged by two-photon fluorescence microscopy. Mean (SD) concentrations were calculated from five globes tested for each protocol. Peak riboflavin concentration of 0.09% (± 0.01) was observed within the most superficial stroma (stromal depth 0-10 μm) in positive controls (epithelium-off). At the same depth, peak stromal riboflavin concentrations for MedioCross TE, Ricrolin+, Paracel/Xtra, and Ribocross TE were 0.054% (± 0.01), 0.031% (0.003), 0.021% (± 0.001), and 0.015% (± 0.004), respectively. At a depth of 300 μm (within the demarcation zone commonly seen after corneal cross-linking), the stromal concentration in epithelium-off positive controls was 0.075% (± 0.006), while at the same depth MedioCross TE and Ricrolin+ achieved 0.018% (± 0.006) and 0.016% (0.002), respectively. None of the remaining transepithelial protocols achieved concentrations above 0.005% at this same 300-μm depth. Overall, MedioCross TE was the best-performing transepithelial formulation. Corneal epithelium is a significant barrier to riboflavin absorption into the stroma. Existing commercial transepithelial CXL protocols achieve relatively low riboflavin concentrations in the anterior corneal stroma when compared to gold standard epithelium-off absorption

  18. Selective corneal optical aberration (SCOA) for customized ablation

    Science.gov (United States)

    Jean, Benedikt J.; Bende, Thomas

    2001-06-01

    Wavefront analysis still have some technical problems which may be solved within the next years. There are some limitations to use wavefront as a diagnostic tool for customized ablation alone. An ideal combination would be wavefront and topography. Meanwhile Selective Corneal Aberration is a method to visualize the optical quality of a measured corneal surface. It is based on a true measured 3D elevation information of a video topometer. Thus values can be interpreted either using Zernike polynomials or visualized as a so called color coded surface quality map. This map gives a quality factor (corneal aberration) for each measured point of the cornea.

  19. [Corneal manifestations in systemic diseases].

    Science.gov (United States)

    Zarranz Ventura, J; De Nova, E; Moreno-Montañés, J

    2008-01-01

    Systemic diseases affecting the cornea have a wide range of manifestations. The detailed study of all pathologies that cause corneal alteration is unapproachable, so we have centered our interest in the most prevalent or characteristic of them. In this paper we have divided these pathologies in sections to facilitate their study. Pulmonar and conective tissue (like colagen, rheumatologic and idiopathic inflamatory diseases), dermatologic, cardiovascular, hematologic, digestive and hepatopancreatic diseases with corneal alteration are described. Endocrine and metabolic diseases, malnutrition and carential states are also studied, as well as some otorhinolaryngologic and genetic diseases that affect the cornea. Finally, a brief report of ocular toxicity induced by drugs is referred.

  20. Excimer laser-assisted anterior lamellar keratoplasty for keratoconus, corneal problems after laser in situ keratomileusis, and corneal stromal opacities.

    Science.gov (United States)

    Bilgihan, Kamil; Ozdek, Sengül C; Sari, Ayça; Hasanreisoğlu, Berati

    2006-08-01

    To evaluate excimer laser-assisted anterior lamellar keratoplasty to augment thin corneas as in keratoconus ( .05). This technique presents a different modality for the treatment of keratoconus, post-LASIK corneal problems, and other corneal stromal opacities with anterior lamellar keratoplasty. Additional studies with more patients and longer follow-up will help determine the role of this technique as a substitute for penetrating keratoplasty in these patients.

  1. Research on inhibition of corneal neovascularization

    Directory of Open Access Journals (Sweden)

    Zhang-Hui Yang

    2015-12-01

    Full Text Available Corneal transparency is the basis of the normal physiological functions.However, corneal neovascularization(CNVmay occur in the infection, mechanical and chemical injury or under other pathological conditions,which make the cornea lose original transparency and severe visual impairment. In recent years, along with the development of immunology, molecular biology, biochemistry and other disciplines, there is more in-depth understanding on the CNV, and clinical treatment of CNV has made new breakthroughs. This article provides an overview of the inhibition of CNV.

  2. Differentiation of mild keratoconus from corneal warpage according to topographic inferior steepening based on corneal tomography data

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    Lia Florim Patrão

    Full Text Available ABSTRACT We report two cases of suspicious asymmetric bow tie and inferior steepening on topographic evaluations with reflection (Placido and projection (Scheimpflug. Rotating Scheimpflug corneal and anterior segment tomography (Oculus Pentacam HR, Wetzlar, Germany® was performed in the first case, with a maximal keratometric value (Kmax of 43.2 D and an overall deviation value from the Belin/Ambrósio Enhanced Ectasia Display (BAD-D of 1.76, which was observed in the study eye (OD. BAD-D was 6.59 in the fellow eye, which had clinical findings that were consistent with keratoconus stage 2. The second case presented with a Kmax of 45.3 D and BAD-D of 0.76 in OD and 1.01 in OS. This patient had discontinued wearing soft contact lens less than 1 day prior to examination. Corneal tomographic data enabled us to distinguish mild or forme fruste keratoconus from contact lens-induced corneal warpage, and similar findings were observed on curvature maps.

  3. Dynamic ultra high speed Scheimpflug imaging for assessing corneal biomechanical properties

    Directory of Open Access Journals (Sweden)

    Renato Ambrósio Jr

    2013-04-01

    Full Text Available OBJECTIVE: To describe a novel technique for clinical characterization of corneal biomechanics using non-invasive dynamic imaging. METHODS: Corneal deformation response during non contact tonometry (NCT is monitored by ultra-high-speed (UHS photography. The Oculus Corvis ST (Scheimpflug Technology; Wetzlar, Germany has a UHS Scheimpflug camera, taking over 4,300 frames per second and of a single 8mm horizontal slit, for monitoring corneal deformation response to NCT. The metered collimated air pulse or puff has a symmetrical configuration and fixed maximal internal pump pressure of 25 kPa. The bidirectional movement of the cornea in response to the air puff is monitored. RESULTS: Measurement time is 30ms, with 140 frames acquired. Advanced algorithms for edge detection of the front and back corneal contours are applied for every frame. IOP is calculated based on the first applanation moment. Deformation amplitude (DA is determined as the highest displacement of the apex in the highest concavity (HC moment. Applanation length (AL and corneal velocity (CVel are recorded during ingoing and outgoing phases. CONCLUSION: Corneal deformation can be monitored during non contact tonometry. The parameters generated provide clinical in vivo characterization of corneal biomechanical properties in two dimensions, which is relevant for different applications in Ophthalmology.

  4. Reactivation of Herpes Zoster Keratitis With Corneal Perforation After Zoster Vaccination.

    Science.gov (United States)

    Jastrzebski, Andre; Brownstein, Seymour; Ziai, Setareh; Saleh, Solin; Lam, Kay; Jackson, W Bruce

    2017-06-01

    We present a case of reactivated herpes zoster keratouveitis of 6 years duration with corneal perforation requiring penetrating keratoplasty shortly after inoculation with herpes zoster vaccine (Zostavax, Merck, Quebec, Canada). Retrospective case report. A 67-year-old woman with a 5-year history of recurrent unilateral herpes zoster keratouveitis in her right eye presented with another recurrence 2 weeks after Zostavax vaccination. Three months later, she developed descemetocele and 2 months afterward, corneal perforation, which was managed by penetrating keratoplasty. Immunohistopathological examination disclosed positive staining for varicella zoster virus in most of the keratocytes adjacent to the descemetocele and perforation, most vividly in the deeper two-thirds of the stroma where the keratocytes were most dense, but not in corneal epithelium or endothelium. Electron microscopic examination showed universally severely degenerated corneal keratocytes in the corneal stroma adjacent to the perforation with variable numbers of herpes virus capsids present in half of these cells. Only a rare normal-appearing keratocyte was identified in the more peripheral corneal stroma. We present a case of reactivation of herpes keratouveitis shortly after vaccination with Zostavax in a patient with previous herpes zoster ophthalmicus. We demonstrate, for the first time, ultrastructural evidence consistent with inactive virus capsids in diffusely degenerated keratocytes in the extracted corneal tissue.

  5. Evaluation of corneal changes after myopic LASIK using the Pentacam®

    Directory of Open Access Journals (Sweden)

    Khairat YM

    2013-09-01

    Full Text Available Yehia M Khairat, Yasser H Mohamed, Ismail ANO Moftah, Narden N Fouad Department of Ophthalmology, Faculty of Medicine, El-Minya University, Egypt Background: In this study, we used a Pentacam® device to evaluate the corneal changes that occur after laser-assisted in situ keratomileusis (LASIK. Methods: Our study included 60 eyes of 32 patients. All patients were treated for myopia and myopic astigmatism using LASIK. The eyes were examined preoperatively and 3 months postoperatively using a Pentacam to assess corneal changes with regard to curvature, elevation, and asphericity of the cornea. Results: A statistically significant decrease in mean keratometric power of the anterior corneal surface (P = 0.001 compared with its pre-LASIK value was detected after 3 months, but there was no significant change in keratometric power of the posterior surface (P = 0.836. Asphericity (Q-value of the anterior and posterior surfaces increased significantly after LASIK (P = 0.001. A significant forward bulge of the anterior corneal surface 4 mm and 7 mm from the central zone was detected 3 months post-LASIK (P = 0.001 for both, but there was no significant increase in posterior elevation at 4 mm and 7 mm from the center (P = 0.637 and P = 0.26, respectively. No cases of post-LASIK ectasia were detected. Correlation between different parameters of the corneal surface revealed an indirect relation between changes in pachymetry and anterior corneal elevation at 4 mm and 7 mm from the central zone (r = −0.27, P = 0.13, and r = −0.37, P = 0.04, respectively, and a direct proportion between changes in pachymetry and mean keratometric power of the anterior and posterior corneal surfaces (r = 0.7, P = 0.001 and r = 0.4, P = 0.028, respectively. Conclusion: LASIK causes significant changes at the anterior corneal surface but the effect is subtle and insignificant at the posterior surface. Keywords: LASIK, laser-assisted in situ keratomileusis, Pentacam®, corneal

  6. A Clinical Microbiological Study of Corneal Ulcer Patients at Western Gujarat, India

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    Nilesh Dhanjibhai Patel

    2013-06-01

    Full Text Available Corneal ulcer is a major cause of blindness throughout the world. When the cornea is injured by foreign particles, there are chances of infection by the organism and development of ulcer. Bacterial infection in the cornea is invariably an alteration of the defense mechanism of the outer eye. It is essential to determine the local etiology within a given region when planning a corneal ulcer management strategy. Laboratory evaluation is necessary to establish the diagnosis and to guide the antibiotic therapy. One hundred corneal ulcer patients were studied by collecting their corneal scraping samples and processing at Clinical Microbiology department of Shree Meghaji Petharaj Shah Medical College, Jamnagar, Gujarat, India during a period of 17 months. All clinical microbiology laboratory procedures followed standard protocols described in the literature. 40 (40% patients from the age group of 20-70 years had been confirmed as - any organism culture positive - within the corneal ulcer patient population. Fungi were isolated from 26 (26% corneal ulcer patients. The bacterial etiology was confirmed in 14 (14% corneal ulcer patients. The major risk factors for mycotic keratitis were vegetative injury (16, (62%, followed by conjunctivitis (4, (15%, and blunt trauma (3, (11%. Pseudomonas aeruginosa was the most commonly isolated bacterium (6, (43%, followed by Proteus spp. (4, (29%. Corneal Infections due to bacteria and filamentous fungi are a frequent cause of corneal damage. Microbiological investigation is an essential tool in the diagnosis of these infections. The frequency of fungal keratitis has risen over the past 20 to 30 years. Prognosis of bacterial corneal infection has improved since the introduction of specific antibacterial therapy.

  7. A clinical microbiological study of corneal ulcer patients at western Gujarat, India.

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    Rajesh Somabhai Katara

    2013-06-01

    Full Text Available Corneal ulcer is a major cause of blindness throughout the world. When the cornea is injured by foreign particles, there are chances of infection by the organism and development of ulcer. Bacterial infection in the cornea is invariably an alteration of the defense mechanism of the outer eye. It is essential to determine the local etiology within a given region when planning a corneal ulcer management strategy. Laboratory evaluation is necessary to establish the diagnosis and to guide the antibiotic therapy. One hundred corneal ulcer patients were studied by collecting their corneal scraping samples and processing at Clinical Microbiology department of Shree Meghaji Petharaj Shah Medical College, Jamnagar, Gujarat, India during a period of 17 months. All clinical microbiology laboratory procedures followed standard protocols described in the literature. 40 (40% patients from the age group of 20-70 years had been confirmed as - any organism culture positive - within the corneal ulcer patient population. Fungi were isolated from 26 (26% corneal ulcer patients. The bacterial etiology was confirmed in 14 (14% corneal ulcer patients. The major risk factors for mycotic keratitis were vegetative injury (16, (62%, followed by conjunctivitis (4, (15%, and blunt trauma (3, (11%. Pseudomonas aeruginosa was the most commonly isolated bacterium (6, (43%, followed by Proteus spp. (4, (29%. Corneal Infections due to bacteria and filamentous fungi are a frequent cause of corneal damage. Microbiological investigation is an essential tool in the diagnosis of these infections. The frequency of fungal keratitis has risen over the past 20 to 30 years. Prognosis of bacterial corneal infection has improved since the introduction of specific antibacterial therapy.

  8. Corneal complications and visual impairment in vernal keratoconjunctivitis patients

    International Nuclear Information System (INIS)

    Arif, A.S.; Aaqil, B.; Siddiqui, A.; Nazneen, Z.; Farooq, U.

    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. Methods: 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. Results: 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. Conclusion: Vernal kerato-conjunctivitis in the presence of corneal complications is a sight threatening disease and can lead to severe visual impairment. (author)

  9. Corneal biomechanical properties after laser-assisted in situ keratomileusis and photorefractive keratectomy

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    Hwang ES

    2017-10-01

    Full Text Available Eileen S Hwang,1 Brian C Stagg,1 Russell Swan,1 Carlton R Fenzl,1 Molly McFadden,2 Valliammai Muthappan,1 Luis Santiago-Caban,1 Mark D Mifflin,1 Majid Moshirfar1,3 1Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, 2Department of Internal Medicine, University of Utah, Salt Lake City, 3HDR Research Center, Hoopes Vision, Draper, UT, USA Background: The purpose of this study was to evaluate the effects of laser-assisted in situ keratomileusis (LASIK and photorefractive keratectomy (PRK on corneal biomechanical properties.Methods: We used the ocular response analyzer to measure corneal hysteresis (CH and corneal resistance factor (CRF before and after refractive surgery.Results: In all, 230 eyes underwent LASIK and 115 eyes underwent PRK without mitomycin C (MMC. Both procedures decreased CH and CRF from baseline. When MMC was used after PRK in 20 eyes, it resulted in lower corneal biomechanical properties at 3 months when compared to the other procedures, but all three procedures had similar values at 12 months.Conclusion: Significant but similar decreases in corneal biomechanical properties after LASIK, PRK without MMC, and PRK with MMC were noted. Keywords: corneal biomechanics, photorefractive keratectomy, laser-assisted in situ keratomileusis, corneal hysteresis, corneal resistance factor, mitomycin C

  10. Changes in corneal sensitivity following cross-linking for progressive early-stage keratoconus

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    Anelise de Medeiros Lago

    2014-04-01

    Full Text Available Purpose: To evaluate changes in corneal sensitivity following corneal cross-linking (CXL in patients with progressive earlier stage keratoconus. Methods: Thirty-eight eyes of 19 patients (11 women, 8 men were included in a prospective, nonrandomized clinical study. The mean patient age was 22 years (range, 18-26 years. Inclusion criteria were early stage bilateral progressive keratoconus, a transparent cornea, and a thickness of ≥440 µm in the thinnest area of the cornea. Using the Cochet-Bonnet esthesiometer, central corneal sensitivity was measured before surgery, 7 days after surgery, and once a month thereafter until recovery of baseline preoperative levels. Central corneal sensitivity >40 mm was considered normal. Results: Corneal sensitivity gradually returned to preoperative levels in all treated eyes. The mean central corneal sensitivity was 52.2, 24.0, 38.2, 42.5, 50.0, and 52.5 mm before surgery, 7 days after surgery, and at 1, 2, 3, and 4 months after surgery, respectively. Normal levels of corneal sensation, but not baseline (preoperative levels, were observed 2 months after surgery. The preoperative levels were observed 3 months after surgery. Conclusions: Our results suggest that central corneal sensitivity can be decreased for as long as 3 months after CXL for progressive earlier stage keratoconus.

  11. A Rare Form of Corneal Opacity Associated with Spondyloepiphyseal Dysplasia Congenita

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    Yuichiro Ishida

    2018-02-01

    Full Text Available A 13-year-old Japanese female diagnosed with spondyloepiphyseal dysplasia congenita (SEDC was referred for ophthalmologic evaluation. Examination with slit-lamp and optical coherence tomography revealed bilateral thin cornea with diffuse corneal opacity which was localised at the posterior stromal depth in the central cornea. Unlike the two previously reported cases of diffuse and nodular patterns of corneal opacity in SEDC, the current case exhibited a rare form of corneal opacity. SEDC is one of the type II collagenopathies, characterised by dwarfism because the mutations in COL2A1 prevent bone growth. Although the existence of type II collagen has not been reported in the human corneal stroma, the aetiology of the opacity in the corneal stroma in SEDC type II collagenopathy is of interest.

  12. Femtosecond laser-assisted keratoplasty in a child with corneal opacity:case report

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    E. Yu. Markova

    2014-01-01

    Full Text Available Corneal opacities are the fourth cause of blindness world-wide. Over the past two centuries, various corneal transplantation (i.e., keratoplasty methods have been developed and improved. Nowadays, femtolaserssisted keratoplasty is one of most promising techniques. Femtosecond laser have several advantages that provide additional surgical benefits. Among them, no thermal injury, the ability to cut deeply on a single plane and to perform various corneal profiles should be mentioned. In children, corneal disorders are of special importance while femtosecondassisted keraatoplasty case reports are rare. Here, we describe femtosecond laserssisted penetrating keratoplasty in a girl with a rough central corneal opacity.

  13. Edge detection and mathematic fitting for corneal surface with Matlab software.

    Science.gov (United States)

    Di, Yue; Li, Mei-Yan; Qiao, Tong; Lu, Na

    2017-01-01

    To select the optimal edge detection methods to identify the corneal surface, and compare three fitting curve equations with Matlab software. Fifteen subjects were recruited. The corneal images from optical coherence tomography (OCT) were imported into Matlab software. Five edge detection methods (Canny, Log, Prewitt, Roberts, Sobel) were used to identify the corneal surface. Then two manual identifying methods (ginput and getpts) were applied to identify the edge coordinates respectively. The differences among these methods were compared. Binomial curve (y=Ax 2 +Bx+C), Polynomial curve [p(x)=p1x n +p2x n-1 +....+pnx+pn+1] and Conic section (Ax 2 +Bxy+Cy 2 +Dx+Ey+F=0) were used for curve fitting the corneal surface respectively. The relative merits among three fitting curves were analyzed. Finally, the eccentricity (e) obtained by corneal topography and conic section were compared with paired t -test. Five edge detection algorithms all had continuous coordinates which indicated the edge of the corneal surface. The ordinates of manual identifying were close to the inside of the actual edges. Binomial curve was greatly affected by tilt angle. Polynomial curve was lack of geometrical properties and unstable. Conic section could calculate the tilted symmetry axis, eccentricity, circle center, etc . There were no significant differences between 'e' values by corneal topography and conic section ( t =0.9143, P =0.3760 >0.05). It is feasible to simulate the corneal surface with mathematical curve with Matlab software. Edge detection has better repeatability and higher efficiency. The manual identifying approach is an indispensable complement for detection. Polynomial and conic section are both the alternative methods for corneal curve fitting. Conic curve was the optimal choice based on the specific geometrical properties.

  14. Corneal topography measurements for biometric applications

    Science.gov (United States)

    Lewis, Nathan D.

    The term biometrics is used to describe the process of analyzing biological and behavioral traits that are unique to an individual in order to confirm or determine his or her identity. Many biometric modalities are currently being researched and implemented including, fingerprints, hand and facial geometry, iris recognition, vein structure recognition, gait, voice recognition, etc... This project explores the possibility of using corneal topography measurements as a trait for biometric identification. Two new corneal topographers were developed for this study. The first was designed to function as an operator-free device that will allow a user to approach the device and have his or her corneal topography measured. Human subject topography data were collected with this device and compared to measurements made with the commercially available Keratron Piccolo topographer (Optikon, Rome, Italy). A third topographer that departs from the standard Placido disk technology allows for arbitrary pattern illumination through the use of LCD monitors. This topographer was built and tested to be used in future research studies. Topography data was collected from 59 subjects and modeled using Zernike polynomials, which provide for a simple method of compressing topography data and comparing one topographical measurement with a database for biometric identification. The data were analyzed to determine the biometric error rates associated with corneal topography measurements. Reasonably accurate results, between three to eight percent simultaneous false match and false non-match rates, were achieved.

  15. Infiltrados corneales asociados al uso de lentes de contacto Corneal infiltrates associated with contact lens wear

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    Vivian Padrón Álvarez

    2001-12-01

    Full Text Available Se estudiaron 15 pacientes que usan lentes de contacto rígidas, permeables al gas (LCRPG y lentes de contacto blandas (LCB que presentaron infiltrados corneales. Se realizó estudio microbiológico de las lesiones y seguimiento clínico de estos casos. En 3 de los casos estudiados el cultivo fue positivo a estafilococo aureus, el resto de los estudios microbiológicos fueron negativos. Todos los pacientes respondieron rápidamente al retirar la lente de contacto y al tratamiento con antibióticos tópicos y ninguno tuvo afectación permanente de la agudeza visual. El diagnóstico exacto y el manejo apropiado de los infiltrados corneales en pacientes que usan lentes de contacto es de gran importancia por la posibilidad de infección o de secuela visual permanente.15 patients wearing gas permeable rigid contact lenses (GPRCL and soft contanct lenses (SCL that presented corneal infiltrates were studied. A microbiological study of the injuries and a clinical follow-up of these cases were conducted. In 3 of the studied cases the culture was positive to Staphyloccocus aureus. The rest of the mircobiological studies were negative. All the patients responded rapidly to the contact lens removal and to the treatment with topical antibiotics. None of them had permanent affection of visual acuity. The accurate diagnosis and the appropiate management of the corneal infiltrates in patients wearing contact lenses is very important due to the possibility of infection or of permanent visual sequela.

  16. The application of excimer lasers for corneal sculpturing

    International Nuclear Information System (INIS)

    King, M.C.

    1990-01-01

    Of the broad selection of lasers available for surgery, the argon fluoride excimer laser offers a set of attributes that make it uniquely suited for the removal of corneal tissue. With ultraviolet radiation at 193mm, the energy of an individual photon (6.3 electron volts) is sufficient to break bonds in protein molecules without generating molecular vibration (heat). A single laser pulse is capable of removing 0.25 microns of corneal tissue over a well defined area 80 mm 2 in extent. This excision with a lateral precision to a fraction of a micron causes no discernible damage to neighboring cells. The smooth surface left after the tissue is removed promotes a quick and predictable regrowth of the epithelium. The penetration of radiation into the underlying tissue is the order of a micron so there is no potential harm to the lens or retinal tissue. Insignificant mutagenesis or unscheduled DNA synthesis has been detected as a result of tissue irradiation at this wavelength. In the past few years major progress has been made towards developing ophthalmic procedures which utilize the unique properties of this laser. To date there are FDA IDE's (Investigational Device Exemptions) for the following procedures: Photorefractive Keratectomy (PRK) or corneal reshaping for correcting near-sightedness, far-sightedness and astigmatism without the need for eye glasses, contact lenses or conventional refractive surgery (Radial Keratotomy); Partial Excimer Trabeculectomy for relieving the pressure build-up caused by glaucoma; T-Excisons for reducing astigmatism; Myopic Keratomileusis (MKM) for the refractive correction of severe myopia; superficial Keratectomy (corneal smoothing) for treating various corneal scars, dystrophies, recurrent corneal erosion etc. In this paper the fundamentals of beam tissue interaction at 193nm will be discussed

  17. 21 CFR 886.1450 - Corneal radius measuring device.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Corneal radius measuring device. 886.1450 Section 886.1450 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... corneal size by superimposing the image of the cornea on a scale at the focal length of the lens of a...

  18. Corneal-Wavefront guided transepithelial photorefractive keratectomy after corneal collagen cross linking in keratoconus

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    Massimo Camellin

    2017-01-01

    Conclusions: Corneal-Wavefront guided transepithelial PRK ablation profiles after conventional CXL yields to good visual, optical, and refractive results. These treatments are safe and efficacious for the correction of refracto-therapeutic problems in keratoconic patients.

  19. Comparison of Changes in Central Corneal Thickness During Corneal Collagen Cross-Linking, Using Isotonic Riboflavin Solutions With and Without Dextran, in the Treatment of Progressive Keratoconus.

    Science.gov (United States)

    Zaheer, Naima; Khan, Wajid Ali; Khan, Shama; Khan, M Abdul Moqeet

    2018-03-01

    To compare intraoperative changes in central corneal thickness (CCT) during corneal cross-linking, using 2 different isotonic riboflavin solutions either with dextran or with hydroxy propyl methylcellulose, in the treatment of progressive keratoconus. In this retrospective study, we analyzed records of corneal thickness measurements, taken during various steps of cross-linking. Cross-linking was performed using either isotonic riboflavin with dextran (group A) or isotonic riboflavin with hydroxy propyl methylcellulose (without dextran) (group B). CCT measurements were recorded before and after epithelial removal, after saturation with respective isotonic riboflavin solution, after use of hypotonic riboflavin in selected cases, and after ultraviolet A (UV-A) application. A mixed-way analysis of variance was conducted on CCT readings within each group and between both groups, and p dextran causes a significant decrease in corneal thickness, whereas dextran-free isotonic riboflavin causes a significant increase in corneal thickness, thus facilitating the procedure.

  20. Effect of the Regenerative Agent Poly(Carboxymethylglucose Sulfate) on Corneal Wound Healing After Corneal Cross-Linking for Keratoconus.

    Science.gov (United States)

    Kymionis, George D; Liakopoulos, Dimitrios A; Grentzelos, Michael A; Tsoulnaras, Konstantinos I; Detorakis, Efstathios T; Cochener, Béatrice; Tsilimbaris, Miltiadis K

    2015-08-01

    To evaluate the effect of a regenerative agent (RGTA) [Cacicol20-poly(carboxymethyl glucose sulfate); OTR3, Paris, France] on corneal reepithelialization and pain after corneal cross-linking (CXL) for keratoconus. In this prospective comparative (contralateral) clinical study, patients with bilateral progressive keratoconus underwent CXL treatment. The corneal epithelium during CXL was removed using transepithelial phototherapeutic keratectomy (Cretan protocol). One eye of each patient was randomly instilled with an RGTA (Cacicol20) once a day (study group), whereas the fellow eye was instilled with artificial tears (control group). Patients were examined daily until complete reepithelialization. Postoperative examinations included slit-lamp biomicroscopy to assess the epithelial defect size and subjective evaluation of pain. The study enrolled 18 patients (36 eyes). The mean epithelial defect size for study and control groups was 19.6 ± 4.2 mm versus 21.5 ± 2.8 mm, respectively, at day 1 (P = 0.019) and 6.4 ± 3.4 mm versus 7.9 ± 4.3 mm, respectively, at day 2 (P = 0.014). At day 3 postoperatively, 61.1% of study eyes were fully reepithelialized, compared with 11.1% of control eyes (P = 0.002). RGTA (Cacicol20) instillation seems to result in faster corneal reepithelialization after CXL in this study. However, there was no significant effect in subjective pain/discomfort.

  1. Binary Labelings for Plane Quadrangulations and their Relatives

    OpenAIRE

    Felsner, Stefan; Huemer, Clemens; Kappes, Sarah; Orden, David

    2006-01-01

    Motivated by the bijection between Schnyder labelings of a plane triangulation and partitions of its inner edges into three trees, we look for binary labelings for quadrangulations (whose edges can be partitioned into two trees). Our labeling resembles many of the properties of Schnyder's one for triangulations: Apart from being in bijection with tree decompositions, paths in these trees allow to define the regions of a vertex such that counting faces in them yields an algorithm for embedding...

  2. 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.

  3. New therapeutic modality for corneal endothelial disease using Rho-associated kinase inhibitor eye drops.

    Science.gov (United States)

    Koizumi, Noriko; Okumura, Naoki; Ueno, Morio; Kinoshita, Shigeru

    2014-11-01

    Corneal endothelial dysfunction accompanied by visual disturbance is a primary indication for corneal endothelial transplantation. However, despite the value and potential of endothelial graft surgery, a strictly pharmacological approach for treating corneal endothelial dysfunction remains an attractive proposition. Previously, we reported that the selective Rho-associated kinase (ROCK) inhibitor Y-27632 promotes cell adhesion and proliferation, and inhibits the apoptosis of primate corneal endothelial cells in culture. These findings have led us to develop a novel medical treatment for the early phase of corneal endothelial disease using ROCK inhibitor eye drops. In rabbit and monkey models of partial endothelial dysfunction, we showed that corneal endothelial wound healing was accelerated via the topical application of ROCK inhibitor to the ocular surface, resulting in the regeneration of a corneal endothelial monolayer with a high endothelial cell density. Based on these animal studies, we are now attempting to advance the clinical application of ROCK inhibitor eye drops for patients with corneal endothelial dysfunction. A pilot clinical study was performed at the Kyoto Prefectural University of Medicine, and the effects of Y-27632 eye drops after transcorneal freezing were evaluated in 8 patients with corneal endothelial dysfunction. We observed a positive effect of ROCK inhibitor eye drops in treating patients with central edema caused by Fuchs corneal endothelial dystrophy. We believe that our new findings will contribute to the establishment of a new approach for the treatment of corneal endothelial dysfunction.

  4. Exponential Decay Metrics of Topical Tetracaine Hydrochloride Administration Describe Corneal Anesthesia Properties Mechanistically.

    Science.gov (United States)

    Ethington, Jason; Goldmeier, David; Gaynes, Bruce I

    2017-03-01

    To identify pharmacodynamic (PD) and pharmacokinetic (PK) metrics that aid in mechanistic understanding of dosage considerations for prolonged corneal anesthesia. A rabbit model using 0.5% tetracaine hydrochloride was used to induce corneal anesthesia in conjunction with Cochet-Bonnet anesthesiometry. Metrics were derived describing PD-PK parameters of the time-dependent domain of recovery in corneal sensitivity. Curve fitting used a 1-phase exponential dissociation paradigm assuming a 1-compartment PK model. Derivation of metrics including half-life and mean ligand residence time, tau (τ), was predicted by nonlinear regression. Bioavailability was determined by area under the curve of the dose-response relationship with varying drop volumes. Maximal corneal anesthesia maintained a plateau with a recovery inflection at the approximate time of predicted corneal drug half-life. PDs of recovery of corneal anesthesia were consistent with a first-order drug elimination rate. The mean ligand residence time (tau, τ) was 41.7 minutes, and half-life was 28.89 minutes. The mean estimated corneal elimination rate constant (ke) was 0.02402 minute. Duration of corneal anesthesia ranged from 55 to 58 minutes. There was no difference in time domain PD area under the curve between drop volumes. Use of a small drop volume of a topical anesthetic (as low as 11 μL) is bioequivalent to conventional drop size and seems to optimize dosing regiments with a little effect on ke. Prolongation of corneal anesthesia may therefore be best achieved with administration of small drop volumes at time intervals corresponding to the half-life of drug decay from the corneal compartment.

  5. Corneal Graft Rejection: Incidence and Risk Factors

    Directory of Open Access Journals (Sweden)

    Alireza Baradaran-Rafii

    2008-12-01

    Full Text Available

    PURPOSE: To determine the incidence and risk factors of late corneal graft rejection after penetrating keratoplasty (PKP. METHODS: Records of all patients who had undergone PKP from 2002 to 2004 without immunosuppressive therapy other than systemic steroids and with at least one year of follow up were reviewed. The role of possible risk factors such as demographic factors, other host factors, donor factors, indications for PKP as well as type of rejection were evaluated. RESULTS: During the study period, 295 PKPs were performed on 286 patients (176 male, 110 female. Mean age at the time of keratoplasty was 38±20 (range, 40 days to 90 years and mean follow up period was 20±10 (range 12-43 months. Graft rejection occurred in 94 eyes (31.8% at an average of 7.3±6 months (range, 20 days to 39 months after PKP. The most common type of rejection was endothelial (20.7%. Corneal vascularization, regrafting, anterior synechiae, irritating sutures, active inflammation, additional anterior segment procedures, history of trauma, uncontrolled glaucoma, prior graft rejection, recurrence of herpetic infection and eccentric grafting increased the rate of rejection. Patient age, donor size and bilateral transplantation had no significant influence on graft rejection. CONCLUSION: Significant risk factors for corneal graft rejection include

  6. Corneal erosions, bacterial contamination of contact lenses, and microbial keratitis.

    Science.gov (United States)

    Willcox, Mark D P; Naduvilath, Thomas J; Vaddavalli, Pravin K; Holden, Brien A; Ozkan, Jerome; Zhu, Hua

    2010-11-01

    To estimate the rate of corneal erosion coupled with gram-negative bacterial contamination of contact lenses and compare this with the rate of microbial keratitis (MK) with contact lenses. The rate of corneal erosion and contact lens contamination by gram-negative bacteria were calculated from several prospective trials. These rates were used to calculate the theoretical rate of corneal erosion happening at the same time as wearing a contact lens contaminated with gram-negative bacteria. This theoretical rate was then compared with the rates of MK reported in various epidemiological and clinical trials. Corneal erosions were more frequent during extended wear (0.6-2.6% of visits) compared with daily wear (0.01-0.05% of visits). No corneal erosions were observed for lenses worn on a daily disposable basis. Contamination rates for lenses worn on a daily disposable basis were the lowest (2.4%), whereas they were the highest for low Dk lenses worn on an extended wear basis (7.1%). The estimated rate of corneal erosions occurring at the same time as wearing lenses contaminated with gram-negative bacteria was the lowest during daily wear of low Dk lenses (1.56/10,000 [95% CI: 0.23-10.57]) and the highest during extended wear of high Dk lenses (38.55/10,000 [95% CI: 24.77-60.04]). These rates were similar in magnitude to the rates reported for MK of different hydrogel lenses worn on differing wear schedules. The coincidence of corneal erosions during lens wear with gram-negative bacterial contamination of lenses may account for the relative incidence of MK during lens wear with different lens materials and modes of use.

  7. Síndrome erosivo corneal recurrente enmascarado como queratitis epitelial herpética

    Directory of Open Access Journals (Sweden)

    Manuel A. de Alba-Castilla

    2015-10-01

    Conclusiones: Los rasgos distintivos del SECR son: inicio abrupto por la noche o madrugada al despertar, antecedente de trauma corneal o distrofia corneal anterior y ausencia de leucomas corneales. La semejanza sintomatológica y el desconocimiento del SECR incrementan la posibilidad de confundir el diagnóstico.

  8. Crystalline and Crystalline International Disposal Activities

    Energy Technology Data Exchange (ETDEWEB)

    Viswanathan, Hari S. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Chu, Shaoping [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Dittrich, Timothy M. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Hyman, Jeffrey De' Haven [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Karra, Satish [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Makedonska, Nataliia [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Reimus, Paul William [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-03-06

    This report presents the results of work conducted between September 2015 and July 2016 at Los Alamos National Laboratory in the crystalline disposal and crystalline international disposal work packages of the Used Fuel Disposition Campaign (UFDC) for DOE-NE’s Fuel Cycle Research and Development program. Los Alamos focused on two main activities during this period: Discrete fracture network (DFN) modeling to describe flow and radionuclide transport in complex fracture networks that are typical of crystalline rock environments, and a comprehensive interpretation of three different colloid-facilitated radionuclide transport experiments conducted in a fractured granodiorite at the Grimsel Test Site in Switzerland between 2002 and 2013. Chapter 1 presents the results of the DFN work and is divided into three main sections: (1) we show results of our recent study on the correlation between fracture size and fracture transmissivity (2) we present an analysis and visualization prototype using the concept of a flow topology graph for characterization of discrete fracture networks, and (3) we describe the Crystalline International work in support of the Swedish Task Force. Chapter 2 presents interpretation of the colloidfacilitated radionuclide transport experiments in the crystalline rock at the Grimsel Test Site.

  9. Central corneal thickness and related factors in an elderly American Chinese population.

    Science.gov (United States)

    Wang, Dandan; Singh, Kuldev; Weinreb, Robert; Kempen, John; He, Mingguang; Lin, Shan

    2011-07-01

    To assess central corneal thickness and related factors in an elderly American Chinese population residing in San Francisco. Cross-sectional community based study. American Chinese aged 40 years and older were enrolled using random cluster sampling and volunteer screening in the Chinatown district of San Francisco. The following data were obtained: central corneal thickness by ultrasound pachymetry, intraocular pressure by Goldmann applanation tonometry, axial length by A-scan biometry, refractive status and corneal curvature by autorefractor. History of systemic and ocular diseases was collected via standard questionnaire. Central corneal thickness. Of 311 eligible subjects, 274 consented to study participation, and 228 phakic eyes were analyzed. Mean corneal thickness was 524.1 ± 31.1 µm, 545.5 ± 30.9 µm and 538.9 ± 31.8 µm in the sampling cluster, volunteer group and all subjects, respectively. A multiple linear regression model showed corneal thickness to be negatively associated with age (standardized regression coefficient [SRC] = -0.21; P = 0.016) and corneal curvature (SRC = -0.19; P = 0.018) but positively correlated with intraocular pressure (SRC = 0.20; P = 0.023). The distribution of central corneal thickness among this American Chinese population is similar to that reported in studies from East Asia. The independent factors associated with thinner corneas included older age, lower intraocular pressure and greater corneal curvature. While descendents of Chinese immigrants in America have, on average, thicker corneas than their ancestors, this phenomenon is potentially impacted by the level of intraocular pressure. © 2011 The Authors. Clinical and Experimental Ophthalmology © 2011 Royal Australian and New Zealand College of Ophthalmologists.

  10. Evaluation of central and peripheral corneal thicknesses in patients with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Alime Gunes

    2015-08-01

    Full Text Available ABSTRACTPurpose:To evaluate central corneal thickness (CCT and peripheral corneal thickness (PCT in patients with rheumatoid arthritis (RA and to assess the relationships among the corneal parameters, dry eye disease, and clinical variables of RA.Methods:A total of 58 RA patients and 58 control subjects participated in this study. A detailed ophthalmological examination was performed on each subject. Dry eye evaluation was performed using Schirmer’s test, tear break-up time (TBUT, corneal fluorescein staining, and Ocular Surface Disease Index (OSDI. Corneal thickness at the apex point, the center of the pupil, the thinnest point, and PCT (3 mm from the apex to the superior, inferior, nasal, and temporal locations were evaluated using Scheimpflug imaging (Pentacam®. Additionally, the relative peripheral index (RPI was calculated by dividing the PCT by the CCT. The disease severity and quality of life were evaluated with DAS28 and HAQ, respectively. The laboratory evaluation comprised ESR and CRP.Results:The mean corneal thicknesses at the apex point, the center of the pupil, the thinnest point, and the superior, inferior, nasal, and temporal points were significantly thinner in RA patients than controls. Schirmer’s test scores and TBUT were significantly lower, and corneal staining and OSDI scores were significantly higher in RA patients. There were no significant correlations between the corneal parameters and the clinical variables of RA or dry eye tests.Conclusion:The CCT and PCT were thinner in RA patients compared to those in control subjects. However, there were no significant correlations between the corneal parameters and the clinical variables of RA or dry eye tests.

  11. Management of Corneal Bee Sting Injuries.

    Science.gov (United States)

    Rai, Ruju R; Gonzalez-Gonzalez, Luis A; Papakostas, Thanos D; Siracuse-Lee, Donna; Dunphy, Robert; Fanciullo, Lisa; Cakiner-Egilmez, Tulay; Daly, Mary K

    2017-01-01

    To review the management of keratitis after corneal bee stings and to report a case of deep stromal corneal infiltrate secondary to a retained bee stinger managed conservatively in a patient who presented three days after unsanitary manipulation of the stinger apparatus. Case report and review of literature. A 57-year-old male beekeeper was evaluated for pain, blurry vision, and photosensitivity after a corneal bee sting. Of note, the venom sac had been removed with dirty tweezers three days prior to his visit. On exam, a focal infiltrate with diffuse edema was seen surrounding a retained bee stinger in the peripheral cornea. Trace cells in the anterior chamber were also noted. Based on a high suspicion for infectious keratitis, a conservative treatment strategy was elected. Administration of broad-spectrum topical antibiotics with concomitant abstention of corticosteroids led to rapid resolution of the symptoms. Over 16 months of follow-up, the stinger has remained in situ without migration and the patient has maintained 20/20 visual acuity without complications. There is debate on the preferred method for the management of corneal injury secondary to bee stings, especially when it is associated with a retained stinger. We herein present our findings in our appraisal of reported cases. In the aftermath of an ocular bee sting, close surveillance for inflammation and infection is essential. Individual manifestations of these injuries vary in timing, type, and severity; therefore, the accessibility of the stinger and the evolving clinical picture should guide therapeutic decisions.

  12. Conjunctival-corneal melt in association with carotid artery stenosis

    Directory of Open Access Journals (Sweden)

    Rosalind MK Stewart

    2008-10-01

    Full Text Available Rosalind MK Stewart1, Say Aun Quah1, Dan Q Nguyen2, Stephen B Kaye11Royal Liverpool University Hospital, Liverpool, UK; 2Bristol Eye Hospital, Bristol, UKPurpose: To report a case of severe conjunctival-corneal melt in association with carotid artery stenosis.Methods: Observational case report.Results: A 76-year-old man with a history of bilateral severe carotid artery occlusion and nonarteritic ischemic optic neuropathy developed a spontaneous bulbar conjunctival defect. Despite intensive lubrication, and attempts at surgical closure including an amniotic membrane patch graft, it progressed with subsequent adjacent corneal perforation. Thorough investigations revealed no underlying disease, except markedly delayed episcleral vessel filling on anterior segment fluorescein angiography.Conclusions: Neovascularisation is a known factor in the inhibition of ulceration. In light of the findings in this report, ocular ischemia should be considered as a cause or contributing factor in the differential diagnosis of conjunctival-corneal melt.Keywords: conjunctival melt, corneal melt, ocular ischemia, carotid artery stenosis

  13. Keratoprostheses for corneal blindness: a review of contemporary devices

    Science.gov (United States)

    Avadhanam, Venkata S; Smith, Helen E; Liu, Christopher

    2015-01-01

    According to the World Health Organization, globally 4.9 million are blind due to corneal pathology. Corneal transplantation is successful and curative of the blindness for a majority of these cases. However, it is less successful in a number of diseases that produce corneal neovascularization, dry ocular surface and recurrent inflammation, or infections. A keratoprosthesis or KPro is the only alternative to restore vision when corneal graft is a doomed failure. Although a number of KPros have been proposed, only two devices, Boston type-1 KPro and osteo-odonto-KPro, have came to the fore. The former is totally synthetic and the latter is semi-biological in constitution. These two KPros have different surgical techniques and indications. Keratoprosthetic surgery is complex and should only be undertaken in specialized centers, where expertise, multidisciplinary teams, and resources are available. In this article, we briefly discuss some of the prominent historical KPros and contemporary devices. PMID:25945031

  14. An experimental study of BIGH3 gene mutations in the patients with corneal dystrophies

    International Nuclear Information System (INIS)

    Jin Tao; Zou Liuhe; Yang Ling

    2004-01-01

    Objective: To evaluate BIGH3 gene mutations in Chinese patents with corneal dystrophies. Methods: 2ml peripheral venous blood was collected from 15 patients with granular corneal dystrophies and 5 normal subjects. Leucocytes DNA was extracted with standard method. With two pairs of oligonucleotide primers, exon 4 and exon 12 of the BIGH3 gene were amplified using the polymerase chain reaction. Amplified DNA fragments were purified and sequenced directly. Results: Mutations in BIGH3 gene were detected in all the patients with corneal dystrophies. BIGH3 gene mutations were not found in normal subjects. 12 patients with Avellino corneal dystrophy had the missense mutation R124H in the BIGH3 gene. 3 patients with granular corneal dystrophy had the missense mutation R555W in the BIGH3 gene. Conclusion: R124H and R555W mutations in BIGH3 gene were also found in the Chinese patients with Avellino and granular corneal dystrophies. In China, Avellino corneal dystrophy associated with the R124H mutation is the most common form in the corneal dystrophies resulted by BIGH3 gene mutions. Condon 124 and 555 are also the hot spots for the mutations in the BIGH3 gene in the Chinese patients with corneal dystrophies. Molecular genetic analysis may be repuired for proper diagnosis and subclassification of corneal dystrophies. (authors)

  15. Corneal surface reconstruction - a short review

    Directory of Open Access Journals (Sweden)

    Madhavan H N

    2009-01-01

    Full Text Available Cornea is the clear, dome-shaped surface that covers the front of the eye and when damage due to burns or injury and several other diseases, stem cells residing in its rim called "limbus" are stimulated to multiply to support growth of new epithelial cells over its surface. If this ready source of stem cells is damaged or destroyed the natural repair is not possible and such a condition is known as corneal limbal stem cell deficiency (CLSCD disease. Stem cell transplant helps such persons to regenerate the corneal surface. Human corneal limbal stem cell transplantation is at present an established procedure with reasonable good clinical outcome particularly when autologous limbal epithelial tissue from a fellow unaffected eye is used. 1, 2 A major concern related to the autograft is the possibility of CLSCD at the donor site, 3 techniques that allowed the expansion of a small limbal biopsy in the laboratory using cell cultures that could be then transplanted to the affected eye have been developed ,4, 5 Human amniotic membrane (HAM is used as a scaffold for both culturing the human limbal epithelial cells and for ocular surface reconstruction with the cultured limbal epithelial cells. 4-7 However, researchers have used alternative scaffolds like collagen 8, fibrin gel 9 and cross-linked gel of fibronectin and fibrin. 10 All these are biological materials and also need for animal 3T3 feeder layer for stem cell cultures. The properties of HAM are unique including antiadhesive effects, bacteriostatic effects, wound protection, pain reduction, and improvement of epithelialization and characteristically lacking imunogenicity. The use of amniotic membrane transplantation (AMT to treat ocular surface abnormalities was first reported by Graziella Pellegrini, chief of stem cell laboratory at Giovanni Paolo Hospital in Venice, Italy, who was the first to demonstrate the limbal stem cell transplant in 1997. Amniotic membrane has been successfully used in

  16. Corneal Endothelial Safety of Intracameral Preservative-free 1% Xylocaine

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    Shah Alpesh

    2004-01-01

    Full Text Available Purpose : To evaluate the effect of intracameral preservative-free 1% xylocaine on the corneal endothelium as an adjuvant to topical anaesthesia during phacoemulsification and Acrysof foldable IOL implantation. Material & Methods: This is a prospective, controlled, randomised, double-masked study. 106 patients with soft to moderately dense (Grade 1-3 senile cataract and corneal endothelial cell density of >1500/mm2 were randomised to the xylocaine group (n=53 and control group(n=53. Central endothelial specular microscopy and ultrasound corneal pachymetry were performed preoperatively. On the first postoperative day the eyes were evaluated for corneal oedema and Descemet′s folds. Ultrasound corneal pachymetry was performed at 1, 3 and 12 months. Specular microscopy was performed at 3 and 12 months. Cell loss was expressed as a percentage of preoperative cell density. Six patients could not complete one year follow-up. Chi-square and paired t test (2 tail statistical tests were applied for analysis. Results: Four (7.54% patients in the xylocaine group and 5 (9.43% in the control group had a few Descemet′s folds associated with mild central stromal oedema. Corneal thickness increased from 549.3µ ± 37.2µ to 555.5µ ± 36.5µ in the xylocaine group and from 553.1µ ± 36.2µ to 559.3µ ± 40.5µ in the control group at the one-month postoperative visit. Thickness returned to the preoperative level in xylocaine group 549.6µ ± 34.5µ and control group 554.7µ ± 41.1µ at three months. (P=0.484 The percentage of cell loss was 4.47 ± 2.53% in the xylocaine group and 4.49 ± 3.09 % in the control group at one year. (P=0.97 Conclusion: Intracameral preservative-free 1% xylocaine does not appear to affect corneal endothelium adversely during phacoemulsification.

  17. Validation of Na,K-ATPase pump function of corneal endothelial cells for corneal regenerative medicine.

    Science.gov (United States)

    Hatou, Shin; Higa, Kazunari; Inagaki, Emi; Yoshida, Satoru; Kimura, Erika; Hayashi, Ryuhei; Tsujikawa, Motokazu; Tsubota, Kazuo; Nishida, Kohji; Shimmura, Shigeto

    2013-12-01

    Tissue-engineering approaches to cultivate corneal endothelial cells (CECs) or induce CECs from stem cells are under investigation for the treatment of endothelial dysfunction. Before clinical application, a validation method to determine the quality of these cells is required. In this study, we quantified the endothelial pump function required for maintaining the corneal thickness using rabbit CECs (RCECs) and a human CEC line (B4G12). The potential difference of RCECs cultured on a permeable polyester membrane (Snapwell), B4G12 cells on Snapwell, or B4G12 cells on a collagen membrane (CM6) was measured by an Ussing chamber system, and the effect of different concentrations of ouabain (Na,K-ATPase specific inhibitor) was obtained. A mathematical equation derived from the concentration curve revealed that 2 mM ouabain decreases pump function of RCECs to 1.0 mV, and 0.6 mM ouabain decreases pump function of B4G12 on CM6 to 1.0 mV. Ouabain injection into the anterior chamber of rabbit eyes at a concentration of pump function >1.0 mV is required to maintain the corneal thickness. These results can be used for standardization of CEC pump function and validation of tissue-engineered CEC sheets for clinical use.

  18. Effects of edible bird's nest (EBN on cultured rabbit corneal keratocytes

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    Hun Lee

    2011-10-01

    Full Text Available Abstract Background There has been no effective treatment or agent that is available for corneal injury in promoting corneal wound healing. Previous studies on edible bird's nest extract (EBN had reported the presence of hormone-like substance; avian epidermal growth factor that could stimulate cell division and enhance regeneration. This study aimed to investigate the effects of EBN on corneal keratocytes proliferative capacity and phenotypical changes. Methods Corneal keratocytes from six New Zealand White Rabbits were isolated and cultured until Passage 1. The proliferative effects of EBN on corneal keratocytes were determined by MTT assay in serum-containing medium (FDS and serum-free medium (FD. Keratocytes phenotypical changes were morphologically assessed and gene expression of aldehyde dehydrogenase (ALDH, collagen type 1 and lumican were determined through RT-PCR. Results The highest cell proliferation was observed when both media were supplemented with 0.05% and 0.1% EBN. Cell proliferation was also consistently higher in FDS compared to FD. Both phase contrast micrographs and gene expression analysis confirmed the corneal keratocytes retained their phenotypes with the addition of EBN. Conclusions These results suggested that low concentration of EBN could synergistically induce cell proliferation, especially in serum-containing medium. This could be a novel breakthrough as both cell proliferation and functional maintenance are important during corneal wound healing. The in vitro test is considered as a crucial first step for nutri-pharmaceutical formation of EBN-based eye drops before in vivo application.

  19. Corneal regeneration by induced human buccal mucosa cultivated on an amniotic membrane following alkaline injury.

    Science.gov (United States)

    Man, Rohaina Che; Yong, Then Kong; Hwei, Ng Min; Halim, Wan Haslina Wan Abdul; Zahidin, Aida Zairani Mohd; Ramli, Roszalina; Saim, Aminuddin Bin; Idrus, Ruszymah Binti Hj

    2017-01-01

    Various clinical disorders and injuries, such as chemical, thermal, or mechanical injuries, may lead to corneal loss that results in blindness. PURPOSE : The aims of this study were to differentiate human buccal mucosa (BMuc) into corneal epithelial-like cells, to fabricate engineered corneal tissue using buccal mucosal epithelial cells, and to reconstruct a damaged corneal epithelium in a nude rat model. BMuc were subjected to 10 d of induction factors to investigate the potential of cells to differentiate into corneal lineages. Corneal stem cell markers β1-integrin, C/EBPδ, ABCG2, p63, and CK3 were upregulated in the gene expression analysis in induced BMuc, whereas CK3 and p63 showed significant protein expression in induced BMuc compared to the uninduced cells. BMuc were then left to reach 80% confluency after differential trypsinization. The cells were harvested and cultivated on a commercially available untreated air-dried amniotic membrane (AM) in a Transwell system in induction medium. The corneal constructs were fabricated and then implanted into damaged rat corneas for up to 8 weeks. A significant improvement was detected in the treatment group at 8 weeks post-implantation, as revealed by slit lamp biomicroscopy analysis. The structure and thickness of the corneal layer were also analyzed using histological staining and time-domain optical coherence tomography scans and were found to resemble a native corneal layer. The protein expression for CK3 and p63 were continuously detected throughout the corneal epithelial layer in the corneal construct. In conclusion, human BMuc can be induced to express a corneal epithelial-like phenotype. The addition of BMuc improves corneal clarity, prevents vascularization, increases corneal thickness and stromal alignment, and appears to have no adverse effect on the host after implantation.

  20. Corneal collagen cross-linking and liposomal amphotericin B combination therapy for fungal keratitis in rabbits

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    Zhao-Qin Hao

    2016-11-01

    Full Text Available AIM: To observe the therapeutic effect of corneal collagen cross-linking (CXL in combination with liposomal amphotericin B in fungal corneal ulcers. METHODS: New Zealand rabbits were induced fungal corneal ulcers by scratching and randomly divided into 3 groups, i.e. control, treated with CXL, and combined therapy of CXL with 0.25% liposomal amphotericin B (n=5 each. The corneal lesions were documented with slit-lamp and confocal microscopy on 3, 7, 14, 21 and 28d after treatment. The corneas were examined with transmission electron microscopy (TEM at 4wk. RESULTS: A rabbit corneal ulcer model of Fusarium was successfully established. The corneal epithelium defect areas in the two treatment groups were smaller than that in the control group on 3, 7, 14 and 21d (P<0.05. The corneal epithelium defect areas of the combined group was smaller than that of the CXL group (P<0.05 on 7 and 14d, but there were no statistical differences on 3, 21 and 28d. The corneal epithelium defects of the two treatment groups have been healed by day 21. The corneal epithelium defects of the control group were healed on 28d. The diameters of the corneal collagen fiber bundles (42.960±7.383 nm in the CXL group and 37.040±4.160 nm in the combined group were thicker than that of the control group (24.900±1.868 nm, but there was no difference between the two treatment groups. Some corneal collagen fiber bundles were distorted and with irregular arrangement, a large number of fibroblasts could be seen among them but no inflammatory cells in both treatment groups. CONCLUSION: CXL combined with liposomal amphotericin B have beneficial effects on fungal corneal ulcers. The combined therapy could alleviate corneal inflammattions, accelerate corneal repair, and shorten the course of disease.

  1. Comparison of stromal corneal nerves between normal and keratoconus patients using confocal microscopy.

    Science.gov (United States)

    Ramírez Fernández, M; Hernández Quintela, E; Naranjo Tackman, R

    2014-08-01

    To evaluate the differences in stromal corneal nerves between normal patients and keratoconus patients. A total of 140 eyes of 70 normal patients (group A) and 122 eyes of 87 keratoconus patients (group B) were examined with the confocal microscope, with a central scan of the total corneal thickness being taken. The morphology and thickness of the corneal stromal nerves were evaluated by using the Navis v. 3.5.0. software. Nerve thickness was obtained from the mean between the widest and the narrowest portions of each stromal nerve. Corneal stromal nerves were observed as irregular linear hyper-reflective structures with wide and narrow portions in all cases. Mean corneal stromal nerves thickness in group A was 5.7±1.7 (range from 3.3 to 10.4 μ), mean corneal stromal nerves thickness in group B was 7.2±1.9 (range from 3.5 to 12.0 μ). There was a statistical significant difference (P<.05) in stromal corneal nerves thickness between group A and group B. Stromal corneal nerves morphology was similar in both groups, but stromal nerves were thicker in keratoconus patients. Copyright © 2013 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  2. Efficient Generation of Human Embryonic Stem Cell-Derived Corneal Endothelial Cells by Directed Differentiation.

    Directory of Open Access Journals (Sweden)

    Kathryn L McCabe

    Full Text Available To generate human embryonic stem cell derived corneal endothelial cells (hESC-CECs for transplantation in patients with corneal endothelial dystrophies.Feeder-free hESC-CECs were generated by a directed differentiation protocol. hESC-CECs were characterized by morphology, expression of corneal endothelial markers, and microarray analysis of gene expression.hESC-CECs were nearly identical morphologically to primary human corneal endothelial cells, expressed Zona Occludens 1 (ZO-1 and Na+/K+ATPaseα1 (ATPA1 on the apical surface in monolayer culture, and produced the key proteins of Descemet's membrane, Collagen VIIIα1 and VIIIα2 (COL8A1 and 8A2. Quantitative PCR analysis revealed expression of all corneal endothelial pump transcripts. hESC-CECs were 96% similar to primary human adult CECs by microarray analysis.hESC-CECs are morphologically similar, express corneal endothelial cell markers and express a nearly identical complement of genes compared to human adult corneal endothelial cells. hESC-CECs may be a suitable alternative to donor-derived corneal endothelium.

  3. Central Corneal Thickness And Its Relationship To Intra-ocular And Epidemiological Determinants

    International Nuclear Information System (INIS)

    Tayyab, A.; Masrur, A.

    2016-01-01

    Objective: To measure central corneal thickness in Pakistani population and determine its relationship to intra-ocular pressure, age, gender and ethnicity. Study Design: Cross-sectional observation study. Place and Duration of Study: Pakistan Institute of Medical Sciences, Islamabad, Pakistan, between December 2013 and February 2015. Methodology: The right eyes of 1000 cases (496 males and 504 females) were recruited for this study. Inclusion criteria were Pashtun or Punjabi ethnicity, intra-ocular pressure < 22 mmHg, gonioscopically open angles, cup-disk-ratio < 0.5, and age matched normal visual fields. Cases with prior ocular surgery, contact lens use, corneal pathologies, myopia or hypermetropia > ±3.0 diopters, astigmatism of > ±1.0 diopters were excluded. Central corneal thickness was measured using a TopCon non-contact specular microscope. Intra-ocular pressure was measured using Goldmann applanation tonometer. Frequency distribution, test of significance, and regression analysis was carried out using Statistical Package for Social Sciences version 20.0. Result: Mean age was 47.31 ±11.78 years. Ethnic composition was 51.6 percentage (n=516) Pashtun and 48.4 percentage (n=484) Punjabi. The mean central corneal thickness was 503.96 (±12.47) meu m, while the mean intra-ocular pressure was 15.61 (±2.68) mmHg. Regression analysis showed a significant association between central corneal thickness and intra-ocular pressure (p=0.00) and age (p=0.00). A ±100 μ change in central corneal thickness was associated with change in IOP of ±3.30 mmHg, whereas central corneal thickness decreased by 0.12 meu m per year. No significant association could be established between central corneal thickness and ethnicity (p=0.19). Conclusion: Central corneal thickness of the studied races was comparable to non-Caucasians which affects intra-ocular pressure measurements, and decreases with increasing age. No relationship was observed between central corneal thickness and

  4. The Influence of Lamellar Orientation on Corneal Material Behavior: Biomechanical and Structural Changes in an Avian Corneal Disorder

    Science.gov (United States)

    Elsheikh, Ahmed; Kassem, Wael; Kamma-Lorger, Christina S.; Hocking, Paul M.; White, Nick; Inglehearn, Chris F.; Ali, Manir; Meek, Keith M.

    2011-01-01

    Purpose. Retinopathy, globe enlarged (RGE) is an inherited genetic disease of chickens with a corneal phenotype characterized by loss of tissue curvature and changes in peripheral collagen fibril alignment. This study aimed to characterize the material behavior of normal and RGE chicken corneas under inflation and compare this with new spatial- and depth-resolved microstructural information to investigate how stromal fibril architecture determines corneal behavior under intraocular pressure (IOP). Methods. Six RGE chicken corneas and six age-matched normal controls were tested using trephinate inflation and their stress-strain behavior determined as a function of posterior pressure. Second harmonic generation mulitphoton microscopy was used to compare the in-plane appearance and degree of through-plane interlacing of collagen lamellae between normal and mutant corneas. Results. RGE corneas displayed a 30–130% increase in material stiffness [Etangent(RGE) = 0.94 ± 0.18 MPa to 3.09 ± 0.66 MPa; Etangent(normals) = 0.72 ± 0.13 MPa to 1.34 ± 0.35 MPa] (P ≤ 0.05). The normal in-plane disposition of anterior collagen in the peripheral cornea was altered in RGE but through-plane lamellar interlacing was unaffected. Conclusions. This article demonstrates changes in corneal material behavior in RGE that are qualitatively consistent with microstructural collagen alterations identified both herein and previously. This study indicates that, in general, changes in stromal fibril orientation may significantly affect corneal material behavior and thereby its response to IOP. PMID:21051696

  5. Inhibition of erythropoietin siRNA on corneal neovascularization of rabbit

    Directory of Open Access Journals (Sweden)

    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.

  6. Healing of corneal epithelial wounds in marine and freshwater fish.

    Science.gov (United States)

    Ubels, J L; Edelhauser, H F

    The corneal epithelium of a fish is in direct contact with the aquatic environment and is a barrier to movement of ions and water into and through the cornea. This tissue layer is thus important in maintenance of corneal transparency. When the epithelium is wounded, its protective function is lost and corneal transparency remains compromised until the epithelial barrier is re-established. This study was undertaken to investigate the healing response of the fish cornea to epithelial abrasion. Wounds were stained with fluorescein and photographed during healing. Wound areas were measured by planimetry. The cornea of the sculpin, a marine teleost, becomes edematous after wounding and heals at 2.54 to 3.42 mm2/hr. Nonswelling corneas of the elasmobranchs--dogfish shark and skate--heal at 1.29 mm2/hr, respectively. The wounded eye of the rainbow trout, a freshwater teleost, is stressed by the low osmolality of the environment. Severe corneal edema and cataracts develop following epithelial wounding, and the cornea heals at 0.64 mm2/hr. Although the healing rates in teleosts differ from those in mammals, histology shows that the corneal healing mechanism is essentially the same in fish and mammals.

  7. Fusarium dimerum Species Complex (Fusarium penzigii) Keratitis After Corneal Trauma.

    Science.gov (United States)

    do Carmo, Anália; Costa, Esmeralda; Marques, Marco; Quadrado, Maria João; Tomé, Rui

    2016-12-01

    We report a case of a keratitis associated with a Fusarium penzigii-a Fusarium dimerum species complex (FDSC)-in a 81-year-old woman after a corneal trauma with a tree branch. At patient admittance, slit lamp biomicroscopy revealed an exuberant chemosis, an inferior corneal ulcer with an associated inflammatory infiltrate, a central corneal abscess, bullous keratopathy and posterior synechiae. Corneal scrapes were obtained for identification of bacteria and fungi, and the patient started antibiotic treatment on empirical basis. Few days later, the situation worsened with the development of hypopyon. By that time, Fusarium was identified in cultures obtained from corneal scrapes and the patient started topical amphotericin B 0.15 %. Upon the morphological identification of the Fusarium as a FDSC, and since there was no clinical improvement, the treatment with amphotericin B was suspended and the patient started voriconazole 10 mg/ml, eye drops, hourly and voriconazole 200 mg iv, every 12 h for 1 month. The hypopyon resolved and the inflammatory infiltrate improved, but the abscess persisted at the last follow-up visit. The molecular identification revealed that the FDSC was a F. penzigii.

  8. Determination of corneal elasticity coefficient using the ORA database.

    Science.gov (United States)

    Avetisov, Sergei E; Novikov, Ivan A; Bubnova, Irina A; Antonov, Alexei A; Siplivyi, Vladimir I

    2010-07-01

    To propose a new approach for the study of corneal biomechanics using the Reichert Ocular Response Analyzer (ORA) database, which is based on changes in velocity retardation in the central cornea at the peak of flattening. The ORA applanation curve was analyzed using a mathematical technique, which allowed calculation of the elasticity coefficient (Ke), which is primarily characteristic of the elastic properties of the cornea. Elasticity coefficient values were obtained in patients with presumably different biomechanical properties of the cornea: "normal" cornea (71 eyes, normal group), keratoconus (34 eyes, keratoconus group), LASIK (36 eyes, LASIK group), and glaucoma with elevated and compensated intraocular pressure (lOP) (38 eyes, glaucoma group). The mean Ke value in the normal group was 11.05 +/- 1.6, and the corneal thickness correlation coefficient r2 was 0.48. In the keratoconus group, the mean Ke value was 4.91 +/- 1.87 and the corneal thickness correlation coefficient r2 was 0.47. In the LASIK group, Ke and r2 were 5.99 +/- 1.18 and 0.39, respectively. In the glaucoma group, the same eyes that experienced a two-fold reduction in lOP developed a statistically significant reduction in the Ke (1.06 times lower), whereas their corneal hysteresis value increased 1.25 times. The elasticity coefficient calculated using the ORA applanation curve can be used in the evaluation of corneal biomechanical properties.

  9. The Evaluation of Corneal Fragility After UVA/Riboflavin Crosslinking.

    Science.gov (United States)

    Li, Zhiwei; Wang, Yumeng; Xu, Yanyun; Jhanji, Vishal; Zhang, Chunxiao; Mu, Guoying

    2017-03-01

    To evaluate the fragility of cornea after UVA/riboflavin crosslinking (CXL). Sixty New Zealand rabbits received UVA/riboflavin crosslinking treatment (wavelength 365 nm, irradiance 3.0 mW/cm, and total dose 5.4 J/cm) on right eyes. Animals were sacrificed before and immediately after treatment (day 0), day 1, 3, 7, and 28 after treatment. A 4×10 mm corneal strip for biomechanical evaluation was harvested after sacrifice. The corneal fragility was evaluated by measurement of elongation rate, whereby the elongation rate equals elongation length/baseline length. The Youngs modulus and maximal stress were 1.41±0.51 MPa and 5.56±1.84 MPa before CXL, and increased to 2.31±0.68 MPa (P=0.008) and 9.25±2.74 MPa (P=0.04), respectively, on day 0, then maintained a stable level within a 28 days follow-up. The elongation rate was 62.04±9.34% before CXL and decreased to 48.95%±8.24% (P=0.02) on day 0, then maintained a stable level within a 28 days follow-up. This study showed an increase in the corneal fragility after UVA/riboflavin crosslinking along with an increase in the corneal stiffness. A long-term follow-up should be taken to evaluate the potential deleterious effect of the increasing corneal fragility after UVA/riboflavin crosslinking.

  10. Mechanisms of allograft rejection of corneal endothelium

    International Nuclear Information System (INIS)

    Tagawa, Y.; Silverstein, A.M.; Prendergast, R.A.

    1982-01-01

    The local intraocular graft-vs.-host (GVH) reaction, involving the destruction of the corneal endothelial cells of the rabbit host by sensitized donor lymphoid cells, has been used to study the mechanism of corneal allograft rejection. Pretreatment of donor cells with a specific mouse monoclonal hybridoma anti-T cell antibody and complement suppresses the destructive reaction, suggesting that a cellular-immune mechanism is primarily involved. Pretreatment of donor cells with mitomycin-C completely abolishes the local GVH reaction, indicating that the effector lymphocytes must undergo mitosis within the eye before they can engage in target cell destruction. Finally, studies of the local GVH reaction in irradiated leukopenic recipients or in preinflamed rabbit eyes suggest that host leukocytes may contribute nonspecifically to enhance the destructive process. These studies show that the local ocular GVH reaction may provide a useful model for the study of the mechanisms involved in the rejection of corneal allografts

  11. Crystalline and Crystalline International Disposal Activities

    Energy Technology Data Exchange (ETDEWEB)

    Viswanathan, Hari S. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Chu, Shaoping [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Reimus, Paul William [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Makedonska, Nataliia [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Hyman, Jeffrey De' Haven [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Karra, Satish [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Dittrich, Timothy M. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2015-12-21

    This report presents the results of work conducted between September 2014 and July 2015 at Los Alamos National Laboratory in the crystalline disposal and crystalline international disposal work packages of the Used Fuel Disposition Campaign (UFDC) for DOE-NE’s Fuel Cycle Research and Development program.

  12. Changes in corneal epithelial layer inflammatory cells in aqueous tear-deficient dry eye.

    Science.gov (United States)

    Lin, Hui; Li, Wei; Dong, Nuo; Chen, Wensheng; Liu, Jing; Chen, Lelei; Yuan, Hongxia; Geng, Zhixin; Liu, Zuguo

    2010-01-01

    To investigate the morphology, distribution, and density of inflammatory cells in the corneal epithelium of aqueous tear-deficient dry eye. Thirty-two patients with non-Sjögren's syndrome (NSS) dry eye, 14 patients with Sjögren's syndrome (SS) dry eye, and 33 healthy volunteers were studied. In vivo laser scanning confocal microscopy was used to investigate both Langerhans cell (LCs) and leukocyte distribution and density in the peripheral and central corneal epithelium. LC morphology was also evaluated. Multifactor regression analysis assessed whether there is a correlation between clinical manifestations and inflammatory cell densities. LCs were present in both central (34.9 +/- 5.7 cells/mm(2)) and peripheral (90.7 +/- 8.2 cells/mm(2)) parts of the normal corneal epithelium. Moreover, LC density increased dramatically in the central corneal epithelium in patients with NSS (89.8 +/- 10.8 cells/mm(2)) and SS (127.9 +/- 23.7 cells/mm(2)). The ratio of LCs with obvious processes was much higher in patients with dry eye than in healthy volunteers. LC density also increased in peripheral corneal epithelium in patients with SS, but not in those with NSS. Leukocyte density in normal corneal epithelium was very low, whereas it increased in the central corneal epithelium (4.6 +/- 1.0 cells/mm(2)) in NSS and in both central (49.0 +/- 12.9 cells/mm(2)) and peripheral (84.2 +/- 36.8 cells/mm(2)) corneal epithelium in SS. Densities of LCs and leukocytes showed significant correlation with the severity found in clinical evaluation. The LC and leukocyte changes in the corneal epithelium suggest their involvement in aqueous tear-deficient dry eye pathophysiology. In vivo dynamic assessment of central corneal inflammatory cell density may serve as an indicator of dry eye severity and provide new insight for dry eye treatment.

  13. Corneal endothelial cell loss and corneal biomechanical characteristics after two-step sequential or combined phaco-vitrectomy surgery for idiopathic epiretinal membrane

    DEFF Research Database (Denmark)

    Hamoudi, Hassan; Christensen, Ulrik Correll; La Cour, Morten

    2017-01-01

    with non-contact specular microscopy. Pachymetry [central cornea thickness (CCT)], keratometry and cornea volume (CV) were measured with Pentacam Scheimpflug camera. Primary outcome was change in CED after 12 months; secondary outcomes were changes in CCT and CV after 12 months. RESULTS: Sixty-two eyes......PURPOSE: To assess the impact of sequential and combined surgery [cataract surgery and 23-gauge pars plana vitrectomy (PPV) with peeling] on corneal endothelium cell density (CED) and corneal biomechanical characteristics. METHODS: Phakic eyes with epiretinal membrane (ERM) were prospectively...... allocated to (i) cataract surgery and subsequent PPV (CAT group), (ii) PPV and subsequent cataract surgery (VIT group) or (iii) phacovitrectomy (COMBI group). Eyes were examined at baseline, 1 month after each surgery, and at 3 and 12 months follow-up. Corneal endothelium cell density (CED) was assessed...

  14. Ocular forward light scattering and corneal backward light scattering in patients with dry eye.

    Science.gov (United States)

    Koh, Shizuka; Maeda, Naoyuki; Ikeda, Chikako; Asonuma, Sanae; Mitamura, Hayato; Oie, Yoshinori; Soma, Takeshi; Tsujikawa, Motokazu; Kawasaki, Satoshi; Nishida, Kohji

    2014-09-18

    To evaluate ocular forward light scattering and corneal backward light scattering in patients with dry eye. Thirty-five eyes in 35 patients with dry eye and 20 eyes of 20 healthy control subjects were enrolled. The 35 dry eyes were classified into two groups according to whether superficial punctate keratopathy in the central 6-mm corneal zone (cSPK) was present or not. Ocular forward light scattering was quantified with a straylight meter. Corneal backward light scattering from the anterior, middle, and posterior corneal parts was assessed with a corneal densitometry program using the Scheimpflug imaging system. Both dry eye groups had significantly higher intraocular forward light scattering than the control group (both Pdry eye group with cSPK had significantly higher values in anterior and total corneal backward light scattering than the other two groups. Moderate positive correlations were observed between the cSPK score and corneal backward light scattering from the anterior cornea (R=0.60, Pdry eyes than in normal eyes. Increased corneal backward light scattering in dry eye at least partially results from cSPK overlying the optical zone. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

  15. MICRO DIATHERMOCOAGULATION IN THE TREATMENT OF INFECTIOUS CORNEAL ULCERS

    Directory of Open Access Journals (Sweden)

    E. A. Kasparova

    2016-01-01

    Full Text Available Aim. To improve the treatment of early infectious corneal ulcers by combining microdiathermocoagulation (MDC, external autocytokinotherapy, and antiviral and/or antibacterial therapy. patients and methods. The study enrolled 2 groups of outpatients (a total of 112 patients, 112 eyes who either showed no improvement or deteriorated under 7-day to 1.5-month therapeutic treatment. Group I included 70 patients (70 eyes with superficial corneal ulcers due to herpes virus infection under antiviral therapy (instillations and periocular injections of Poludan (PolyA:PoliU as well as Zovirax 3% ophthalmic ointment, group II — 42 patients (42 eyes with early-stage purulent corneal ulcers under instillations of modern antibiotics (current-generation fluoroquinolones. results and discussion. The combination of MDC and external autocytokinotherapy is the most effective treatment for torpid herpetic ulcerative keratitis that allows a reliable reduction in the recovery period: from 24.1±2.2 days (therapeutic treatment only down to 9.2±1.3 days (both methods plus antiviral therapy. Moreover, MDC is the treatment of choice in outpatients with purulent corneal ulcer in its early stage. The healing period in this case can be also reliably reduced (р<0.05 from 18.6±1.9 days (MDC plus antibacterial therapy. Hence, MDC is a highly effective urgent method of treatment available to ambulatory care patients with herpetic keratitis and early-stage purulent corneal ulcers. External autocytokinotherapy shows a pronounced anti-inflammatory and regenerative effect. When applied together, MDC and external autocytokinotherapy act synergistically and provide twice as short treatment periods. MDC as well as its combination with external autocytokinotherapy, if started early, allow to avoid keratoplasty in most patients with herpetic keratitis and early-stage purulent corneal ulcers.

  16. Does Dry Eye Affect Repeatability of Corneal Topography Measurements?

    Directory of Open Access Journals (Sweden)

    Aysun Şanal Doğan

    2018-04-01

    Full Text Available Objectives: The purpose of this study was to assess the repeatability of corneal topography measurements in dry eye patients and healthy controls. Materials and Methods: Participants underwent consecutive corneal topography measurements (Sirius; Costruzione Strumenti Oftalmici, Florence, Italy. Two images with acquisition quality higher than 90% were accepted. The following parameters were evaluated: minimum and central corneal thickness, aqueous depth, apex curvature, anterior chamber volume, horizontal anterior chamber diameter, iridocorneal angle, cornea volume, and average simulated keratometry. Repeatability was assessed by calculating intra-class correlation coefficient. Results: Thirty-three patients with dry eye syndrome and 40 healthy controls were enrolled to the study. The groups were similar in terms of age (39 [18-65] vs. 30.5 [18-65] years, p=0.198 and gender (M/F: 4/29 vs. 8/32, p=0.366. Intra-class correlation coefficients among all topography parameters within both groups showed excellent repeatability (>0.90. Conclusion: The anterior segment measurements provided by the Sirius corneal topography system were highly repeatable for dry eye patients and are sufficiently reliable for clinical practice and research.

  17. Does Dry Eye Affect Repeatability of Corneal Topography Measurements?

    Science.gov (United States)

    Doğan, Aysun Şanal; Gürdal, Canan; Köylü, Mehmet Talay

    2018-04-01

    The purpose of this study was to assess the repeatability of corneal topography measurements in dry eye patients and healthy controls. Participants underwent consecutive corneal topography measurements (Sirius; Costruzione Strumenti Oftalmici, Florence, Italy). Two images with acquisition quality higher than 90% were accepted. The following parameters were evaluated: minimum and central corneal thickness, aqueous depth, apex curvature, anterior chamber volume, horizontal anterior chamber diameter, iridocorneal angle, cornea volume, and average simulated keratometry. Repeatability was assessed by calculating intra-class correlation coefficient. Thirty-three patients with dry eye syndrome and 40 healthy controls were enrolled to the study. The groups were similar in terms of age (39 [18-65] vs. 30.5 [18-65] years, p=0.198) and gender (M/F: 4/29 vs. 8/32, p=0.366). Intra-class correlation coefficients among all topography parameters within both groups showed excellent repeatability (>0.90). The anterior segment measurements provided by the Sirius corneal topography system were highly repeatable for dry eye patients and are sufficiently reliable for clinical practice and research.

  18. [E-PTFE Membrane for the Management of Perforated Corneal Ulcer].

    Science.gov (United States)

    Pahor, D; Pahor, A

    2016-10-01

    Purpose: To present the surgical management of perforated corneal ulcer using PRECLUDE® Pericardial Membrane, composed of expanded polytetrafluoroethylene (e-PTFE; GORE-TEX®), as an alternative surgical procedure in patients at high risk of graft rejections and to evaluate side effects for a prolonged period. Patients and Methods: The study included all patients who were admitted to our department and underwent surgical repair of perforated corneal ulcer with the e-PTFE membrane between 2010 and 2015. In total, 8 patients (8 eyes) were enrolled. Medical records of all patients were retrospectively reviewed. The operation was performed under peribulbar anaesthesia. Non-absorbable, microporous, watertight 0.1 mm thick e-PTFE membrane was used to close the corneal ulcer. The membrane was cut to overlap the defect adequately and to achieve the desired tissue attachment without preparing the conjunctiva or superficial trephination of the cornea. The membrane was fixed to the healthy cornea with several non-absorbable sutures (Prolene® 10.0), in order to achieve the proper stress without wrinkling. Results: Five of 8 patients were treated for systemic immunological diseases. Sjögren's syndrome was diagnosed in 2 patients, granulomatosis with polyangiitis in one, vasculitis with a history of previous sclerokeratitis in one and systemic lupus erythematosus in one. In 2 patients, corneal perforation was observed as a complication of corneal infection and in one patient as a late complication of a severe chemical burn. Corneal perforations were successfully covered with e-PTFE membrane in all patients. E-PTFE membrane was well tolerated in all patients and the eye was always preserved. After 3 to 4 months, the membrane was removed in 7 patients. The underlying cornea was thin, firm, stable and vascularised. In one patient with Sjögren's syndrome, the e-PTFE membrane is still in place. Conclusion: Surgical management of perforated corneal ulcer using E-PTFE membrane

  19. Resolution of persistent corneal erosion after administration of topical rebamipide

    Directory of Open Access Journals (Sweden)

    Kashima T

    2012-08-01

    Full Text Available Tomoyuki Kashima,1,2 Hideo Akiyama,1 Fumihide Miura,2 Shoji Kishi11Department of Ophthalmology, Gunma University School of Medicine, Maebashi, Japan; 2Department of Ophthalmology, Saku Central Hospital, Saku, JapanAbstract: Rebamipide is an antiulcer agent used to treat gastric ulcer and gastritis. Biological effects of rebamipide include cytoprotection, wound healing, and anti-inflammatory properties that are known to be universal for a variety of tissues in addition to gastrointestinal mucosa. The therapeutic effects of rebamipide eye drops are due to its ability to increase corneal and conjunctival mucin-like substances and improve corneal and conjunctival injury in vivo. In this paper, we report a case of Sjögren's syndrome with complete disappearance of corneal erosion after administration of rebamipide eye drops. This was observed even though corneal erosion had not improved for 6 months after punctal occlusion surgery. The patient was a 33-year-old female, diagnosed with Sjögren's syndrome by a salivary gland biopsy. The corneal and conjunctival surfaces were filled with dense erosions, which did not improve with topical drugs. Punctal plugs were applied several times; however, the plugs were repeatedly shed. All four puncta of both eyelids were surgically occluded, and both corneal and conjunctival erosion was clearly improved. However, the erosion in the inferior cornea of both eyes had not improved for 6 months after surgery. We used the newly approved topical rebamipide for treatment of this patient. The corneal erosion gradually improved and completely disappeared 4 weeks after administration of the drug. Dry eye sensation disappeared at the same time. Both membrane-associated mucin and secreted mucin in the ocular surface are thought to be essential for maintenance of the tear film. Induction of mucin from ocular surface epithelium could be an effective treatment in cases of dry eye caused by mucin deficiency. Through its various

  20. 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.

  1. Discovery of molecular markers to discriminate corneal endothelial cells in the human body

    NARCIS (Netherlands)

    Yoshihara, Masahito; Ohmiya, Hiroko; Hara, Susumu; Kawasaki, Satoshi; Hayashizaki, Yoshihide; Itoh, Masayoshi; Kawaji, Hideya; Tsujikawa, Motokazu; Nishida, Kohji; Clevers, J.C.; van de Wetering, M.L.

    2015-01-01

    The corneal endothelium is a monolayer of hexagonal corneal endothelial cells (CECs) on the inner surface of the cornea. CECs are critical in maintaining corneal transparency through their barrier and pump functions. CECs in vivo have a limited capacity in proliferation, and loss of a significant

  2. Discovery of Molecular Markers to Discriminate Corneal Endothelial Cells in the Human Body

    NARCIS (Netherlands)

    Yoshihara, Masahito; Ohmiya, Hiroko; Hara, Susumu; Kawasaki, Satoshi; Hayashizaki, Yoshihide; Itoh, Masayoshi; Kawaji, Hideya; Tsujikawa, Motokazu; Nishida, Kohji; Forrest, Alistair R. R.; Rehli, Michael; Baillie, J. Kenneth; de Hoon, Michiel J. L.; Haberle, Vanja; Lassmann, Timo; Kulakovskiy, Ivan V.; Lizio, Marina; Andersson, Robin; Mungall, Christopher J.; Meehan, Terrence F.; Schmeier, Sebastian; Bertin, Nicolas; Jørgensen, Mette; Dimont, Emmanuel; Arner, Erik; Schmidl, Christian; Schaefer, Ulf; Medvedeva, Yulia A.; Plessy, Charles; Vitezic, Morana; Severin, Jessica; Semple, Colin A.; Ishizu, Yuri; Francescatto, Margherita; Alam, Intikhab; Albanese, Davide; Altschuler, Gabriel M.; Archer, John A. C.; Arner, Peter; Babina, Magda; Baker, Sarah; Balwierz, Piotr J.; Beckhouse, Anthony G.; Pradhan-Bhatt, Swati; Blake, Judith A.; Blumenthal, Antje; Bodega, Beatrice; Bonetti, Alessandro; Briggs, James; Geijtenbeek, Teunis B.

    2015-01-01

    The corneal endothelium is a monolayer of hexagonal corneal endothelial cells (CECs) on the inner surface of the cornea. CECs are critical in maintaining corneal transparency through their barrier and pump functions. CECs in vivo have a limited capacity in proliferation, and loss of a significant

  3. Corneal Epithelial Remodeling and Its Effect on Corneal Asphericity after Transepithelial Photorefractive Keratectomy for Myopia

    Directory of Open Access Journals (Sweden)

    Jie Hou

    2016-01-01

    Full Text Available Purpose. To evaluate the changes in epithelial thickness profile following transepithelial photorefractive keratectomy (T-PRK for myopia and to investigate the effect of epithelial remodeling on corneal asphericity. Methods. Forty-four patients (44 right eyes who underwent T-PRK were retrospectively evaluated. Epithelial thickness was measured using spectral-domain optical coherence tomography at different corneal zones (central, 2 mm; paracentral, 2–5 mm; and mid-peripheral, 5-6 mm preoperatively and at 1 week and 1, 3, and 6 months postoperatively. The correlation between the changes in corneal epithelial thickness (ΔCET and postoperative Q-value changes (ΔQ was analyzed 6 months postoperatively. Results. Epithelial thickness at 6 months showed a negative meniscus-like lenticular pattern with less central thickening, which increased progressively toward the mid-periphery (3.69±4.2, 5.19±3.8, and 6.23±3.9 μm at the center, paracenter, and mid-periphery, resp., P<0.01. A significant positive relationship was observed between epithelial thickening and ΔQ 6 months postoperatively (r=0.438, 0.580, and 0.504, resp., P<0.01. Conclusions. Significant epithelial thickening was observed after T-PRK and showed a lenticular change with more thickening mid-peripherally, resulting in increased oblateness postoperatively. Epithelial remodeling may modify the epithelial thickness profile after surface ablation refractive surgery for myopia.

  4. A genome-wide association study of corneal astigmatism: The CREAM Consortium

    OpenAIRE

    Shah, Rupal L.; Li, Qing; Zhao, Wanting; Tedja, Milly S.; Tideman, J. Willem L.; Khawaja, Anthony P.; Fan, Qiao; Yazar, Seyhan; Williams, Katie M.; Verhoeven, Virginie J.M.; Xie, Jing; Wang, Ya Xing; Hess, Moritz; Nickels, Stefan; Lackner, Karl J.

    2018-01-01

    Purpose To identify genes and genetic markers associated with corneal astigmatism. Methods: A meta-analysis of genome-wide association studies (GWASs) of corneal astigmatism undertaken for 14 European ancestry (n=22,250) and 8 Asian ancestry (n=9,120) cohorts was performed by the Consortium for Refractive Error and Myopia. Cases were defined as having >0.75 diopters of corneal astigmatism. Subsequent gene-based and gene-set analyses of the meta-analyzed results of European ancestry cohorts we...

  5. A genome-wide association study of corneal astigmatism: The CREAM Consortium

    OpenAIRE

    Shah, Rupal L.; Li, Qing; Zhao, Wanting; Tedja, Milly S.; Tideman, J. Willem L.; Khawaja, Anthony P.; Fan, Qiao; Yazar, Seyhan; Williams, Katie M.; Verhoeven, Virginie J.M.; Xie, Jing; Wang, Ya Xing; Hess, Moritz; Nickels, Stefan; Lackner, Karl J.

    2018-01-01

    Purpose To identify genes and genetic markers associated with corneal astigmatism. Methods A meta-analysis of genome-wide association studies (GWASs) of corneal astigmatism undertaken for 14 European ancestry (n=22,250) and 8 Asian ancestry (n=9,120) cohorts was performed by the Consortium for Refractive Error and Myopia. Cases were defined as having >0.75 diopters of corneal astigmatism. Subsequent gene-based and gene-set analyses of the meta-analyzed results of European ancestry cohorts wer...

  6. A genome-wide association study of corneal astigmatism: The CREAM Consortium.

    OpenAIRE

    Shah, Rupal L; Li, Qing; Zhao, Wanting; Tedja, Milly S; Tideman, J Willem L; Khawaja, Anthony P; Fan, Qiao; Yazar, Seyhan; Williams, Katie M; Verhoeven, Virginie J M; Xie, Jing; Wang, Ya Xing; Hess, Moritz; Nickels, Stefan; Lackner, Karl J

    2018-01-01

    Purpose To identify genes and genetic markers associated with corneal astigmatism. Methods A meta-analysis of genome-wide association studies (GWASs) of corneal astigmatism undertaken for 14 European ancestry (n=22,250) and 8 Asian ancestry (n=9,120) cohorts was performed by the Consortium for Refractive Error and Myopia. Cases were defined as having >0.75 diopters of corneal astigmatism. Subsequent gene-based and gene-set analyses of the meta-analyzed results of European ancestry...

  7. A genome-wide association study of corneal astigmatism : The CREAM Consortium

    OpenAIRE

    Shah, Rupal L.; Li, Qing; Zhao, Wanting; Tedja, Milly S.; Tideman, J. Willem L.; Khawaja, Anthony P.; Fan, Qiao; Yazar, Seyhan; Williams, Katie M.; Verhoeven, Virginie J.M.; Xie, Jing; Wang, Ya Xing; Hess, Moritz; Nickels, Stefan; Lackner, Karl J.

    2018-01-01

    Purpose: To identify genes and genetic markers associated with corneal astigmatism. Methods: A meta-analysis of genome-wide association studies (GWASs) of corneal astigmatism undertaken for 14 European ancestry (n=22,250) and 8 Asian ancestry (n=9,120) cohorts was performed by the Consortium for Refractive Error and Myopia. Cases were defined as having >0.75 diopters of corneal astigmatism. Subsequent gene-based and gene-set analyses of the meta-analyzed results of European ancestry cohor...

  8. A genome-wide association study of corneal astigmatism:The CREAM consortium

    OpenAIRE

    Shah, Rupal L.; Li, Qing; Zhao, Wanting; Tedja, Milly S.; Tideman, J. Willem L.; Khawaja, Anthony P.; Fan, Qiao; Yazar, Seyhan; Williams, Katie M.; Verhoeven, Virginie J.M.; Xie, Jing; Wang, Ya Xing; Hess, Moritz; Nickels, Stefan; Lackner, Karl J.

    2018-01-01

    Purpose: To identify genes and genetic markers associated with corneal astigmatism. Methods: A meta-analysis of genome-wide association studies (GWASs) of corneal astigmatism undertaken for 14 European ancestry (n=22,250) and 8 Asian ancestry (n=9,120) cohorts was performed by the Consortium for Refractive Error and Myopia. Cases were defined as having >0.75 diopters of corneal astigmatism. Subsequent gene-based and gene-set analyses of the meta-analyzed results of European ancestry cohort...

  9. Applications of Biomaterials in Corneal Endothelial Tissue Engineering.

    Science.gov (United States)

    Wang, Tsung-Jen; Wang, I-Jong; Hu, Fung-Rong; Young, Tai-Horng

    2016-11-01

    When corneal endothelial cells (CECs) are diseased or injured, corneal endothelium can be surgically removed and tissue from a deceased donor can replace the original endothelium. Recent major innovations in corneal endothelial transplantation include replacement of diseased corneal endothelium with a thin lamellar posterior donor comprising a tissue-engineered endothelium carried or cultured on a thin substratum with an organized monolayer of cells. Repairing CECs is challenging because they have restricted proliferative ability in vivo. CECs can be cultivated in vitro and seeded successfully onto natural tissue materials or synthetic polymeric materials as grafts for transplantation. The optimal biomaterials for substrata of CEC growth are being investigated. Establishing a CEC culture system by tissue engineering might require multiple biomaterials to create a new scaffold that overcomes the disadvantages of single biomaterials. Chitosan and polycaprolactone are biodegradable biomaterials approved by the Food and Drug Administration that have superior biological, degradable, and mechanical properties for culturing substratum. We successfully hybridized chitosan and polycaprolactone into blended membranes, and demonstrated that CECs proliferated, developed normal morphology, and maintained their physiological phenotypes. The interaction between cells and biomaterials is important in tissue engineering of CECs. We are still optimizing culture methods for the maintenance and differentiation of CECs on biomaterials.

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

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    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

  11. Correlation between Corneal Thickness and Degree of Myopic Refractory Error

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    A Mortazavi

    2005-01-01

    Full Text Available Background: corneal thickness is an important factor in refractive surgeries such as Radial Keratotomy (RK, Photo Refractive Keratotomy (PRK and Laser Insitu Keratomileusis (LASIK. This study evaluated the correlation between this factor and the degree of myopic refractory error. Methods: In this cross-sectional study, 224 myopic eyes (112 patients which had undergone LASIK operation were assessed. These patients had referred to Aban Eye Clinic, Isfahan, Iran, during August and September 2002. Corneal thickness was measured by ORB SCAN Topoghraphy, and cycloplegic refraction was performed with autorefratometery and retinoscopy. Suspected keratoconus cases and hyperopic patients were excluded. Results: The patients' age was 27.2 ± 1.36 in men (N = 35 and 30.13 ± 1.04 in women (N = 77. Mean value of myopic refractory error in male patients was 5.1 ± 0.24D and in female patients was 3.8 ± 0.36D. Mean of corneal thickness was 540 ± 5.25 µM and 530 ± 5.88 µM in male and female patients respectively. There was no correlation between the degree of myopia and corneal thickness in any of the patients. Also in this research, no relations between the age and myopia were found. Right eye (P > 0.5, r = 0.124 Left eye (P > 0.5, r = 0.104. Conclusion: Based on our findings, corneal thickness and myopic refectory error do not seem to have any relations. (r = 0.039, p = 0.684. Keywords: Corneal Thickness, Cornea, Myopia, LASIK, Refractory Error

  12. p53 protein expression in corneal squamous cell carcinomas of dogs

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    Lucas Bahdour Cossi

    2015-06-01

    Full Text Available Ocular tumors play an increasing concern in veterinary ophthalmology. Corneal squamous cell carcinoma is unfrequent in dogs, and by this way it has little studies. Studies that investigated the carcinogenesis mechanisms wich could help to the development of ocular squamous cell carcinoma (SCC in dog are rare. The aim of this work was to identify by immunohistochemical techniques, the p53 protein expression in the spontaneous dog corneal SCC. For this work, were used five cases of corneal SCC and one case of actinic keratitis. The sections were obtained from paraffin-wax blocks and submitted to histopathological and immunohistochemical analysis. All the six samples showed immunolabeling to cytokeratin and p53 protein. These results support the conclusions that the immunoreactivity of p53 protein by immunohistochemistry is present in canine corneal SCC suppporting its role in carcinogenesis of this tumor, but not provides prognostic indicators in cases of SCC corneal in dog; and can be a association of exposure to solar radiation with the possible mutation of the TP53 gene.

  13. Host immune cellular reactions in corneal neovascularization

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    Nizar S. Abdelfattah

    2016-04-01

    Full Text Available Corneal neovascularization (CNV is a global important cause of visual impairment. The immune mechanisms leading to corneal heme- and lymphangiogenesis have been extensively studied over the past years as more attempts were made to develop better prophylactic and therapeutic measures. This article aims to discuss immune cells of particular relevance to CNV, with a focus on macrophages, Th17 cells, dendritic cells and the underlying immunology of common pathologies involving neovascularization of the cornea. Hopefully, a thorough understanding of these topics would propel the efforts to halt the detrimental effects of CNV.

  14. [New international classification of corneal dystrophies and clinical landmarks].

    Science.gov (United States)

    Lisch, W; Seitz, B

    2008-07-01

    The International Committee on Classification of Corneal Dystrophies, briefly IC (3)D, was founded with the sponsorship of the American Cornea Society and the American Academy of Ophthalmology in July 2005. This committee consists of 17 corneal experts (1) from USA, Asia and Europe. The goal of this group was to develop a new, internationally accepted classification of corneal dystrophies (CD) based on modern clinical, histological and genetical knowledge. The aim of the new classification should be to avoid wrong interpretations and misnomers of the different forms of CD. The IC (3)D extensive manuscript is in press as Supplement publication in the journal "Cornea". The 25 different CD are divided in four categories by clinical and genetical knowledge. Additionally, templates for each type of CD are included. Finally, many typical color slit-lamp photos are presented in the publication together with essential references and current genetical results in tabular form. As members of IC (3)D the authors present a clinical landmark survey of the different corneal dystrophies. The ophthalmologist is the first to examine and to diagnose a new patient with a probable CD at the slit-lamp. Our elaborated table of landmarks is supposed to be a "bridge" for the ophthalmologist to precisely define the corneal opacities of a presumed CD. This "bridge" makes it easier for them to study the IC (3)D Supplement publication and to get more information including adequate differential diagnosis.

  15. Assessment of corneal epithelial thickness in dry eye patients.

    Science.gov (United States)

    Cui, Xinhan; Hong, Jiaxu; Wang, Fei; Deng, Sophie X; Yang, Yujing; Zhu, Xiaoyu; Wu, Dan; Zhao, Yujin; Xu, Jianjiang

    2014-12-01

    To investigate the features of corneal epithelial thickness topography with Fourier-domain optical coherence tomography (OCT) in dry eye patients. In this cross-sectional study, 100 symptomatic dry eye patients and 35 normal subjects were enrolled. All participants answered the ocular surface disease index questionnaire and were subjected to OCT, corneal fluorescein staining, tear breakup time, Schirmer 1 test without anesthetic (S1t), and meibomian morphology. Several epithelium statistics for each eye, including central, superior, inferior, minimum, maximum, minimum - maximum, and map standard deviation, were averaged. Correlations of epithelial thickness with the symptoms of dry eye were calculated. The mean (±SD) central, superior, and inferior corneal epithelial thickness was 53.57 (±3.31) μm, 52.00 (±3.39) μm, and 53.03 (±3.67) μm in normal eyes and 52.71 (±2.83) μm, 50.58 (±3.44) μm, and 52.53 (±3.36) μm in dry eyes, respectively. The superior corneal epithelium was thinner in dry eye patients compared with normal subjects (p = 0.037), whereas central and inferior epithelium were not statistically different. In the dry eye group, patients with higher severity grades had thinner superior (p = 0.017) and minimum (p dry eye corneal epithelium was thinner than normal eyes in the superior region. In more severe dry eye disease patients, the superior and minimum epithelium was much thinner, with a greater range of map standard deviation.

  16. Tissue and cellular biomechanics during corneal wound injury and repair.

    Science.gov (United States)

    Raghunathan, Vijay Krishna; Thomasy, Sara M; Strøm, Peter; Yañez-Soto, Bernardo; Garland, Shaun P; Sermeno, Jasmyne; Reilly, Christopher M; Murphy, Christopher J

    2017-08-01

    Corneal wound healing is an enormously complex process that requires the simultaneous cellular integration of multiple soluble biochemical cues, as well as cellular responses to the intrinsic chemistry and biophysical attributes associated with the matrix of the wound space. Here, we document how the biomechanics of the corneal stroma are altered through the course of wound repair following keratoablative procedures in rabbits. Further we documented the influence that substrate stiffness has on stromal cell mechanics. Following corneal epithelial debridement, New Zealand white rabbits underwent phototherapeutic keratectomy (PTK) on the right eye (OD). Wound healing was monitored using advanced imaging modalities. Rabbits were euthanized and corneas were harvested at various time points following PTK. Tissues were characterized for biomechanics with atomic force microscopy and with histology to assess inflammation and fibrosis. Factor analysis was performed to determine any discernable patterns in wound healing parameters. The matrix associated with the wound space was stiffest at 7days post PTK. The greatest number of inflammatory cells were observed 3days after wounding. The highest number of myofibroblasts and the greatest degree of fibrosis occurred 21days after wounding. While all clinical parameters returned to normal values 400days after wounding, the elastic modulus remained greater than pre-surgical values. Factor analysis demonstrated dynamic remodeling of stroma occurs between days 10 and 42 during corneal stromal wound repair. Elastic modulus of the anterior corneal stroma is dramatically altered following PTK and its changes coincide initially with the development of edema and inflammation, and later with formation of stromal haze and population of the wound space with myofibroblasts. Factor analysis demonstrates strongest correlation between elastic modulus, myofibroblasts, fibrosis and stromal haze thickness, and between edema and central corneal

  17. In-vivo corneal pulsation in relation to in-vivo intraocular pressure and corneal biomechanics assessed in-vitro. An animal pilot study.

    Science.gov (United States)

    Rogala, Maja M; Danielewska, Monika E; Antończyk, Agnieszka; Kiełbowicz, Zdzisław; Rogowska, Marta E; Kozuń, Marta; Detyna, Jerzy; Iskander, D Robert

    2017-09-01

    The aim was to ascertain whether the characteristics of the corneal pulse (CP) measured in-vivo in a rabbit eye change after short-term artificial increase of intraocular pressure (IOP) and whether they correlate with corneal biomechanics assessed in-vitro. Eight New Zealand white rabbits were included in this study and were anesthetized. In-vivo experiments included simultaneous measurements of the CP signal, registered with a non-contact method, IOP, intra-arterial blood pressure, and blood pulse (BPL), at the baseline and short-term elevated IOP. Afterwards, thickness of post-mortem corneas was determined and then uniaxial tensile tests were conducted leading to estimates of their Young's modulus (E). At the baseline IOP, backward stepwise regression analyses were performed in which successively the ocular biomechanical, biometric and cardiovascular predictors were separately taken into account. Results of the analysis revealed that the 3rd CP harmonic can be statistically significantly predicted by E and central corneal thickness (Models: R 2  = 0.662, p biomechanics in-vitro was confirmed. In particular, spectral analysis revealed that higher amplitude and power of the 3rd CP harmonic indicates higher corneal stiffness, while the 1st CP harmonic correlates positively with the corresponding harmonic of the BPL signal. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. IκB kinase β regulates epithelium migration during corneal wound healing.

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    Liang Chen

    2011-01-01

    Full Text Available The IKKβ is known to regulate transcription factor NF-κB activation leading to inflammatory responses. Recent gene knockout studies have shown that IKKβ can orchestrate local inflammatory responses and regulate homeostasis of epithelial tissues. To investigate whether IKKβ has an intrinsic role in epithelial cells, we established an in vivo system in the immune privileged corneal epithelium. We generated triple transgenic Krt12(rtTA/rtTAt/tet-O-Cre/Ikkβ(F/F (Ikkβ(ΔCE/ΔCE mice by crossing the Krt12-rtTA knock-in mice, which express the reverse tetracycline transcription activator in corneal epithelial cells, with the tet-O-Cre and Ikkβ(F/F mice. Doxycycline-induced IKKβ ablation occurred in corneal epithelial cells of triple transgenic Ikkβ(ΔCE/ΔCE mice, but loss of IKKβ did not cause ocular abnormalities in fetal development and postnatal maintenance. Instead, loss of IKKβ significantly delayed healing of corneal epithelial debridement without affecting cell proliferation, apoptosis or macrophage infiltration. In vitro studies with human corneal epithelial cells (HCEpi also showed that IKKβ was required for cytokine-induced cell migration and wound closure but was dispensable for cell proliferation. In both in vivo and in vitro settings, IKKβ was required for optimal activation of NF-κB and p38 signaling in corneal epithelial cells, and p38 activation is likely mediated through formation of an IKKβ-p38 protein complex. Thus, our studies in corneal epithelium reveal a previously un-recognized role for IKKβ in the control of epithelial cell motility and wound healing.

  19. Corneal aldehyde dehydrogenase and glutathione S-transferase activity after excimer laser keratectomy in guinea pigs.

    Science.gov (United States)

    Bilgihan, K; Bilgihan, A; Hasanreisoğlu, B; Turkozkan, N

    1998-03-01

    The free radical balance of the eye may be changed by excimer laser keratectomy. Previous studies have demonstrated that excimer laser keratectomy increases the corneal temperature, decreases the superoxide dismutase activity of the aqueous, and induces lipid peroxidation in the superficial corneal stroma. Aldehyde dehydrogenase (ALDH) and glutathione S-transferase (GST) are known to play an important role in corneal metabolism, particularly in detoxification of aldehydes, which are generated from free radical reactions. In three groups of guinea pigs mechanical corneal de-epithelialisation was performed in group I, superficial corneal photoablation in group II, and deep corneal photoablation in group III, and the corneal ALDH and GST activities measured after 48 hours. The mean ALDH and GST activities of group I and II showed no differences compared with the controls (p > 0.05). The corneal ALDH activities were found to be significantly decreased (p < 0.05) and GST activities increased (p < 0.05) in group III. These results suggest that excimer laser treatment of high myopia may change the ALDH and GST activities, metabolism, and free radical balance of the cornea.

  20. Treatment with mPEG-SPA improves the survival of corneal grafts in rats by immune camouflage.

    Science.gov (United States)

    Wang, Shuangyong; Li, Liangliang; Liu, Ying; Li, Chaoyang; Zhang, Min; Wang, Bowen; Huang, Zheqian; Gao, Xinbo; Wang, Zhichong

    2015-03-01

    We investigated the immune camouflage effects of methoxy polyethylene glycol succinimidyl propionate (mPEG-SPA) on corneal antigens and explored a novel approach for reducing corneal antigenicity, thereby decreasing corneal graft rejection. Importantly, this approach did not alter normal local immunity. Corneal grafts were treated with mPEG-SPA 5KD or 20KD (3% W/V), which could shield major histocompatibility antigen class I molecules (RT1-A) of corneal grafts. Skin grafts of Wistar rats were transplanted to SD rats. Then the splenic lymphocytes were isolated from SD rats. Subsequently, the lymphocytes were co-cultured with autologous corneal grafts or untreated corneal grafts and PEGylated grafts treated with mPEG-SPA 5KD or 20KD obtained from the counterpart skin donors, which were used as autologous control, allogeneic control, mPEG-SPA 5KD group and mPEG-SPA 20KD group, respectively. Lymphocyte proliferation was lower in mPEG-SPA 5KD group and mPEG-SPA 20KD group than in the allogeneic control. SD rats with corneal neovascularisation were used as recipients for high-risk corneal transplantation and were randomly divided into four groups: autologous control, allogeneic control, mPEG-SPA 5KD group and mPEG-SPA 20KD group. The recipients received corneal grafts from Wistar rats. Corneal graft survival was prolonged and graft rejection was reduced in the mPEG-SPA 5KD group and the mPEG-SPA 20KD group compared to the allogeneic control. Thus, we think that mPEG-SPA could immunologically camouflage corneal antigens to prolong corneal grafts survival in high-risk transplantation. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Evaluation of Corneal Topography and Biomechanical Parameters after Use of Systemic Isotretinoin in Acne Vulgaris

    Directory of Open Access Journals (Sweden)

    Yusuf Yildirim

    2014-01-01

    Full Text Available Purpose. We report the effect of isotretinoin on corneal topography, corneal thickness, and biomechanical parameters in patients with acne vulgaris. Method. Fifty-four eyes of 54 patients who received oral isotretinoin for treatment of acne vulgaris were evaluated. All patients underwent a corneal topographical evaluation with a Scheimpflug camera combined with Placido-disk (Sirius, ultrasonic pachymetry measurements, and corneal biomechanical evaluation with an ocular response analyzer at baseline, in the 1st, 3rd, and 6th months of treatment, and 6 months after isotretinoin discontinuation. Results. The thinnest corneal thickness measured with Sirius differed significantly in the 1st, 3rd, and 6th months compared with the baseline measurement; there was no significant change in ultrasonic central corneal thickness measurements and biomechanical parameters (corneal hysteresis and corneal resistance factor throughout the study. Average simulated keratometry and surface asymmetry index increased significantly only in the first month of treatment according to the baseline. All changes disappeared 6 months after the end of treatment. Conclusion. Basal tear secretion and corneal morphologic properties were significantly influenced during the systemic isotretinoin treatment and the changes were reversible after discontinuation. No statistical important biomechanical differences were found to be induced by isotretinoin.

  2. The Favorable Effect of Mesenchymal Stem Cell Treatment on the Antioxidant Protective Mechanism in the Corneal Epithelium and Renewal of Corneal Optical Properties Changed after Alkali Burns

    OpenAIRE

    Cejka, Cestmir; Holan, Vladimir; Trosan, Peter; Zajicova, Alena; Javorkova, Eliska; Cejkova, Jitka

    2016-01-01

    The aim of this study was to examine whether mesenchymal stem cells (MSCs) and/or corneal limbal epithelial stem cells (LSCs) influence restoration of an antioxidant protective mechanism in the corneal epithelium and renewal of corneal optical properties changed after alkali burns. The injured rabbit corneas (with 0.25 N NaOH) were untreated or treated with nanofiber scaffolds free of stem cells, with nanofiber scaffolds seeded with bone marrow MSCs (BM-MSCs), with adipose tissue MSCs (Ad-MSC...

  3. Isolated corneal papilloma-like lesion associated with human papilloma virus type 6.

    Science.gov (United States)

    Park, Choul Yong; Kim, Eo-Jin; Choi, Jong Sun; Chuck, Roy S

    2011-05-01

    To report a case of a corneal papilloma-like lesion associated with human papilloma virus type 6. A 48-year-old woman presented with a 2-year history of ocular discomfort and gradual visual deterioration in her right eye. Ophthalmic examination revealed an elevated, semitranslucent, well-defined vascularized mass approximately 4 × 2.5 mm in size localized to the right cornea. The surface of the mass appeared smooth and many small, shallow, and irregular elevations were noted. An excisional biopsy was performed. The underlying cornea was markedly thinned, and fine ramifying vasculature was also noted on the exposed corneal stroma. Typical koilocytic change was observed on the histopathologic examination. Polymerase chain reaction revealed the existence of human papilloma virus type 6 DNA. Here we describe a case of an isolated corneal papilloma-like lesion. Although the corneal extension of the limbal or the conjunctival papillomas has been commonly observed, an isolated corneal papilloma-like lesion with underlying stromal destruction has only rarely been reported.

  4. 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.

  5. In vivo human corneal hydration control dynamics: A new model

    NARCIS (Netherlands)

    Odenthal, M.T.P.; Nieuwendaal, C.P.; Venema, H.W.; Oosting, J.; Kok, J.H.C.; Kijlstra, A.

    1999-01-01

    PURPOSE. To introduce a new model describing human in vivo corneal deswelling after hypoxic contact lens wear, based on a damped harmonic oscillator, which can describe an overshoot in corneal deswelling, to compare this new model with the currently used exponential model, and also to test whether a

  6. In vivo human corneal hydration control dynamics: a new model

    NARCIS (Netherlands)

    Odenthal, M. T.; Nieuwendaal, C. P.; Venema, H. W.; Oosting, J.; Kok, J. H. C.; Kijlstra, A.

    1999-01-01

    PURPOSE: To introduce a new model describing human in vivo corneal deswelling after hypoxic contact lens wear, based on a damped harmonic oscillator, which can describe an overshoot in corneal deswelling, to compare this new model with the currently used exponential model, and also to test whether a

  7. Crystalline Silica Primer

    Science.gov (United States)

    ,

    1992-01-01

    Crystalline silica is the scientific name for a group of minerals composed of silicon and oxygen. The term crystalline refers to the fact that the oxygen and silicon atoms are arranged in a threedimensional repeating pattern. This group of minerals has shaped human history since the beginning of civilization. From the sand used for making glass to the piezoelectric quartz crystals used in advanced communication systems, crystalline silica has been a part of our technological development. Crystalline silica's pervasiveness in our technology is matched only by its abundance in nature. It's found in samples from every geologic era and from every location around the globe. Scientists have known for decades that prolonged and excessive exposure to crystalline silica dust in mining environments can cause silicosis, a noncancerous lung disease. During the 1980's, studies were conducted that suggested that crystalline silica also was a carcinogen. As a result of these findings, crystalline silica has been regulated under the Occupational Safety and Health Administration's (OSHA) Hazard Communication Standard (HCS). Under HCS, OSHAregulated businesses that use materials containing 0.1% or more crystalline silica must follow Federal guidelines concerning hazard communication and worker training. Although the HCS does not require that samples be analyzed for crystalline silica, mineral suppliers or OSHAregulated

  8. Corticosteroids for bacterial keratitis: the Steroids for Corneal Ulcers Trial (SCUT).

    Science.gov (United States)

    Srinivasan, Muthiah; Mascarenhas, Jeena; Rajaraman, Revathi; Ravindran, Meenakshi; Lalitha, Prajna; Glidden, David V; Ray, Kathryn J; Hong, Kevin C; Oldenburg, Catherine E; Lee, Salena M; Zegans, Michael E; McLeod, Stephen D; Lietman, Thomas M; Acharya, Nisha R

    2012-02-01

    To determine whether there is a benefit in clinical outcomes with the use of topical corticosteroids as adjunctive therapy in the treatment of bacterial corneal ulcers. Randomized, placebo-controlled, double-masked, multicenter clinical trial comparing prednisolone sodium phosphate, 1.0%, to placebo as adjunctive therapy for the treatment of bacterial corneal ulcers. Eligible patients had a culture-positive bacterial corneal ulcer and received topical moxifloxacin for at least 48 hours before randomization. The primary outcome was best spectacle-corrected visual acuity (BSCVA) at 3 months from enrollment. Secondary outcomes included infiltrate/scar size, reepithelialization, and corneal perforation. Between September 1, 2006, and February 22, 2010, 1769 patients were screened for the trial and 500 patients were enrolled. No significant difference was observed in the 3-month BSCVA (-0.009 logarithm of the minimum angle of resolution [logMAR]; 95% CI, -0.085 to 0.068; P = .82), infiltrate/scar size (P = .40), time to reepithelialization (P = .44), or corneal perforation (P > .99). A significant effect of corticosteroids was observed in subgroups of baseline BSCVA (P = .03) and ulcer location (P = .04). At 3 months, patients with vision of counting fingers or worse at baseline had 0.17 logMAR better visual acuity with corticosteroids (95% CI, -0.31 to -0.02; P = .03) compared with placebo, and patients with ulcers that were completely central at baseline had 0.20 logMAR better visual acuity with corticosteroids (-0.37 to -0.04; P = .02). We found no overall difference in 3-month BSCVA and no safety concerns with adjunctive corticosteroid therapy for bacterial corneal ulcers. Adjunctive topical corticosteroid use does not improve 3-month vision in patients with bacterial corneal ulcers. clinicaltrials.gov Identifier: NCT00324168.

  9. Hyaluronan protection of corneal endothelial cells against extracellular histones after phacoemulsification.

    Science.gov (United States)

    Kawano, Hiroki; Sakamoto, Taiji; Ito, Takashi; Miyata, Kazunori; Hashiguchi, Teruto; Maruyama, Ikuro

    2014-11-01

    To determine the effect of histones on corneal endothelial cells generated during cataract surgery. Kagoshima University Hospital, Kagoshima, Japan. Experimental study. Standard phacoemulsification was performed on enucleated pig eyes. Histones in the anterior segment of the eye were determined by immunohistochemistry. Cultured human corneal endothelial cells were exposed to histones for 18 hours, and cell viability was determined by 2-(2-methoxy-4-nitrophenyl)-3-(4-nitro-phenyl)-5-(2,4-disulfophenyl)-2H-tetrazolium, monosodium salt assay. The concentration of interleukin-6 (IL-6) in the culture medium of human corneal endothelial cells was measured using enzyme-linked immunosorbent assay. The effects of signal inhibitors U0126, SB203580, and SP600125 were evaluated. The protective effect of hyaluronan against histones was evaluated in human corneal endothelial cells with and without hyaluronan. Cellular debris containing histones was observed in the anterior chamber of pig eyes after phacoemulsification. Exposure of human corneal endothelial cells to 50 μg/mL of histones or more led to cytotoxic effects. The IL-6 concentration was significantly increased dose dependently after exposure of human corneal endothelial cells to histones (Phistone-induced IL-6 production was significantly decreased by extracellular signal-regulated kinases 1/2 and p-38 mitogen-activated protein kinase inhibitors (Phistones caused formation of histone aggregates, decreased the cytotoxic effects of the histones, and blocked the increase in IL-6 (PHistones were released extracellularly during phacoemulsification and exposure of human corneal endothelial cells to histones increased the IL-6 secretion. The intraoperative use of hyaluronan may decrease the cytotoxic effects of histones released during cataract surgery. 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.

  10. Corneal endothelial cell density and morphology in healthy Turkish eyes.

    Science.gov (United States)

    Arıcı, Ceyhun; Arslan, Osman Sevki; Dikkaya, Funda

    2014-01-01

    Purpose. To describe the normative values of corneal endothelial cell density, morphology, and central corneal thickness in healthy Turkish eyes. Methods. Specular microscopy was performed in 252 eyes of 126 healthy volunteers (M : F, 42 : 84). Parameters studied included mean endothelial cell density (MCD), mean cell area (MCA), coefficient of variation (CV) in cell size, percentage of hexagonal cells, and central corneal thickness (CCT). Results. The mean age of volunteers was 44.3 ± 13.5 (range, 20 to 70) years. There was a statistically significant decrease in MCD (P Filipino eyes and higher than that described in Indian, Thai, and Iranian eyes.

  11. Clinical observation of cryotherapy and amniotic membrane transplantation in the management of Fusarium corneal ulcer

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    Qiong Xie

    2014-10-01

    Full Text Available AIM:To examine the efficacy and safety of cryotherapy in the management of Fusarium corneal ulcer. METHODS: Retrospective contract analysis of the clinical data of 41 patients(41 eyeswho infected with Fusarium corneal ulcer. All of them underwent focal lesion keratectomy combined with amniotic membrane transplantation between January 2010 and May 2013. The cryotherapy treatment group of 22 cases(22 eyes, non-cryotherapy group of 19 cases(19 eyes. All the cases were followed up for 3~12mo. We analyzed the healing of corneal ulcer, corneal neovascularization, postoperative visual acuity, complications and ulcer recurrences. RESULTS: There were no significant difference for the two groups at the cure rate and the recovery rate, the corneal neovascularization and postoperative visual acuity(P>0.05. The total effective rate and corneal healing time in cryotherapy group was significantly higher than that in non-cryotherapy group(PPCONCLUSION: Cryotherapy is an effective and safe method for the treatment of Fusarium corneal ulcer.

  12. Corneal Vibrations during Intraocular Pressure Measurement with an Air-Puff Method

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    Robert Koprowski

    2018-01-01

    Full Text Available Introduction. The paper presents a commentary on the method of analysis of corneal vibrations occurring during eye pressure measurements with air-puff tonometers, for example, Corvis. The presented definition and measurement method allow for the analysis of image sequences of eye responses—cornea deformation. In particular, the outer corneal contour and sclera fragments are analysed, and 3D reconstruction is performed. Methods. On this basis, well-known parameters such as eyeball reaction or corneal response are determined. The next steps of analysis allow for automatic and reproducible separation of four different corneal vibrations. These vibrations are associated with (1 the location of the maximum of cornea deformation; (2 the cutoff area measured in relation to the cornea in a steady state; (3 the maximum of peaks occurring between applanations; and (4 the other characteristic points of the corneal contour. Results. The results obtained enable (1 automatic determination of the amplitude of vibrations; (2 determination of the frequency of vibrations; and (3 determination of the correlation between the selected types of vibrations. Conclusions. These are diagnostic features that can be directly applied clinically for new and archived data.

  13. Effects of Granulocyte-Macrophage Colony-Stimulating (GM-CSF Factor on Corneal Epithelial Cells in Corneal Wound Healing Model.

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    Chang Rae Rho

    Full Text Available Granulocyte-macrophage colony-stimulating factor (GM-CSF is a pleiotropic cytokine that activates granulocyte and macrophage cell lineages. It is also known to have an important function in wound healing. This study investigated the effect of GM-CSF in wound healing of human corneal epithelial cells (HCECs. We used human GM-CSF derived from rice cells (rice cell-derived recombinant human GM-CSF; rhGM-CSF. An in vitro migration assay was performed to investigate the migration rate of HCECs treated with various concentrations of rhGM-CSF (0.1, 1.0, and 10.0 μg/ml. MTT assay and flow cytometric analysis were used to evaluate the proliferative effect of rhGM-CSF. The protein level of p38MAPK was analyzed by western blotting. For in vivo analysis, 100 golden Syrian hamsters were divided into four groups, and their corneas were de-epithelialized with alcohol and a blade. The experimental groups were treated with 10, 20, or 50 μg/ml rhGM-CSF four times daily, and the control group was treated with phosphate-buffered saline. The corneal wound-healing rate was evaluated by fluorescein staining at the initial wounding and 12, 24, 36, and 48 hours after epithelial debridement. rhGM-CSF accelerated corneal epithelial wound healing both in vitro and in vivo. MTT assay and flow cytometric analysis revealed that rhGM-CSF treatment had no effects on HCEC proliferation. Western blot analysis demonstrated that the expression level of phosphorylated p38MAPK increased with rhGM-CSF treatment. These findings indicate that rhGM-CSF enhances corneal wound healing by accelerating cell migration.

  14. Treatment of Corneal Neovascularization Using Anti-VEGF Bevacizumab

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    Deli Krizova

    2014-01-01

    Full Text Available Purpose. To evaluate antiangiogenic effect of local use of bevacizumab (anti-VEGF antibody in patients with corneal neovascularization. Methods. Patients were divided into two groups. All patients suffered from some form of corneal neovascularization (NV. Patients in group A received 0.2–0.5 mL of bevacizumab solution subconjunctivally (concentration 25 mg/mL in a single dose. Group A included 28 eyes from 27. Patients in group B applied bevacizumab eye drops twice daily (concentration 2.5 mg/mL for two weeks. Group B included 38 eyes from 35 patients. We evaluated the number of corneal segments affected by NV, CDVA, and the incidence of complications and subjective complaints related to the treatment. The minimum follow-up period was six months. Results. By the 6-month follow-up, in group A the percentage reduction of the affected peripheral segments was 21.6% and of the central segments was 9.6%; in group B the percentage reduction of the central segments was 22.7% and of the central segments was 38.04%. In both groups we noticed a statistically significant reduction in the extent of NV. Conclusion. The use of bevacizumab seems to be an effective and safe method in the treatment of corneal neovascularization, either in the subconjunctival or topical application form.

  15. Intrastromal corneal ring segments for management of keratoconus

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    Sri Ganesh

    2013-01-01

    Full Text Available Keratoconus is a progressive corneal ectasia, which can be managed both by conservative measures like glasses or contact lenses in non-progressive cases or surgical procedures like collagen crosslinking (CXL with or without adjuvant measures like intrastromal corneal rings segments (ICRS or topography guided ablation. Various kinds of ICRS are available to the surgeon, but it is most essential to be able to plan the implantation of the ring to optimize outcomes. Aims: The aim of this study is to evaluate the visual outcome and progression in patients of keratoconus implanted with ICRS. Materials and Methods: Two different types of ICRS-Intacs (Addition Technology and Kerarings (Mediphacos Inc. were implanted in 2 different cohorts of patients and were followed-up to evaluate the outcome of the procedure. All patients underwent a complete ocular examination including best spectacle corrected visual acuity, slit lamp examination fundus examination, corneal topography and pachymetry. The ICRS implantation is done with CXL to stop the progression of the disease. Improvement in uncorrected visual acuity (UCVA, best spectacle corrected visual acuity and topographic changes were analyzed. Results: A significant improvement in keratometry and vision was seen in both groups. Conclusion: ICRS have been found to reduce corneal irregularity and flatten keratometry with improvement in UCVA and best corrected visual acuity.

  16. The Impact of Pterygium Excision on Corneal Astigmatism

    International Nuclear Information System (INIS)

    Khan, F. A.; Niazi, S. P. K.; Khan, D. A.

    2014-01-01

    Objective: To compare the corneal astigmatism before and after the excision of pterygium and also to determine the correlation of pterygium size with the postoperative corneal astigmatism. Study Design: Cross-sectional interventional study. Place and Duration of Study: Eye Department, Combined Military Hospital, Abbottabad, from May 2011 to March 2012. Methodology: Thirty patients underwent pterygium excision. Pre-operatively Snellen visual acuity, manifest refraction and slit lamp examination was done. The size of the pterygium was recorded in mm by projecting a horizontal slit lamp beam from the limbus to the apex. All the pterygium were equal to or greater than 2.5 mm. Keratometry was performed with an automated keratometer. Keratometric data was recorded pre-operatively and at 28 days postoperatively. Wilcoxon signed rank test was used for comparing the pre-operative and the postoperative corneal astigmatism. Spearman's rank order was calculated to observe correlation of pterygium size with the postoperative astigmatism. Results: The median (mean rank) pre-operative astigmatism of 2.25 (15.50) reduced to a median (mean rank) postoperative astigmatism of 1.30 (14.96). This decrease in the postoperative astigmatism was statistically significant (p < 0.001). There was a statistically non-significant correlation between the postoperative astigmatism and the pterygium size (rs = -0.29, p = 0.12). Conclusion: Pterygium excision caused significant reduction in corneal astigmatism. (author)

  17. Advanced glycation end products delay corneal epithelial wound healing through reactive oxygen species generation.

    Science.gov (United States)

    Shi, Long; Chen, Hongmei; Yu, Xiaoming; Wu, Xinyi

    2013-11-01

    Delayed healing of corneal epithelial wounds is a serious complication in diabetes. Advanced glycation end products (AGEs) are intimately associated with the diabetic complications and are deleterious to the wound healing process. However, the effect of AGEs on corneal epithelial wound healing has not yet been evaluated. In the present study, we investigated the effect of AGE-modified bovine serum albumin (BSA) on corneal epithelial wound healing and its underlying mechanisms. Our data showed that AGE-BSA significantly increased the generation of intracellular ROS in telomerase-immortalized human corneal epithelial cells. However, the generation of intracellular ROS was completely inhibited by antioxidant N-acetylcysteine (NAC), anti-receptor of AGEs (RAGE) antibodies, or the inhibitor of NADPH oxidase. Moreover, AGE-BSA increased NADPH oxidase activity and protein expression of NADPH oxidase subunits, p22phox and Nox4, but anti-RAGE antibodies eliminated these effects. Furthermore, prevention of intracellular ROS generation using NAC or anti-RAGE antibodies rescued AGE-BSA-delayed epithelial wound healing in porcine corneal organ culture. In conclusion, our results demonstrated that AGE-BSA impaired corneal epithelial wound healing ex vivo. AGE-BSA increased intracellular ROS generation through NADPH oxidase activation, which accounted for the delayed corneal epithelial wound healing. These results may provide better insights for understanding the mechanism of delayed healing of corneal epithelial wounds in diabetes.

  18. CORNEAL ENDOTHELIAL CELL DENSITY IN ACUTE ANGLE CLOSURE GLAUCOMA

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    Nishat Sultana K

    2016-09-01

    Full Text Available BACKGROUND Angle closure is characterised by apposition of the peripheral iris against the trabecular meshwork resulting in obstruction of aqueous outflow. Acute angle-closure glaucoma is characterised by pain, redness and blurred vision. The pain is typically a severe deep ache that follows the trigeminal distribution and maybe associated with nausea, vomiting, bradycardia and profuse sweating. The blurred vision, which is typically marked maybe caused by stretching of the corneal lamellae initially and later oedema of the cornea as well as a direct effect of the IOP on the optic nerve head. The modifications in corneal endothelial cell density after a crisis of angle-closure glaucoma is being evaluated. AIMS AND OBJECTIVES The objective of the study is to assess the corneal endothelial cell count (density by specular microscopy in patients presenting with acute angle-closure glaucoma. METHODS Corneal endothelial cell counts of 20 eyes of patients with PACG with an earlier documented symptomatic acute attack unilaterally were compared with 20 fellow eyes. Evaluation of patient included visual acuity, intraocular pressure, gonioscopy, disc findings and specular microscopy. RESULTS The mean endothelial cell density was 2104 cells/mm2 in the eye with acute attack and 2615 cells/mm2 in the fellow eye. The average endothelial cell count when the duration of attack lasted more than 72 hours was 1861 cells/mm2 . CONCLUSION Corneal endothelial cell density was found to be significantly reduced in eyes following an acute attack of primary angle closure glaucoma.

  19. Development and Effects of FTY720 Ophthalmic Solution on Corneal Allograft Survival

    OpenAIRE

    Zhaochuan Liu; Haotian Lin; Chulong Huang; Wan Chen; Wu Xiang; Yu Geng; Weirong Chen

    2015-01-01

    Fingolimod (FTY720), a novel class of sphingosine 1-phosphate receptor modulators, has received special interest among ophthalmologists, particularly given that oral administration of FTY720 has proven to effectively treat corneal graft rejection in animal models. However, no studies have examined the performance of FTY720 as an ophthalmic solution in reducing corneal rejection in high-risk corneal rejection models, and the stability and ocular irritation profile of FTY720 ophthalmic solution...

  20. A new multiple noncontinuous puncture (pointage technique for corneal tattooing

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    Jin Hyoung Park

    2015-10-01

    Full Text Available AIM:To assess the safety and cosmetic efficacy of a new multiple noncontinuous transepithelial puncture technique for tattooing a decompensated cornea.METHODS:It was anon-comparative clinical case series study.The study examines 33 eyes in 33 patients with total corneal opacity due to corneal decompensation, which developed following intraocular surgery.Corneal tattooing was performed using the multiple noncontinuous transepithelial puncture technique (i.e. pointage. The safety of this new surgical strategy was assessed by occurrence of adverse events for the follow-up period. The cosmetic efficacy was determined by the patient’s cosmetic satisfaction and independent observer’s opinion about patient appearance.RESULTS:Seven women and 26 men were included in the study. The mean age was 46.4±17.5y (range:7-67. In total, 30 of 33 patients (91% reported cosmetic satisfaction within the follow-up period. Only 3 patients (9% required additional tattooing due to cosmetic unsatisfaction. Cosmetic outcomes were analyzed and classified as excellent or good in 13 (39% and 17 (52% patients, respectively. No serious adverse events developed, except delayed epithelial healing in 3 cases.CONCLUSION:The cosmetic outcomes of the multiple noncontinuous transepithelial puncture technique for corneal tattooing were good. The safety of this method is higher than conventional procedures. This new procedure also provides improved cost-effectiveness and safety over current corneal tattooing techniques.

  1. Prevalence of corneal astigmatism before cataract surgery in northeast China

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    Zuo-Feng Guo

    2016-05-01

    Full Text Available AIM:To analyze the prevalence and presentation patterns of corneal astigmatism in cataract surgery candidates of Shenyang in northeast China.METHODS:A retrospective survey was used to study the corneal astigmatism which were measured by intraocular lens(IOLMaster optical biometer before cataract surgery between Jan. 1st, 2014 and Dec. 31st, 2014. Descriptive statistics of corneal astigmatism data were analyzed.RESULTS:The keratometric data from 4 543 eyes from 3 821 patients with a mean age of 66.36±10.38y(SD. In 10.50% of eyes, corneal astigmatism was between 0.5 diopters(Dor less; in 30.05% of eyes, it was 0.5-1.0 D; in 23.60%, it was 1.0-1.5 D; in 13.19%, it was 1.5-2.0 D; in 7.68%, it was 2.0-2.5 D; in 6.41%, it was 2.5-3.0 D; in 8.58%, it was 3.0 D or higher. With-the-rule astigmatism was found in 27.69% of eyes, while against-the-rule was found in 53.84% of eyes.CONCLUSION:About 59.46% of eyes in this study had preoperative corneal astigmatism equal to or above 1.0 D. Findings indicated more surgical techniques or toric intraocular lenses to meet the potential demand of the cataract surgery candidates.

  2. Cornea stress test--evaluation of corneal endothelial function in vivo by contact lens induced stress

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    Saini Jagjit

    1997-01-01

    Full Text Available Reliable and valid assessment of corneal endothelial function is a critical input for diagnosing, prognosticating and monitoring progression of disorders affecting corneal endothelium. In 123 eyes, corneal endothelial function was assessed employing data from the corneal hydration recovery dynamics. Serial pachometric readings were recorded on Haag-Striet pachometer with Mishima-Hedbys modification before and after two hours of thick soft contact lens wear. Percentage Recovery Per Hour (PRPH was derived from raw data as an index of endothelial function. Assessed PRPH in pseudophakic corneal oedema and Fuchs′ endothelial dystrophy eyes (35.9 +/- 9.8% was significantly lower than normal controls (61.9 +/- 10.5%. On employing receiver operation characteristics curve analysis the tested results demonstrated high sensitivity (87% and specificity (92% for detection of low endothelial function at PRPH cut off of 47.5%. Using this PRPH cut off, 80% of Fuchs′ endothelial dystrophy and 93.3% of pseudophakic corneal oedema eyes could be demonstrated to have low endothelial function. A total of 66.7% of diabetic eyes also demonstrated PRPH of lower than 47.5%. Clear corneal grafts demonstrated PRPH values of 24.6% to 73.0%. Of 6 corneal grafts that demonstrated initial PRPH of lower than 47.5%, 4 failed within 4 to 6 months. Our data demonstrated high sensitivity and specificity of this corneal stress test. PRPH index was useful in quantifying endothelial function in clinical disorders including diabetes mellitus. The index PRPH was demonstrated to be useful in monitoring and prognosticating outcome of corneal grafts.

  3. Evaluation of corneal thickness alterations during menstrual cycle in productive age women

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    Negar Amiri Ghahfarokhi

    2015-01-01

    Full Text Available Purpose: To determine the change in corneal thickness through different phases of menstrual cycle in women who are in their productive age. Materials and Methods: Fifty healthy women with normal past medical history were enrolled in this prospective study. Central corneal thickness was measured with ultrasound pachymeter three times during a menstrual cycle: Beginning of the cycle (days 1-3, ovulation time, and at the end of cycle (days 27-32. We confirmed ovulation time with determining a peak in luteinizing hormone in urine. To avoid the diurnal variation of the corneal thickness which is well recognized, we checked all our subjects at 10 in the morning. Results: In days 1 to 3 of menstruation, mean corneal thickness was 541.40±11.36 and 540.82±11.70 microns for left and right eyes respectively. At ovulation time the mean thickness changed to 556.50±7.11 and 555.98±7.26 microns for left and right eyes respectively, and at the end of the cycle, the corneal thickness turned in to 536.38±12.83 and 535.48±13.08 microns for left and right eyes respectively. The difference of corneal thickness was statistically significant relating to the different stages of menstrual cycle. Conclusion: The thickest cornea during the menstruation cycle is achieved at the ovulation time and the thinnest at the end of the cycle and this should be taken in to account whilst plan to do a corneal refractive surgery.

  4. Therapeutic effects of zerumbone in an alkali-burned corneal wound healing model.

    Science.gov (United States)

    Kim, Jong Won; Jeong, Hyuneui; Yang, Myeon-Sik; Lim, Chae Woong; Kim, Bumseok

    2017-07-01

    Cornea is an avascular transparent tissue. Ocular trauma caused by a corneal alkali burn induces corneal neovascularization (CNV), inflammation, and fibrosis, leading to vision loss. The purpose of this study was to examine the effects of Zerumbone (ZER) on corneal wound healing caused by alkali burns in mice. CNV was induced by alkali-burn injury in BALB/C female mice. Topical ZER (three times per day, 3μl each time, at concentrations of 5, 15, and 30μM) was applied to treat alkali-burned mouse corneas for 14 consecutive days. Histopathologically, ZER treatment suppressed alkali burn-induced CNV and decreased corneal epithelial defects induced by alkali burns. Corneal tissue treated with ZER showed reduced mRNA levels of pro-angiogenic genes, including vascular endothelial growth factor, matrix metalloproteinase-2 and 9, and pro-fibrotic factors such as alpha smooth muscle actin and transforming growth factor-1 and 2. Immunohistochemical analysis demonstrated that the infiltration of F4/80 and/or CCR2 positive cells was significantly decreased in ZER-treated corneas. ZER markedly inhibited the mRNA and protein levels of monocyte chemoattractant protein-1 (MCP-1) in human corneal fibroblasts and murine peritoneal macrophages. Immunoblot analysis revealed that ZER decreased the activation of signal transducer and activator of transcription 3 (STAT3), with consequent reduction of MCP-1 production by these cells. In conclusion, topical administration of ZER accelerated corneal wound healing by inhibition of STAT3 and MCP-1 production. Copyright © 2017. Published by Elsevier B.V.

  5. Hevin plays a pivotal role in corneal wound healing.

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    Shyam S Chaurasia

    Full Text Available BACKGROUND: Hevin is a matricellular protein involved in tissue repair and remodeling via interaction with the surrounding extracellular matrix (ECM proteins. In this study, we examined the functional role of hevin using a corneal stromal wound healing model achieved by an excimer laser-induced irregular phototherapeutic keratectomy (IrrPTK in hevin-null (hevin(-/- mice. We also investigated the effects of exogenous supplementation of recombinant human hevin (rhHevin to rescue the stromal cellular components damaged by the excimer laser. METHODOLOGY/PRINCIPAL FINDINGS: Wild type (WT and hevin (-/- mice were divided into three groups at 4 time points- 1, 2, 3 and 4 weeks. Group I served as naïve without any treatment. Group II received epithelial debridement and underwent IrrPTK using excimer laser. Group III received topical application of rhHevin after IrrPTK surgery for 3 days. Eyes were analyzed for corneal haze and matrix remodeling components using slit lamp biomicroscopy, in vivo confocal microscopy, light microscopy (LM, transmission electron microscopy (TEM, immunohistochemistry (IHC and western blotting (WB. IHC showed upregulation of hevin in IrrPTK-injured WT mice. Hevin (-/- mice developed corneal haze as early as 1-2 weeks post IrrPTK-treatment compared to the WT group, which peaked at 3-4 weeks. They also exhibited accumulation of inflammatory cells, fibrotic components of ECM proteins and vascularized corneas as seen by IHC and WB. LM and TEM showed activated keratocytes (myofibroblasts, inflammatory debris and vascular tissues in the stroma. Exogenous application of rhHevin for 3 days reinstated inflammatory index of the corneal stroma similar to WT mice. CONCLUSIONS/SIGNIFICANCE: Hevin is transiently expressed in the IrrPTK-injured corneas and loss of hevin predisposes them to aberrant wound healing. Hevin (-/- mice develop early corneal haze characterized by severe chronic inflammation and stromal fibrosis that can be rescued

  6. Minocycline inhibits alkali burn-induced corneal neovascularization in mice.

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    Ou Xiao

    Full Text Available The purpose of this study was to investigate the effects of minocycline on alkali burn-induced corneal neovascularization (CNV. A total of 105 mice treated with alkali burns were randomly divided into three groups to receive intraperitoneal injections of either phosphate buffered saline (PBS or minocycline twice a day (60 mg/kg or 30 mg/kg for 14 consecutive days. The area of CNV and corneal epithelial defects was measured on day 4, 7, 10, and14 after alkali burns. On day 14, a histopathological examination was performed to assess morphological change and the infiltration of polymorphonuclear neutrophils (PMNs. The mRNA expression levels of vascular endothelial growth factor (VEGF and its receptors (VEGFRs, basic fibroblast growth factor (bFGF, matrix metalloproteinases (MMPs, interleukin-1α, 1β, 6 (IL-1α, IL-1β, IL-6 were analyzed using real-time quantitative polymerase chain reaction. The expression of MMP-2 and MMP-9 proteins was determined by gelatin zymography. In addition, enzyme-linked immunosorbent assay was used to analyze the protein levels of VEGFR1, VEGFR2, IL-1β and IL-6. Minocycline at a dose of 60 mg/kg or 30 mg/kg significantly enhanced the recovery of the corneal epithelial defects more than PBS did. There were significant decreases of corneal neovascularization in the group of high-dosage minocycline compared with the control group at all checkpoints. On day 14, the infiltrated PMNs was reduced, and the mRNA expression of VEGFR1, VEGFR2, bFGF, IL-1β, IL-6, MMP-2, MMP-9, -13 as well as the protein expression of VEGFR2, MMP-2, -9, IL-1β, IL-6 in the corneas were down-regulated with the use of 60 mg/kg minocycline twice a day. Our results showed that the intraperitoneal injection of minocycline (60 mg/kg b.i.d. can significantly inhibit alkali burn-induced corneal neovascularization in mice, possibly by accelerating corneal wound healing and by reducing the production of angiogenic factors, inflammatory cytokines and MMPs.

  7. SUITABILITY OF CORNEAL TISSUE FOR TRANSPLANTATION PROCURED FROM HANGING CASES

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    Rekha Gyanchand

    2017-06-01

    Full Text Available BACKGROUND Requirement of donor cornea is essential to target the corneal blind. The best method to procure such corneas is from any major hospitals, which has a mortuary facility. The eye donation with hanging as the cause of death is very common in a mortuary setup. Some factors that are concerning regarding corneas procured from death due to hanging is the prolonged exposure of the cornea at the time of death, the exact time of death is not known, most of the cadavers are refrigerated for investigations as these arrive at the mortuary usually at night. Due to these reasons, the corneal surgeons are hesitant to use corneas procured from death due to hanging for corneal transplantation. Analysing these corneas would contribute to a great extent to the donor cornea pool in providing sight to the corneal blind, especially as majority are young individuals who commit suicide by hanging. In this study, the donor corneas were analysed with regards to corneal epithelial defect, endothelial cell morphology and utilisation of these corneas for transplantation. The aim of the HCRP study is to analyse the effect of death due to hanging on donor cornea. 1. Corneal epithelial status. 2. Corneal endothelial cell morphology. 3. Utilisation of corneas for transplantation. MATERIALS AND METHODS Donor corneas from 22 donors who died due to hanging were procured from hospital mortuary. All the 44 corneas were transplanted. Various parameters like demography, death to enucleation time, cadaver preservation in cold storage, endothelial cell density and utilisation of cornea for transplantation were noted. Design- Retrospective study. Statistical Analysis- Descriptive statistics, Pearson and Spearman correlation and Chi-square test were used to test the hypotheses. RESULTS Out of the 44 corneas analysed, 75% of the donors were refrigerated as a part of medicolegal investigations protocol. The average DTP time was 12 hours in refrigerated group and 5 hours in non

  8. Assessment of refractive astigmatism and simulated therapeutic refractive surgery strategies in coma-like-aberrations-dominant corneal optics.

    Science.gov (United States)

    Zhou, Wen; Stojanovic, Aleksandar; Utheim, Tor Paaske

    2016-01-01

    The aim of the study is to raise the awareness of the influence of coma-like higher-order aberrations (HOAs) on power and orientation of refractive astigmatism (RA) and to explore how to account for that influence in the planning of topography-guided refractive surgery in eyes with coma-like-aberrations-dominant corneal optics. Eleven eyes with coma-like-aberrations-dominant corneal optics and with low lenticular astigmatism (LA) were selected for astigmatism analysis and for treatment simulations with topography-guided custom ablation. Vector analysis was used to evaluate the contribution of coma-like corneal HOAs to RA. Two different strategies were used for simulated treatments aiming to regularize irregular corneal optics: With both strategies correction of anterior corneal surface irregularities (corneal HOAs) were intended. Correction of total corneal astigmatism (TCA) and RA was intended as well with strategies 1 and 2, respectively. Axis of discrepant astigmatism (RA minus TCA minus LA) correlated strongly with axis of coma. Vertical coma influenced RA by canceling the effect of the with-the-rule astigmatism and increasing the effect of the against-the-rule astigmatism. After simulated correction of anterior corneal HOAs along with TCA and RA (strategies 1 and 2), only a small amount of anterior corneal astigmatism (ACA) and no TCA remained after strategy 1, while considerable amount of ACA and TCA remained after strategy 2. Coma-like corneal aberrations seem to contribute a considerable astigmatic component to RA in eyes with coma-like-aberrations dominant corneal optics. If topography-guided ablation is programmed to correct the corneal HOAs and RA, the astigmatic component caused by the coma-like corneal HOAs will be treated twice and will result in induced astigmatism. Disregarding RA and treating TCA along with the corneal HOAs is recommended instead.

  9. Corneal wound healing is compromised by immunoproteasome deficiency.

    Directory of Open Access Journals (Sweden)

    Deborah A Ferrington

    Full Text Available Recent studies have revealed roles for immunoproteasome in regulating cell processes essential for maintaining homeostasis and in responding to stress and injury. The current study investigates how the absence of immunoproteasome affects the corneal epithelium under normal and stressed conditions by comparing corneas from wildtype (WT mice and those deficient in two immunoproteasome catalytic subunits (lmp7(-/-/mecl-1(-/-, L7M1. Immunoproteasome expression was confirmed in WT epithelial cells and in cells of the immune system that were present in the cornea. More apoptotic cells were found in both corneal explant cultures and uninjured corneas of L7M1 compared to WT mice. Following mechanical debridement, L7M1 corneas displayed delayed wound healing, including delayed re-epithelialization and re-establishment of the epithelial barrier, as well as altered inflammatory cytokine production compared to WT mice. These results suggest that immunoproteasome plays an important role in corneal homeostasis and wound healing.

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

    Science.gov (United States)

    Omar, Nazri; Bou Chacra, Charbel T; Tabbara, Khalid F

    2013-01-01

    The aim of this work was to describe the indications, complications, and outcomes of penetrating keratoplasty (PKP) in Saudi Arabia. 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. 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 in vascularized cornea was 3.89 (95% CI 1.36-11.09). At last visit following PKP, 34 (40%) eyes had best spectacle-corrected visual acuity of 20/40 or better, and 51 (60.0%) eyes had 20/80 or better. Best spectacle-corrected visual acuity was worse than 20/400 in 15 (17.6%) eyes. The overall corneal graft survival in a private setting in Saudi Arabia can be excellent. Thorough preoperative evaluation and comprehensive postoperative management are

  11. Traumatic corneal flap displacement after laser in situ keratomileusis (LASIK).

    Science.gov (United States)

    Tsai, Tsung-Han; Peng, Kai-Ling; Lin, Chien-Jen

    2017-01-01

    Laser in situ keratomileusis (LASIK) is the most common and popular procedure performed for the correction of refractive errors in the last two decades. We report a case of traumatic flap displacement with flap folding which occurred 3 years after LASIK was performed. Previous literature suggests that vision prognosis would be closely related to proper and prompt management of traumatic flap displacement with flap folding 3 years after LASIK. A 23-year-old female presented to our hospital who had undergone uneventful LASIK in both eyes 3 years prior. Unfortunately, she had suffered a blunt trauma in her right eye in a car accident. A late onset of corneal flap displacement was found with upper and lower portion of the flap being folded inside the corneal bed. Surgical intervention for debridement with subsequent reposition of corneal flap was performed as soon as possible in the operating room. A bandage contact lens was placed, and topical antibiotic and corticosteroids were given postoperatively. Two days after the operation, the displaced corneal flap was found to be well attached smoothly on the corneal bed without folds. The best-corrected visual acuity was 6/6 with refraction of -0.75 D to 1.0 D ×175° in her right eye 1 month later. We reviewed a total of 19 published cases of late-onset traumatic flap dislocations or displacements after LASIK with complete data from 2000 to 2014. Traumatic displacement of corneal flaps after LASIK may occur after blunt injury with specific direction of force to the flap margin, especially tangential one. According to the previous literature, late-onset traumatic flap displacement may happen at any time after LASIK and be caused by various types of injuries. Fortunately, good visual function could mostly be restored with immediate and proper management.

  12. Corneal Deformation Response and Ocular Geometry: A Noninvasive Diagnostic Strategy in Marfan Syndrome.

    Science.gov (United States)

    Beene, Lauren C; Traboulsi, Elias I; Seven, Ibrahim; Ford, Matthew R; Sinha Roy, Abhijit; Butler, Robert S; Dupps, William J

    2016-01-01

    To evaluate corneal air-puff deformation responses and ocular geometry as predictors of Marfan syndrome. Prospective observational clinical study. Sixteen investigator-derived, 4 standard Ocular Response Analyzer (ORA), and geometric variables from corneal tomography and optical biometry using Oculus Pentacam and IOL Master were assessed for discriminative value in Marfan syndrome, measuring right eyes of 24 control and 13 Marfan syndrome subjects. Area under the receiver operating characteristic (AUROC) curve was assessed in univariate and multivariate analyses. Six investigator-derived ORA variables successfully discriminated Marfan syndrome. The best lone disease predictor was Concavity Min (Marfan syndrome 47.5 ± 20, control 69 ± 14, P = .003; AUROC = 0.80). Corneal hysteresis (CH) and corneal resistance factor (CRF) were decreased (Marfan syndrome CH 9.45 ± 1.62, control CH 11.24 ± 1.21, P = .01; Marfan syndrome CRF 9.77 ± 1.65, control CRF 11.03 ± 1.72, P = .01) and corneas were flatter in Marfan syndrome (Marfan syndrome Kmean 41.25 ± 2.09 diopter, control Kmean 42.70 ± 1.81 diopter, P = .046). No significant differences were observed in central corneal thickness, axial eye length, or intraocular pressure. A multivariate regression model incorporating corneal curvature and hysteresis loop area (HLA) provided the best predictive value for Marfan syndrome (AUROC = 0.85). This study describes novel biodynamic features of corneal deformation responses in Marfan syndrome, including increased deformation, decreased bending resistance, and decreased energy dissipation capacity. A predictive model incorporating HLA and corneal curvature shows greatest potential for noninvasive clinical diagnosis of Marfan syndrome. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Rapid, automated mosaicking of the human corneal subbasal nerve plexus.

    Science.gov (United States)

    Vaishnav, Yash J; Rucker, Stuart A; Saharia, Keshav; McNamara, Nancy A

    2017-11-27

    Corneal confocal microscopy (CCM) is an in vivo technique used to study corneal nerve morphology. The largest proportion of nerves innervating the cornea lie within the subbasal nerve plexus, where their morphology is altered by refractive surgery, diabetes and dry eye. The main limitations to clinical use of CCM as a diagnostic tool are the small field of view of CCM images and the lengthy time needed to quantify nerves in collected images. Here, we present a novel, rapid, fully automated technique to mosaic individual CCM images into wide-field maps of corneal nerves. We implemented an OpenCV image stitcher that accounts for corneal deformation and uses feature detection to stitch CCM images into a montage. The method takes 3-5 min to process and stitch 40-100 frames on an Amazon EC2 Micro instance. The speed, automation and ease of use conferred by this technique is the first step toward point of care evaluation of wide-field subbasal plexus (SBP) maps in a clinical setting.

  14. Differentiation and molecular profiling of human embryonic stem cell-derived corneal epithelial cells.

    Science.gov (United States)

    Brzeszczynska, J; Samuel, K; Greenhough, S; Ramaesh, K; Dhillon, B; Hay, D C; Ross, J A

    2014-06-01

    It has been suggested that the isolation of scalable populations of limbal stem cells may lead to radical changes in ocular therapy. In particular, the derivation and transplantation of corneal stem cells from these populations may result in therapies providing clinical normality of the diseased or damaged cornea. Although feasible in theory, the lack of donor material in sufficient quantity and quality currently limits such a strategy. A potential scalable source of corneal cells could be derived from pluripotent stem cells (PSCs). We developed an in vitro and serum-free corneal differentiation model which displays significant promise. Our stepwise differentiation model was designed with reference to development and gave rise to cells which displayed similarities to epithelial progenitor cells which can be specified to cells displaying a corneal epithelial phenotype. We believe our approach is novel, provides a robust model of human development and in the future, may facilitate the generation of corneal epithelial cells that are suitable for clinical use. Additionally, we demonstrate that following continued cell culture, stem cell-derived corneal epithelial cells undergo transdifferentiation and exhibit squamous metaplasia and therefore, also offer an in vitro model of disease.

  15. Factores de riesgo en pacientes con sospecha de úlcera corneal micótica en Pinar del Río Risk factors found in patients with possible diagnosis of mycotic corneal ulcer in Pinar del Río province

    Directory of Open Access Journals (Sweden)

    Janet González Sotero

    2010-12-01

    Full Text Available OBJETIVOS: Identificar los principales factores de riesgo en pacientes con sospecha de úlcera corneal micótica en la provincia Pinar del Río. MÉTODOS: Se realizó una investigación observacional, analítica de tipo caso-control. La información fue obtenida a través de la revisión de historias clínicas de los pacientes que ingresaron en el Servicio de Oftalmología del Hospital Clinicoquirúrgico "Abel Santamaría Cuadrado" con impresión diagnóstica de úlcera corneal micótica en el periodo comprendido entre el 1 de enero de 2004 y el 30 de noviembre de 2007. Se emplearon como variables edad, sexo, ocupación, tipo de lugar de residencia, antecedente reciente de trauma corneal con materia vegetal, trauma corneal, uso de lentes de contacto, uso de esteroides tópicos, enfermedades sistémicas inmunosupresoras, cirugía ocular previa y enfermedades crónicas de la superficie ocular. Se emplearon medidas de frecuencia y asociación. RESULTADOS: Se determinó que la ocupación, el tipo de lugar de residencia y el antecedente de trauma corneal con materia vegetal constituyen posibles factores de riesgo de la úlcera corneal micótica en esa provincia. La frecuencia de la úlcera corneal micótica fue de un 27 % con respecto al total de pacientes ingresados con diagnóstico de úlcera corneal. El sexo más afectado fue el masculino y el grupo etario el de 38 a 57 años. CONCLUSIONES: El antecedente de trauma corneal con materia vegetal, el lugar de residencia rural y las actividades laborales relacionadas con la manipulación directa de plantas constituyeron factores de riesgo de úlcera corneal micótica en los pacientes estudiados. La frecuencia de la úlcera corneal micótica en el estudio se correspondió con el patrón observado en países con clima cálido y húmedo, especialmente cerca del ecuador. La úlcera corneal micótica es más común en hombres en edades laboralmente activas.OBJECTIVE: To identify the main risk factors in

  16. A circum-corneal conjunctival nevus in a child

    DEFF Research Database (Denmark)

    Svahn, T.F.; Heegaard, Steffen; Prause, Jan Ulrik

    2012-01-01

    An amelanotic, circum-corneal nevus in a 2-year-old child is described. The nevus presented at birth as a red spot in the nasal conjunctiva that subsequently enlarged to completely encircle the cornea. The tumour was partially removed three times, but at the age of 6 years, the nevus still covers...... the entire limbal region. The case illustrates that circum-corneal redness in a child may be caused by a nevus and that a conjunctival limbal nevus in a child tend to recur after incomplete excision....

  17. Effects of dehydration on corneal tissue absorption of topical azithromycin in rabbits.

    Science.gov (United States)

    Tabbara, Khalid F; Kotb, Amgad A; Hammouda, Ehab F; Elkum, Naser

    2005-10-01

    To assess the corneal tissue absorption of azithromycin in desiccated and normal eyes of rabbits. A total of 25 New Zealand Albino rabbits weighing 2-3 kg each were included. One eye of each rabbit was desiccated. The other eye was left as control. Azithromycin 1.5% topical eyedrops were instilled in both eyes. Five rabbits were sacrificed at each of the following time points: 30 min, 3 hr, 6 hr, and 12 hr. Corneal tissues specimens were subjected to high-performance liquid chromatography mass spectrometry. A paired t test was used to evaluate the statistical difference in corneal tissue absorptions of azithromycin at each time point. The mean corneal tissue levels of azithromycin in dry eyes were 66.3 microg/ml, 92.6 microg/ml, 117.5 microg/ml, and 179.9 microg/ml, and the mean corneal tissue levels of azithromycin in normal eyes were 42.0 microg/ml, 43.4 microg/ml, 43.3 microg/ml, and 80.0 microg/ml at 30 min, 3 hr, 6 hr, and 12 hr respectively. Both groups showed increase in corneal tissue absorption overtime (p < 0.0001). Significantly higher levels of azithromycin were noted in dry eyes at each time point except at the 30-min time point. This study demonstrated that corneas exposed to desiccation showed statistically significant increase in azithromycin level compared to normal eyes.

  18. Traumatic corneal flap displacement after laser in situ keratomileusis (LASIK

    Directory of Open Access Journals (Sweden)

    Tsai TH

    2017-04-01

    Full Text Available Tsung-Han Tsai,1 Kai-Ling Peng,1 Chien-Jen Lin2 1Department of Ophthalmology, 2Department of Radiology, Chi Mei Medical Center, Tainan, Taiwan Background: Laser in situ keratomileusis (LASIK is the most common and popular procedure performed for the correction of refractive errors in the last two decades. We report a case of traumatic flap displacement with flap folding which occurred 3 years after LASIK was performed. Previous literature suggests that vision prognosis would be closely related to proper and prompt management of traumatic flap displacement with flap folding 3 years after LASIK.Case presentation: A 23-year-old female presented to our hospital who had undergone uneventful LASIK in both eyes 3 years prior. Unfortunately, she had suffered a blunt trauma in her right eye in a car accident. A late onset of corneal flap displacement was found with upper and lower portion of the flap being folded inside the corneal bed. Surgical intervention for debridement with subsequent reposition of corneal flap was performed as soon as possible in the operating room. A bandage contact lens was placed, and topical antibiotic and corticosteroids were given postoperatively. Two days after the operation, the displaced corneal flap was found to be well attached smoothly on the corneal bed without folds. The best-corrected visual acuity was 6/6 with refraction of −0.75 D to 1.0 D ×175° in her right eye 1 month later.Literature review: We reviewed a total of 19 published cases of late-onset traumatic flap dislocations or displacements after LASIK with complete data from 2000 to 2014.Conclusion: Traumatic displacement of corneal flaps after LASIK may occur after blunt injury with specific direction of force to the flap margin, especially tangential one. According to the previous literature, late-onset traumatic flap displacement may happen at any time after LASIK and be caused by various types of injuries. Fortunately, good visual function could

  19. Corneal Endothelial Alterations in Chronic Renal Failure.

    Science.gov (United States)

    Sati, Alok; Jha, Ashok; Moulick, P S; Shankar, Sandeep; Gupta, Sandeep; Khan, M A; Dogra, Manu; Sangwan, Virender S

    2016-10-01

    To evaluate the corneal endothelial changes in patients with chronic renal failure. A total of 128 corneas of 128 subjects were studied, and 3 groups were formed. The first, the dialyzed group, composed of 32 corneas of 32 patients; the second, the nondialyzed group, composed of 34 corneas of 34 patients; and the third, the age-matched control group, composed of 64 corneas of 64 healthy subjects were examined by a specular microscope and the endothelial parameters were compared. The dialyzed group (enhanced level of toxins in the blood) was further analyzed to assess the influence of blood urea, serum creatinine, serum calcium, and serum phosphorus including the duration of dialysis on corneal endothelium. On comparing the 3 groups using analysis of variance and posthoc tests, a significant difference was found in the central corneal thickness (CCT) and endothelial cell density (CD) between the control (CCT: 506 ± 29 μm, CD: 2760 ± 304 cells/mm) and dialyzed groups (CCT: 549 ± 30 μm, CD: 2337 ± 324 cells/mm) [P chronic renal failure, more marked in patients undergoing hemodialysis and with raised blood urea level.

  20. Interference figures of polarimetric interferometry analysis of the human corneal stroma.

    Directory of Open Access Journals (Sweden)

    Rodolfo Mastropasqua

    Full Text Available A rotating polarimetric 90°-cross linear-filter interferometry system was used to detect the morphological characteristics and features of interference patterns produced in in-vivo corneal stroma in healthy human corneas of 23 subjects. The characteristic corneal isogyres presenting with an evident cross-shaped pattern, grossly aligned with the fixation axis, were observed in all patients with centers within the pupillary dark area, impeding the exact determination of the center point. During the rotational scan in 78.3% of the eyes the cross-shaped pattern of the isogyre gradually separated to form two distinct hyperbolic arcs in opposite quadrants, reaching their maximal separation at 45 degrees with respect to angle of cross-shaped pattern formation. The corneal cross and hyperbolic-pattern repeated every 90° throughout the 360° rotational scan. While the interpretation of the isogyres presents particular difficulties, two summary parameters can be extracted for each cornea: the presence/orientation of a single or two dark areas in post-processed images and isochromes. However, the development of dedicated software for semi-quantitative analysis of these parameters and enantiomorphism may become available in the near future. The possible application of polarimetric interferometry in the field of both corneal pathologies and corneal surgery may be of great interest for clinical purposes.

  1. Multiquadrant Subtenon Triamcinolone Injection for Acute Corneal Graft Rejection: A Case Report

    Directory of Open Access Journals (Sweden)

    Sunali Goyal

    2017-05-01

    Full Text Available Background: We report a case of reversal of an acute corneal graft rejection following multiquadrant subtenon triamcinolone injection. Case Presentation: A 19-year-old woman who had acute corneal graft rejection failed to show resolution of the graft rejection after standard treatment with systemic, intravenous, and topical steroids. The graft rejection, however, responded to injection of triamcinolone in multiple subtenon quadrants. Conclusions: For corneal graft rejection, multiquadrant subtenon triamcinolone injections may be a safe adjunct to systemic treatment.

  2. Influence of corneal parameters in keratoconus on IOP readings obtained with different tonometers.

    Science.gov (United States)

    Firat, Penpe Gul; Orman, Gozde; Doganay, Selim; Demirel, Soner

    2013-03-01

    Accurate intraocular pressure (IOP) measurement is important but of unsure reliability in patients with keratoconus. Different types and models of tonometers are available. This study investigated the influence of corneal parameters on IOP readings obtained by a Goldmann applanation tonometer, a non-contact tonometer and a dynamic contour tonometer. IOP readings with the Goldmann applanation, non-contact and dynamic contour tonometers were obtained from 52 patients with keratoconus and from 50 normal subjects and their corneal parameters were measured using a Pentacam. The mean IOP measurements in keratoconus obtained with the Goldmann applanation, non-contact and dynamic contour tonometers were statistically significantly different from the mean IOP measurements in the normal subjects (p contact tonometers but not on the dynamic contour tonometer. In the control group, thinnest and central corneal thicknesses had a significant effect on findings with the Goldmann and non-contact tonometers but not on the dynamic contour tonometer. The corneal volume (CV) had no significant effect on the three tonometers in both groups. The corneal parameters affecting the IOP readings of the Goldmann applanation tonometers, non-contact tonometers and the dynamic contour tonometers are not the same. While the Goldmann applanation and non-contact tonometers were significantly affected by the corneal parameters that were measured, the dynamic contour tonometer was not affected by any of these corneal parameters. © 2013 The Authors. Clinical and Experimental Optometry © 2013 Optometrists Association Australia.

  3. Investigation of Overrun-Processed Porous Hyaluronic Acid Carriers in Corneal Endothelial Tissue Engineering.

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    Jui-Yang Lai

    Full Text Available Hyaluronic acid (HA is a linear polysaccharide naturally found in the eye and therefore is one of the most promising biomaterials for corneal endothelial regenerative medicine. This study reports, for the first time, the development of overrun-processed porous HA hydrogels for corneal endothelial cell (CEC sheet transplantation and tissue engineering applications. The hydrogel carriers were characterized to examine their structures and functions. Evaluations of carbodiimide cross-linked air-dried and freeze-dried HA samples were conducted simultaneously for comparison. The results indicated that during the fabrication of freeze-dried HA discs, a technique of introducing gas bubbles in the aqueous biopolymer solutions can be used to enlarge pore structure and prevent dense surface skin formation. Among all the groups studied, the overrun-processed porous HA carriers show the greatest biological stability, the highest freezable water content and glucose permeability, and the minimized adverse effects on ionic pump function of rabbit CECs. After transfer and attachment of bioengineered CEC sheets to the overrun-processed HA hydrogel carriers, the therapeutic efficacy of cell/biopolymer constructs was tested using a rabbit model with corneal endothelial dysfunction. Clinical observations including slit-lamp biomicroscopy, specular microscopy, and corneal thickness measurements showed that the construct implants can regenerate corneal endothelium and restore corneal transparency at 4 weeks postoperatively. Our findings suggest that cell sheet transplantation using overrun-processed porous HA hydrogels offers a new way to reconstruct the posterior corneal surface and improve endothelial tissue function.

  4. Laser thermokeratoplasty after lamellar corneal cutting.

    Science.gov (United States)

    Ismail, M M; Pérez-Santonja, J J; Alió, J L

    1999-02-01

    To evaluate the effect of laser thermokeratoplasty (LTK) in eyes that previously had a lamellar corneal cut. University of Al-Azhar, Cairo, Egypt, and Instituto Oftalmológico de Alicante, Spain. In 15 eyes (10 patients), noncontact LTK was applied 6 to 8 weeks after a lamellar corneal cut had been made. Central pachymetry, keratometry, and videokeratography were performed and uncorrected visual acuity, best spectacle-corrected visual acuity (BSCVA), and manifest and cycloplegic refractions measured before and 1, 6, 12, and 18 months after LTK. Mean follow-up was 19.13 months. Mean refraction was +5.93 diopters (D) +/- 1.9 (SD) before LTK and -0.43 +/- 1.5 D at 1 month, +1.63 +/- 1.6 D at 6 months, 1.91 +/- 1.41 at 12 months, and +2.01 +/- 1.5 D at the end of the study. Total regression did not occur in any case. Mean BSCVA before LTK was 0.66 +/- 0.2, and spontaneous visual acuity at the end of the study was 0.58 +/- 0.18. No patient lost any lines of preoperative BSCVA. There was no significant difference between the results at 12 months and at the end of the study. Corneal lamellar cutting appeared to improve the magnitude of the refractive effect of noncontact LTK and to decrease the amount of regression.

  5. Tectonic corneal graft for conjunctival rhinosporidiosis with scleral melt

    Directory of Open Access Journals (Sweden)

    Pushpa Jacob

    2011-01-01

    Full Text Available A 16 year old girl presented with irritation and watering of the right eye for 3 months. On examination, the superior perilimbal sclera was ectatic with incarcerated uveal tissue covered by conjunctiva. The conjunctiva showed discreet, yellow white mucoid spots. Excision biopsy of the conjunctiva showed subepithelial spherules of sporangia containing numerous endospores, suggestive of rhinosporidiosis. Diathermy was applied to flatten the staphyloma. The ectatic area was covered with a corneal patch graft. The patient was started on prednisolone acetate eye drops and oral dapsone for 6 months. Corneal graft was well incorporated and conjunctivalized by 3 months. Since the graft was not seen within the palpebral aperture, there was good cosmetic result. The corneal graft had the added advantage of transparency which allowed visualization of the underlying tissue to diagnose early recurrence. There was no recurrence at 6 months.

  6. Bioactive Antimicrobial Peptides as Therapeutics for Corneal Wounds and Infections.

    Science.gov (United States)

    Griffith, Gina L; Kasus-Jacobi, Anne; Pereira, H Anne

    2017-06-01

    Significance: More than 2 million eye injuries and infections occur each year in the United States that leave civilians and military members with reduced or complete vision loss due to the lack of effective therapeutics. Severe ocular injuries and infections occur in varied settings including the home, workplace, and battlefields. In this review, we discuss the potential of developing antimicrobial peptides (AMPs) as therapeutics for the treatment of corneal wounds and infections for which the current treatment options are inadequate. Recent Advances: Standard-of-care employs the use of fluorescein dye for the diagnosis of ocular defects and is followed by the use of antibiotics and/or steroids to treat the infection and reduce inflammation. Recent advances for treating corneal wounds include the development of amniotic membrane therapies, wound chambers, and drug-loaded hydrogels. In this review, we will discuss an innovative approach using AMPs with the dual effect of promoting corneal wound healing and clearing infections. Critical Issues: An important aspect of treating ocular injuries is that treatments need to be effective and administered expeditiously. This is especially important for injuries that occur during combat and in individuals who demonstrate delayed wound healing. To overcome gaps in current treatment modalities, bioactive peptides based on naturally occurring cationic antimicrobial proteins are being investigated as new therapeutics. Future Directions: The development of new therapeutics that can treat ocular infections and promote corneal wound healing, including the healing of persistent corneal epithelial defects, would be of great clinical benefit.

  7. Response of human corneal fibroblasts on silk film surface patterns.

    Science.gov (United States)

    Gil, Eun Seok; Park, Sang-Hyug; Marchant, Jeff; Omenetto, Fiorenzo; Kaplan, David L

    2010-06-11

    Transparent, biodegradable, mechanically robust, and surface-patterned silk films were evaluated for the effect of surface morphology on human corneal fibroblast (hCF) cell proliferation, orientation, and ECM deposition and alignment. A series of dimensionally different surface groove patterns were prepared from optically graded glass substrates followed by casting poly(dimethylsiloxane) (PDMS) replica molds. The features on the patterned silk films showed an array of asymmetric triangles and displayed 37-342 nm depths and 445-3 582 nm widths. hCF DNA content on all patterned films were not significantly different from that on flat silk films after 4 d in culture. However, the depth and width of the grooves influenced cell alignment, while the depth differences affected cell orientation; overall, deeper and narrower grooves induced more hCF orientation. Over 14 d in culture, cell layers and actin filament organization demonstrated that confluent hCFs and their cytoskeletal filaments were oriented along the direction of the silk film patterned groove axis. Collagen type V and proteoglycans (decorin and biglycan), important markers of corneal stromal tissue, were highly expressed with alignment. Understanding corneal stromal fibroblast responses to surface features on a protein-based biomaterial applicable in vivo for corneal repair potential suggests options to improve corneal tissue mimics. Further, the approaches provide fundamental biomaterial designs useful for bioengineering oriented tissue layers, an endemic feature in most biological tissue structures that lead to critical tissue functions.

  8. Vessel cauterization as a therapeutic adjunct in persistent disciform corneal stromal edema

    Directory of Open Access Journals (Sweden)

    Lasisi Akinola Muideen

    2014-01-01

    Full Text Available This is a case report of a symptomatic non-clearing, vascularized, disciform, corneal stromal edema with a feeder vessel that has remained refractory to medical therapy of antiviral, steroid, and antibiotics, for a period of three weeks, but showed a rapid improvement in visual acuity of 0.1 Log mar within five days of feeder vessel cauterization, together with improvement of two psychometric scales in corneal cloudiness on a scale range of 0 to 3, clinical evidence of resolution of corneal edema, and subjective resolution of the patient′s symptoms. Cauterization was done under magnification with a ball cautery point warmed in a spirit lamp following topical anesthesia. This intervention may become handy in difficult non-clearing corneal edema and prevent blinding consequences, in a low-resource facility, in selected applicable cases.

  9. Postoperative influences of the torsional phacoemulsification on foveal thickness and corneal edema

    Directory of Open Access Journals (Sweden)

    Lei Li

    2014-05-01

    Full Text Available AIM: To report the influences onfoveal thickness and corneal edema after torsional phacoemulsification.METHODS: Totally 52 patients(52 eyeswith age-related cataract were randomly assigned to phacoemulsification using torsional mode(26 eyesor conventional ultrasound mode(26 eyes. The foveal thickness examined by optical coherence tomography(OCTafter surgery at 1, 4 and 12wk and corneal edema was examined by slit lamp after surgery at 1d.RESULTS: The postoperative averagefoveal thickness datas of the two groups, comparing with corresponding preoperative datas, were significantly augmented at 1, 4 and 12wk(PPP>0.05. The effects of corneal edema in torsional group were slighter(PCONCLUSION: The postoperative influences onfoveal thickness and corneal edema with torsional mode are slighter than that with ultrasound mode, and the postoperative reactions with torsional mode are efficiently reduced.

  10. Chronic migraine is associated with reduced corneal nerve fiber density and symptoms of dry eye.

    Science.gov (United States)

    Kinard, Krista I; Smith, A Gordon; Singleton, J Robinson; Lessard, Margaret K; Katz, Bradley J; Warner, Judith E A; Crum, Alison V; Mifflin, Mark D; Brennan, Kevin C; Digre, Kathleen B

    2015-04-01

    We used in vivo corneal confocal microscopy to investigate structural differences in the sub-basal corneal nerve plexus in chronic migraine patients and a normal population. We used a validated questionnaire and tests of lacrimal function to determine the prevalence of dry eye in the same group of chronic migraine patients. Activation of the trigeminal system is involved in migraine. Corneal nociceptive sensation is mediated by trigeminal axons that synapse in the gasserian ganglion and the brainstem, and serve nociceptive, protective, and trophic functions. Noninvasive imaging of the corneal sub-basal nerve plexus is possible with in vivo corneal confocal microscopy. For this case-control study, we recruited chronic migraine patients and compared them with a sex- and age-similar group of control subjects. Patients with peripheral neuropathy, a disease known to be associated with a peripheral neuropathy, or prior corneal or intraocular surgery were excluded. Participants underwent in vivo corneal confocal microscopy using a Heidelberg Retinal Tomography III confocal microscope with a Rostock Cornea Module. Nerve fiber length, nerve branch density, nerve fiber density, and tortuosity coefficient were measured using established methodologies. Migraine participants underwent testing of basal tear production with proparacaine, corneal sensitivity assessment with a cotton-tip applicator, measurement of tear break-up time, and completion of a validated dry eye questionnaire. A total of 19 chronic migraine patients and 30 control participants completed the study. There were no significant differences in age or sex. Nerve fiber density was significantly lower in migraine patients compared with controls (48.4 ± 23.5 vs. 71.0 ± 15.0 fibers/mm2 , P dry eye syndrome. We found that in the sample used in this study, the presence of structural changes in nociceptive corneal axons lends further support to the hypothesis that the trigeminal system plays a critical role

  11. Effect of pirfenidone on the proliferation of rat corneal stromal cells

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    Jun-Jie Chen

    2015-02-01

    Full Text Available AIM: To investigate the effects of pirfenidone(PFDon the proliferation and transfomring growth factor-β1(TGF-β1expression in vitro culture rat corneal stromal cells. METHODS: Corneal stromal cells from 8 to 10wk SD rats were isolated, cultured and treated with different concentrations of PFD 0mg/mL(control group, 0.15mg/mL(experimental group Ⅰ, 0.3mg/mL(experimental group Ⅱ, 1mg/mL(experimental group Ⅲfor 48h. CCK-8 assay was performed to assess cell proliferation, while immunocytochemistry and Western Blot were used to detect the expression of ki-67 and TGF-β1 expression, respectively. RESULTS: Compared with control group, PFD significantly inhibited the proliferation in a dose-dependent manner(all P1 in a dose-dependent manner(PCONCLUSION: Pirfenidone can significantly inhibit the proliferation of rat corneal stromal cell by down regulating TGF-β1 expression, therefore, it has potential prospect in lightening the corneal wound healing reaction.

  12. Preoperative corneal astigmatism among adult patients with cataract in Northern Nigeria

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    Mohammed Isyaku

    2014-01-01

    Full Text Available The prevalence and nature of corneal astigmatism among patients with cataract has not been well-documented in the resident African population. This retrospective study was undertaken to investigate preexisting corneal astigmatism in adult patients with cataract. We analyzed keratometric readings acquired by manual Javal-Schiotz keratometry before surgery between January 1, 2011 and December 31, 2011. There were 3,169 patients (3286 eyes aged between 16 and 110 years involved with a Male to female ratio of 1.4:1. Mean keratometry in diopters was K1 = 43.99 and K2 = 43.80. Mean corneal astigmatism was 1.16 diopter and a majority (45.92% of eyes had astigmatism between 1.00 and 1.99 diopters. Two-thirds of the eyes (66.9% in this study had preoperative corneal astigmatism equal to or above 1.00 diopter. Findings will help local cataract surgeons to estimate the potential demand for toric intraocular lenses.

  13. Evaluation of Corneal Neovascularization Using Optical Coherence Tomography Angiography in Patients With Limbal Stem Cell Deficiency.

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    Oie, Yoshinori; Nishida, Kohji

    2017-11-01

    Detection of the exact area of corneal neovascularization using slit-lamp photography is often difficult. Thus, we evaluated corneal neovascularization in patients with limbal stem cell deficiency using optical coherence tomography angiography (OCTA). Five patients with 5 eyes showing partial or total limbal stem cell deficiency were enrolled. Three eyes had severe corneal scarring. Five 6- × 6-mm images (frontal, upper, lower, nasal, and temporal) were obtained by OCTA. Slit-lamp photography was performed for all patients on the same day. OCTA has 2 advantages over slit-lamp photography for clear demonstration of corneal neovascularization. First, OCTA can show neovascularization in cases with severe corneal opacification. Second, OCTA can detect not only large vessels but also small vessels that cannot be seen by slit-lamp photography. OCTA is a powerful tool for objective evaluation of vascularization in the anterior and posterior segments of the eye. We have demonstrated that OCTA can visualize corneal neovascularization in patients with corneal diseases more clearly than slit-lamp photography.

  14. RECURRENT CORNEAL EROSION SYNDROME (a review

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    S. V. Trufanov

    2015-01-01

    Full Text Available Recurrent corneal erosion (RCE syndrome is characterized by episodes of recurrent spontaneous epithelial defects. Main clinical symptoms (pain, redness, photophobia, lacrimation occurred at night. Corneal lesions revealed by slit lamp exam vary depending on the presence of corneal epithelium raise, epithelial microcysts or epithelial erosions, stromal infiltrates and opacities. Microtraumas, anterior corneal dystrophies, and herpesvirus give rise to RCE. Other causes or factors which increase the risk of RCE syndrome include meibomian gland dysfunction, keratoconjunctivitis sicca, diabetes, and post-LASIK conditions. Basal membrane abnormalities and instability of epithelial adhesion to stroma play a key role in RCE pathogenesis. Ultrastructural changes in RCE include abnormalities of basal epithelial cells and epithelial basal membrane, absence or deficiency of semi-desmosomes, loss of anchor fibrils. Increase in matrix metalloproteinases and collagenases which contribute to basal membrane destruction results in recurrent erosions and further development of abnormal basal membrane. The goals of RCE therapy are to reduce pain (in acute stage, to stimulate re-epithelization, and to restore «adhesion complex» of basal membrane. In most cases, RCE responds to simple conservative treatment that includes lubricants, healing agents, and eye patches. RCEs that are resistant to simple treatment, require complex approach. Non-invasive methods include long-term contact lens use, instillations of autologous serum (eye drops, injections of botulinum toxin (induces ptosis, antiviral agent use or oral intake of metalloproteinase inhibitors. Cell membrane stabilizers, i.e., antioxidants, should be included into treatment approaches as well. Antioxidant effect of Emoxipine promotes tissue reparation due to the prevention of cell membrane lipid peroxidation as well as due to its anti-hypoxic, angioprotective, and antiplatelet effects. If conservative therapy

  15. Surgical therapies for corneal perforations: 10 years of cases in a tertiary referral hospital

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    Yokogawa H

    2014-10-01

    Full Text Available Hideaki Yokogawa, Akira Kobayashi, Natsuko Yamazaki, Toshinori Masaki, Kazuhisa Sugiyama Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Kanazawa, JapanPurpose: To report surgical therapies for corneal perforations in a tertiary referral hospital.Methods: Thirty-one eyes of 31 patients (aged 62.4±18.3 years with surgically treated corneal perforations from January 2002 to July 2013 were included in this study. Demographic data such as cause of corneal perforation, surgical procedures, and visual outcomes were retrospectively analyzed.Results: The causes of corneal perforation (n=31 were divided into infectious (n=8, 26% and noninfectious (n=23, 74% categories. Infectious causes included fungal ulcer, herpetic stromal necrotizing keratitis, and bacterial ulcer. The causes of noninfectious keratopathy included corneal melting after removal of a metal foreign body, severe dry eye, lagophthalmos, canaliculitis, the oral anticancer drug S-1, keratoconus, rheumatoid arthritis, neurotrophic ulcer, atopic keratoconjunctivitis, and unknown causes. Initial surgical procedures included central large corneal graft (n=17, small corneal graft (n=7, and amniotic membrane transplantation (n=7. In two cases the perforation could not be sealed during the first surgical treatment and required subsequent procedures. All infectious keratitis required central large penetrating keratoplasty to obtain anatomical cure. In contrast, several surgical options were used for the treatment of noninfectious keratitis. After surgical treatment, anatomical cure was obtained in all cases. Mean postoperative best corrected visual acuity was better at 6 months (logMAR 1.3 than preoperatively (logMAR 1.8.Conclusion: Surgical therapies for corneal perforations in our hospital included central large lamellar/penetrating keratoplasty, small peripheral patch graft, and amniotic membrane transplantation. All treatments were effective. Corneal

  16. Endoscopy-guided vitreoretinal surgery following penetrating corneal injury: a case report

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    Motoko Kawashima

    2010-08-01

    Full Text Available Motoko Kawashima1, Shinichi Kawashima2, Murat Dogru1,3, Makoto Inoue4, Jun Shimazaki1,51Department of Ophthalmology, Tokyo Dental College, Chiba, Japan; 2Department of Ophthalmology, International University of Health and Welfare, Tokyo, Japan; 3Department of Ocular Surface and Visual Optics, Keio University School of Medicine, Tokyo, Japan; 4Kyorin Eye Center, Tokyo, Japan; 5Department of Ophthalmology, Keio University School of Medicine, Tokyo, JapanIntroduction: Severe ocular trauma requires emergency surgery, and a fresh corneal graft may not always be available. We describe a case of perforating eye injury with corneal ­opacity, suspected endophthalmitis, and an intraocular foreign body. The patient was successfully treated with a two-step procedure comprising endoscopy-guided vitrectomy followed by corneal transplantation. This surgical technique offers a good option to vitrectomy with simultaneous keratoplasty in emergency cases where no graft is immediately available and there is the ­possibility of infection due to the presence of a foreign body.Case presentation: A 55-year-old Japanese woman was referred to our hospital with a ­perforating corneal and lens injury sustained with a muddy ferrous rod. Primary corneal sutures and lensectomy were performed immediately. Vitreoretinal surgery was required due to ­suspected endophthalmitis, vitreous hemorrhage, retinal detachment, dialysis and necrosis of the peripheral retina. Instead of conventional vitrectomy, endoscopy-guided vitreous surgery was performed with the Solid Fiber Catheter AS-611 (FiberTech, Tokyo, Japan due to the presence of corneal opacity and the unavailability of a donor cornea. The retina was successfully attached with the aid of a silicon oil tamponade. Following removal of the silicon oil at 3 months after surgery, penetrating keratoplasty and intraocular lens implantation with ciliary sulcus suture fixation were performed. At 6 months after penetrating

  17. Experiment of amnion epithelial cell suspension liquid used for acute rabbit corneal alkali burn

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    Yan-Yan Zhang

    2017-10-01

    Full Text Available AIM: To investigate the effects of amnion epithelial cell(AECsuspension liquid on the biological behavior of the rabbit's corneal epithelium, combined with the in vitro and in vivo experiments. METHODS: The rabbit's corneal epithelium were cultured in the lower chamber of transwell, and AEC suspension liquid was dropwised in the upper chamber. There was only culture medium in the upper chamber of the control group. The proliferation of rabbit's corneal epithelium was observed with CCK-8 automated colorimetry and the expression of PCNA was detected by immunocytochemistry. We used the scratch wound assay to detect the migration of corneal epithelial cell(CEC. The in vivo models were established by placing a 10mm diameter corneal trephine in the center of the cornea, within 1mol/L NaOH for 1min. We divided those into three groups: treatment group of AEC suspension liquid eye drop, AEC suspension liquid subconjunctival injection and the control group without any treatment. Using the slit-lamp biomicroscope and fluorescence staining to observe the cornea per week. After 28d we took the eyeballs with the HE staining. The expression of VEGF was detected by immunohistochemistry. RESULTS: The activity of CEC with AEC treatment was much higher than the control group(PPIn vivo, the inflammation of the corneal and the CNV of the AEC group were all significantly reduced compared with the control group(PPCONCLUSION: AEC suspension liquid can promote the proliferation and migration of the rabbit's corneal epithelium. The potential of AEC suspension liquid as a therapy for acute corneal alkali burn.

  18. Changes in the micromorphology of the corneal subbasal nerve plexus in patients after plaque brachytherapy

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    Zhivov, Andrey; Winter, Karsten; Peschel, Sabine; Stachs, Oliver; Wree, Andreas; Hildebrandt, Guido; Guthoff, Rudolf

    2013-01-01

    To quantify the development of radiation neuropathy in corneal subbasal nerve plexus (SNP) after plaque brachytherapy, and the subsequent regeneration of SNP micromorphology and corneal sensation. Nine eyes of 9 melanoma patients (ciliary body: 3, iris: 2, conjunctiva: 4) underwent brachytherapy (ruthenium-106 plaque, dose to tumour base: 523 ± 231 Gy). SNP micromorphology was assessed by in-vivo confocal microscopy. Using software developed in–house, pre-irradiation findings were compared with those obtained after 3 days, 1, 4 and 7 months, and related to radiation dose and corneal sensation. After 3 days nerve fibres were absent from the applicator zone and central cornea, and corneal sensation was abolished. The earliest regenerating fibres were seen at the one-month follow-up. By 4 months SNP structures had increased to one-third of pre-treatment status (based on nerve fibre density and nerve fibre count), and corneal sensation had returned to approximately two-thirds of pre-irradiation values. Regeneration of SNP and corneal sensation was nearly complete 7 months after plaque brachytherapy. The evaluation of SNP micromorphology and corneal sensation is a reliable and clinically useful method for assessing neuropathy after plaque brachytherapy. Radiation-induced neuropathy of corneal nerves develops quickly and is partly reversible within 7 months. The clinical impact of radiation-induced SNP damage is moderate

  19. Toxic corneal epitheliopathy after intravitreal methotrexate and its treatment with oral folic acid.

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    Gorovoy, Ian; Prechanond, Tidarat; Abia, Maravillas; Afshar, Armin R; Stewart, Jay M

    2013-08-01

    To determine whether oral folic acid can ameliorate an iatrogenic, visually significant corneal epitheliopathy, which commonly occurs with intravitreal injections of methotrexate for the treatment of intraocular lymphoma. We report 2 cases of visually significant corneal epitheliopathy occurring after intravitreal injections of methotrexate for intraocular lymphoma. The first patient did not receive any treatment for the corneal disease, and the second patient with bilateral intraocular lymphoma received 1 mg of oral folic acid daily, a commonly used dosage for patients on systemic methotrexate. In the first patient without treatment, there was a complete regression of the corneal epithelial disease only when the frequency of intravitreal methotrexate was reduced from weekly to monthly as per a commonly used dosage regimen for methotrexate. In the second patient, the corneal disease improved 80% within 1 week of initiating oral folic acid for her eye already experiencing severe epitheliopathy during her weekly dosing regimen of methotrexate and also had significantly decreased epithelial disease in her second eye that started weekly intravitreal methotrexate several weeks after beginning oral folic acid. Currently, oral folic acid supplements are recommended for patients using systemic methotrexate to minimize drug toxicity. We suggest a similar use in patients undergoing intravitreal methotrexate injections to decrease toxic effects on the corneal epithelium.

  20. [Current quality management situation and administration countermeasure study of enterprises marketing corneal contact lens].

    Science.gov (United States)

    Liu, Yungui; Yao, Ying; Shangguan, Shihao; Gu, Qun; Gao, Wuming; Chen, Yaoshui

    2014-05-01

    Study the current quality management situation of enterprises marketing corneal contact lens via systemic investigations and explore effective administration countermeasures in the future. The quality management indicators of sixty-two corneal contact lens marketing enterprises in Xuhui district of Shanghai were systematically investigated and enterprises of different operation models was compared and analyzed. Wholesale enterprises and retail chain enterprises are apparently better than independent enterprises almost in all facets. Facilitate market accession of corneal contact lens marketing enterprises, encourage the business model of retail chain, enhance supervision of corneal contact lens marketing enterprises, especially independent franchisors.

  1. Seven-year changes in corneal power and aberrations after PRK or LASIK.

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    Ivarsen, Anders; Hjortdal, Jesper

    2012-09-06

    To examine long-term changes in corneal power and aberrations in myopic patients randomized to photorefractive keratectomy (PRK) or laser in situ keratomileusis (LASIK). Forty-five patients with myopia from -6 to -8 diopters (spherical equivalent refraction) were randomized to PRK (n = 20) or LASIK (n = 25). Patients were examined preoperatively and for up to 7 years after surgery. Measurements included refraction, topography (TMS-1), and ultrasound pachymetry. By 3 years, 16 PRK and 15 LASIK patients were examined and by 7 years, 9 PRK and 7 LASIK subjects were available. Only patients who had not been reoperated and attended the two late controls were included in data analyses. Optical analysis of topographic data was used to calculate corneal power and wavefront aberrations. PRK and LASIK caused a similar reduction in corneal power. During the first year after PRK, corneal power increased, but remained stable from 1 to 7 years. In contrast, corneal power continued to increase from 1 to 7 years after LASIK. Both PRK and LASIK caused an increase in coma-like and spherical aberrations that remained constant for 7 years. No significant changes in other higher-order aberrations were observed. The cornea may not be stable even 7 years after LASIK, as indicated by the continuing increase in corneal power. In contrast, PRK appears stable from 1 year post surgery. Coma-like and spherical aberrations are permanently increased after PRK and LASIK. (ClinicalTrials.gov number, NCT00404105.).

  2. Corneal Mechanical Thresholds Negatively Associate With Dry Eye and Ocular Pain Symptoms.

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    Spierer, Oriel; Felix, Elizabeth R; McClellan, Allison L; Parel, Jean Marie; Gonzalez, Alex; Feuer, William J; Sarantopoulos, Constantine D; Levitt, Roy C; Ehrmann, Klaus; Galor, Anat

    2016-02-01

    To examine associations between corneal mechanical thresholds and metrics of dry eye. This was a cross-sectional study of individuals seen in the Miami Veterans Affairs eye clinic. The evaluation consisted of questionnaires regarding dry eye symptoms and ocular pain, corneal mechanical detection and pain thresholds, and a comprehensive ocular surface examination. The main outcome measures were correlations between corneal thresholds and signs and symptoms of dry eye and ocular pain. A total of 129 subjects participated in the study (mean age 64 ± 10 years). Mechanical detection and pain thresholds on the cornea correlated with age (Spearman's ρ = 0.26, 0.23, respectively; both P Dry eye symptom severity scores and Neuropathic Pain Symptom Inventory (modified for the eye) scores negatively correlated with corneal detection and pain thresholds (range, r = -0.13 to -0.27, P eye pain (pain to wind, light, temperature) and explained approximately 32% of measurement variability (R = 0.57). Mechanical detection and pain thresholds measured on the cornea are correlated with dry eye symptoms and ocular pain. This suggests hypersensitivity within the corneal somatosensory pathways in patients with greater dry eye and ocular pain complaints.

  3. Corneal Mechanical Thresholds Negatively Associate With Dry Eye and Ocular Pain Symptoms

    Science.gov (United States)

    Spierer, Oriel; Felix, Elizabeth R.; McClellan, Allison L.; Parel, Jean Marie; Gonzalez, Alex; Feuer, William J.; Sarantopoulos, Constantine D.; Levitt, Roy C.; Ehrmann, Klaus; Galor, Anat

    2016-01-01

    Purpose To examine associations between corneal mechanical thresholds and metrics of dry eye. Methods This was a cross-sectional study of individuals seen in the Miami Veterans Affairs eye clinic. The evaluation consisted of questionnaires regarding dry eye symptoms and ocular pain, corneal mechanical detection and pain thresholds, and a comprehensive ocular surface examination. The main outcome measures were correlations between corneal thresholds and signs and symptoms of dry eye and ocular pain. Results A total of 129 subjects participated in the study (mean age 64 ± 10 years). Mechanical detection and pain thresholds on the cornea correlated with age (Spearman's ρ = 0.26, 0.23, respectively; both P Dry eye symptom severity scores and Neuropathic Pain Symptom Inventory (modified for the eye) scores negatively correlated with corneal detection and pain thresholds (range, r = −0.13 to −0.27, P eye pain (pain to wind, light, temperature) and explained approximately 32% of measurement variability (R = 0.57). Conclusions Mechanical detection and pain thresholds measured on the cornea are correlated with dry eye symptoms and ocular pain. This suggests hypersensitivity within the corneal somatosensory pathways in patients with greater dry eye and ocular pain complaints. PMID:26886896

  4. The Effect of Pterygium and Pterygium Surgery on Corneal Biomechanics.

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    Koç, Mustafa; Yavrum, Fuat; Uzel, Mehmet Murat; Aydemir, Emre; Özülken, Kemal; Yılmazbaş, Pelin

    2018-01-01

    To evaluate the effect of pterygium and pterygium surgery on corneal biomechanics by ocular response analyzer (ORA, Reichert, USA). This study considered 68 eyes (from 34 patients with a mean age of 21.2±7.1 years) with unilateral nasal, primary pterygium (horizontal length biomechanics. The correlation of the ORA measurements with the pterygium area was evaluated. Mean pterygium horizontal length and area were 3.31±1.43 mm and 6.82±2.17 mm 2 , respectively. There was no statistically significant difference between the eyes with and without pterygium in corneal hysteresis (CH, p=0.442), corneal resistance factor (CRF, p=0.554), corneal-compensated intraocular pressure (IOP cc , p=0.906), and Goldmann-correlated IOP (IOP g , p=0.836). All preoperative parameters decreased after surgery; however, none of them were statistically significant (CH, p=0.688; CRF, p=0.197; IOP cc , p=0.503; IOP g , p=0.231). There were no correlations between pterygium area and ORA measurements (p>0.05). Pterygium biomechanics. These results may be taken into account when cornea biomechanics, mainly intraocular pressure measurements, are important.

  5. Corneal structure and transparency

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    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

  6. Inhibition of multiple pathogenic pathways by histone deacetylase inhibitor SAHA in a corneal alkali-burn injury model

    Science.gov (United States)

    Li, Xinyu; Zhou, Qinbo; Hanus, Jakub; Anderson, Chastain; Zhang, Hongmei; Dellinger, Michael; Brekken, Rolf; Wang, Shusheng

    2013-01-01

    Neovascularization (NV) in the cornea is a major cause of vision impairment and corneal blindness. Hemangiogenesis and lymphangiogenesis induced by inflammation underlie the pathogenesis of corneal NV. The current mainstay treatment, corticosteroid, treats the inflammation associated with corneal NV, but is not satisfactory due to such side effects as cataract and the increase in intraocular pressure. It is imperative to develop a novel therapy that specifically targets the hemangiogenesis, lymphangiogenesis and inflammation pathways underlying corneal NV. Histone deacetylase inhibitors (HDACi) have been in clinical trials for cancer and other diseases. In particular, HDACi suberoylanilide hydroxamic acid (SAHA, vorinostat, Zolinza) has been approved by the FDA for the treatment of cutaneous T-cell lymphoma. The functional mechanism of SAHA in cancer and especially in corneal NV remains unclear. Here, we show that topical application of SAHA inhibits neovascularization in an alkali-burn corneal injury model. Mechanistically, SAHA inhibits corneal NV by repressing hemangiogenesis, inflammation pathways and previously overlooked lymphangiogenesis. Topical SAHA is well tolerated on the ocular surface. In addition, the potency of SAHA in corneal NV appears to be comparable to the current steroid therapy. SAHA may possess promising therapeutic potential in alkali-burn corneal injury and other inflammatory neovascularization disorders. PMID:23186311

  7. Removal of the basement membrane enhances corneal wound healing.

    Science.gov (United States)

    Pal-Ghosh, Sonali; Pajoohesh-Ganji, Ahdeah; Tadvalkar, Gauri; Stepp, Mary Ann

    2011-12-01

    Recurrent corneal erosions are painful and put patients' vision at risk. Treatment typically begins with debridement of the area around the erosion site followed by more aggressive treatments. An in vivo mouse model has been developed that reproducibly induces recurrent epithelial erosions in wild-type mice spontaneously within two weeks after a single 1.5 mm corneal debridement wound created using a dulled-blade. This study was conducted to determine whether 1) inhibiting MMP9 function during healing after dulled-blade wounding impacts erosion development and 2) wounds made with a rotating-burr heal without erosions. Oral or topical inhibition of MMPs after dulled-blade wounding does not improve healing. Wounds made by rotating-burr heal with significantly fewer erosions than dulled-blade wounds. The localization of MMP9, β4 integrin and basement membrane proteins (LN332 and type VII collagen), immune cell influx, and reinnervation of the corneal nerves were compared after both wound types. Rotating-burr wounds remove the anterior basement membrane centrally but not at the periphery near the wound margin, induce more apoptosis of corneal stromal cells, and damage more stromal nerve fibers. Despite the fact that rotating-burr wounds do more damage to the cornea, fewer immune cells are recruited and significantly more wounds resolve completely. Copyright © 2011 Elsevier Ltd. All rights reserved.

  8. CLINICAL OUTCOME OF PENETRATING KERATOPLASTY IN CORNEAL OPACITIES OF DIFFERENT AETIOLOGY- A CLINICAL STUDY

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    Dipak Bhuyan

    2017-01-01

    Full Text Available BACKGROUND Corneal transplantation or grafting is an operation in which abnormal corneal host tissue is replaced by healthy donor cornea. According to the World Health Organization (WHO, corneal diseases are among the major causes of vision loss and blindness in the world today after cataract and glaucoma. The aim of the study is to- 1. Evaluate the different aetiology of corneal opacity including active infective aetiology as indicated for penetrating keratoplasty. 2. Determine the clinical outcome of penetrating keratoplasty in relation to graft survival, graft rejection and peri-operative complications in different aetiology groups. 3. Determine the final visual outcome. MATERIALS AND METHODS Candidates for keratoplasty were selected from- 1. Eye Bank of Regional Institute of Ophthalmology (R.I.O. 2. R.I.O OPD. The study period was from September 2014 to August 2015. 30 cases were taken in the study. Descriptive statistics were applied to analyse the data wherever necessary. RESULTS 34.6±19.73 yrs. (mean±SD was the mean age at which transplants were done in the study. Out of total 30 cases, 13 (43.33% and 17 (56.66% were male and female, respectively. The different indications for penetrating keratoplasty are- Post ulcer corneal opacity in 14 cases (46.66%, posttraumatic corneal opacity 9 cases (30%, pseudophakic bullous keratopathy 4 cases (13.33%, corneal dystrophy in 2 cases (6.66% and non-healing corneal ulcer in 1 case (3.33%. 16 cases (53.33% showed clear graft till the last follow up while 11 (33.33% cases showed partially clear graft resulting in improved visual outcome while 3 cases (10.00% of the grafts were opaque due to graft failure. CONCLUSION The major indications for penetrating keratoplasty in this part of the world are post ulcer and posttraumatic corneal opacity and majority of them are illiterate agricultural workers who failed to get adequate treatment on time. Graft survival rate is high, which can be attributed to the

  9. Corneal Deformation Response and Ocular Geometry: A Non-invasive Diagnostic Strategy in Marfan Syndrome

    Science.gov (United States)

    Beene, Lauren C.; Traboulsi, Elias I.; Seven, Ibrahim; Ford, Matthew R.; Roy, Abhijit Sinha; Butler, Robert S.; Dupps, William J.

    2015-01-01

    Purpose To evaluate corneal air-puff deformation responses and ocular geometry as predictors of Marfan syndrome. Design Prospective observational clinical study Methods Sixteen investigator-derived, 4 standard Ocular Response Analyzer (ORA), and geometric variables from corneal tomography and optical biometry using Oculus Pentacam and IOL Master were assessed for discriminative value in Marfan syndrome, measuring right eyes of 24 control and 13 Marfan syndrome subjects. Area under the receiver operating characteristic (AUROC) curve was assessed in univariate and multivariate analyses Results Six investigator-derived ORA variables successfully discriminated Marfan syndrome. The best lone disease predictor was Concavity Min (Marfan syndrome 47.5 ± 20, control 69 ± 14, p = 0.003; AUROC = 0.80). Corneal hysteresis and corneal resistance factor were decreased (Marfan syndrome CH 9.45 ± 1.62, control CH 11.24 ± 1.21, p = 0.01; Marfan syndrome CRF 9.77 ± 1.65, control CRF 11.03 ± 1.72, p = 0.01) and corneas were flatter in Marfan syndrome (Marfan syndrome Kmean 41.25 ± 2.09 D, control Kmean 42.70 ± 1.81 D, p = 0.046). No significant differences were observed in central corneal thickness, axial eye length, or intraocular pressure. A multivariate regression model incorporating corneal curvature and hysteresis loop area (HLA) provided the best predictive value for Marfan syndrome (AUROC = 0.85). Conclusions This study describes novel biodynamic features of corneal deformation responses in Marfan syndrome, including increased deformation, decreased bending resistance, and decreased energy dissipation capacity. A predictive model incorporating HLA and corneal curvature shows greatest potential for non-invasive clinical diagnosis of Marfan syndrome. PMID:26432567

  10. Management of a Small Paracentral Corneal Perforation Using Iatrogenic Iris Incarceration and Tissue Adhesive

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    Akira Kobayashi

    2012-07-01

    Full Text Available Background: Surgical intervention for corneal perforation is indicated when the anterior chamber does not reform within a short period of time. Herein, we report the successful management of a small paracentral corneal perforation using autologous iris incarceration and tissue adhesive. Case: A 41-year-old man developed a small paracentral corneal perforation (0.5 mm in size in the right eye, while the treating physician attempted to remove the residual rust ring after removal of a piece of metallic foreign body. Observations: The eye was initially managed with a bandage soft contact lens to ameliorate the aqueous leakage; however, without success. Iatrogenic iris incarceration of the wound was first induced, followed by application of cyanoacrylate tissue adhesive to the perforated site. As a result, the anterior chamber was immediately reformed and maintained. Complete corneal epithelialization of the perforation was achieved in 2 months without visual compromises. Conclusions: Cyanoacrylate tissue adhesive with iatrogenic incarceration of the autologous iris was effective in treating this type of small corneal perforation. This technique is simple and potentially useful for small paracentral corneal perforations outside the visual axis and without good apposition.

  11. Corneal neurotoxicity due to topical benzalkonium chloride.

    Science.gov (United States)

    Sarkar, Joy; Chaudhary, Shweta; Namavari, Abed; Ozturk, Okan; Chang, Jin-Hong; Yco, Lisette; Sonawane, Snehal; Khanolkar, Vishakha; Hallak, Joelle; Jain, Sandeep

    2012-04-06

    The aim of this study was to determine and characterize the effect of topical application of benzalkonium chloride (BAK) on corneal nerves in vivo and in vitro. Thy1-YFP+ neurofluorescent mouse eyes were treated topically with vehicle or BAK (0.01% or 0.1%). Wide-field stereofluorescence microscopy was performed to sequentially image the treated corneas in vivo every week for 4 weeks, and changes in stromal nerve fiber density (NFD) and aqueous tear production were determined. Whole-mount immunofluorescence staining of corneas was performed with antibodies to axonopathy marker SMI-32. Western immunoblot analyses were performed on trigeminal ganglion and corneal lysates to determine abundance of proteins associated with neurotoxicity and regeneration. Compartmental culture of trigeminal ganglion neurons was performed in Campenot devices to determine whether BAK affects neurite outgrowth. BAK-treated corneas exhibited significantly reduced NFD and aqueous tear production, and increased inflammatory cell infiltration and fluorescein staining at 1 week (P reduction in neurites occurred after BAK addition to compartmental cultures of dissociated trigeminal ganglion cells. Although both BAK doses (0.0001% and 0.001%) reduced nerve fiber length, the reduction was significantly more with the higher dose (P < 0.001). Topical application of BAK to the eye causes corneal neurotoxicity, inflammation, and reduced aqueous tear production.

  12. Modeling of corneal and retinal pharmacokinetics after periocular drug administration.

    Science.gov (United States)

    Amrite, Aniruddha C; Edelhauser, Henry F; Kompella, Uday B

    2008-01-01

    To develop pharmacokinetics models to describe the disposition of small lipophilic molecules in the cornea and retina after periocular (subconjunctival or posterior subconjunctival) administration. Compartmental pharmacokinetics analysis was performed on the corneal and retinal data obtained after periocular administration of 3 mg of celecoxib (a selective COX-2 inhibitor) to Brown Norway (BN) rats. Berkeley Madonna, a differential and difference equation-based modeling software, was used for the pharmacokinetics modeling. The data were fit to different compartment models with first-order input and disposition, and the best fit was selected on the basis of coefficient of regression and Akaike information criteria (AIC). The models were validated by using the celecoxib data from a prior study in Sprague-Dawley (SD) rats. The corneal model was also fit to the corneal data for prednisolone at a dose of 2.61 mg in albino rabbits, and the model was validated at two other doses of prednisolone (0.261 and 26.1 mg) in these rabbits. Model simulations were performed with the finalized model to understand the effect of formulation on corneal and retinal pharmacokinetics after periocular administration. Celecoxib kinetics in the BN rat cornea can be described by a two-compartment (periocular space and cornea, with a dissolution step for periocular formulation) model, with parallel elimination from the cornea and the periocular space. The inclusion of a distribution compartment or a dissolution step for celecoxib suspension did not lead to an overall improvement in the corneal data fit compared with the two-compartment model. The more important parameter for enhanced fit and explaining the apparent lack of an increase phase in the corneal levels is the inclusion of the initial leak-back of the dose from the periocular space into the precorneal area. The predicted celecoxib concentrations from this model also showed very good correlation (r = 0.99) with the observed values in

  13. Vps35-deficiency impairs SLC4A11 trafficking and promotes corneal dystrophy.

    Directory of Open Access Journals (Sweden)

    Wei Liu

    Full Text Available Vps35 (vacuolar protein sorting 35 is a major component of retromer that selectively promotes endosome-to-Golgi retrieval of transmembrane proteins. Dysfunction of retromer is a risk factor for the pathogenesis of Parkinson's disease (PD and Alzheimer's disease (AD. However, Vps35/retromer's function in the eye or the contribution of Vps35-deficiency to eye degenerative disorders remains to be explored. Here we provide evidence for a critical role of Vps35 in mouse corneal dystrophy. Vps35 is expressed in mouse and human cornea. Mouse cornea from Vps35 heterozygotes (Vps35+/- show features of dystrophy, such as loss of both endothelial and epithelial cell densities, disorganizations of endothelial, stroma, and epithelial cells, excrescences in the Descemet membrane, and corneal edema. Additionally, corneal epithelial cell proliferation was reduced in Vps35-deficient mice. Intriguingly, cell surface targeting of SLC4A11, a membrane transport protein (OH- /H+ /NH3 /H2O of corneal endothelium, whose mutations have been identified in patients with corneal dystrophy, was impaired in Vps35-deficient cells and cornea. Taken together, these results suggest that SLC4A11 appears to be a Vps35/retromer cargo, and Vps35-regulation of SLC4A11 trafficking may underlie Vps35/retromer regulation of corneal dystrophy.

  14. Corneal biomechanical changes in diabetes mellitus and their influence on intraocular pressure measurements.

    Science.gov (United States)

    Sahin, Afsun; Bayer, Atilla; Ozge, Gökhan; Mumcuoğlu, Tarkan

    2009-10-01

    To investigate possible corneal biomechanical changes in patients with diabetes mellitus and understand the influence of such changes on intraocular pressure measurements. The study group was composed of 120 eyes from 61 healthy control subjects and 81 eyes from 43 diabetic subjects. IOP was measured first with an ocular response analyzer (ORA) and subsequently with a Goldmann applanation tonometer (GAT). Central corneal thickness (CCT) was measured with an ultrasonic pachymeter attached to the ORA. Axial length (AL), anterior chamber depth (ACD), and keratometry readings were acquired with partial coherence laser interferometry during the same visit before all IOP and CCT determinations were made. Corneal hysteresis (CH) was found to be significantly lower in diabetic patients when compared with healthy control subjects (9.51 +/- 1.82 mm Hg vs. 10.41 +/- 1.66 mm Hg, P < 0.0001). There was no significant difference in terms of corneal resistance factor (CRF; P = 0.8). Mean CCT, GAT IOP, Goldmann-correlated IOP (IOPg), and corneal-compensated IOP (IOPcc) were significantly higher in diabetic patients than in healthy control subjects (P = 0.01 for CCT, P < 0.0001 for GAT IOP, IOPg, and IOPcc). Diabetes affects corneal biomechanics and results in lower CH values than those in healthy control subjects, which may cause clinically relevant high IOP measurements independent of CCT.

  15. [Marketing role of corneal graft tissue donation to an eye bank and donors' socioeconomic profile].

    Science.gov (United States)

    Farias, Roberta Jansen de Mello; Sousa, Luciene Barbosa de

    2008-01-01

    Penetrating keratoplasty has been the leading and the most successful type of transplant in the world, however corneal deficiency is a commom problem usually presented to corneal surgeons. Impact evaluation of the number of corneal graft donations to the Sorocaba Eye Bank after the implementation of a corneal graft procurement system; to draw the socioeconomic profile of corneal graft donors of the Sorocaba Eye Bank (SEB). Retrospective study on donations to SEB from its creation and after the development of media marketing. Prospective analysis of the socioeconomic profile of corneal graft donors by a questionnaire sent as letters to the families of the donors in a certain month. SEB began its work in 1971 by spreading need of organ donation through lectures in churches, shopping malls, community meetings, radio programs, television programs, etc. In the 70s, the number of retrieved corneal grafts was 1 or 2/month. Between 1984 - 1989 a procurement coordination team was trained to act in mortuaries and by 2000 they also began to work in public hospitals. In 1984 only 260 corneal grafts were retrieved. This number has been increasing to 2,778 corneal graft donations in 2004. The questionnaire was answered by 76 of the 93 donor families, with a response rate of 81.7%. Donor age had a mean of 65.1 +/- 14.7 y/o, forty-two (55.3%) were men. Educational level of the donor families was an important factor for organ donation, once 36.8% had concluded high school and 34.2% completed university. The great majority, sixty-three (82.9%) of the corneal grafts were donated through the efforts of the procurement coordination team. The role of the media and institutional credibility are mandatory for public commitment to organ donation. The proficiency of the procurement coordination team requires intensive training, as the results show that 82.9% donations were made thanks to their efforts.

  16. Corneal stroma microfibrils.

    Science.gov (United States)

    Hanlon, Samuel D; Behzad, Ali R; Sakai, Lynn Y; Burns, Alan R

    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 (∼10 nm diameter). Immunogold evidence clearly

  17. 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

  18. Corneal haze following PRK with mitomycin C as a retreatment versus prophylactic use in the contralateral eye.

    Science.gov (United States)

    Netto, Marcelo V; Chalita, Maria Regina; Krueger, Ronald R

    2007-01-01

    To report photorefractive keratectomy (PRK) treated with mitomycin C (MMC) for previous corneal haze in one eye and PRK with MMC to prevent corneal haze formation in the fellow eye. A 40-year-old woman underwent PRK with MMC to treat previous corneal haze (secondary to previous PRK without MMC) for residual refractive error of +0.50 +0.25 x 165 in the left eye and PRK with MMC to prevent corneal haze in the right eye. Postoperative slit-lamp examination revealed no haze in the right eye, but continued mild haze in the left eye. Treatment with PRK and MMC for previous corneal haze is not as effective as primary PRK with MMC in preventing postoperative corneal haze formation.

  19. Extracción de cristalino transparente en pacientes hipermétropes Extraction of transparent crystalline lens in hypermetrope patients

    Directory of Open Access Journals (Sweden)

    Eduardo Rojas Alvarez

    2011-06-01

    Full Text Available OBJETIVOS: Describir los resultados obtenidos en la extracción de cristalino transparente de pacientes hipermétropes. MÉTODOS: Se efectuó un estudio descriptivo, prospectivo y longitudinal, en el período de septiembre de 2009 a febrero de 2010. Fueron estudiados 60 ojos de 30 pacientes con hipermetropía, quienes acudieron al Instituto Cubano de Oftalmología "Ramón Pando Ferrer" y no cumplieron los criterios establecidos para cirugía refractiva corneal. Se aplicó la fórmula Hoffer Q por IOL máster para el cálculo del lente intraocular, técnica quirúrgica estándar, facoemulsificación (facoaspiración, poder ultrasónico: 10 % (pulsado, vacío: 350 mmHg, flujo: 25 cc/min; túnel corneal, capsulorrexis amplia e implante de lente intraocular monofocal en saco capsular. Se realizó el análisis estadístico por promedio asociado a prueba T para datos pareados. RESULTADOS: La edad promedio fue de 39 ± 2,6 años. La longitud axil promedio fue de 21 ± 2 mm. La mejor agudeza visual sin corrección ascendió de 0,08 en el preoperatorio a 0,72 en el posoperatorio. La mejor agudeza visual con corrección varió de 0,92 a 0,98. El valor de la esfera se redujo de 5,25 a - 0,50 y el cilindro de 0,75 a - 0,25 dioptrías; en consecuencia, el equivalente esférico disminuyó de 4,75 en el preoperatorio a -1,00 dioptrías en el período posoperatorio, específicamente en el ojo dominante a 0,46 y en el no dominante a -0,97 dioptrÍas. CONCLUSIONES: La monovisión resulta efectiva en los pacientes. La extracción de cristalino transparente en pacientes hipermétropes es una opción útil cuando estos no son candidatos a cirugía refractiva corneal.OBJECTIVES: To describe the results obtained in the extraction of the transparent crystalline lens in hypermetrope patients. METHODS: A longitudinal, prospective and descriptive study was conducted from September, 2009 to February, 2010. Sixty eyes was studied from 30 patients presenting with

  20. Establishment of functioning human corneal endothelial cell line with high growth potential.

    Directory of Open Access Journals (Sweden)

    Tadashi Yokoi

    Full Text Available Hexagonal-shaped human corneal endothelial cells (HCEC form a monolayer by adhering tightly through their intercellular adhesion molecules. Located at the posterior corneal surface, they maintain corneal translucency by dehydrating the corneal stroma, mainly through the Na(+- and K(+-dependent ATPase (Na(+/K(+-ATPase. Because HCEC proliferative activity is low in vivo, once HCEC are damaged and their numbers decrease, the cornea begins to show opacity due to overhydration, resulting in loss of vision. HCEC cell cycle arrest occurs at the G1 phase and is partly regulated by cyclin-dependent kinase inhibitors (CKIs in the Rb pathway (p16-CDK4/CyclinD1-pRb. In this study, we tried to activate proliferation of HCEC by inhibiting CKIs. Retroviral transduction was used to generate two new HCEC lines: transduced human corneal endothelial cell by human papillomavirus type E6/E7 (THCEC (E6/E7 and transduced human corneal endothelial cell by Cdk4R24C/CyclinD1 (THCEH (Cyclin. Reverse transcriptase polymerase chain reaction analysis of gene expression revealed little difference between THCEC (E6/E7, THCEH (Cyclin and non-transduced HCEC, but cell cycle-related genes were up-regulated in THCEC (E6/E7 and THCEH (Cyclin. THCEH (Cyclin expressed intercellular molecules including ZO-1 and N-cadherin and showed similar Na(+/K(+-ATPase pump function to HCEC, which was not demonstrated in THCEC (E6/E7. This study shows that HCEC cell cycle activation can be achieved by inhibiting CKIs even while maintaining critical pump function and morphology.

  1. Confocal microscopy and electrophysiological study of single patient corneal endothelium cell cultures

    Science.gov (United States)

    Tatini, Francesca; Rossi, Francesca; Coppi, Elisabetta; Magni, Giada; Fusco, Irene; Menabuoni, Luca; Pedata, Felicita; Pugliese, Anna Maria; Pini, Roberto

    2016-04-01

    The characterization of the ion channels in corneal endothelial cells and the elucidation of their involvement in corneal pathologies would lead to the identification of new molecular target for pharmacological treatments and to the clarification of corneal physiology. The corneal endothelium is an amitotic cell monolayer with a major role in preserving corneal transparency and in regulating the water and solute flux across the posterior surface of the cornea. Although endothelial cells are non-excitable, they express a range of ion channels, such as voltage-dependent Na+ channels and K+ channels, L-type Ca2 channels and many others. Interestingly, purinergic receptors have been linked to a variety of conditions within the eye but their presence in the endothelium and their role in its pathophysiology is still uncertain. In this study, we were able to extract endothelial cells from single human corneas, thus obtaining primary cultures that represent the peculiarity of each donor. Corneas were from tissues not suitable for transplant in patients. We characterized the endothelial cells by confocal microscopy, both within the intact cornea and in the primary endothelial cells cultures. We also studied the functional role of the purinergic system (adenosine, ATP and their receptors) by means of electrophysiological recordings. The experiments were performed by patch clamp recordings and confocal time-lapse microscopy and our results indicate that the application of purinergic compounds modulates the amplitude of outward currents in the isolated endothelial cells. These findings may lead to the proposal of new therapies for endothelium-related corneal diseases.

  2. Corneal Nerve Regeneration after Self-Retained Cryopreserved Amniotic Membrane in Dry Eye Disease

    Directory of Open Access Journals (Sweden)

    Thomas John

    2017-01-01

    Full Text Available Purpose. To evaluate the efficacy of self-retained cryopreserved amniotic membrane (CAM in promoting corneal nerve regeneration and improving corneal sensitivity in dry eye disease (DED. Methods. In this prospective randomized clinical trial, subjects with DED were randomized to receive CAM (study group or conventional maximum treatment (control. Changes in signs and symptoms, corneal sensitivity, topography, and in vivo confocal microscopy (IVCM were evaluated at baseline, 1 month, and 3 months. Results. Twenty subjects (age 66.9 ± 8.9 were enrolled and 17 completed all follow-up visits. Signs and symptoms were significantly improved in the study group yet remained constant in the control. IVCM showed a significant increase in corneal nerve density in the study group (12,241 ± 5083 μm/mm2 at baseline, 16,364 ± 3734 μm/mm2 at 1 month, and 18,827 ± 5453 μm/mm2 at 3 months, p=0.015 but was unchanged in the control. This improvement was accompanied with a significant increase in corneal sensitivity (3.25 ± 0.6 cm at baseline, 5.2 ± 0.5 cm at 1 month, and 5.6 ± 0.4 cm at 3 months, p<0.001 and corneal topography only in the study group. Conclusions. Self-retained CAM is a promising therapy for corneal nerve regeneration and accelerated recovery of the ocular surface health in patients with DED. The study is registered at clinicaltrials.gov with trial identifier: NCT02764814.

  3. Corneal perforation after conductive keratoplasty with previous refractive surgery.

    Science.gov (United States)

    Kymionis, George D; Titze, Patrik; Markomanolakis, Marinos M; Aslanides, Ioannis M; Pallikaris, Ioannis G

    2003-12-01

    A 56-year-old woman had conductive keratoplasty (CK) for residual hyperopia and astigmatism. Three years before the procedure, the patient had arcuate keratotomy, followed by laser in situ keratomileusis 2 years later for high astigmatism correction in both eyes. During CK, a corneal perforation occurred in the right eye; during the postoperative examination, an iris perforation and anterior subcapsule opacification were seen beneath the perforation site. The perforation was managed with a bandage contact lens and an antibiotic-steroid ointment; it had a negative Seidel sign by the third day. The surgery in the left eye was uneventful. Three months after the procedure, the uncorrected visual acuity was 20/32 and the best corrected visual acuity 20/20 in both eyes with a significant improvement in corneal topography. Care must be taken to prevent CK-treated spots from coinciding with areas in the corneal stroma that might have been altered by previous refractive procedures.

  4. Cell therapy of congenital corneal diseases with umbilical mesenchymal stem cells: lumican null mice.

    Directory of Open Access Journals (Sweden)

    Hongshan Liu

    Full Text Available BACKGROUND: Keratoplasty is the most effective treatment for corneal blindness, but suboptimal medical conditions and lack of qualified medical personnel and donated cornea often prevent the performance of corneal transplantation in developing countries. Our study aims to develop alternative treatment regimens for congenital corneal diseases of genetic mutation. METHODOLOGY/PRINCIPAL FINDINGS: Human mesenchymal stem cells isolated from neonatal umbilical cords were transplanted to treat thin and cloudy corneas of lumican null mice. Transplantation of umbilical mesenchymal stem cells significantly improved corneal transparency and increased stromal thickness of lumican null mice, but human umbilical hematopoietic stem cells failed to do the same. Further studies revealed that collagen lamellae were re-organized in corneal stroma of lumican null mice after mesenchymal stem cell transplantation. Transplanted umbilical mesenchymal stem cells survived in the mouse corneal stroma for more than 3 months with little or no graft rejection. In addition, these cells assumed a keratocyte phenotype, e.g., dendritic morphology, quiescence, expression of keratocyte unique keratan sulfated keratocan and lumican, and CD34. Moreover, umbilical mesenchymal stem cell transplantation improved host keratocyte functions, which was verified by enhanced expression of keratocan and aldehyde dehydrogenase class 3A1 in lumican null mice. CONCLUSIONS/SIGNIFICANCE: Umbilical mesenchymal stem cell transplantation is a promising treatment for congenital corneal diseases involving keratocyte dysfunction. Unlike donated corneas, umbilical mesenchymal stem cells are easily isolated, expanded, stored, and can be quickly recovered from liquid nitrogen when a patient is in urgent need.

  5. A fully automated cell segmentation and morphometric parameter system for quantifying corneal endothelial cell morphology.

    Science.gov (United States)

    Al-Fahdawi, Shumoos; Qahwaji, Rami; Al-Waisy, Alaa S; Ipson, Stanley; Ferdousi, Maryam; Malik, Rayaz A; Brahma, Arun

    2018-07-01

    Corneal endothelial cell abnormalities may be associated with a number of corneal and systemic diseases. Damage to the endothelial cells can significantly affect corneal transparency by altering hydration of the corneal stroma, which can lead to irreversible endothelial cell pathology requiring corneal transplantation. To date, quantitative analysis of endothelial cell abnormalities has been manually performed by ophthalmologists using time consuming and highly subjective semi-automatic tools, which require an operator interaction. We developed and applied a fully-automated and real-time system, termed the Corneal Endothelium Analysis System (CEAS) for the segmentation and computation of endothelial cells in images of the human cornea obtained by in vivo corneal confocal microscopy. First, a Fast Fourier Transform (FFT) Band-pass filter is applied to reduce noise and enhance the image quality to make the cells more visible. Secondly, endothelial cell boundaries are detected using watershed transformations and Voronoi tessellations to accurately quantify the morphological parameters of the human corneal endothelial cells. The performance of the automated segmentation system was tested against manually traced ground-truth images based on a database consisting of 40 corneal confocal endothelial cell images in terms of segmentation accuracy and obtained clinical features. In addition, the robustness and efficiency of the proposed CEAS system were compared with manually obtained cell densities using a separate database of 40 images from controls (n = 11), obese subjects (n = 16) and patients with diabetes (n = 13). The Pearson correlation coefficient between automated and manual endothelial cell densities is 0.9 (p system, and the possibility of utilizing it in a real world clinical setting to enable rapid diagnosis and for patient follow-up, with an execution time of only 6 seconds per image. Copyright © 2018 Elsevier B.V. All rights reserved.

  6. Quantitative Assessment of Ultrastructure and Light Scatter in Mouse Corneal Debridement Wounds

    Science.gov (United States)

    Boote, Craig; Du, Yiqin; Morgan, Sian; Harris, Jonathan; Kamma-Lorger, Christina S.; Hayes, Sally; Lathrop, Kira L.; Roh, Danny S.; Burrow, Michael K.; Hiller, Jennifer; Terrill, Nicholas J.; Funderburgh, James L.; Meek, Keith M.

    2012-01-01

    Purpose. The mouse has become an important wound healing model with which to study corneal fibrosis, a frequent complication of refractive surgery. The aim of the current study was to quantify changes in stromal ultrastructure and light scatter that characterize fibrosis in mouse corneal debridement wounds. Methods. Epithelial debridement wounds, with and without removal of basement membrane, were produced in C57BL/6 mice. Corneal opacity was measured using optical coherence tomography, and collagen diameter and matrix order were quantified by x-ray scattering. Electron microscopy was used to visualize proteoglycans. Quantitative PCR (Q-PCR) measured mRNA transcript levels for several quiescent and fibrotic markers. Results. Epithelial debridement without basement membrane disruption produced a significant increase in matrix disorder at 8 weeks, but minimal corneal opacity. In contrast, basement membrane penetration led to increases in light scatter, matrix disorder, and collagen diameter, accompanied by the appearance of abnormally large proteoglycans in the subepithelial stroma. This group also demonstrated upregulation of several quiescent and fibrotic markers 2 to 4 weeks after wounding. Conclusions. Fibrotic corneal wound healing in mice involves extensive changes to collagen and proteoglycan ultrastructure, consistent with deposition of opaque scar tissue. Epithelial basement membrane penetration is a deciding factor determining the degree of ultrastructural changes and resulting opacity. PMID:22467580

  7. Evaluation of corneal biomechanical properties following penetrating keratoplasty using ocular response analyzer

    Directory of Open Access Journals (Sweden)

    Vanathi Murugesan

    2014-01-01

    Full Text Available Purpose: To evaluate corneal biomechanical properties in eyes that has undergone penetrating keratoplasty (PK. Materials and Methods: Retrospective observational study in a tertiary care centre. Data recorded included ocular response analyzer (ORA values of normal and post-keratoplasty eyes [corneal hysteresis (CH, corneal resistance factor (CRF, Goldmann-correlated intraocular pressure (IOPg, and cornea-compensated intraocular pressure (IOPcc], corneal topography, and central corneal thickness (CCT. Wilcoxon signed rank test was used to analyze the difference in ORA parameter between post-PK eyes and normal eyes. Correlation between parameters was evaluated with Spearman′s rho correlation. Results: The ORA study of 100 eyes of 50 normal subjects and 54 post-keratoplasty eyes of 51 patients showed CH of 8.340 ± 1.85 and 9.923 ± 1.558, CRF of 8.846 ± 2.39 and 9.577 ± 1.631 in post-PK eyes and normal eyes, respectively. CH and CRF did not correlate with post-keratoplasty astigmatism (P = 0.311 and 0.276, respectively while a significant correlation was observed with IOPg (P = 0.004 and IOPcc (P < 0.001. Conclusion: Biomechanical profiles were significantly decreased in post-keratoplasty eyes with significant correlation with higher IOP as compared with that in normal eyes.

  8. IL-8 and MCP Gene Expression and Production by LPS-Stimulated Human Corneal Stromal Cells

    Directory of Open Access Journals (Sweden)

    Roni M. Shtein

    2012-01-01

    Full Text Available Purpose. To determine time course of effect of lipopolysaccharide (LPS on production of interleukin-8 (IL-8 and monocyte chemotactic protein (MCP by cultured human corneal stromal cells. Methods. Human corneal stromal cells were harvested from donor corneal specimens, and fourth to sixth passaged cells were used. Cell cultures were stimulated with LPS for 2, 4, 8, and 24 hours. Northern blot analysis of IL-8 and MCP gene expression and ELISA for IL-8 and MCP secretion were performed. ELISA results were analyzed for statistical significance using two-tailed Student's t-test. Results. Northern blot analysis demonstrated significantly increased IL-8 and MCP gene expression after 4 and 8 hours of exposure to LPS. ELISA for secreted IL-8 and MCP demonstrated statistically significant increases (P<0.05 after corneal stromal cell stimulation with LPS. Conclusions. This paper suggests that human corneal stromal cells may participate in corneal inflammation by secreting potent leukocyte chemotactic and activating proteins in a time-dependent manner when exposed to LPS.

  9. Corneal ulcers: For the general practitioner

    African Journals Online (AJOL)

    Speci c enquiry as to instillation of medication (e.g. steroid drops) or home ... unaided and then with pinhole, with the fellow eye occluded. As a corneal ... topical anaesthetic drops will assist in making the patient comfortable enough to open ...

  10. In situ ultrahigh-resolution optical coherence tomography characterization of eye bank corneal tissue processed for lamellar keratoplasty.

    Science.gov (United States)

    Brown, Jamin S; Wang, Danling; Li, Xiaoli; Baluyot, Florence; Iliakis, Bernie; Lindquist, Thomas D; Shirakawa, Rika; Shen, Tueng T; Li, Xingde

    2008-08-01

    To use optical coherence tomography (OCT) as a noninvasive tool to perform in situ characterization of eye bank corneal tissue processed for lamellar keratoplasty. A custom-built ultrahigh-resolution OCT (UHR-OCT) was used to characterize donor corneal tissue that had been processed for lamellar keratoplasty. Twenty-seven donor corneas were analyzed. Four donor corneas were used as controls, whereas the rest were processed into donor corneal buttons for lamellar transplantation by using hand dissection, a microkeratome, or a femtosecond laser. UHR-OCT was also used to noninvasively characterize and monitor the viable corneal tissue immersed in storage medium over 3 weeks. The UHR-OCT captured high-resolution images of the donor corneal tissue in situ. This noninvasive technique showed the changes in donor corneal tissue morphology with time while in storage medium. The characteristics of the lamellar corneal tissue with each processing modality were clearly visible by UHR-OCT. The in situ characterization of the femtosecond laser-cut corneal tissue was noted to have more interface debris than shown by routine histology. The effects of the femtosecond laser microcavitation bubbles on the corneal tissue were well visualized at the edges of the lamellar flap while in storage medium. The results of our feasibility study show that UHR-OCT can provide superb, in situ microstructural characterization of eye bank corneal tissue noninvasively. The UHR-OCT interface findings and corneal endothelial disc thickness uniformity analysis are valuable information that may be used to optimize the modalities and parameters for lamellar tissue processing. The UHR-OCT is a powerful approach that will allow us to further evaluate the tissue response to different processing techniques for posterior lamellar keratoplasty. It may also provide information that can be used to correlate with postoperative clinical outcomes. UHR-OCT has the potential to become a routine part of tissue

  11. Kinetics of corneal epithelium turnover in vivo. Studies of lovastatin

    International Nuclear Information System (INIS)

    Cenedella, R.J.; Fleschner, C.R.

    1990-01-01

    The authors developed a direct chemical approach for estimating the rate of turnover of the corneal epithelium in vivo. The method was used to examine the effects of lovastatin, a potent inhibitor of cholesterol biosynthesis, on proliferation and turnover of the epithelium. Corneal DNA was labeled by pulse injection (IP) of the rat with 3H-thymidine, and 3H-labeled DNA was recovered from peripheral and central corneas over the next 15 days. Only the epithelium became labeled, and the loss of label by cell desquamation began 3 days after injection. The loss of 3H-DNA from the cornea (peripheral plus central region) followed first-order kinetics. The half-life of the disappearance was about 3 days. The peripheral cornea became more highly labeled than the central cornea and began to lose 3H-DNA before the central cornea. These observations support the possibility of a higher mitotic rate in the peripheral region and the centripetal movement of a population of peripheral epithelial cells in the normal cornea. The half-lives of the disappearance of 3H-DNA from peripheral and central corneas measured between days 5 and 15 postinjection were identical, both at 3 days. Complete turnover of the corneal epithelium would, therefore, require about 2 weeks (4-5 half-lives). Treatment of the rat with lovastatin had no obvious effects upon the proliferation or turnover of the corneal epithelium. Although lovastatin inhibited corneal 3-hydroxy-3-methylglutaryl coenzyme A reductase, the key regulatory enzyme of cholesterol synthesis, the cornea compensated by induction of this enzyme so that there was no net inhibition of cholesterol synthesis in the cornea

  12. The treatment of acute corneal hydrops by subtotal penetrating keratoplasty. Clinical case

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    I. A. Loskutov

    2014-07-01

    Full Text Available Clinical case of acute hydrops treatment using subtotal penetrating keratoplasty (PK is presented. The diagnosis of acute hydrops was based on clinical and functional evaluations including optical coherent tomography (OCT. A part of diseased cornea was removed and examined under a light microscope. These studies revealed morphological changes in almost all corneal layers. OCT and histology demonstrated that PK was indicated to this patient. Recent literature data on the epidemiology and pathogenesis of acute hydrops are presented. This rare disease results from tears in the Descemet’s membrane that allow aqueous humor to enter the stroma. Current treatment is aimed to suppress corneal inflammation, restore endothelium and Descemet’s membrane integrity and drain stromal cysts to optimize cornea healing. In this case, subtotal PK was performed due to the significant corneal thinning and a high risk of its melting. «Material for corneal graft» (iLab, Moscow, Russia was used as a donor material.

  13. Microscopia confocal en cirugía refractiva corneal: ¿útil o imprescindible?

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    Eduardo Rojas Álvarez

    Full Text Available Introducción: el estudio morfométrico de la córnea con posterioridad a la cirugía refractiva corneal con Láser Excímer, se ha convertido, en los últimos años, en tema de investigación recurrente a nivel internacional, con vistas a obtener resultados in vivo del tejido corneal y por tanto, evaluar estas novedosas tecnologías. Objetivo: describir las aplicaciones de la microscopia confocal de la córnea en cirugía refractiva con Láser Excímer. Método: se realizó un estudio exploratorio del tema, teniendo en cuenta las publicaciones de los últimos 5 años de los autores más representativos, así como las revistas de mayor impacto de la especialidad. Se utilizó la plataforma Infomed, específicamente la Biblioteca Virtual de Salud (Ebsco,Hinari, PERii, SciELO Cuba, SciELO regional, PLoS Medicine, Pubmed Central, Biomed Central, DOAJ, Free Medical Journals. La información fue resumida para la elaboración del informe final. Resultados: se han obtenido en diferentes estudios valores de densidad corneal por subcapas, grosores corneales, características de células y nervios corneales, evolución en el tiempo de estos cambios y relaciones estadísticas entre variables morfométricas. Conclusiones: el oftalmólogo dedicado a cirugía refractiva corneal debe dominar e incorporar a su práctica cotidiana la microscopia confocal corneal como una herramienta pre y posoperatoria que ya se ha hecho imprescindible en vistas a elevar la seguridad de este tipo de tratamiento. No todo está dicho, la línea investigativa del tema apunta a un mayor desarrollo en los años venideros que tiene como atenuante la poca accesibilidad a este proceder en otros países por su elevado costo.

  14. Breakdown evaluation of corneal epithelial barrier caused by antiallergic eyedrops using an electrophysiologic method.

    Science.gov (United States)

    Nakashima, Mikiro; Nakamura, Tadahiro; Teshima, Mugen; To, Hideto; Uematsu, Masafumi; Kitaoka, Takashi; Taniyama, Kotaro; Nishida, Koyo; Nakamura, Junzo; Sasaki, Hitoshi

    2008-02-01

    The aim of this study was to examine the usefulness of an electrophysiologic method for predicting corneal epithelial breakdown by antiallergic eyedrops and comparing the results with those in other appraisal methods. Six kinds of antiallergic eyedrops, including benzalkonium chloride (BK) as an ophthalmic preservative and two kinds of BK-free antiallergic eyedrops, were used in this study. Eyedrops were applied to excise rabbit corneas and monitoring was performed according to an electrophysiologic method, using a commercially available chamber system to mimic human tear turnover. Changes in transepithelial electrical resistance (TEER) in the corneal surface were recorded. The cytotoxicity of each kind of eyedrops in a normal rabbit corneal epithelial (NRCE) cell line and a human endothelial cell line EA.hy926 was also examined. The extent of decrease in the corneal TEER after applying antiallergic eyedrops was dependent on the concentration of the BK included as a preservative, but it was also affected by the different kinds of drugs when the BK concentration was low. Higher cytotoxicity of the eyedrops against the NRCE and EA.hy926 cell lines was observed with a reduction of TEER. Monitoring changes in the corneal TEER, according to the electrophysiologic method with the application of antiallergic eyedrops, is useful for predicting corneal epithelial breakdown caused by their instillation.

  15. Preliminary observation on the effects of Huoxuelishuimingmu Granules in treating corneal edema after phacoemulsification

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    Qun-Ying Li

    2013-10-01

    Full Text Available AIM: To investigate the effects of Huoxuelishuimingmu Granules on corneal edema after phacoemulsification.METHODS: Ninety cases with at least second degree corneal edema the first day after phacoemulsification were randomly divided into the routinely treated group and the Huoxuelishuimingmu Granules intervened group, 45 cases for each group. To the routinely treated group, Tobramycin and Dexamethasone Eye Drops, Compound Tropicamide Eye Drops and Recombinant Bovine Basic Fibroblast Growth Factor Eye Drops were administered in turn during the treatment. While to the Huoxuelishuimingmu Granules intervened group, traditional Chinese medicines with the function of promoting blood circulation, alleviating water retention and removing nebula named Huoxuelishuimingmu Granules were additionally administered. The curative effects and the time taken for vanishment of corneal edema in each group were then observed. One week was counted as a course of treatment and curative effects were calculated after two courses.RESULTS: The Huoxuelishuimingmu Granules intervened group showed a much higher clinical cure rate and took quite shorter time for vanishment of corneal edema compared with the group treated with routine drugs(PP>0.05. CONCLUSION: Huoxuelishuimingmu Granules has a preferable clinical effect on corneal edema after phacoemulsification, shortening the duration of corneal edema and restoring the sight of patients in advance.

  16. Changes of Corneal Wavefront Aberrations in Dry Eye Patients after Treatment with Artificial Lubricant Drops

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    Ning Lu

    2016-01-01

    Full Text Available Purpose. To evaluate the corneal aberration changes in dry eye patients after treatment with artificial eye drops. Methods. Thirty mild to moderate dry eye patients treated with artificial eye drops and twenty comparable dry eye patients were recruited as controls. Anterior corneal aberrations over 3 mm and 5 mm analytical zones including total, 3rd to 5th high order aberrations (HOAs, spherical aberration (SA, and vertical (V-coma and horizontal coma (H-coma obtained from corneal topography data at baseline and 2 weeks after treatment were evaluated. Results. For 3 mm zone, trefoils, V-coma, H-coma terms, and 3rd and 5th HOAs were significantly decreased (p0.05. Conclusions. Treatment with artificial eye drops can effectively improve the corneal optical quality of dry eye patients by ameliorating the HOAs of anterior corneal surface.

  17. Determining Factors for Fast Corneal Sensitivity Recovery After Pterygium Excision

    OpenAIRE

    Julio Morán, Gemma; Campos, Pamela; Pujol Vives, Pere; Munguia, Aitana; Mas Aixalà, Enric

    2016-01-01

    Purpose: To establish determining factors for fast corneal sensitivity (CS) recovery after pterygium excision. Methods: Thirty-two eyes of 14 males and 18 females with primary nasal pterygium were recruited. Differences in CS (in the 4 quadrants and the center using a Cochet–Bonnet esthesiometer), pterygium corneal area (PCA), tear osmolarity, tear break-up time, Schirmer test, and ocular symptoms were analyzed before and 1 month after lesion excision. The relationship between CS recovery...

  18. The effect of contact lens usage on corneal biomechanical parameters in myopic patients.

    Science.gov (United States)

    Cankaya, Ali B; Beyazyildiz, Emrullah; Ileri, Dilek; Ozturk, Faruk

    2012-07-01

    To determine and compare the corneal biomechanical properties in myopic patients who use contact lenses and those who do not use contact lenses. The study consisted of 56 myopic patients who used contact lenses (study group) and 123 myopic patients who did not use contact lenses (control group). Intraocular pressure (IOP) was measured with an ocular response analyzer (ORA) and a Goldmann applanation tonometer. Central corneal thickness was measured with an ultrasonic pachymeter. Axial length and anterior chamber depth measurements were acquired with contact ultrasound A-scan biometry. The differences in ORA parameters between study and control group participants were analyzed. The mean corneal hysteresis in study and control groups was 10.1 ± 1.6 mm Hg (6.5-15.9 mm Hg) and 9.7 ± 1.5 mm Hg (6.3-14.2 mm Hg), respectively (P = 0.16). The mean corneal resistance factor was 10.4 ± 1.9 mm Hg (4.6-15.5 mm Hg) in the study group compared with 9.6 ± 1.9 mm Hg (5.1-15.0 mm Hg) in the control group. The difference for corneal resistance factor was statistically significant (P = 0.014). There was no significant difference in corneal-compensated IOP (P = 0.24). Mean Goldmann-correlated IOP was significantly higher in the study group than in control subjects (15.8 ± 3.2 vs. 14.7 ± 3.7 mm Hg) (P = 0.044). None of the corneal biomechanical parameters was significantly correlated to duration of contact lens usage in the study group. Our results suggest that ORA-generated parameters may be different in subjects with and without contact lens usage. Further longitudinal studies need to be performed to establish the relevance of our results.

  19. Assessment of corneal biomechanical parameters in myopes and emmetropes using the Corvis ST.

    Science.gov (United States)

    Lee, Rachel; Chang, Robert T; Wong, Ian Y H; Lai, Jimmy S M; Lee, Jacky W Y; Singh, Kuldev

    2016-03-01

    Prior studies have demonstrated conflicting results regarding the relationship between corneal biomechanical properties and refractive error. Thus, the purpose of this study was to compare the corneal biomechanical parameters of myopes and emmetropes. Ninety-four subjects with varying degrees of myopia (aged 29 to 74 years, spherical equivalent [SE] -0.5 to -17.5 D) and 25 emmetropes (aged 19 to 75 years, SE: -0.5 to +0.5 D) presenting at the Queen Mary Hospital, Hong Kong were recruited sequentially for this prospective study. All patients were phakic with no history of coexisting ocular disease. The corneal biomechanical parameters of the right eye of each subject were analysed using the Corvis ST non-contact tonometer. Intraocular pressure (IOP) was measured using both the Corvis ST and the Topcon Non-Contact Tonometer CT-80. Refractive error was measured by non-cycloplegic subjective and objective refractometry. High myopes (SE greater than -6.00 D) demonstrated greater mean outward applanation velocities (p < 0.001) and peak distance measurements (p = 0.009) compared to both low to moderate myopes (SE -0.50 to -6.00 D) and emmetropes. Both outward applanation velocity and peak distance were moderately correlated with refractive error (p ≤ 0.001), strongly correlated with IOP and weakly correlated with central corneal thickness. There were no statistically significant differences in age, IOP or central corneal thickness among emmetropes, low to moderate myopes or high myopes. Within this study of Chinese subjects, high myopes demonstrate greater corneal mean outward applanation velocity on Corvis ST testing, than emmetropes. In particular, those with high myopia (SE greater than -6.00 D) show a distinct corneal biomechanical profile relative to those with either emmetropia or low to moderate myopia using the Corvis ST. © 2016 Optometry Australia.

  20. Precision of anterior and posterior corneal curvature measurements taken with the Oculus Pentacam

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    Elizabeth Chetty

    2016-06-01

    Full Text Available In the era of rapid advances in technology, new ophthalmic instruments are constantly influencing health sciences and necessitating investigations of the accuracy and precision of the new technology. The Oculus Pentacam (70700 has been available for some time now and numerous studies have investigated the precision of some of the parameters that the Pentacam is capable of measuring. Unfortunately some of these studies fall short in confusing the meaning of accuracy and precision and in not being able to analyse the data correctly or completely. The aim of this study was to investigate the precision of the anterior and posterior corneal curvature measurements taken with the Oculus Pentacam (70700 holistically with sound multivariate statistical methods. Twenty successive Pentacam measurements were taken over three different measuring sessions on one subject. Keratometric data for both the anterior and posterior corneal surfaces were analysed using multivariate statistics to determine the precision of the Oculus Pentacam. This instrument was found to have good precision both clinically and statistically for anterior corneal measurements but only good clinical precision for the posterior corneal surface. Key words: Oculus Pentacam; keratometric variation; corneal curvature; multivariate statistics

  1. Detecting thermal phase transitions in corneal stroma by fluorescence micro-imaging analysis

    Science.gov (United States)

    Matteini, P.; Rossi, F.; Ratto, F.; Bruno, I.; Nesi, P.; Pini, R.

    2008-02-01

    Thermal modifications induced in corneal stroma were investigated by the use of fluorescence microscopy. Freshly extracted porcine corneas were immersed for 5 minutes in a water bath at temperatures in the 35-90°C range and stored in formalin. The samples were then sliced in 200-μm-thick transversal sections and analyzed under a stereomicroscope to assess corneal shrinkage. Fluorescence images of the thermally treated corneal samples were acquired using a slow-scan cooled CCD camera, after staining the slices with Indocyanine Green (ICG) fluorescent dye which allowed to detect fluorescence signal from the whole tissue. All measurements were performed using an inverted epifluorescence microscope equipped with a mercury lamp. The thermally-induced modifications to the corneal specimens were evaluated by studying the grey level distribution in the fluorescence images. For each acquired image, Discrete Fourier Transform (DFT) and entropy analyses were performed. The spatial distribution of DFT absolute value indicated the spatial orientation of the lamellar planes, while entropy was used to study the image texture, correlated to the stromal structural transitions. As a result, it was possible to indicate a temperature threshold value (62°C) for high thermal damage, resulting in a disorganization of the lamellar planes and in full agreement with the measured temperature for corneal shrinkage onset. Analysis of the image entropy evidenced five strong modifications in stromal architecture at temperatures of ~45°C, 53°C, 57°C, 66°C, 75°C. The proposed procedure proved to be an effective micro-imaging method capable of detecting subtle changes in corneal tissue subjected to thermal treatment.

  2. Clinical observation of cutting fluctuations on central corneal thickness after laser subepithelial keratomileusis

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    Wei Cheng

    2017-09-01

    Full Text Available AIM:To evaluate the percentage of cutting fluctuations of central corneal thickness(CCTintraoperative used low concentration(0.02%mitomycin C(MMCafter laser-assisted subepithelial keratomileusis(LASEK. METHODS: In this prospective study, low and medium myopia group(spherical equivalent≤6.0DShas 138 patients(276 eyes. Low concentration MMC used topically in 69 patients(138 eyesrandomized after excimer laser ablation; the another traditional LASEK as control. High myopia group(6.0DSt test and their repeatability was assessed using the coefficient of variation(CV.RESULTS: At 3mo after operation, the difference of central corneal thickness and cutting value between different treatment groups was statistically significant(PPPPCONCLUSION: The study on percentage of cutting fluctuations of central corneal thickness, further confirmed low concentrations MMC in reducing postoperative corneal stromal proliferation reaction, inhibition of haze production.

  3. Comparison of corneal sensation between small incision lenticule extraction (SMILE) and femtosecond laser-assisted LASIK for myopia.

    Science.gov (United States)

    Li, Meiyan; Zhou, Zimei; Shen, Yang; Knorz, Michael C; Gong, Lan; Zhou, Xingtao

    2014-02-01

    To compare the impact on corneal sensation after small incision lenticule extraction (SMILE) and femtosecond laser-assisted LASIK (femto-LASIK) in patients with myopia. In this prospective, nonrandomized comparative study, 71 subjects were enrolled. Thirty-eight eyes of 38 patients underwent SMILE and 33 eyes of 33 patients underwent femto-LASIK. Corneal sensation was tested with Cochet-Bonnet esthesiometry in five corneal areas preoperatively and at 1 week and 1, 3, and 6 months postoperatively. Comparison of corneal sensation was performed for the SMILE and femto-LASIK groups. Additionally, the correlations were evaluated between the postoperative corneal sensation, preoperative spherical equivalent, and ablation depth. All tested areas within the cap or flap demonstrated corneal hypoesthesia immediately after both surgeries. SMILE-treated eyes showed less compromised corneal sensation than femto-LASIK-treated eyes at all postoperative visits in the central, inferior, nasal, and temporal areas at the 1-week and 1-month visits. In the SMILE group, the inferior, nasal, and temporal quadrants recovered faster than other areas. In the femto-LASIK group, the sensation over the flap did not recover to preoperative levels by postoperative 6 months. There was no correlation between postoperative corneal sensation, preoperative spherical equivalent, and ablation depth in both groups. The impairment of corneal sensation was less significant in the SMILE group than in the femto-LASIK group and was independent of preoperative spherical equivalent or ablation depth. Copyright 2014, SLACK Incorporated.

  4. Pilot Study for OCT Guided Design and Fit of a Prosthetic Device for Treatment of Corneal Disease

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    Hong-Gam T. Le

    2012-01-01

    Full Text Available Purpose. To assess optical coherence tomography (OCT for guiding design and fit of a prosthetic device for corneal disease. Methods. A prototype time domain OCT scanner was used to image the anterior segment of patients fitted with large diameter (18.5–20 mm prosthetic devices for corneal disease. OCT images were processed and analyzed to characterize corneal diameter, corneal sagittal height, scleral sagittal height, scleral toricity, and alignment of device. Within-subject variance of OCT-measured parameters was evaluated. OCT-measured parameters were compared with device parameters for each eye fitted. OCT image correspondence with ocular alignment and clinical fit was assessed. Results. Six eyes in 5 patients were studied. OCT measurement of corneal diameter (coefficient of variation, %, cornea sagittal height (%, and scleral sagittal height (% is highly repeatable within each subject. OCT image-derived measurements reveal strong correlation between corneal sagittal height and device corneal height ( and modest correlation between scleral and on-eye device toricity (. Qualitative assessment of a fitted device on OCT montages reveals correspondence with slit lamp images and clinical assessment of fit. Conclusions. OCT imaging of the anterior segment is suitable for custom design and fit of large diameter (18.5–20 mm prosthetic devices used in the treatment of corneal disease.

  5. Non-invasive measurement of corneal hydration.

    Science.gov (United States)

    March, W F; Bauer, N J

    2001-01-01

    To investigate the feasibility of a confocal Raman spectroscopic technique for the noncontact assessment of corneal hydration in vivo in two legally blind subjects. A laser beam (632.8 nm; 15 mJ) was maintained on the cornea using a microscope objective lens (25x magnification, NA=0.5, f=10 mm) both for focusing the incident light as well as collecting the Raman backscattered light, in a 180 degrees backscatter configuration. An optical fiber, acting as the confocal pinhole for elimination of light from out-of-focus places, was coupled to a spectrometer that dispersed the collected light onto a sensitive array-detector for rapid spectral data acquisition over a range from 2,890 to 3,590 cm(-1). Raman spectra were recorded from the anterior 100 to 150 microm of the cornea over a period of time before and after topical application of a mild dehydrating solution. The ratio between the amplitudes of the signals at 3,400 cm(-1) (OH-vibrational mode of water) and 2,940 cm(-1) (CH-vibrational mode of proteins) was used as a measure of corneal hydration. High signal-to-noise ratio (SNR 25) Raman spectra were obtained from the human corneas using 15 mJ of laser light energy. Qualitative changes in the hydration of the anterior-most part of the corneas could be observed as a result of the dehydrating agent. Confocal Raman spectroscopy could potentially be applied clinically as a noncontact tool for the assessment of corneal hydration in vivo.

  6. Corneal power, thickness, and stiffness: results of a prospective randomized controlled trial of PRK and LASIK for myopia.

    Science.gov (United States)

    Hjortdal, Jesper Ø; Møller-Pedersen, Torben; Ivarsen, Anders; Ehlers, Niels

    2005-01-01

    To compare the short-, medium-, and long-term changes in corneal optical power and corneal aberrations, central corneal thickness, and corneal "stiffness" assessed by pneumotonometry readings in patients having laser in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK) for myopia. Department of Ophthalmology, Arhus University Hospital, Arhus, Denmark. One eye of each of 45 patients with myopia ranging from -6.00 to -8.00 diopters (D) (spherical equivalent spectacle refraction [SER]) was randomized to LASIK (n=25; mean SER -7.12 D +/- 0.57 [SD]) or PRK (n=20; mean SER -6.91 +/- 0.57 D). Data were collected prospectively before and 1, 3, 6, 12, and 36 months after surgery. Measurements included corneal topography (TMS-1, Tomey), corneal thickness (ultrasound pachymetry), and apparent intraocular pressure (IOP) (pneumotonometry). Retreatments were not performed during the first year, and retreated eyes were excluded from the 3-year follow-up. Changes in corneal power and aberrations, thickness, and apparent IOP were calculated in a pair-wise manner for 3 time periods: short term (preoperative to 1 month after surgery), medium term (1 to 12 months after surgery), and long term (1 to 3 years after surgery). In the short term, corneal power decreased equally in LASIK and PRK eyes. Spherical aberrations and coma-like aberrations increased equally, while corneal thickness decreased significantly less in LASIK eyes than in PRK eyes. The apparent IOP decreased more in LASIK eyes than in PRK eyes. In the medium term, corneal power increased significantly in both groups. Spherical aberrations decreased significantly in PRK eyes but not in LASIK eyes. From 1 to 12 months, corneal thickness increased more in PRK eyes than in LASIK eyes. During this period, the apparent IOP increased significantly in LASIK eyes. In the long term, corneal power and corneal aberrations did not change significantly in either group. Corneal thickness increased slightly but

  7. Selenium-binding lactoferrin is taken into corneal epithelial cells by a receptor and prevents corneal damage in dry eye model animals.

    Science.gov (United States)

    Higuchi, Akihiro; Inoue, Hiroyoshi; Kaneko, Yoshio; Oonishi, Erina; Tsubota, Kazuo

    2016-11-11

    The ocular surface is strongly affected by oxidative stress, which causes many ocular diseases including dry eye. Previously, we showed that selenium compounds, e.g., selenoprotein P and Se-lactoferrin, were candidates for treatment of dry eye. This paper shows the efficacy of Se-lactoferrin for the treatment of dry eye compared with Diquas as a control drug using two dry eye models and incorporation of lactoferrin into corneal epithelial cells via lactoferrin receptors. We show the efficacy of Se-lactoferrin eye drops in the tobacco smoke exposure rat dry eye model and short-term rabbit dry eye model, although Diquas eye drops were only effective in the short-term rabbit dry eye model. These results indicate that Se-lactoferrin was useful in the oxidative stress-causing dry eye model. Se-lactoferrin was taken into corneal epithelium cells via lactoferrin receptors. We identified LRP1 as the lactoferrin receptor in the corneal epithelium involved in lactoferrin uptake. Se-lactoferrin eye drops did not irritate the ocular surface of rabbits. Se-lactoferrin was an excellent candidate for treatment of dry eye, reducing oxidative stress by a novel mechanism.

  8. [Influence AquaLase at corneal endothelial cells].

    Science.gov (United States)

    Jirásková, N; Rozsíval, P; Ludvíková, M; Burova, M; Nekolová, J

    2009-07-01

    To assess the effect of the cleaning of the posterior capsule using pulses of balanced salt solution (BSS) on the corneal endothelial cells. This pilot study involves 43 patients with bilateral cataracts having lens removal using torsional phacoemulsification (Ozil, Infiniti, Alcon) and bimanul irrigation/aspiration (I/A). Posterior capsule of the right eye of each patient was cleaned using pulses of BSS (AquaLase, Infiniti, Alcon). Surgery was performed by one of 2 surgeons (NJ, PR), both eyes of each patient was operated on by the same surgeon. Best corrected visual acuity (BCVA), endotelial cell count and pachymetry were evaluated pre- and postoperatively as well as occurence af peri- and postoperative complications. Preoperative mean pachymetry (P) was 566 +/- 45 microm in the right eye (RE) and 562 +/- 42 microm in the left eye (LE), mean endotelial cell count (ECC) 2541 +/- 317 cells/mm2 (RE) and 2567 +/- 311 cells/mm2 (LE). Three months after surgery P was 557 +/- 43 microm (RE) and 558 +/- 45 microm (LE) and ECC 2368 +/- 416 cells/mm2 (RE) and 2396 +/- 417 cells/mm2 (LE). There was no statistical difference in postoperative changes of both corneal parameters between right and left eyes. Best corrected visual acuity improved in all eyes and no peri-or postoperative complications occured. Cleaning of the posterior capsule using AquaLase is safe for corneal endothelial cells.

  9. Efficacy of highly hydrophilic soft contact lenses for persistent corneal epithelial defects after anterior segment surgery

    Directory of Open Access Journals (Sweden)

    Zhi-Wei Peng

    2015-02-01

    Full Text Available AIM:To investigate the efficacy of highly hydrophilic soft contact lenses for persistent corneal epithelial defects.METHODS:In this retrospective case analysis, 28 patients(28 eyeswith persistent corneal epithelial defects after anterior segment surgery from January 2011 to June 2013 in our hospital were reviewed. After regular treatment for at least 2wk, the persistent corneal epithelial defects were treated with highly hydrophilic soft contact lenses, until the corneal epithelial healing. Continued to wear the same lens no more than 3wk, or in need of replacement the new one. All cases were followed up for 6mo. Key indicators of corneal epithelial healling, corneal fluorescein staining and ocular symptoms improvement were observed.RESULTS: Twenty-one eyes were cured(75.00%, markedly effective in 5 eyes(17.86%, effective in 2 eyes(7.14%, no invalid cases, the total efficiency of 100.00%. Ocular symptoms of 25 cases(89.29%relieved within 2d, the rest 3 cases(10.71%relieved within 1wk. The corneal epithelial of 6 cases(21.43%repaired in 3wk, 13 cases(46.43%in 6wk, 7 cases(25.00%in 9wk, 2 cases(7.14%over 12wk. There were no signs of secondary infection. And no evidence of recurrence in 6mo. CONCLUSION: Highly hydrophilic soft contact lenses could repair persistent corneal epithelial defects after anterior segment surgery significantly, while quickly and effectively relieve a variety of ocular irritation.

  10. Polysaccharide hydrogel combined with mesenchymal stem cells promotes the healing of corneal alkali burn in rats.

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    Yifeng Ke

    Full Text Available Corneal chemical burns are common ophthalmic injuries that may result in permanent visual impairment. Although significant advances have been achieved on the treatment of such cases, the structural and functional restoration of a chemical burn-injured cornea remains challenging. The applications of polysaccharide hydrogel and subconjunctival injection of mesenchymal stem cells (MSCs have been reported to promote the healing of corneal wounds. In this study, polysaccharide was extracted from Hardy Orchid and mesenchymal stem cells (MSCs were derived from Sprague-Dawley rats. Supplementation of the polysaccharide significantly enhanced the migration rate of primarily cultured rat corneal epithelial cells. We examined the therapeutic effects of polysaccharide in conjunction with MSCs application on the healing of corneal alkali burns in rats. Compared with either treatment alone, the combination strategy resulted in significantly better recovery of corneal epithelium and reduction in inflammation, neovascularization and opacity of healed cornea. Polysaccharide and MSCs acted additively to increase the expression of anti-inflammatory cytokine (TGF-β, antiangiogenic cytokine (TSP-1 and decrease those promoting inflammation (TNF-α, chemotaxis (MIP-1α and MCP-1 and angiogenesis (VEGF and MMP-2. This study provided evidence that Hardy Orchid derived polysaccharide and MSCs are safe and effective treatments for corneal alkali burns and that their benefits are additive when used in combination. We concluded that combination therapy with polysaccharide and MSCs is a promising clinical treatment for corneal alkali burns and may be applicable for other types of corneal disorder.

  11. Polysaccharide Hydrogel Combined with Mesenchymal Stem Cells Promotes the Healing of Corneal Alkali Burn in Rats

    Science.gov (United States)

    Liu, Xun; Yu, Min; Yang, Chunbo; Li, Xiaorong

    2015-01-01

    Corneal chemical burns are common ophthalmic injuries that may result in permanent visual impairment. Although significant advances have been achieved on the treatment of such cases, the structural and functional restoration of a chemical burn-injured cornea remains challenging. The applications of polysaccharide hydrogel and subconjunctival injection of mesenchymal stem cells (MSCs) have been reported to promote the healing of corneal wounds. In this study, polysaccharide was extracted from Hardy Orchid and mesenchymal stem cells (MSCs) were derived from Sprague-Dawley rats. Supplementation of the polysaccharide significantly enhanced the migration rate of primarily cultured rat corneal epithelial cells. We examined the therapeutic effects of polysaccharide in conjunction with MSCs application on the healing of corneal alkali burns in rats. Compared with either treatment alone, the combination strategy resulted in significantly better recovery of corneal epithelium and reduction in inflammation, neovascularization and opacity of healed cornea. Polysaccharide and MSCs acted additively to increase the expression of anti-inflammatory cytokine (TGF-β), antiangiogenic cytokine (TSP-1) and decrease those promoting inflammation (TNF-α), chemotaxis (MIP-1α and MCP-1) and angiogenesis (VEGF and MMP-2). This study provided evidence that Hardy Orchid derived polysaccharide and MSCs are safe and effective treatments for corneal alkali burns and that their benefits are additive when used in combination. We concluded that combination therapy with polysaccharide and MSCs is a promising clinical treatment for corneal alkali burns and may be applicable for other types of corneal disorder. PMID:25789487

  12. [Analysis of the Effect of Non-phacoemulsification Cataract Operation on Corneal Endothelial Cell Nucleus Division].

    Science.gov (United States)

    Huang, Zufeng; Miao, Xiaoqing

    2015-09-01

    To investigate the effect of non-phacoemulsification cataract operation in two different patterns of nucleus delivery on the quantity and morphology of corneal endothelial cells and postoperative visual acuity. Forty patients diagnosed with cataract underwent cataract surgery and were assigned into the direct nuclear delivery and semi-nuclear delivery groups. Lens density was measured and divided into the hard and soft lenses according to Emery-little lens nucleus grading system. Non-phacoemulsification cataract operation was performed. At 3 d after surgery, the quantity and morphology of corneal endothelium were counted and observed under corneal endothelial microscope. During 3-month postoperative follow-up, the endothelial cell loss rate, morphological changes and visual acuity were compared among four groups. Corneal endothelial cell loss rate in the direct delivery of hard nucleus group significantly differed from those in the other three groups before and 3 months after operation (P nucleus, semi-delivery of hard nucleus and semi-delivery soft nucleus groups (all P > 0.05). Preoperative and postoperative 2-d visual acuity did not differ between the semi-delivery of hard nucleus and direct delivery of soft nucleus groups (P = 0.49), significantly differed from those in the semi-delivery of soft nucleus (P = 0.03) and direct delivery of hard nucleus groups (P = 0.14). Visual acuity at postoperative four months did not differ among four groups (P = 0.067). During non-phacoemulsification cataract surgery, direct delivery of hard nucleus caused severe injury to corneal endothelium and semi-delivery of soft nucleus yielded mild corneal endothelial injury. Slight corneal endothelial injury exerted no apparent effect upon visual acuity and corneal endothelial morphology at three months after surgery.

  13. Corneal backscatter in insulin-dependent and non-insulin-dependent diabetes mellitus patients: a pilot study

    Directory of Open Access Journals (Sweden)

    Ana M Calvo-Maroto

    Full Text Available ABSTRACT Purpose: To compare central corneal backscatter obtained from Scheimpflug images between patients with insulin-dependent and non-insulin-dependent diabetes mellitus (IDDM and NIDDM, respectively and healthy controls. Methods: Seven patients with IDDM (7 eyes, eleven patients with NIDDM (11 eyes, and sixteen healthy subjects (16 eyes were included in this pilot study. Scheimpflug imaging system (Pentacam, Oculus Inc., Germany was used to obtain optical sections of the cornea. Seven meridians were analyzed for each eye, oriented from 70° to 110°. Optical density values for the central 3-mm and 5-mm zones of the cornea were obtained by image analysis using external software. Results: Corneal backscatter was significantly higher in the diabetic patients than in the controls for the central 3-mm (p=0.016 and 5-mm (p=0.014 zones. No significant differences in corneal backscatter were found between the IDDM and NIDDM groups for either zone (both p>0.05. In the NIDDM group, significant correlations were observed for both central zones between corneal backscatter and age (3 mm: r=0.604, p=0.025; 5 mm: r=0.614, p=0.022 and central corneal thickness (3 mm: r=0.641, p=0.017; 5 mm: r=0.671, p=0.012; this was not found in the IDDM group (p>0.05. The presence of diabetes showed a significant effect on central corneal backscatter (Kruskal-Wallis test, p<0.001. Conclusions: Diabetic patients showed higher values of corneal light backscatter than healthy subjects. Corneal optical density analysis may be a useful tool for monitoring and assessing the ocular changes caused by diabetes.

  14. Effects of topical vitamin E on corneal superoxide dismutase, glutathione peroxidase activities and polymorphonuclear leucocyte infiltration after photorefractive keratectomy.

    Science.gov (United States)

    Bilgihan, Ayse; Bilgihan, Kamil; Yis, Ozgür; Sezer, Cem; Akyol, Gülen; Hasanreisoglu, Berati

    2003-04-01

    Photorefractive keratectomy (PRK) induces free radical formation and polymorphonuclear (PMN) cell infiltration in the cornea. Vitamin E is a free radical scavenger and protects the cells from reactive oxygen species. We investigated the effects of topical vitamin E on corneal PMN cell infiltration and corneal antioxidant enzyme activities after PRK. We studied four groups, each consisting of seven eyes. Group 1 were control eyes. In group 2 the corneal epithelium was removed by a blunt spatula (epithelial scrape). In group 3, corneal photoablation (59 micro m, 5 dioptres) was performed after epithelial removal (traditional PRK). In group 4 we tested the effects of topical Vitamin E after traditional PRK. Corneal tissues were removed and studied with enzymatic analysis (measurement of corneal superoxide dismutase and glutathione peroxidase activities) and histologically. Stromal PMN leucocyte counts were significantly higher after mechanical epithelial removal and traditional PRK (p < 0.05). Corneal superoxide dismutase and glutathione peroxidase activities decreased significantly after mechanical epithelial removal and traditional PRK (p < 0.05). In group 4, treated with vitamin E, corneal superoxide dismutase activity did not differ significantly from that in the medically non-treated groups, nor did corneal PMN cell infiltration after traditional PRK. The reduction of corneal glutathione peroxidase activity after PRK was reduced significantly after topical vitamin E treatment. Topical vitamin E treatment may be useful for reducing the harmful effects of reactive oxygen radical after epithelial scraping and PRK in that it increases corneal glutathione peroxidase activity.

  15. Optimization of human corneal endothelial cell culture: density dependency of successful cultures in vitro.

    Science.gov (United States)

    Peh, Gary S L; Toh, Kah-Peng; Ang, Heng-Pei; Seah, Xin-Yi; George, Benjamin L; Mehta, Jodhbir S

    2013-05-03

    Global shortage of donor corneas greatly restricts the numbers of corneal transplantations performed yearly. Limited ex vivo expansion of primary human corneal endothelial cells is possible, and a considerable clinical interest exists for development of tissue-engineered constructs using cultivated corneal endothelial cells. The objective of this study was to investigate the density-dependent growth of human corneal endothelial cells isolated from paired donor corneas and to elucidate an optimal seeding density for their extended expansion in vitro whilst maintaining their unique cellular morphology. Established primary human corneal endothelial cells were propagated to the second passage (P2) before they were utilized for this study. Confluent P2 cells were dissociated and seeded at four seeding densities: 2,500 cells per cm2 ('LOW'); 5,000 cells per cm2 ('MID'); 10,000 cells per cm2 ('HIGH'); and 20,000 cells per cm2 ('HIGH(×2)'), and subsequently analyzed for their propensity to proliferate. They were also subjected to morphometric analyses comparing cell sizes, coefficient of variance, as well as cell circularity when each culture became confluent. At the two lower densities, proliferation rates were higher than cells seeded at higher densities, though not statistically significant. However, corneal endothelial cells seeded at lower densities were significantly larger in size, heterogeneous in shape and less circular (fibroblastic-like), and remained hypertrophic after one month in culture. Comparatively, cells seeded at higher densities were significantly homogeneous, compact and circular at confluence. Potentially, at an optimal seeding density of 10,000 cells per cm2, it is possible to obtain between 10 million to 25 million cells at the third passage. More importantly, these expanded human corneal endothelial cells retained their unique cellular morphology. Our results demonstrated a density dependency in the culture of primary human corneal endothelial

  16. Comparison of Corneal Biomechanical Properties between Indian and Chinese Adults.

    Science.gov (United States)

    Chua, Jacqueline; Nongpiur, Monisha E; Zhao, Wanting; Tham, Yih Chung; Gupta, Preeti; Sabanayagam, Charumathi; Aung, Tin; Wong, Tien Yin; Cheng, Ching-Yu

    2017-09-01

    To investigate the difference in corneal hysteresis (CH) and corneal resistance factor (CRF) between Indian and Chinese populations. Population-based cross-sectional study. Three hundred eighty-two Singaporean Indian persons and 764 Singaporean Chinese 50 years of age or older were included from the Singapore Indian Eye Study and Singapore Chinese Eye Study, respectively. Participants underwent standardized systemic and ocular examinations and interviewer-administered questionnaires for risk factor assessment. The CH and CRF were measured with the Ocular Response Analyzer (Reichert Ophthalmic Instruments, Buffalo, NY). Information on genetic ancestry was derived using principal component analysis. Linear regression models were used to investigate the association of CH and CRF with potential risk factors. Corneal hysteresis and CRF. After excluding participants with a history of intraocular surgery, a diagnosis of glaucoma suspect or glaucoma, refractive surgery, or presence of corneal abnormalities, CH and CRF readings were available for 382 Indian persons. For each Indian participant, 2 Chinese participants were selected and matched for age and gender (n = 764). There were no differences in the clinical measurements of CH (10.6±1.6 mmHg; P = 0.670) or CRF (10.3±1.7 mmHg; P = 0.103) between the ethnic groups. However, after adjusting for covariates, Indian persons had, on average, 0.18-mmHg higher CH levels than in Chinese (95% confidence interval [CI], 0.02-0.38; P = 0.031). Consistently, CH level was correlated significantly with genetic ancestry in the Southeast Asian population. Corneal resistance factor level was not associated independently with self-reported ethnicity (95% CI, -0.10 to 0.29; P = 0.335). Chinese have lower CH than Indian persons, and this disparity may reflect biomechanical differences of the cornea. Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

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

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    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

  18. Lack of evidence for protein AA reactivity in amyloid deposits of lattice corneal dystrophy and amyloid corneal degeneration.

    Science.gov (United States)

    Gorevic, P D; Rodrigues, M M; Krachmer, J H; Green, C; Fujihara, S; Glenner, G G

    1984-08-15

    Amyloid fibrils occurring in primary and myeloma-associated (AL), secondary (AA), and certain neuropathic hereditary forms of systemic amyloidosis can be distinguished biochemically or immunohistologically as being composed of immunoglobulin light chain, protein AA, or prealbumin respectively. All types of systemic and several localized forms of amyloidosis contain amyloid P component (protein AP). We studied formalin-fixed tissue from eight cases of lattice corneal dystrophy by the immunoperoxidase method using antisera to proteins AA and AP, to normal serum prealbumin and prealbumin isolated from a case of hereditary amyloidosis, and to light-chain determinants; additional cases were examined by indirect immunofluorescence of fresh-frozen material. We found weak (1:10 dilution) staining with anti-AP, but no reactivity with other antisera. Congo red staining was resistant to pretreatment of sections with potassium permanganate, a characteristic of non-AA amyloid. Two-dimensional gels of solubilized proteins from frozen tissue from two cases of lattice corneal dystrophy resembled those obtained from normal human cornea. Western blots of two cases of polymorphous amyloid degeneration and solubilized protein from normal cornea did not react with radioactive iodine-labeled anti-AA or anti-AP with purified protein AP and unfixed protein AA amyloid tissue as controls. We were unable to corroborate the presence of protein AA in the amyloid deposits of lattice corneal dystrophy. Although staining with antiserum to protein AP was demonstrable, the molecular configuration of this protein in stromal deposits remains to be defined.

  19. The influence of Australian eye banking practices on corneal graft survival.

    Science.gov (United States)

    Keane, Miriam C; Lowe, Marie T; Coster, Douglas J; Pollock, Graeme A; Williams, Keryn A

    2013-08-19

    To identify eye banking practices that influence corneal graft survival. Prospective cohort study of records of 19,254 followed corneal grafts in 15160 patients, submitted to the Australian Corneal Graft Registry between May 1985 and July 2012. Influence of corneal preservation method (organ culture, moist pot, Optisol, other); death-to-enucleation, death-to-preservation and enucleation-to-graft times; transportation by air; graft era; and indication for graft on probability of graft survival at most recent follow-up. In multivariate analysis, 919 penetrating grafts performed using corneas transported interstate by air exhibited worse survival than 14,684 grafts performed using corneas retrieved and used locally (hazard ratio [HR], 1.44; 95% CI, 1.21-1.73; P = 0.001). This was also the case for traditional lamellar grafts (64 corneas transported by air and 813 used locally; HR, 1.69; 95% CI, 1.03-2.78; P = 0.038). Indication for graft influenced survival of penetrating grafts (4611 keratoconus, 727 emergency or high-risk, 10,265 other indication; global P < 0.001) and traditional lamellar grafts (65 keratoconus, 212 emergency or high-risk, 600 other indication; global P < 0.001). The preservation medium in which corneas used for traditional lamellar grafts were stored exerted a marginal influence on graft survival (global P = 0.047). Donor corneas transported interstate exhibited poorer survival after transplantation than those retrieved and grafted locally. Higher proportions of emergency procedures involving transported corneas did not account for this difference. Where possible, efforts to avoid transportation of corneal tissue by air freight within Australia may be warranted.

  20. The steroids for corneal ulcers trial: study design and baseline characteristics.

    Science.gov (United States)

    Srinivasan, Muthiah; Mascarenhas, Jeena; Rajaraman, Revathi; Ravindran, Meenakshi; Lalitha, Prajna; Glidden, David V; Ray, Kathryn J; Hong, Kevin C; Oldenburg, Catherine E; Lee, Salena M; Zegans, Michael E; McLeod, Stephen D; Lietman, Thomas M; Acharya, Nisha R

    2012-02-01

    To provide comprehensive trial methods and baseline data for the Steroids for Corneal Ulcers Trial and to present epidemiological characteristics such as risk factors, causative organisms, and ulcer severity. Baseline data from a 1:1 randomized, placebo-controlled, double-masked clinical trial comparing prednisolone phosphate, 1%, with placebo as adjunctive therapy for the treatment of bacterial corneal ulcers. Eligible patients had a culture-positive bacterial corneal ulcer and had been taking moxifloxacin for 48 hours. The primary outcome for the trial is best spectacle-corrected visual acuity at 3 months from enrollment. This report provides comprehensive baseline data, including best spectacle-corrected visual acuity, infiltrate size, microbiological results, and patient demographics, for patients enrolled in the trial. Of 500 patients enrolled, 97% were in India. Two hundred twenty patients (44%) were agricultural workers. Median baseline visual acuity was 0.84 logMAR (Snellen, 20/125) (interquartile range, 0.36-1.7; Snellen, 20/50 to counting fingers). Baseline visual acuity was not significantly different between the United States and India. Ulcers in India had larger infiltrate/scar sizes (P = .04) and deeper infiltrates (P = .04) and were more likely to be localized centrally (P = .002) than ulcers enrolled in the United States. Gram-positive bacteria were the most common organisms isolated from the ulcers (n = 366, 72%). The Steroids for Corneal Ulcers Trial will compare the use of a topical corticosteroid with placebo as adjunctive therapy for bacterial corneal ulcers. Patients enrolled in this trial had diverse ulcer severity and on average significantly reduced visual acuity at presentation. clinicaltrials.gov Identifier: NCT00324168.

  1. Influence of corneal biomechanical properties on intraocular pressure differences between an air-puff tonometer and the Goldmann applanation tonometer.

    Science.gov (United States)

    Tranchina, Laura; Lombardo, Marco; Oddone, Francesco; Serrao, Sebastiano; Schiano Lomoriello, Domenico; Ducoli, Pietro

    2013-01-01

    To estimate the influence of corneal properties on intraocular pressure (IOP) differences between an air-puff tonometer (NT530P; Nidek) and the Goldmann applanation tonometer (Haag-Streit). The influence of central corneal thickness (CCT), keratometry, and Ocular Response Analyzer (Reichert) measurements of corneal viscoelasticity [corneal hysteresis (CH) and corneal resistance factor (CRF)] on IOP differences between tonometers was evaluated. The CRF was calculated to be the best predictor of the differences in IOP readings between tonometers (r2=0.23; Ptonometers. Corneal resistance to applanation induced by either contact or noncontact tonometers was calculated to be the most determinant factor in influencing IOP differences between applanation tonometers.

  2. Application of Corvis ST to evaluate the effect of femtosecond laser-assisted cataract surgery on corneal biomechanics.

    Science.gov (United States)

    Wei, Yinjuan; Xu, Lingxiao; Song, Hui

    2017-08-01

    The aim of the present study was to evaluate the effects of femtosecond laser-assisted cataract surgery (FLACS) and phacoemulsification on corneal biomechanics using corneal visualization Scheimpflug technology. The medical records of 50 eyes from 50 patients who received phacoemulsification and intraocular lens implantation because of age-related factors between June 2014 and September 2014 were retrospectively analyzed. FLACS was used in 12 eyes (FLACS group), and conventional phacoemulsification in 38 eyes (PHACO group). The evaluation of corneal biomechanical parameters included the first/second applanation time (A-time1/A-time2), the first/second applanation length (A-length1/A-length2), corneal velocity during the first/second applanation moment (Vin/Vout), highest concavity time, highest concavity-radius (HC-radius), peak distance (PD), deformation amplitude (DA), central corneal thickness (CCT), and intraocular pressure (IOP). The differences in A-length1/A-length2, IOP, CCT, PD, and DA were significant in the PHACO group between those before, 1 week after, and 1 month after surgery. No significant differences in corneal biomechanical parameters were found between those at 1 month after surgery and before surgery. There were significant differences in IOP and CCT in the FLACS group between those before, 1 week after, and 1 month after surgery. There were no significant differences in the other corneal biomechanical parameters. No significant differences were found in corneal biomechanical parameters between those 1 month after surgery and before surgery. There were significant differences in A-length1/A-length2, CCT, PD, and DA between the two groups at 1 week after surgery. There were no significant differences in corneal biomechanical parameters between the two groups at 1 month after surgery. In conclusion, the effect of FLACS on corneal biomechanics is smaller than that of phacoemulsification. The corneal biomechanical parameters are restored to

  3. Oxidative Stress to the Cornea, Changes in Corneal Optical Properties, and Advances in Treatment of Corneal Oxidative Injuries

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    Cestmir Cejka

    2015-01-01

    Full Text Available Oxidative stress is involved in many ocular diseases and injuries. The imbalance between oxidants and antioxidants in favour of oxidants (oxidative stress leads to the damage and may be highly involved in ocular aging processes. The anterior eye segment and mainly the cornea are directly exposed to noxae of external environment, such as air pollution, radiation, cigarette smoke, vapors or gases from household cleaning products, chemical burns from splashes of industrial chemicals, and danger from potential oxidative damage evoked by them. Oxidative stress may initiate or develop ocular injury resulting in decreased visual acuity or even vision loss. The role of oxidative stress in the pathogenesis of ocular diseases with particular attention to oxidative stress in the cornea and changes in corneal optical properties are discussed. Advances in the treatment of corneal oxidative injuries or diseases are shown.

  4. Corneal decompensation following filtering surgery with the Ex-PRESS® mini glaucoma shunt device

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    Tojo N

    2015-03-01

    Full Text Available Naoki Tojo, Atsushi Hayashi, Akio Miyakoshi Department of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan Purpose: To report a case of corneal decompensation due to the Ex-PRESS® mini glaucoma shunt device (Ex-PRESS.Patient and methods: A 75-year-old man had pseudoexfoliation glaucoma in his right eye. He underwent filtration surgery with Ex-PRESS. His intraocular pressure was 7 mmHg after 9 months.Results: We observed partial decompensation of the corneal endothelium adjacent to the filtering bleb. Specular microscopy revealed a marked decrease in the endothelial cell density at the center of the cornea.Conclusion: Anterior segment optical coherence tomography is very useful for evaluating corneal edema and the position of Ex-PRESS. It is important to follow up with an examination of the corneal endothelial cells. Keywords: Ex-PRESS, bullous keratopathy, trabeculectomy, complication, cornea 

  5. Central corneal thickness among glaucoma patients attending ...

    African Journals Online (AJOL)

    AAU_CHS

    ocular pressure measurement and is different among different ethnic population and subtypes of glaucoma. The central corneal thickness of different subtypes of glaucoma at Menelik II Hospital ... Intraocular pressure is a key element in the.

  6. Corneal endothelial glutathione after photodynamic change

    International Nuclear Information System (INIS)

    Hull, D.S.; Riley, M.V.; Csukas, S.; Green, K.

    1982-01-01

    Rabbit corneal endothelial cells perfused with 5 X 10(-6)M rose bengal and exposed to incandescent light demonstrated no alteration of either total of or percent oxidized glutathione after 1 hr. Addition of 5400 U/ml catalase to the perfusing solution had no effect on total glutathione levels but caused a marked reduction in percent oxidized glutathione in corneas exposed to light as well as in those not exposed to light. Substitution of sucrose for glucose in the perfusing solution had no effect on total or percent oxidized glutathione. Perfusion of rabbit corneal endothelium with 0.5 mM chlorpromazine and exposure to ultraviolet (UV) light resulted in no change in total glutathione content. A marked reduction in percent oxidized glutathione occurred, however, in corneas perfused with 0.5 mM chlorpromazine both in the presence and absence of UV light. It is concluded that photodynamically induced swelling of corneas is not the result of a failure of the glutathione redox system

  7. Analysis of central corneal thickness in different degrees of diabetic retinopathy

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    Shan Hua

    2014-06-01

    Full Text Available AIM: To study central corneal thickness(CCTand correlation in different degrees of diabetic retinopathy(DR.METHODS: A total of 65 cases(130 eyeswith different degrees of DR and 35 normal cases(70 eyesas the age-and gender-matched control group were examined by corneal endothelial microscope, to measure CCT and statistics RESULTS: Compared to control group, there were no significant difference of CCT both mild and medium nonproliferative diabetic retinopathy(NPDRgroups(P>0.05. While the CCT of severe NPDR group and proliferative diabetic retinopathy(PDRgroup were thicker than control group, and the differences were statistically significant(PPPr=0.173, PCONCLUSION: The CCT increases with severity of DR. Taking care of protecting corneal endothelium is very important in the time of therapeutic measure, especially intraocular operation, to decrease complication.

  8. A Comparative Study of Vertebrate Corneal Structure: The Evolution of a Refractive Lens.

    Science.gov (United States)

    Winkler, Moritz; Shoa, Golroxan; Tran, Stephanie T; Xie, Yilu; Thomasy, Sarah; Raghunathan, Vijay K; Murphy, Christopher; Brown, Donald J; Jester, James V

    2015-04-01

    Although corneal curvature plays an important role in determining the refractive power of the vertebrate eye, the mechanisms controlling corneal shape remain largely unknown. To address this question, we performed a comparative study of vertebrate corneal structure to identify potential evolutionarily based changes that correlate with the development of a corneal refractive lens. Nonlinear optical (NLO) imaging of second-harmonic-generated (SHG) signals was used to image collagen and three-dimensionally reconstruct the lamellar organization in corneas from different vertebrate clades. Second-harmonic-generated images taken normal to the corneal surface showed that corneal collagen in all nonmammalian vertebrates was organized into sheets (fish and amphibians) or ribbons (reptiles and birds) extending from limbus to limbus that were oriented nearly orthogonal (ranging from 77.7°-88.2°) to their neighbors. The slight angular offset (2°-13°) created a rotational pattern that continued throughout the full thickness in fish and amphibians and to the very posterior layers in reptiles and birds. Interactions between lamellae were limited to "sutural" fibers in cartilaginous fish, and occasional lamellar branching in fish and amphibians. There was a marked increase in lamellar branching in higher vertebrates, such that birds ≫ reptiles > amphibians > fish. By contrast, mammalian corneas showed a nearly random collagen fiber organization with no orthogonal, chiral pattern. Our data indicate that nonmammalian vertebrate corneas share a common orthogonal collagen structural organization that shows increased lamellar branching in higher vertebrate species. Importantly, mammalian corneas showed a different structural organization, suggesting a divergent evolutionary background.

  9. Corneal endothelial expansion promoted by human bone marrow mesenchymal stem cell-derived conditioned medium.

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    Makiko Nakahara

    Full Text Available Healthy corneal endothelium is essential for maintaining corneal clarity, as the damage of corneal endothelial cells and loss of cell count causes severe visual impairment. Corneal transplantation is currently the only therapy for severe corneal disorders. The greatly limited proliferative ability of human corneal endothelial cells (HCECs, even in vitro, has challenged researchers to establish efficient techniques for the cultivating HCECs, a pivotal issue for clinical applications. The aim of this study was to evaluate conditioned medium (CM obtained from human bone marrow-derived mesenchymal stem cells (MSCs (MSC-CM for use as a consistent expansion protocol of HCECs. When HCECs were maintained in the presence of MSC-CM, cell morphology assumed a hexagonal shape similar to corneal endothelial cells in vivo, as opposed to the irregular cell shape observed in control cultures in the absence of MSC-CM. They also maintained the functional protein phenotypes; ZO-1 and Na(+/K(+-ATPase were localized at the intercellular adherent junctions and pump proteins of corneal endothelium were accordingly expressed. In comparison to the proliferative potential observed in the control cultures, HCECs maintained in MSC-CM were found to have more than twice as many Ki67-positive cells and a greatly increased incorporation of BrdU into DNA. MSC-CM further facilitated the cell migration of HCECs. Lastly, the mechanism of cell proliferation mediated by MSC-CM was investigated, and phosphorylation of Akt and ERK1/2 was observed in HCECs after exposure to MSC-CM. The inhibitor to PI 3-kinase maintained the level of p27(Kip1 for up to 24 hours and greatly blocked the expression of cyclin D1 and D3 during the early G1 phase, leading to the reduction of cell density. These findings indicate that MSC-CM not only stimulates the proliferation of HCECs by regulating the G1 proteins of the cell cycle but also maintains the characteristic differentiated phenotypes necessary

  10. Inhibitory effects of regorafenib, a multiple tyrosine kinase inhibitor, on corneal neovascularization

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    Halil Ibrahim Onder

    2014-04-01

    Full Text Available AIM:To evaluate the inhibitory effects of regorafenib (BAY 73-4506, a multikinase inhibitor, on corneal neovascularization (NV.METHODS:Thirty adult male Sprague-Dawley rats weighing 250-300 g, were used. Corneal NV was induced by NaOH in the left eyes of each rat. Following the establishment of alkali burn, the animals were randomized into five groups according to topical treatment. Group 1 (n = 6 received 0.9% NaCl, Group 2 (n = 6 received dimethyl sulfoxide, Group 3 (n = 6 received regorafenib 1 mg/mL, Group 4 (n =6 received bevacizumab 5 mg/mL and Group 5 (n = 6 received 0.1% dexamethasone phosphate. On the 7d, the corneal surface covered with neovascular vessels was measured on photographs as the percentage of the cornea’s total area using computer-imaging analysis. The corneas obtained from rats were semiquantitatively evaluated for caspase-3 and vascular endothelial growth factor by immunostaining.RESULTS:A statistically significant difference in the percent area of corneal NV was found among the groups (P <0.001. Although the Group 5 had the smallest percent area of corneal NV, there was no difference among Groups 3, 4 and 5 (P >0.005. There was a statistically significant difference among the groups in apoptotic cell density (P = 0.002. The staining intensity of vascular endothelial growth factor in the epithelial and endothelial layers of cornea was significantly different among the groups (P <0.05. The staining intensity of epithelial and endothelial vascular endothelial growth factor was significantly weaker in Groups 3, 4 and 5 than in Groups 1 and 2.CONCLUSION: Topical administration of regorafenib 1 mg/mL is partly effective for preventing alkali-induced corneal NV in rats.

  11. Early Corneal Innervation and Trigeminal Alterations in Parkinson Disease: A Pilot Study.

    Science.gov (United States)

    Arrigo, Alessandro; Rania, Laura; Calamuneri, Alessandro; Postorino, Elisa Imelde; Mormina, Enricomaria; Gaeta, Michele; Marino, Silvia; Di Lorenzo, Giuseppe; Quartarone, Angelo; Anastasi, Giuseppe; Puzzolo, Domenico; Aragona, Pasquale

    2018-04-01

    To describe corneal innervation and trigeminal alterations in drug-naive patients with Parkinson disease (PD). A case series study was conducted by recruiting 3 early drug-naive patients with PD, 2 men and 1 woman (age: 72, 68, and 66, respectively). Ophthalmologic assessment included Ocular Surface Disease Index questionnaire, visual acuity by the logarithm of the minimum angle of resolution score, pupillary light reflexes, extrinsic ocular movements, corneal sensitivity, and slit-lamp examination. Corneal innervation parameter changes were evaluated in vivo using the Confoscan 4 confocal microscope, and they were compared with a control data set. The Heidelberg Retina Tomograph 3 (HRT3) has been used to assess retinal alterations in our patients, if compared with normal range values provided by the HRT3. Moreover, 3T magnetic resonance imaging (MRI) analysis of water diffusion property changes of trigeminal nerves was performed. All data were analyzed and compared with 2 control data sets made by 14 age-matched controls. Patients with PD showed profound alterations of corneal innervation and of trigeminal diffusion MRI parameters, compared with controls. Strong differences (PD vs. controls) were found for deep nerve tortuosity (Kallinikos mean 19.94 vs. 2.13) and the number of beadings (mean 34.2 vs. 15.5). HRT3 retinal evaluation revealed less structural changes compared with the normal range. Diffusion MRI showed profound changes of white matter diffusion properties (PD vs. controls), with fractional anisotropy decrement (mean 0.3029 vs. 0.3329) and mean diffusivity increment (mean 0.00127 vs. 0.00106). Corneal innervation changes might occur earlier in patients with PD than in retinal ones. Confocal corneal innervation analysis might provide possible early biomarkers for a better PD evaluation and for its earlier diagnosis.

  12. Effects of Pentacam on the posterior corneal surface height changes after LASEK and LASIK operation

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    Qing-Song Zhang

    2014-05-01

    Full Text Available AIM: To explore the application of Pentacam excimer laser epithelial keratomileusis(LASEKand excimer laser in situ keratomileusis(LASIKafter the changes of posterior corneal surface height.METHODS: Retrospective analysis of clinical data of 100 patients with myopia by using LASEK and LASIK for the treatment of the 50 patients(100 eyesin our hospital from January 2013 to June 2013, surface height changes after preoperative and postoperative 3 months were compared by measuring Pentacam corneal analysis system.RESULTS: Three months after operation, the LASEK posterior corneal surface height was 7.4±5.0mm, significantly higher than 5.6±3.4mm before operation, LASIK posterior corneal surface height was 7.5±5.1mm, significantly higher than 5.5±3.5mm before operation, the differences were statistically significant(PP>0.05.CONCLUSION: LASEK and LASIK on corneal posterior surface forward, LASIK is slightly obvious in early period.

  13. Penetrating keratoplasty for treatment of corneal abscesses in horses – case report

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    Zita Makra

    2013-01-01

    Full Text Available This case report describes the surgical technique and outcome of allograft transplantation to treat full thickness corneal abscesses in three horses. In all three cases penetrating keratoplasty was performed. Each affected eye had an abscess within the corneal stroma. An initial full thickness circular corneal incision was made around the lesion. After excision of the stromal abscess the created defect was replaced with a larger diameter full thickness donor graft and the initial corneal incision was repaired. All of the horses that underwent penetrating keratoplasty procedure healed with a scar at the graft site and remained visual. Penetrating keratoplasty is an effective technique for surgical removal of medically nonresponsive full thickness stromal abscess in horses and results in a visual and cosmetically acceptable globe. The advantages of this technique compared to medical therapy are that there is less scarring, shorter healing times and less damage of the globe because of the concurrent uveitis. To the authors’ knowledge, clinical experience with penetrating keratoplasty in horses has not been reported in Europe so far.

  14. Management of nontraumatic corneal perforation with tectonic drape patch and cyanoacrylate glue.

    Science.gov (United States)

    Khalifa, Yousuf M; Bailony, M Rami; Bloomer, Michele M; Killingsworth, Daniel; Jeng, Bennie H

    2010-10-01

    To report a case of nontraumatic corneal perforation managed with a tectonic drape patch. Interventional case report. A 60-year-old patient with a corneal scar in his left eye likely secondary to herpes simplex virus interstitial keratitis underwent laser peripheral iridotomy for narrow angles. He developed progressive thinning of the cornea overlying the scar that led to a descemetocele and then ultimately a 1.2- × 1.7-mm perforation. Intraoperatively, several attempts were made to seal the perforation with cyanoacrylate glue, but the wound continued to leak. Sterile plastic drape that was on the surgical field was fashioned into a 2-mm-diameter patch, and the peripheral edge of the tectonic drape patch was glued over the perforation, successfully sealing the cornea. One week later, the drape patch was intact without leak, and a penetrating keratoplasty was carried out without complication. Tectonic drape patch technique for nontraumatic corneal perforations in which there is tissue loss is a viable temporizing option when cyanoacrylate glue alone fails and when there is no corneal tissue or amniotic membrane available to close the wound.

  15. Corneal endothelium in xeroderma pigmentosum: clinical specular microscopy study.

    Science.gov (United States)

    Mohamed, Ashik; Peguda, Rajini; Ramappa, Muralidhar; Ali, Mohammad Javed; Chaurasia, Sunita

    2016-06-01

    Xeroderma pigmentosum is a condition caused due to a defective DNA repair mechanism when exposed to ultraviolet radiation. Many of the patients with this disorder develop severely oedematous cornea with varying degrees of anterior corneal haze, which necessitates a full-thickness keratoplasty or selective endothelial keratoplasty. Presence of corneal oedema suggests that these patients have a dysfunctional endothelium. The purpose of this study is to evaluate the corneal endothelium in the patients with xeroderma pigmentosum when clinical specular microscopy was feasible. Thirteen patients with classic skin changes of xeroderma pigmentosum were included in the study conducted during January 2010-December 2012. An age-matched group of 13 volunteers were included as controls who were emmetropes without any history of ocular or systemic illness. Corneal endothelium was assessed using specular microscopy from the central clear area of cornea. The mean age of the patients with xeroderma pigmentosum was 16.6±7.2 years and that of the controls was 17.4±6.9 years (p=0.78). The number of analysed cells and endothelial cell density were significantly higher in controls (pxeroderma pigmentosum (p≤0.007). The specular microscopic findings in patients with xeroderma pigmentosum are suggestive of an accelerated endothelial cell loss. It is pertinent that the treating physicians must be involved in emphasising proper ocular protection from ultraviolet radiation to prevent avoidable blindness from xeroderma pigmentosum. 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/

  16. CCL20, (gamma)(delta) T cells, and IL-22 in corneal epithelial healing

    Science.gov (United States)

    After corneal epithelial abrasion, leukocytes and platelets rapidly enter the corneal stroma, and CCR6 (+) IL-17(+) gamma delta T cells migrate into the epithelium. Gamma delta T-cell-deficient (TCRd(-/-)) mice have significantly reduced inflammation and epithelial wound healing. Epithelial CCL20 mR...

  17. Semi-quantitative assessments of dextran toxicity on corneal endothelium: conceptual design of a predictive algorithm.

    Science.gov (United States)

    Filev, Filip; Oezcan, Ceprail; Feuerstacke, Jana; Linke, Stephan J; Wulff, Birgit; Hellwinkel, Olaf J C

    2017-03-01

    Dextran is added to corneal culture medium for at least 8 h prior to transplantation to ensure that the cornea is osmotically dehydrated. It is presumed that dextran has a certain toxic effect on corneal endothelium but the degree and the kinetics of this effect have not been quantified so far. We consider that such data regarding the toxicity of dextran on the corneal endothelium could have an impact on scheduling and logistics of corneal preparation in eye banking. In retrospective statistic analyses, we compared the progress of corneal endothelium (endothelium cell loss per day) of 1334 organ-cultured corneal explants in media with and without dextran. Also, the influence of donor-age, sex and cause of death on the observed dextran-mediated effect on endothelial cell counts was studied. Corneas cultured in dextran-free medium showed a mean endothelium cell count decrease of 0.7% per day. Dextran supplementation led to a mean endothelium cell loss of 2.01% per day; this reflects an increase by the factor of 2.9. The toxic impact of dextran was found to be time dependent; while the prevailing part of the effect was observed within the first 24 h after dextran-addition. Donor age, sex and cause of death did not seem to have an influence on the dextran-mediated toxicity. Based on these findings, we could design an algorithm which approximately describes the kinetics of dextran-toxicity. We reproduced the previously reported toxic effect of dextran on the corneal endothelium in vitro. Additionally, this is the first work that provides an algorithmic instrument for the semi-quantitative calculation of the putative endothelium cell count decrease in dextran containing medium for a given incubation time and could thus influence the time management and planning of corneal transplantations.

  18. Corneal Opacity in Domestic Ducks Experimentally Infected With H5N1 Highly Pathogenic Avian Influenza Virus.

    Science.gov (United States)

    Yamamoto, Y; Nakamura, K; Yamada, M; Mase, M

    2016-01-01

    Domestic ducks can be a key factor in the regional spread of H5N1 highly pathogenic avian influenza (HPAI) virus in Asia. The authors performed experimental infections to examine the relationship between corneal opacity and H5N1 HPAI virus infection in domestic ducks (Anas platyrhyncha var domestica). A total of 99 domestic ducks, including 3 control birds, were used in the study. In experiment 1, when domestic ducks were inoculated intranasally with 2 H5N1 HPAI viruses, corneal opacity appeared more frequently than neurologic signs and mortality. Corneal ulceration and exophthalmos were rare findings. Histopathologic examinations of the eyes of domestic ducks in experiment 2 revealed that corneal opacity was due to the loss of corneal endothelial cells and subsequent keratitis with edema. Influenza viral antigen was detected in corneal endothelial cells and some other ocular cells by immunohistochemistry. Results suggest that corneal opacity is a characteristic and frequent finding in domestic ducks infected with the H5N1 HPAI virus. Confirming this ocular change may improve the detection rate of infected domestic ducks in the field. © The Author(s) 2015.

  19. Superficial corneal foreign body: laboratory and epidemiologic aspects Corpo estranho corneal superficial: aspectos laboratoriais e epidemiológicos

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    Ednajar Tavares Macedo Filho

    2005-12-01

    Full Text Available PURPOSE: To determine by bacterioscopy and culture the microorganisms carried by corneal foreign body and their sensitivity to antibiotics by antibiotic sensitivity test. METHODS: A prospective study was carried out and information was collected on 101 patients who presented with corneal foreign body at the São Paulo Hospital Eye Emergency Service. Prior to any treatment, a sample of the ipsilateral inferior conjunctival fornix and the foreign body were collected and immersed in thioglycolate broth. Samples were sown on solid culture media including blood, chocolate and Sabouraud agar. Bacterioscopic examination using Gram and Giemsa staining and sensitivity test were performed. Positive foreign body culture results were compared to ipsilateral conjunctival fornix culture to exclude possible normal flora growth. RESULTS: Approximately 92% of patients were males with a mean age of 35 years and in 62.4% (95% confidence interval: 52.2 - 71.8% had the right eye was affected. Foreign body positive cultures were achieved in 32.7% (95% confidence interval: 23.7 - 42.7% of the cases. The microorganisms isolated from the foreign body culture were identified as: Streptococcus, alpha-hemolytic (n=4, Staphylococcus aureus (n=4, Staphylococcus, coagulase-negative (n=4, Corynebacterium xerosis (n=3, unidentified Gram-positive bacillus (n=2, Moraxella sp (n=1, Serratia sp (n=1, Acynetobacter sp (n=1. The microbial sensitivity test showed that 95% of the cases were sensitive to chloramphenicol and 90% were sensitive to ciprofloxacin, these being antibiotics used in our routine service. CONCLUSION: Superficial corneal foreign body acts as important contaminant vector and the great majority of isolated bacteria were sensitive to the antibiotic prophylaxis used in the treatment.OBJETIVOS: Identificar por meio de cultura e bacterioscopia os microrganismos veiculados por corpo estranho corneal e sua sensibilidade aos antibióticos em teste de antibiograma. M

  20. Latest progress of BIGH3 gene in corneal diseases and diabetic retinopathy

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    Fan-Qian Song

    2017-03-01

    Full Text Available BIGH3 gene plays an important role in ocular diseases. On the one hand, it is closely related to the occurrence of corneal diseases. BIGH3 gene can inhibit corneal neovascularization, lead to corneal dystrophy, participate in keratoconus formation. On the other hand, it can lead to the formation of neovascularization in diabetic retinopathy. The latest experiments show that TGF beta secreted by macrophages can promote the expression of BIGH3 mRNA and BIGH3 protein, and promote apoptosis of retinal endothelial cells and pericytes, which leads to the formation of neovascularization in diabetic retinopathy. This article will describe the new progress of BIGH3 gene in ocular diseases from several aspects as mentioned above.

  1. Preliminary study of corneal penetration of /sup 125/I-labelled idoxuridine liposome

    Energy Technology Data Exchange (ETDEWEB)

    Dharma, S.K.; Fishman, P.H.; Peyman, G.A.

    1986-01-01

    We compared corneal penetration of idoxuridine (IDU) to liposome-encapsulated IDU. Liposomes of phosphatidic acid, phosphatidyl choline and alphatocopherol in a molar ratio 1:8:1 were prepared using the reverse phase evaporation method. New Zealand albino rabbits received either 0.1% solution of I/sup 125/-labelled aqueous IDU or liposome-encapsulated IDU topically every 2 min for 6 min. Corneal, aqueous, and vitreous samples were assayed for I/sup 125/ radioactivity at 15 min and at 1, 2, 3, and 6 h following drug application. Our results indicated that corneal penetration of liposomal IDU was significantly increased over the regular form of the drug for a time interval of 6 h.

  2. A preliminary study of corneal penetration of 125I-labelled idoxuridine liposome

    International Nuclear Information System (INIS)

    Dharma, S.K.; Fishman, P.H.; Peyman, G.A.

    1986-01-01

    We compared corneal penetration of idoxuridine (IDU) to liposome-encapsulated IDU. Liposomes of phosphatidic acid, phosphatidyl choline and alphatocopherol in a molar ratio 1:8:1 were prepared using the reverse phase evaporation method. New Zealand albino rabbits received either 0.1% solution of I 125 -labelled aqueous IDU or liposome-encapsulated IDU topically every 2 min for 6 min. Corneal, aqueous, and vitreous samples were assayed for I 125 radioactivity at 15 min and at 1, 2, 3, and 6 h following drug application. Our results indicated that corneal penetration of liposomal IDU was significantly increased over the regular form of the drug for a time interval of 6 h. (author)

  3. Modificaciones de la curvatura posterior corneal después de la cirugía refractiva láser Modifications in the corneal posterior curve after laser refractive surgery

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    Lorelei Ortega Díaz

    2011-06-01

    Full Text Available OBJETIVO: Describir las modificaciones de la curvatura posterior corneal en pacientes sometidos a cirugía refractiva láser en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer" en el período de mayo a octubre de 2010. MÉTODOS: Se realizó un estudio descriptivo, longitudinal y prospectivo, con un universo de 257 pacientes (504 ojos sometidos a cirugía refractiva láser. La muestra quedó conformada por 31 pacientes (59 ojos. Se analizaron variables como edad, sexo, equivalente esférico, paquimetría preoperatoria, cantidad de ablación, estroma residual y diferencia de elevación posterior corneal, esta última obtenida del mapa de diferencia del topógrafo Galilei, con medición preoperatoria al mes y a los tres meses de la cirugía. Mediante análisis de regresión múltiple fueron valorados dichos cambios de la paquimetría, la cantidad de ablación y el estroma residual. RESULTADOS: El equivalente esférico, la paquimetría, la cantidad de ablación y el estroma residual se encontraron dentro de los parámetros de seguridad establecidos. La diferencia promedio de la elevación corneal posterior fue de 15,62 µm al mes y de 11,78 µm a los tres meses, con disminución significativa con el tiempo (p= 0,000. Se observó asociación con la paquimetría preoperatoria y el estroma residual, y se encontró una correlación inversa entre este último y la elevación corneal posterior a los tres meses. CONCLUSIONES: La cirugía refractiva láser induce un aumento precoz en la elevación corneal posterior, con disminución progresiva hacia el tercer mes. Los factores que más influyeron en estos cambios fueron el estroma residual y la paquimetría preoperatoria.OBJECTIVES: To describe the modifications in the corneal posterior curve in patients underwent laser refractive surgery in the "Ramón Pando Ferrer" Cuban Institute of Ophthalmology from May to October, 2020. METHODS: A prospective, longitudinal and descriptive study was conducted

  4. Espesor corneal y variables epidemiológicas y fisiológicas en población de riesgo de glaucoma Corneal thickness and the epidemiological and physiological variables seen in the glaucoma risk population

    Directory of Open Access Journals (Sweden)

    Idalia Triana Casado

    2012-12-01

    Full Text Available Objetivo: caracterizar el espesor corneal central en pacientes con factores de riesgo de glaucoma crónico simple. Métodos: se realizó un estudio epidemiológico, observacional, descriptivo y longitudinal prospectivo, en el Servicio de Glaucoma del Hospital "Dr. Salvador Allende" durante el año 2010. El universo estuvo constituido por 1 238 pacientes que acudieron a la consulta de oftalmología por síntomas astenópicos. La muestra, aplicados los criterios de inclusión y exclusión, quedó conformada por 656 pacientes con factores de riesgo de la enfermedad, de estos se desecharon 19 por una diferencia entre los ojos de 10 µm o más de espesor corneal. Las variables analizadas fueron: espesor corneal, edad, sexo, color de la piel y presión intraocular. Resultados: de los pacientes con factores de riesgo de glaucoma, predominaron aquellos entre 50 y 59 años de edad (22,76 %, masculinos (60,28 % y de piel no blanca (57,29 %. El espesor corneal estuvo disminuido (61,85 % y la presión intraocular aumentada (55,41 %, aún con ajuste (46,93 %. Conclusiones: la disminución del espesor corneal estuvo relacionada con la edad, el sexo femenino, la piel no blanca y el aumento de la presión intraocular en aquellos pacientes sospechosos de glaucoma.Objective: to characterize the central corneal thickness seen in patients with simple chronic glaucoma risk factors. Methods: a prospective longitudinal, descriptive, observational, and epidemiological study was conducted in the Glaucoma Service of “Dr. Salvador Allende” hospital during 2010. The universe of study was made up of 1 238 patients that went to the ophthalmological service due to asthenopic symptoms. Taking the inclusion and exclusion criteria into account, the final sample was composed by 656 patients with glaucoma risk factors, 19 of whom were excluded because of 10 µm and over difference in the corneal thickness between the eyes. The analyzed variables were corneal thickness, age

  5. Meretoja’s Syndrome: Lattice Corneal Dystrophy, Gelsolin Type

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    I. Casal

    2017-01-01

    Full Text Available Lattice corneal dystrophy gelsolin type was first described in 1969 by Jouko Meretoja, a Finnish ophthalmologist. It is caused by an autosomal dominant mutation in gelsolin gene resulting in unstable protein fragments and amyloid deposition in various organs. The age of onset is usually after the third decade of life and typical diagnostic triad includes progressive bilateral facial paralysis, loose skin, and lattice corneal dystrophy. We report a case of a 53-year-old female patient referred to our Department of Ophthalmology by severe dry eye and incomplete eyelid closure. She had severe bilateral facial paresis, significant orbicularis, and perioral sagging as well as hypoesthesia of extremities and was diagnosed with Meretoja’s syndrome at the age of 50, confirmed by the presence of gelsolin mutation. At our observation she had bilateral diminished tear film break-up time and Schirmer test, diffuse keratitis, corneal opacification, and neovascularization in the left eye. She was treated with preservative-free lubricants and topical cyclosporine, associated with nocturnal complete occlusion of both eyes, and underwent placement of lacrimal punctal plugs. Ocular symptoms are the first to appear and our role as ophthalmologists is essential for the diagnosis, treatment, and monitoring of ocular alterations in these patients.

  6. Risk assessment for ectasia after corneal refractive surgery.

    Science.gov (United States)

    Randleman, J Bradley; Woodward, Maria; Lynn, Michael J; Stulting, R Doyle

    2008-01-01

    To analyze the epidemiologic features of ectasia after excimer laser corneal refractive surgery, to identify risk factors for its development, and to devise a screening strategy to minimize its occurrence. Retrospective comparative and case-control study. All cases of ectasia after excimer laser corneal refractive surgery published in the English language with adequate information available through December 2005, unpublished cases seeking treatment at the authors' institution from 1998 through 2005, and a contemporaneous control group who underwent uneventful LASIK and experienced a normal postoperative course. Evaluation of preoperative characteristics, including patient age, gender, spherical equivalent refraction, pachymetry, and topographic patterns; perioperative characteristics, including type of surgery performed, flap thickness, ablation depth, and residual stromal bed (RSB) thickness; and postoperative characteristics including time to onset of ectasia. Development of postoperative corneal ectasia. There were 171 ectasia cases, including 158 published cases and 13 unpublished cases evaluated at the authors' institution. Ectasia occurred after LASIK in 164 cases (95.9%) and after photorefractive keratectomy (PRK) in 7 cases (4.1%). Compared with controls, more ectasia cases had abnormal preoperative topographies (35.7% vs. 0%; Pvs. 40.0 years; Pvs. -5.09 diopters; Pvs. 546.5 microm; Pvs. 317.3 microm; PLASIK that, if validated, represents a significant improvement over current screening strategies.

  7. Superficial corneal crosslinking during laser in situ keratomileusis.

    Science.gov (United States)

    Seiler, Theo G; Fischinger, Isaak; Koller, Tobias; Derhartunian, Viktor; Seiler, Theo

    2015-10-01

    To determine the safety of superficial corneal crosslinking after laser in situ keratomileusis (LASIK). Institut für Refraktive und Ophthalmo-Chirurgie, Zurich, Switzerland. Prospective study. Eyes with an ectasia risk score of 2 or higher were treated with standard LASIK (90 μm flap) for myopia correction, after which a rapid corneal crosslinking was performed in the interface (riboflavin 0.5% for 2 minutes, 9 mW/cm(2) for 5 minutes) (Group 1). The follow-up was up to 1 year. The prevalence of complications was statistically compared with that in a group of eyes matched regarding age, sex, and attempted refractive correction that were treated with standard LASIK only (Group 2). One month postoperatively, 5 eyes in Group 1 lost 1 line of corrected distance visual acuity (CDVA) compared with 1 eye in Group 2 (P rate of less than 5%. The refractive success was identical in both groups. Early postoperative complications such as erosions (16%), diffuse lamellar keratitis (DLK) stage 1 (38%), and DLK stage 2 (5%) were statistically significantly more frequent after superficial corneal crosslinking, leading to a statistically significantly reduced uncorrected distance visual acuity at 1 month (P interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  8. Measurement of Angle Kappa Using Ultrasound Biomicroscopy and Corneal Topography.

    Science.gov (United States)

    Yeo, Joon Hyung; Moon, Nam Ju; Lee, Jeong Kyu

    2017-06-01

    To introduce a new convenient and accurate method to measure the angle kappa using ultrasound biomicroscopy (UBM) and corneal topography. Data from 42 eyes (13 males and 29 females) were analyzed in this study. The angle kappa was measured using Orbscan II and calculated with UBM and corneal topography. The angle kappa of the dominant eye was compared with measurements by Orbscan II. The mean patient age was 36.4 ± 13.8 years. The average angle kappa measured by Orbscan II was 3.98° ± 1.12°, while the average angle kappa calculated with UBM and corneal topography was 3.19° ± 1.15°. The difference in angle kappa measured by the two methods was statistically significant (p topography to calculate the angle kappa. This method is convenient to use and allows for measurement of the angle kappa without an expensive device. © 2017 The Korean Ophthalmological Society

  9. Effects of vitrectomy combined with cataract surgery on the corneal endothelial cells in diabetic retinopathy

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    Lei Zhan

    2017-08-01

    Full Text Available AIM: To investigate the effects of vitrectomy combined with cataract surgery on the corneal endothelial cells in diabetic retinopathy. METHODS: A retrospective study was designed. 160 patients(160 eyeswith diabetic retinopathy from Jan 2015 to Feb 2017 were divided into two groups according to cataract. 74 patients(74 eyeswere operated on vitrectomy, and 86 patients(86 eyeson vitrectomy combined with phacoemulsification cataract surgery and capsular bag implantation of foldable intraocular lens. To record the change of corneal endothelial cells density, average cellular area, coefficient of variation and percentage of hexagonal endothelial cell before and after treatment with Topcon corneal specular microscope. RESULTS: Before and after surgery, the results of corneal endothelial cells density, average cellular area, coefficient of variation and percentage of hexagonal endothelial cell in simple vitrectomy group were no significant difference(P>0.05; After treatment corneal endothelial cells density and percentage of hexagonal endothelial cell were changed with statistical difference as the same as average cellular area and coefficient of variation(PPCONCLUSION: It has certain influence on the corned endothelial cells when using vitrectomy combined with cataract surgery in diabetic retinopathy. For patients with indications, it should be paid attention to protecting the corneal endothelial cells.

  10. Mycotic corneal ulcers in upper Assam

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    Reema Nath

    2011-01-01

    Full Text Available Purpose : To study the association of various risk factors and epidemiological variables of mycotic keratitis treated at a tertiary referral hospital of upper Assam. Materials and Methods: In this hospital-based prospective study a total of 310 consecutive corneal ulcer cases attending the ophthalmology outpatient department of Assam Medical College were enrolled between April 2007 and March 2009. After clinical and slit-lamp biomicroscopic examination in all suspected cases, smears and culture examination for fungus was done to establish the etiology. Demographic information and associated probable risk factors of individual cases were noted in a predesigned questionnaire. Results: In 188 (60.6% cases fungal etiology could be established. Out of them 67.6% were males. The most commonly affected age group was 41-50 years (25.5%. The maximum (23.4% cases were reported during the paddy harvesting season in Assam (January and February. Fungal element could be demonstrated in 65.2% cases in direct potassium hydroxide (KOH mount. The commonest predisposing factor was corneal injury (74.5%. While diabetes was a significant systemic predisposing factor in mixed bacterial and fungal infections in 11.1% cases, blocked naso-lacrimal duct was the local predisposing factor in 11.1% of cases. Fusarium solani (25% was the commonest isolate followed by Aspergillus species (19%, Curvularia species (18.5% and Penicillium species (15.2%. Yeasts were isolated in 2.7% (n=5 cases. Conclusions : Ocular trauma was the commonest cause of fungal corneal ulcer in Assam and Fusarium solani was the commonest species responsible for it. Most of the mycotic ulcer cases come from rural areas including the tea gardens.

  11. Cultivation of corneal endothelial cells on a pericellular matrix prepared from human decidua-derived mesenchymal cells.

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    Ryohei Numata

    Full Text Available The barrier and pump functions of the corneal endothelium are essential for the maintenance of corneal transparency. Although corneal transplantation is the only current therapy for treating corneal endothelial dysfunction, the potential of tissue-engineering techniques to provide highly efficient and less invasive therapy in comparison to corneal transplantation has been highly anticipated. However, culturing human corneal endothelial cells (HCECs is technically difficult, and there is no established culture protocol. The aim of this study was to investigate the feasibility of using a pericellular matrix prepared from human decidua-derived mesenchymal cells (PCM-DM as an animal-free substrate for HCEC culture for future clinical applications. PCM-DM enhanced the adhesion of monkey CECs (MCECs via integrin, promoted cell proliferation, and suppressed apoptosis. The HCECs cultured on the PCM-DM showed a hexagonal morphology and a staining profile characteristic of Na⁺/K⁺-ATPase and ZO-1 at the plasma membrane in vivo, whereas the control HCECs showed a fibroblastic phenotype. The cell density of the cultured HCECs on the PCM-DM was significantly higher than that of the control cells. These results indicate that PCM-DM provides a feasible xeno-free matrix substrate and that it offers a viable in vitro expansion protocol for HCECs while maintaining cellular functions for use as a subsequent clinical intervention for tissue-engineered based therapy of corneal endothelial dysfunction.

  12. Reconstruction of limbal stem cell deficient corneal surface with induced human bone marrow mesenchymal stem cells on amniotic membrane.

    Science.gov (United States)

    Rohaina, Che Man; Then, Kong Yong; Ng, Angela Min Hwei; Wan Abdul Halim, Wan Haslina; Zahidin, Aida Zairani Mohd; Saim, Aminuddin; Idrus, Ruszymah B H

    2014-03-01

    The cornea can be damaged by a variety of clinical disorders or chemical, mechanical, and thermal injuries. The objectives of this study were to induce bone marrow mesenchymal stem cells (BMSCs) to corneal lineage, to form a tissue engineered corneal substitute (TEC) using BMSCs, and to treat corneal surface defects in a limbal stem cell deficiency model. BMSCs were induced to corneal lineage using limbal medium for 10 days. Induced BMSCs demonstrated upregulation of corneal stem cell markers; β1-integrin, C/EBPδ, ABCG2, and p63, increased protein expression of CK3 and p63 significantly compared with the uninduced ones. For TEC formation, passage 1 BMSCs were trypsinized and seeded on amniotic membrane in a transwell co-culture system and were grown in limbal medium. Limbal stem cell deficiency models were induced by alkaline injury, and the TEC was implanted for 8 weeks. Serial slit lamp evaluation revealed remarkable improvement in corneal regeneration in terms of corneal clarity and reduced vascularization. Histologic and optical coherence tomography analyses demonstrated comparable corneal thickness and achieved stratified epithelium with a compact stromal layer resembling that of normal cornea. CK3 and p63 were expressed in the newly regenerated cornea. In conclusion, BMSCs can be induced into corneal epithelial lineage, and these cells are viable for the formation of TEC, to be used for the reconstruction of the corneal surface in the limbal stem cell deficient model. Copyright © 2014 Mosby, Inc. All rights reserved.

  13. Inhibition of corneal neovascularization by recombinant adenovirus-mediated sFlk-1 expression

    International Nuclear Information System (INIS)

    Yu Hui; Wu Jihong; Li Huiming; Wang Zhanli; Chen Xiafang; Tian Yuhua; Yi Miaoying; Ji Xunda; Ma Jialie; Huang Qian

    2007-01-01

    The interaction of vascular endothelial growth factor (VEGF) and its receptors (Flt-1, Flk-1/KDR) is correlated with neovascularization in the eyes. Therefore, blocking the binding of VEGF and the corresponding receptor has become critical for inhibiting corneal neovascularization. In this study, we have expressed the cDNA for sFlk-1 under the control of cytomegalovirus immediate-early promoter (CMV) from an E1/partial E3 deleted replication defective recombinant adenovirus, and Ad.sflk-1 expression was determined by Western blotting. We have shown that conditioned media from Ad.sflk-1-infected ARPE-19 cells significantly reduced VEGF-induced human umbilical vein endothelial cells (HUVEC) and murine endothelial cells (SVEC) proliferation in vitro compared with the control vector. In vivo, adenoviral vectors expressing green fluorescent protein alone (Ad.GFP) were utilized to monitor gene transfer to the cornea. Moreover, in the models of corneal neovascularization, the injection of Ad.sflk-1 (10 8 PFU) into the anterior chamber could significantly inhibit angiogenic changes compared with Ad.null-injected and vehicle-injected models. Immunohistochemical analysis showed that corneal endothelial cells and corneal stroma of cauterized rat eyes were efficiently transduced and expressed sFlk-1. These results not only support that adenoviral vectors are capable of high-level transgene expression but also demonstrate that Ad.sflk-1 gene therapy might be a feasible approach for inhibiting the development of corneal neovascularization

  14. Queratectomía fototerapéutica en distrofia reticular corneal Phototherapeutical keratetocomy in corneal lattice dystrophy

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    Miguel O Mokey Castellanos

    2007-06-01

    Full Text Available Se realizó un estudio retrospectivo en pacientes con distrofia corneal reticular en los que la recurrencia de la afección ocurrió después de diez años o más de realizada la queratoplastia perforante y en pacientes que presentaban la afección sin tratamiento quirúrgico previo, a los cuales se les realizó queratectomía fototerapéutica con excímer láser. Esta alternativa terapéutica se aplica en afecciones del estroma anterior de la córnea en la que se producen irregularidades en la superficie de esta y disminución de la visión. Fueron tratados 5 ojos correspondientes a 4 pacientes, 3 de ellos pertenecían a una misma familia. Los resultados terapéuticos y visuales mejoraron la calidad de vida de los pacientes, y se postergó la necesidad de retrasplante o trasplante. No tuvimos complicaciones. El excímer láser se convirtió en una alternativa, segura y eficaz en el tratamiento de estas afeccionesA retrospective study was performed on patients with lattice corneal dystrophy, who suffered recurrence ten or more years after penetrating keratoplasty and on patients suffering the same problem but without any previous surgical treatment, who had undergone phototherapeutical keratectomy with Excimer laser. This therapeutic alternative is useful for anterior stromal keratopathy in where corneal irregularities decrease the vision. Five eyes have been treated from 4 patients, 3 of them were relatives. The visual and therapeutical results improved the quality of life of patients, thus postponing the need for transplant or retransplant. No complications were encountered. Laser Excímer became an effective and safe alternative in the treatment of such diseases

  15. Corneal tissue ablation using 6.1 μm quantum cascade laser

    Science.gov (United States)

    Huang, Yong; Kang, Jin U.

    2012-03-01

    High absorption property of tissues in the IR range (λ> 2 μm) results in effective tissue ablation, especially near 3 μm. In the mid-infrared range, wavelengths of 6.1 μm and 6.45 μm fall into the absorption bands of the amide protein groups Amide-I and Amide-II, respectively. They also coincide with the deformation mode of water, which has an absorption peak at 6.1 μm. This coincidence makes 6.1 μm laser a better ablation tool that has promising effectiveness and minimum collateral damages than 3 μm lasers. In this work, we performed bovine corneal ablation test in-vitro using high-power 6.1μm quantum cascade laser (QCL) operated at pulse mode. Quantum cascade laser has the advantages of low cost, compact size and tunable wavelength, which makes it great alternative Mid-IR light source to conventional tunable free-electron lasers (FEL) for medical applications. Preliminary results show that effective corneal stroma craters were achieved with much less collateral damage in corneal tissue that contains less water. Future study will focus on optimizing the control parameters of QCL to attain neat and precise ablation of corneal tissue and development of high peak power QCL.

  16. 21 CFR 886.1220 - Corneal electrode.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Corneal electrode. 886.1220 Section 886.1220 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL... to the cornea to provide data showing the changes in electrical potential in the retina after...

  17. Comparison of Central Corneal Thickness Measured by Standard Ultrasound Pachymetry, Corneal Topography, Tono-Pachymetry and Anterior Segment Optical Coherence Tomography.

    Science.gov (United States)

    González-Pérez, Javier; Queiruga Piñeiro, Juan; Sánchez García, Ángelx; González Méijome, José Manuel

    2018-04-10

    To compare central corneal thickness (CCT) measured by standard ultrasound pachymetry (USP), and three non-contact devices in healthy eyes. A cross-sectional study of CCT measurement in 52 eyes of 52 healthy volunteers was done by a single examiner at Ocular Surface and Contact Lens Laboratory. Three consecutive measurements were done by standard USP, non-contact tono-pachymeter, Pentacam corneal topographer, and Anterior Segment Optical Coherence Tomography (AS-OCT). The mean values were used for assessment. The results were compared using multivariate ANOVA, linear regression, and Pearson correlation. Agreement among the devices was analyzed using mean differences and Bland-Altman analysis with 95% limits of agreement (LoA). Finally, reliability was analyzed using intraclass correlation coefficient (ICC). Mean CCT by ultrasound pachymeter, tono-pachymeter, corneal topographer and AS-OCT were 558.9 ± 31.2 µm, 525.8 ± 43.1 µm, 550.4 ± 30.5 µm, and 545.9 ± 30.5 µm respectively. There was a significant positive correlation between AS-OCT and USP (Pearson correlation = 0.957, p device, and USP. Mean CCT among USP, Pentacam and AS-OCT were comparable and had significant linear correlations. In clinical practice, these three modalities could be interchangeable in healthy patients.

  18. Metaherpetic corneal disease in a dog associated with partial limbal stem cell deficiency and neurotrophic keratitis.

    Science.gov (United States)

    Ledbetter, Eric C; Marfurt, Carl F; Dubielzig, Richard R

    2013-07-01

    To describe clinical, in vivo confocal microscopic, histopathologic, and immunohistochemical features of a dog with metaherpetic corneal disease that developed subsequent to a protracted episode of canine herpesvirus-1 (CHV-1) dendritic ulcerative keratitis. A 7-year-old, spayed-female, Miniature Schnauzer was treated for bilateral CHV-1 dendritic ulcerative keratitis. Following resolution of ulcerative keratitis, sectoral peripheral superficial corneal gray opacification, vascularization, and pigmentation slowly migrated centripetally to the axial cornea of both eyes. Corneal sensitivity measured with a Cochet-Bonnet esthesiometer was dramatically and persistently reduced. In vivo corneal confocal microscopic examination revealed regions of epithelium with a conjunctival phenotype. In these areas, the surface epithelium was thin, disorganized, and composed of hyper-reflective epithelial cells. Goblet cells and Langerhans cells were frequent, and the subbasal nerve plexus was completely absent or markedly diminished. Histopathologic abnormalities in the globes were restricted to the superficial cornea and included sectoral corneal conjunctivalization, increased anterior stromal spindle cells, and vascularization. Immunohistochemical evaluation of the corneas with anti-neurotublin antibody demonstrated attenuation of the epithelial and subbasal nerve plexuses with marked stromal hyperinnervation and increased numbers of morphologically abnormal neurites. Similar to herpes simplex virus keratitis in humans, CHV-1 ulcerative keratitis may be associated with the development of chronic degenerative corneal disease in dogs. In the described dog, this chronic corneal disease included progressive corneal opacification because of partial limbal stem cell deficiency and neurotrophic keratitis. Long-term monitoring of dogs following resolution of active CHV-1 keratitis may be indicated, particularly when ulcerations persist for an extended period. © 2012 American College of

  19. Extended latanoprost release from commercial contact lenses: in vitro studies using corneal models.

    Directory of Open Access Journals (Sweden)

    Saman Mohammadi

    Full Text Available In this study, we compared, for the first time, the release of a 432 kDa prostaglandin F2a analogue drug, Latanoprost, from commercially available contact lenses using in vitro models with corneal epithelial cells. Conventional polyHEMA-based and silicone hydrogel soft contact lenses were soaked in drug solution (131 μg = ml solution in phosphate buffered saline. The drug release from the contact lens material and its diffusion through three in vitro models was studied. The three in vitro models consisted of a polyethylene terephthalate (PET membrane without corneal epithelial cells, a PET membrane with a monolayer of human corneal epithelial cells (HCEC, and a PET membrane with stratified HCEC. In the cell-based in vitro corneal epithelium models, a zero order release was obtained with the silicone hydrogel materials (linear for the duration of the experiment whereby, after 48 hours, between 4 to 6 μg of latanoprost (an amount well within the range of the prescribed daily dose for glaucoma patients was released. In the absence of cells, a significantly lower amount of drug, between 0.3 to 0.5 μg, was released, (p <0:001. The difference observed in release from the hydrogel lens materials in the presence and absence of cells emphasizes the importance of using an in vitro corneal model that is more representative of the physiological conditions in the eye to more adequately characterize ophthalmic drug delivery materials. Our results demonstrate how in vitro models with corneal epithelial cells may allow better prediction of in vivo release. It also highlights the potential of drug-soaked silicone hydrogel contact lens materials for drug delivery purposes.

  20. Proton nuclear magnetic resonance study on the barrier function of pig corneal epithelium and endothelium

    International Nuclear Information System (INIS)

    Yokoi, Norihiko; Kinoshita, Shigeru; Morimoto, Taketoshi; Yoshizaki, Kazuo.

    1995-01-01

    Using gadolinium diethylenetriaminepentaacetic acid (Gd-DTPA) as a tracer, the barrier function of the corneal epithelium and endothelium was evaluated by proton nuclear magnetic resonance. Whole pig eyes and cornea excised with scleral rim, which had been incubated in dextran-added Gd-DTPA solution, were subjected to T 1 relaxation measurement and magnetic resonance imaging (MRI). After incubation, the T 1 relaxation rate (1/T 1 ) of the excised cornea increased to a steady value, whereas that of the cornea from the whole eye increased only slightly. These results indicated that the increase in the T 1 relaxation rate of the excised cornea was attributable to Gd-DTPA penetration from the corneal endothelium and that the corneal epithelium exhibited a strong barrier function against Gd-DTPA entry. The MRI study also confirmed the strong barrier, enhanced signals being detected within the aqueous fluid in the T 1 -weighted image only when the corneal epithelium was abraded. Since Gd-DTPA scarcely penetrates the intact corneal epithelium, Gd-DTPA-enhanced MRI shows potential as a quantitative tracer in evaluating epithelial barrier disruption. (author)

  1. Protective effects of trehalose on the corneal epithelial cells.

    Science.gov (United States)

    Aragona, Pasquale; Colosi, Pietro; Rania, Laura; Colosi, Francesca; Pisani, Antonina; Puzzolo, Domenico; Micali, Antonio

    2014-01-01

    Aim of the present work was to evaluate the effects of the trehalose on the corneal epithelium undergoing alcohol delamination. Twelve patients undergoing laser subepithelial keratomileusis (LASEK) were consecutively included in the study. The right eyes were pretreated with 3% trehalose eye drops, whilst left eyes were used as control. Epithelial specimens were processed for cells vitality assessment, apoptosis, and light and transmission electron microscopy; a morphometric analysis was performed in both groups. In both trehalose-untreated eyes (TUE) and trehalose-treated eyes (TTE), the percentage of vital cells was similar and no apoptotic cells were observed. In TUE, the corneal epithelium showed superficial cells with reduced microfolds, wing cells with vesicles and dilated intercellular spaces, and dark basal cells with vesicles and wide clefts. In TTE, superficial and wing cells were better preserved, and basal cells were generally clear with intracytoplasmatic vesicles. The morphometric analysis showed statistically significant differences between the two groups: the TTE epithelial height was higher, the basal cells showed larger area and clearer cytoplasm. The distribution of desmosomes and hemidesmosomes was significantly different between the groups. Trehalose administration better preserved morphological and morphometric features of alcohol-treated corneal epithelium, when compared to controls.

  2. Tectonic DSAEK for the Management of Impending Corneal Perforation

    Directory of Open Access Journals (Sweden)

    Enrique O. Graue-Hernandez

    2012-01-01

    Full Text Available Purpose. To report a case of severe corneal thinning secondary to dry eye treated with a tectonic Descemet stripping automated lamellar keratoplasty (DSAEK and amniotic membrane graft. Methods. A 72-year-old man with a history of long standing diabetes mellitus type 2 and dry eye presented with 80% corneal thinning and edema on the right eye and no signs of infectious disease, initially managed with topical unpreserved lubrication and 20% autologous serum drops. Eight weeks after, the defect advanced in size and depth until Descemetocele was formed. Thereafter, he underwent DSAEK for tectonic purposes. One month after the procedure, the posterior lamellar graft was well adhered but a 4 mm epithelial defect was still present. A multilayered amniotic membrane graft was then performed. Results. Ocular surface healed quickly and reepithelization occurred over a 2-week period. Eight months after, the ocular surface remained stable and structurally adequate. Conclusion. Tectonic DSAEK in conjunction with multilayered amniotic graft may not only provide structural support and avoid corneal perforation, but may also promote reepithelization and ocular surface healing and decrease concomitant inflammation.

  3. Corneal clarity measurements in healthy volunteers across different age groups: Observational study.

    Science.gov (United States)

    Alzahrani, Khaled; Carley, Fiona; Brahma, Arun; Morley, Debbie; Hillarby, M Chantal

    2017-11-01

    The aim of this study was to standardize and investigate the changes in corneal clarity with age. Densitometry software for the Oculus Pentacam was used to examine corneal clarity at different age groups.A total of 192 eyes from 97 healthy participants were included in this cohort comparative nonrandomized, cross-sectional study. An Oculus Pentcam was used to image the cornea of healthy participants grouped by age (between 10 and 70 years old). Data from the densitometry output have been used to determine clarity in concentric zones and different depths of the cornea.Corneal densitometry (CD) across all ages showed significant differences between groups when divided into the following layers: anterior, central, and posterior or divided into 0 to 2, 2 to 6, and 6 to 10 mm concentric zones (P age in all 3 layers of the periphery (6-10 mm) (P age group had lower clarity than the 20 to 30-age group (P age is differed when the cornea is divided into layers and zones. This study suggests that there are other factors that may play an essential role in corneal clarity as well as age.

  4. Corneal Aberrations in Former Preterm Infants: Results From The Wiesbaden Prematurity Study.

    Science.gov (United States)

    Fieß, Achim; Schuster, Alexander K; Kölb-Keerl, Ruth; Knuf, Markus; Kirchhof, Bernd; Muether, Philipp S; Bauer, Jacqueline

    2017-12-01

    To compare corneal aberrations in former preterm infants to that of full-term infants. A prospective cross-sectional study was carried out measuring the corneal shape with Scheimpflug imaging in former preterm infants of gestational age (GA) ≤32 weeks and full-term infants with GA ≥37 weeks now being aged between 4 to 10 years. The main outcome measures were corneal aberrations including astigmatism (Zernike: Z2-2; Z22), coma (Z3-1; Z31), trefoil (Z3-3; Z33), spherical aberration (Z40) and root-mean square of higher-order aberrations (RMS HOA). Multivariable analysis was performed to assess independent associations of gestational age groups and of retinopathy of prematurity (ROP) occurrence with corneal aberrations adjusting for sex and age at examination. A total of 259 former full-term and 226 preterm infants with a mean age of 7.2 ± 2.0 years were included in this study. Statistical analysis revealed an association of extreme prematurity (GA ≤28 weeks) with higher-order and lower-order aberrations of the total cornea. Vertical coma was higher in extreme prematurity (P prematurity rather than with ROP occurrence.

  5. The effects of topical diclofenac, topical flurbiprofen, and humidity on corneal sensitivity in normal dogs.

    Science.gov (United States)

    Dorbandt, Daniel M; Labelle, Amber L; Mitchell, Mark A; Hamor, Ralph E

    2017-03-01

    To determine the immediate and chronic effects of topical 0.1% diclofenac and 0.03% flurbiprofen on corneal sensitivity in normal canine eyes. Eighteen normal, nonbrachycephalic dogs. A prospective, randomized, masked, crossover study was performed. To determine the immediate effects associated with treatment, the study drug was instilled into the eye every 5 min for five doses, and corneal sensitivity of treated and untreated eyes was obtained prior to treatment and every 15 min post-treatment for 60 min. To determine the chronic effects, the study drug was instilled every 12 h for 30 days, and corneal sensitivity of treated and untreated eyes was obtained prior to treatment on days 0 and 30. A washout period of at least 30 days occurred between drug crossover. Ambient temperature and humidity were measured throughout the study. After multiple instillations, there was no difference in corneal sensitivity between eyes over time for diclofenac (P = 0.67) or flurbiprofen (P = 0.54), with a median sensitivity of 25 mm (1.8 g/mm 2 ). After chronic dosing, there was no difference in corneal sensitivity between eyes over time for diclofenac (P = 0.82) or flurbiprofen (P = 0.56), with a median sensitivity of 35 mm (1.0 g/mm 2 ). Decreasing ambient humidity was associated with an increase in sensitivity measurements (P = 0.0001). Neither diclofenac nor flurbiprofen had an effect on corneal sensitivity after multiple-drops or twice-daily dosing for 30 days. Ambient humidity may have an effect on corneal sensitivity measurements, with a longer filament length eliciting a blink response at lower humidity. © 2016 American College of Veterinary Ophthalmologists.

  6. Mutations in LOXHD1, a Recessive-Deafness Locus, Cause Dominant Late-Onset Fuchs Corneal Dystrophy

    Science.gov (United States)

    Riazuddin, S. Amer; Parker, David S.; McGlumphy, Elyse J.; Oh, Edwin C.; Iliff, Benjamin W.; Schmedt, Thore; Jurkunas, Ula; Schleif, Robert; Katsanis, Nicholas; Gottsch, John D.

    2012-01-01

    Fuchs corneal dystrophy (FCD) is a genetic disorder of the corneal endothelium and is the most common cause of corneal transplantation in the United States. Previously, we mapped a late-onset FCD locus, FCD2, on chromosome 18q. Here, we present next-generation sequencing of all coding exons in the FCD2 critical interval in a multigenerational pedigree in which FCD segregates as an autosomal-dominant trait. We identified a missense change in LOXHD1, a gene causing progressive hearing loss in humans, as the sole variant capable of explaining the phenotype in this pedigree. We observed LOXHD1 mRNA in cultured human corneal endothelial cells, whereas antibody staining of both human and mouse corneas showed staining in the corneal epithelium and endothelium. Corneal sections of the original proband were stained for LOXHD1 and demonstrated a distinct increase in antibody punctate staining in the endothelium and Descemet membrane; punctate staining was absent from both normal corneas and FCD corneas negative for causal LOXHD1 mutations. Subsequent interrogation of a cohort of >200 sporadic affected individuals identified another 15 heterozygous missense mutations that were absent from >800 control chromosomes. Furthermore, in silico analyses predicted that these mutations reside on the surface of the protein and are likely to affect the protein's interface and protein-protein interactions. Finally, expression of the familial LOXHD1 mutant allele as well as two sporadic mutations in cells revealed prominent cytoplasmic aggregates reminiscent of the corneal phenotype. All together, our data implicate rare alleles in LOXHD1 in the pathogenesis of FCD and highlight how different mutations in the same locus can potentially produce diverse phenotypes. PMID:22341973

  7. Aloe vera: an in vitro study of effects on corneal wound closure and collagenase activity.

    Science.gov (United States)

    Curto, Elizabeth M; Labelle, Amber; Chandler, Heather L

    2014-11-01

    To evaluate the in vitro effects of an aloe vera solution on (i) the viability and wound healing response of corneal cells and (ii) the ability to alter collagenase and gelatinase activities. Primary cultures of corneal epithelial cells and fibroblasts were prepared from grossly normal enucleated canine globes and treated with an aloe solution (doses ranging from 0.0-2 mg/mL). Cellular viability was evaluated using a colorimetric assay. A corneal wound healing model was used to quantify cellular ingrowth across a defect made on the confluent surface. Anticollagenase and antigelatinase activities were evaluated by incubating a bacterial collagenase/gelatinase with aloe solution (doses ranging from 0.0-500 μg/mL) and comparing outcome measures to a general metalloproteinase inhibitor, 1, 10-phenanthroline, and canine serum (doses ranging from 0.0-100%). None of the concentrations of aloe solution tested significantly affected the viability of corneal epithelial cells or fibroblasts. Concentrations ≤175 μg/mL slightly accelerated corneal epithelial cell wound closure; this change was not significant. Concentrations ≥175 μg/mL significantly (P ≤ 0.001) slowed the rate of corneal fibroblast wound closure, while aloe concentrations Aloe solution did not alter the ability for collagenase to degrade gelatin or collagen Type I but increased the ability for collagenase to degrade Type IV collagen. Although additional experiments are required, lower concentrations of aloe solution may be beneficial in healing of superficial corneal wounds to help decrease fibrosis and speed epithelialization. An increase in collagenase activity with aloe vera warrants further testing before considering in vivo studies. © 2014 American College of Veterinary Ophthalmologists.

  8. Quantitative analysis of corneal stromal riboflavin concentration without epithelial removal.

    Science.gov (United States)

    Rubinfeld, Roy S; Stulting, R Doyle; Gum, Glenwood G; Talamo, Jonathan H

    2018-02-01

    To compare the corneal stromal riboflavin concentration and distribution using 2 transepithelial corneal crosslinking (CXL) systems. Absorption Systems, San Diego, California, USA. Experimental study. The stromal riboflavin concentration of 2 transepithelial CXL systems was compared in rabbit eyes in vivo. The systems were the Paracel/Vibex Xtra, comprising riboflavin 0.25% solution containing TRIS and ethylenediaminetetraacetic acid and an isotonic solution of riboflavin 0.25%, (Group 1) and the CXLO system (Group 2). Manufacturers' Instructions For Use were followed. The intensity of riboflavin fluorescence by slitlamp observation 10, 15, and 20 minutes after instillation was graded on a scale of 0 to 5. The animals were humanely killed and the corneal stromal samples analyzed with liquid chromatography and mass spectrometry. The mean riboflavin fluorescence intensity grades in Group 1 (4 eyes) were 3.8, 4.8, and 4.8 at 10, 15, and 20 minutes, respectively. The mean grades in Group 2 (3 eyes) were 2.0, 2.3, and 2.0, respectively. The riboflavin distribution was uniform in Group 1 but not in Group 2. The mean riboflavin concentration by liquid chromatography and mass spectrometry was 27.0 μg/g stromal tissue in Group 1 and 6.7 μg/g in Group 2. A stromal riboflavin concentration theoretically adequate for CXL, 15 μg/g, was achieved in all eyes in Group 1 and no eyes in Group 2. Slitlamp grading correlated well with liquid chromatography and mass spectrometry concentration (R 2  = 0.940). The system used in Group 1 produced corneal riboflavin concentrations that were theoretically adequate for effective transepithelial CXL (≥15 μg/g), while the system in Group 2 did not. Slitlamp grading successfully estimated the corneal riboflavin concentration and can be used to ensure an adequate concentration of riboflavin in the cornea for transepithelial CXL. Copyright © 2018 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  9. Improved sampling and analysis of images in corneal confocal microscopy.

    Science.gov (United States)

    Schaldemose, E L; Fontain, F I; Karlsson, P; Nyengaard, J R

    2017-10-01

    Corneal confocal microscopy (CCM) is a noninvasive clinical method to analyse and quantify corneal nerve fibres in vivo. Although the CCM technique is in constant progress, there are methodological limitations in terms of sampling of images and objectivity of the nerve quantification. The aim of this study was to present a randomized sampling method of the CCM images and to develop an adjusted area-dependent image analysis. Furthermore, a manual nerve fibre analysis method was compared to a fully automated method. 23 idiopathic small-fibre neuropathy patients were investigated using CCM. Corneal nerve fibre length density (CNFL) and corneal nerve fibre branch density (CNBD) were determined in both a manual and automatic manner. Differences in CNFL and CNBD between (1) the randomized and the most common sampling method, (2) the adjusted and the unadjusted area and (3) the manual and automated quantification method were investigated. The CNFL values were significantly lower when using the randomized sampling method compared to the most common method (p = 0.01). There was not a statistical significant difference in the CNBD values between the randomized and the most common sampling method (p = 0.85). CNFL and CNBD values were increased when using the adjusted area compared to the standard area. Additionally, the study found a significant increase in the CNFL and CNBD values when using the manual method compared to the automatic method (p ≤ 0.001). The study demonstrated a significant difference in the CNFL values between the randomized and common sampling method indicating the importance of clear guidelines for the image sampling. The increase in CNFL and CNBD values when using the adjusted cornea area is not surprising. The observed increases in both CNFL and CNBD values when using the manual method of nerve quantification compared to the automatic method are consistent with earlier findings. This study underlines the importance of improving the analysis of the

  10. The potential role of bioengineering and three-dimensional printing in curing global corneal blindness.

    Science.gov (United States)

    Ludwig, Parker E; Huff, Trevor J; Zuniga, Jorge M

    2018-01-01

    An insufficiency of accessible allograft tissue for corneal transplantation leaves many impaired by untreated corneal disease. There is promise in the field of regenerative medicine for the development of autologous corneal tissue grafts or collagen-based scaffolds. Another approach is to create a suitable corneal implant that meets the refractive needs of the cornea and is integrated into the surrounding tissue but does not attempt to perfectly mimic the native cornea on a cellular level. Materials that have been investigated for use in the latter concept include natural polymers such as gelatin, semisynthetic polymers like gelatin methacrylate, and synthetic polymers. There are advantages and disadvantages inherent in natural and synthetic polymers: natural polymers are generally more biodegradable and biocompatible, while synthetic polymers typically provide greater control over the characteristics or property adjustment of the materials. Additive manufacturing could aid in the precision production of keratoprostheses and the personalization of implants.

  11. 14-3-3{sigma} controls corneal epithelial cell proliferation and differentiation through the Notch signaling pathway

    Energy Technology Data Exchange (ETDEWEB)

    Xin, Ying [Stem Cell Institute, James Brown Cancer Center, University of Louisville School of Medicine, 301 E. Muhammad Ali Blvd., Louisville, KY 40202 (United States); Department of Ophthalmology and Visual Sciences, University of Louisville School of Medicine, 301 E. Muhammad Ali Blvd., Louisville, KY 40202 (United States); Lu, Qingxian [Tumor Immunobiology Group, James Brown Cancer Center, University of Louisville School of Medicine, 301 E. Muhammad Ali Blvd., Louisville, KY 40202 (United States); Department of Ophthalmology and Visual Sciences, University of Louisville School of Medicine, 301 E. Muhammad Ali Blvd., Louisville, KY 40202 (United States); Department of Biochemistry and Molecular Biology, University of Louisville School of Medicine, 301 E. Muhammad Ali Blvd., Louisville, KY 40202 (United States); Li, Qiutang, E-mail: q.li@louisville.edu [Stem Cell Institute, James Brown Cancer Center, University of Louisville School of Medicine, 301 E. Muhammad Ali Blvd., Louisville, KY 40202 (United States); Department of Ophthalmology and Visual Sciences, University of Louisville School of Medicine, 301 E. Muhammad Ali Blvd., Louisville, KY 40202 (United States)

    2010-02-19

    14-3-3{sigma} (also called stratifin) is specifically expressed in the stratified squamous epithelium and its function was recently shown to be linked to epidermal stratification and differentiation in the skin. In this study, we investigated its role in corneal epithelium cell proliferation and differentiation. We showed that the 14-3-3{sigma} mutation in repeated epilation (Er) mutant mice results in a dominant negative truncated protein. Primary corneal epithelial cells expressing the dominant negative protein failed to undergo high calcium-induced cell cycle arrest and differentiation. We further demonstrated that blocking endogenous 14-3-3{sigma} activity in corneal epithelial cells by overexpressing dominative negative 14-3-3{sigma} led to reduced Notch activity and Notch1/2 transcription. Significantly, expression of the active Notch intracellular domain overcame the block in epithelial cell differentiation in 14-3-3{sigma} mutant-expressing corneal epithelial cells. We conclude that 14-3-3{sigma} is critical for regulating corneal epithelial proliferation and differentiation by regulating Notch signaling activity.

  12. 14-3-3σ controls corneal epithelial cell proliferation and differentiation through the Notch signaling pathway

    International Nuclear Information System (INIS)

    Xin, Ying; Lu, Qingxian; Li, Qiutang

    2010-01-01

    14-3-3σ (also called stratifin) is specifically expressed in the stratified squamous epithelium and its function was recently shown to be linked to epidermal stratification and differentiation in the skin. In this study, we investigated its role in corneal epithelium cell proliferation and differentiation. We showed that the 14-3-3σ mutation in repeated epilation (Er) mutant mice results in a dominant negative truncated protein. Primary corneal epithelial cells expressing the dominant negative protein failed to undergo high calcium-induced cell cycle arrest and differentiation. We further demonstrated that blocking endogenous 14-3-3σ activity in corneal epithelial cells by overexpressing dominative negative 14-3-3σ led to reduced Notch activity and Notch1/2 transcription. Significantly, expression of the active Notch intracellular domain overcame the block in epithelial cell differentiation in 14-3-3σ mutant-expressing corneal epithelial cells. We conclude that 14-3-3σ is critical for regulating corneal epithelial proliferation and differentiation by regulating Notch signaling activity.

  13. A Comparison of Different Corneal Iontophoresis Protocols for Promoting Transepithelial Riboflavin Penetration.

    Science.gov (United States)

    Gore, Daniel M; O'Brart, David P; French, Paul; Dunsby, Chris; Allan, Bruce D

    2015-12-01

    To measure corneal riboflavin penetration using different transepithelial iontophoresis protocols. Freshly enucleated rabbit eyes were divided into nine treatment groups of 4 eyes. One group, in which 0.1% wt/vol riboflavin was applied for 30 minutes without iontophoresis after corneal epithelial debridement, acted as a control. The remaining groups were treated with an intact epithelium using different riboflavin formulations and varying iontophoresis current, soak, and rinse times. After riboflavin application, eyes were snap frozen in liquid nitrogen. Corneal cross sections 35 μm thick were then imaged immediately by two-photon fluorescence microscopy, using image processing software to quantify stromal riboflavin concentration at different corneal depths. In the epithelium-on iontophoresis treatment groups, greater stromal riboflavin penetration was achieved with higher-concentration riboflavin solutions, greater iontophoresis dosage, and longer solution contact times. A protocol utilizing 0.25% wt/vol riboflavin with benzalkonium chloride (BAC) 0.01% and two cycles of applied current and subsequent soaking (1 mA 5 minutes, soak 5 minutes; 0.5 mA 5 minutes, soak 5 minutes) achieved similar stromal riboflavin penetration to epithelium-off controls. The best-performing non-BAC-containing protocol produced stromal riboflavin penetration approximately 60% that of epithelium-off controls. Riboflavin solutions containing saline resulted in minimal stromal penetration. Riboflavin loading within the epithelium was equivalent to or higher than that in the subjacent stroma, despite rinsing the ocular surface with balanced salt solution. Modified iontophoresis protocols can significantly improve transepithelial riboflavin penetration in experimental corneal collagen cross-linking.

  14. Biomechanical corneal changes induced by different flap thickness created by femtosecond laser

    Directory of Open Access Journals (Sweden)

    Fabricio W. Medeiros

    2011-01-01

    Full Text Available OBJECTIVE: To evaluate the impact of the creation of corneal flaps at different thicknesses on the biomechanical properties of swine corneas. METHOD: Twelve swine eyes were obtained to form two groups: 100 μm flap thickness and 300 μm flap thickness. Each eye was submitted to the following examinations: raster topography to investigate corneal curvature alterations, ocular response analyzer to investigate corneal hysteresis change, optical coherence tomography to measure central corneal and flap thickness and sonic wave propagation velocity as a measure of stiffness, before and immediately after flap creation. After flap amputation, surface wave velocity measurements were repeated. RESULTS: Measured flap thicknesses were statistically different for thin and thick flap groups, with an average of 108.5 + 6.9 and 307.8 + 11.5 μm respectively. Hysteresis and corneal resistance factor did not change significantly after flap creation in the thin flap group. With thicker flaps, both parameters decreased significantly from 8.0 +1.0 to 5.1 +1.5 mmHg and from 8.2 + 1.6 to 4.1 +2.5 mmHg respectively. Simulated keratometry values increased in the thick flap group (from 39.5 + 1 D to 45.9+1.2 D after flap creation but not in the thin flap group (from 40.6 + 0.6 D to 41.4+ 1.0 D. Regarding surface wave velocity analysis, the surgical procedures induced statistically lower results in some positions. CONCLUSION: In the experimental conditions established by this model, thicker flaps presented a greater biomechanical impact on the cornea.

  15. Repeatability of central corneal thickness measurement with the Pentacam HR system

    Directory of Open Access Journals (Sweden)

    Ruiz Simonato Alonso

    2012-02-01

    Full Text Available PURPOSE: To assess the repeatability of central corneal thickness measurement at the geometrical center (Central Corneal Thickness - CCT given by the Pentacam High Resolution (HR Comprehensive Eye Scanner (Oculus, Wetzlar, Germany over time. METHODS: Prospective, single center, observational study. Two separate CCT measurements were taken by the Pentacam corneal tomography exam (CTm 3 to 12 months apart, and compared. RESULTS: One hundred and sixteen eyes (n=116 of 62 health patients were included in this study. Average CCT in first and last visits was 541.6±37 µm and 543.6±36.9 µm respectively. Mean difference between both measurements was 9.2±6.4 µm, and there was no statistically significant difference in CCT measurement between visits, with good correlation between them (P = 0.057, r² = 0,9209. CONCLUSION: Pentacam (HR CTm gives repeatable CCT measurements over time.

  16. Methods Development for the Isolation and Culture of Primary Corneal Endothelial Cells

    Science.gov (United States)

    2017-02-01

    a cell population particularly suitable for low serum propagation, provided that appropriate growth factors are available. A low serum medium...of MGK. 15. SUBJECT TERMS Cornea, chemical warfare agent, corneal endothelial cell, endothelium, growth , isolation, mouse, rabbit, porcine, in...with corneal SM exposure.2 A primary requirement in achieving this goal is to develop methods that enable the isolation of a pure CEC population and

  17. Ex vivo expansion of bovine corneal endothelial cells in xeno-free medium supplemented with platelet releasate.

    Directory of Open Access Journals (Sweden)

    Ming-Li Chou

    Full Text Available Clinical-grade ex vivo expansion of corneal endothelial cells can increase the availability of corneal tissues for transplantation and treatment of corneal blindness. However, these cells have very limited proliferative capacity. Successful propagation has required so far to use very complex growth media supplemented with fetal bovine serum and other xenocomponents. We hypothesized that human platelet releasates rich in multiple growth factors, and in particular neurotrophins, could potentially be a useful supplement for ex vivo expansion of corneal endothelium cells due to their neural crest origin. Platelet releasates were prepared by calcium salt activation of apheresis platelet concentrates, subjected or not to complement inactivation by heat treatment at 56°C for 30 minutes. Platelet releasates were characterized for their content in proteins and were found to contain high amount of growth factors including platelet-derived growth factor-AB (30.56 to 39.08 ng/ml and brain-derived neurotrophic factor (30.57 to 37.11 ng/ml neurotrophins. We compared the growth and viability of corneal endothelium cells in DMEM-F12 medium supplemented with different combinations of components, including 2.5%∼10% of the platelet releasates. Corneal endothelium cells expanded in platelet releasates exhibited good adhesion and a typical hexagonal morphology. Their growth and viability were enhanced when using the complement-inactivated platelet releasate at a concentration of 10%. Immunostaining and Western blots showed that CECs maintained the expressions of four important membrane markers: Na-K ATPase α1, zona occludens-1, phospho-connexin 43 and N-cadherin. In conclusion, our study provides the first proof-of-concept that human platelet releasates can be used for ex vivo expansion of corneal endothelium cells. These findings open a new paradigm for ex vivo propagation protocols of corneal endothelium cells in compliance with good tissue culture practices

  18. Overnight corneal swelling with high and low powered silicone hydrogel lenses.

    Science.gov (United States)

    Moezzi, Amir M; Fonn, Desmond; Varikooty, Jalaiah; Simpson, Trefford L

    2015-01-01

    To compare central corneal swelling after eight hours of sleep in eyes wearing four different silicone hydrogel lenses with three different powers. Twenty-nine neophyte subjects wore lotrafilcon A (Dk, 140), balafilcon A (Dk, 91), galyfilcon A (Dk, 60) and senofilcon A (Dk, 103) lenses in powers -3.00, -10.00 and +6.00 D on separate nights, in random order, and on one eye only. The contra-lateral eye (no lens) served as the control. Central corneal thickness was measured using a digital optical pachometer before lens insertion and immediately after lens removal on waking. For the +6.00 D and -10.00 D, lotrafilcon A induced the least swelling and galyfilcon A the most. The +6.00 D power, averaged across lens materials, induced significantly greater central swelling than the -10.00 and -3.00 D (Re-ANOVA, p<0.001), (7.7±2.9% vs. 6.8±2.8% and 6.5±2.5% respectively) but there was no difference between -10.00 and -3.00 D. Averaged for power, lotrafilcon A induced the least (6.2±2.8%) and galyfilcon A the most (7.6±3.0%) swelling at the center (Re-ANOVA, p<0.001). Central corneal swelling with +6.00 D was significantly greater than -10.00 D lens power despite similar levels of average lens transmissibility of these two lens powers. The differences in corneal swelling of the lens wearing eyes are consistent with the differences in oxygen transmission of the silicone hydrogel lenses. In silicone hydrogel lenses central corneal swelling is mainly driven by central lens oxygen transmissibility. Copyright © 2013 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

  19. Evaluation of intracameral injection of ranibizumab and bevacizumab on the corneal endothelium by scanning electron microscopy.

    Science.gov (United States)

    Ari, Seyhmus; Nergiz, Yusuf; Aksit, Ihsan; Sahin, Alparslan; Cingu, Kursat; Caca, Ihsan

    2015-03-01

    To evaluate the effects of intracameral injection of ranibizumab and bevacizumab on the corneal endothelium by scanning electron microscopy (SEM). Twenty-eight female rabbits were randomly divided into four equal groups. Rabbits in groups 1 and 2 underwent intracameral injection of 1 mg/0.1 mL and 0.5 mg/0.05 mL ranibizumab, respectively; group 3 was injected with 1.25 mg/0.05 mL bevacizumab. All three groups were injected with a balanced salt solution (BSS) into the anterior chamber of the left (fellow) eye. None of the rabbits in group 4 underwent an injection. Corneal thickness and intraocular pressure were measured before the injections, on the first day, and in the first month after injection. The rabbits were sacrificed and corneal tissues were excised in the first month after injection. Specular microscopy was used for the corneal endothelial cell count. Endothelial cell density was assessed and comparisons drawn between the groups and the control. Micrographs were recorded for SEM examination. The structure of the corneal endothelial cells, the junctional area of the cell membrane, the distribution of microvillus, and the cell morphology of the eyes that underwent intracameral injection of vascular endothelial growth factor (VEGF), BSS, and the control group were compared. Corneal thickness and intraocular pressure were not significantly different between the groups that underwent anti-VEGF or BSS injection and the control group on the first day and in the first month of injection. The corneal endothelial cell count was significantly diminished in all three groups; predominantly in group 1 and 2 (P<0.05). The SEM examination revealed normal corneal endothelial histology in group 3 and the control group. Eyes in group 1 exhibited indistinctness of corneal endothelial cell borders, microvillus loss in the luminal surface, excessive blebbing, and disintegration of intercellular junctions. In group 2, the cell structure of the corneal endothelium

  20. Recent advances in corneal collagen cross-linking

    Directory of Open Access Journals (Sweden)

    Gitansha Shreyas Sachdev

    2017-01-01

    Full Text Available Corneal collagen cross-linking has become the preferred modality of treatment for corneal ectasia since its inception in late 1990s. Numerous studies have demonstrated the safety and efficacy of the conventional protocol. Our understanding of the cross-linking process is ever evolving, with its wide implications in the form of accelerated and pulsed protocols. Newer advancements in technology include various riboflavin formulations and the ability to deliver higher fluence protocols with customised irradiation patterns. A greater degree of customisation is likely the path forward, which will aim at achieving refractive improvements along with disease stability. The use of cross-linking for myopic correction is another avenue under exploration. Combination of half fluence cross-linking with refractive correction for high errors to prevent post LASIK regression is gaining interest. This review aims to highlight the various advancements in the cross-linking technology and its clinical applications.

  1. Role of Corneal Stromal Cells on Epithelial Cell Function during Wound Healing

    Directory of Open Access Journals (Sweden)

    Bhavani S. Kowtharapu

    2018-02-01

    Full Text Available Following injury, corneal stromal keratocytes transform into repair-phenotype of activated stromal fibroblasts (SFs and participate in wound repair. Simultaneously, ongoing bi-directional communications between corneal stromal-epithelial cells also play a vital role in mediating the process of wound healing. Factors produced by stromal cells are known to induce proliferation, differentiation, and motility of corneal epithelial cells, which are also subsequently the main processes that occur during wound healing. In this context, the present study aims to investigate the effect of SFs conditioned medium (SFCM on corneal epithelial cell function along with substance P (SP. Antibody microarrays were employed to profile differentially expressed cell surface markers and cytokines in the presence of SFCM and SP. Antibody microarray data revealed enhanced expression of the ITGB1 in corneal epithelial cells following stimulation with SP whereas SFCM induced abundant expression of IL-8, ITGB1, PD1L1, PECA1, IL-15, BDNF, ICAM1, CD8A, CD44 and NTF4. All these proteins have either direct or indirect roles in epithelial cell growth, movement and adhesion related signaling cascades during tissue regeneration. We also observed activation of MAPK signaling pathway along with increased expression of focal adhesion kinase (FAK, paxillin, vimentin, β-catenin and vasodilator-stimulated phosphoprotein (VASP phosphorylation. Additionally, epithelial-to-mesenchymal transition (EMT regulating transcription factors Slug and ZEB1 expression were enhanced in the presence of SFCM. SP enriched the expression of integrin subunits α4, α5, αV, β1 and β3 whereas SFCM increased α4, α5, αV, β1 and β5 integrin subunits. We also observed increased expression of Serpin E1 following SP and SFCM treatment. Wound healing scratch assay revealed enhanced migration of epithelial cells following the addition of SFCM. Taken together, we conclude that SFCM-mediated sustained

  2. Ultrastructural analysis of corneal exposure to UV radiation

    Energy Technology Data Exchange (ETDEWEB)

    Pitts, D.G.; Bergmanson, J.P.G.; Chu, L.W.-F.

    1987-01-01

    The primate cornea was exposed to 300 nm UVR with five levels of radiant expsure from 0.08 to 0.6 Jcm/sup -2/. All cellular layers of the cornea were damaged at the 0.08 Jcm/sup -2/ exposure, and damage became more severe as the exposure level was increased. The corneal cells showed variable response in that essentially normal cells were found among damaged cells. Eight days post-exposure using the 0.6 Jcm/sup -2/ level, the epithelium had regained its normal thickness and was populated largely by normal appearing cells; however, the stroma showed damaged keratocytes and the loss of keratocytes. The corneal basement membranes (the epithelial basement membrane and the posterior limiting lamina) and the anterior limiting lamina were not damaged at any exposure level except for an isolated area along the epithelial basement membrane in one cornea. Therefore, one is lead to conclude that basement membranes are unaffected by UVR. The endothelium continued to demonstrate the loss of mitochondria, endoplasmic reticulum and some vacuoles at 8 days after exposure. However, the endothelium appeared to have resumed its physiological function as demonstrated by the reduced stromal oedema. This research gives the first complete description of UV-B induced corneal damage and repair of the full, in-depth cornea of the primate using the EM.

  3. Ultrastructural analysis of corneal exposure to UV radiation

    International Nuclear Information System (INIS)

    Pitts, D.G.; Bergmanson, J.P.G.; Chu, L. W-F.

    1987-01-01

    The primate cornea was exposed to 300 nm UVR with five levels of radiant expsure from 0.08 to 0.6 Jcm -2 . All cellular layers of the cornea were damaged at the 0.08 Jcm -2 exposure, and damage became more severe as the exposure level was increased. The corneal cells showed variable response in that essentially normal cells were found among damaged cells. Eight days post-exposure using the 0.6 Jcm -2 level, the epithelium had regained its normal thickness and was populated largely by normal appearing cells; however, the stroma showed damaged keratocytes and the loss of keratocytes. The corneal basement membranes (the epithelial basement membrane and the posterior limiting lamina) and the anterior limiting lamina were not damaged at any exposure level except for an isolated area along the epithelial basement membrane in one cornea. Therefore, one is lead to conclude that basement membranes are unaffected by UVR. The endothelium continued to demonstrate the loss of mitochondria, endoplasmic reticulum and some vacuoles at 8 days after exposure. However, the endothelium appeared to have resumed its physiological function as demonstrated by the reduced stromal oedema. This research gives the first complete description of UV-B induced corneal damage and repair of the full, in-depth cornea of the primate using the EM. (author)

  4. Corneal polarimetry after LASIK refractive surgery

    Science.gov (United States)

    Bueno, Juan M.; Berrio, Esther; Artal, Pablo

    2006-01-01

    Imaging polarimetry provides spatially resolved information on the polarization properties of a system. In the case of the living human eye, polarization could be related to the corneal biomechanical properties, which vary from the normal state as a result of surgery or pathologies. We have used an aberro-polariscope, which we recently developed, to determine and to compare the spatially resolved maps of polarization parameters across the pupil between normal healthy and post-LASIK eyes. The depolarization distribution is not uniform across the pupil, with post-surgery eyes presenting larger levels of depolarization. While retardation increases along the radius in normal eyes, this pattern becomes irregular after LASIK refractive surgery. The maps of slow axis also differ in normal and post-surgery eyes, with a larger disorder in post-LASIK eyes. Since these changes in polarization indicate subtle structural modifications of the cornea, this approach can be useful in a clinical environment to follow the biomechanical and optical changes of the cornea after refractive surgery or for the early diagnosis of different corneal pathologies.

  5. Mechanisms of superficial micropunctate corneal staining with sodium fluorescein: the contribution of pooling.

    Science.gov (United States)

    Bandamwar, Kalika L; Garrett, Qian; Papas, Eric B

    2012-04-01

    To establish if sodium fluorescein (SFL) dye accumulation within intercellular spaces on the ocular surface contributes to the appearance of superficial punctate corneal staining. Thirteen subjects bilaterally wore PureVision™ lenses that had been pre-soaked in ReNu MultiPlus® multipurpose solution. After 1h of lens wear, corneal staining with SFL was assessed using a standard slit-lamp technique. Participants who presented with bilateral, corneal staining were selected for further evaluation. A randomly selected eye was rinsed with saline three times. Fellow eyes (control) received no rinsing. After each rinse, the appearance of SFL staining was recorded without any further instillation of the dye. To eliminate any confounding effects of staining due to residual fluorescein in the tear menisci, corneal staining was induced in freshly excised, isolated, rabbit eyes by topical administration of 0.001% PHMB and staining, rinsing and grading were performed as above. Nine out of 13 subjects presented with bilateral diffuse corneal staining (mean grade±SD: 2.4±0.7). The mean staining grades in test and control eyes respectively after each of the three rinses were (1) 2.41±0.41, 2.25±0.69 (p=0.9); (2) 2.34±0.79, 2.1±0.83 (p=0.8); and (3) 1.71±0.65, 1.60±0.79 (p=0.6) there was no significant reduction in staining with rinsing (p>0.05) and no difference was observed between test and control eyes at any sampling-point. Similar observations made in ex vivo rabbit eyes replicated these results. Pooling or accumulation of SFL solution within intercellular spaces does not appear to contribute to the appearance of superficial micropunctate corneal staining. Copyright © 2011 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  6. A case of corneal cystinosis in a patient with rickets and chronic renal failure

    Directory of Open Access Journals (Sweden)

    Jae Yon Won

    2015-01-01

    Full Text Available A 22-year-old man diagnosed with nephropathic cystinosis at the age of 4 years was found to have progressive bilateral corneal crystal deposition. He presented with severe photophobia and decreased visual acuity. Ocular cystinosis was diagnosed on observing the typical crystals. Optical coherence tomography showed multiple areas of stromal hyperreflectivity due to crystal deposits within the corneal stroma. Ex vivo transmission electron microscopy of the cornea showed pathognomonic crystal deposits in corneal stromal keratocytes. Using polymerase chain reaction sequencing of the entire coding region, we identified five gene mutations, including two unreported mutations.

  7. Effects of ultraviolet irradiation on prostaglandin-E2 production by cultured corneal stromal cells

    International Nuclear Information System (INIS)

    Weinreb, R.N.; Yue, B.Y.J.T.; Peyman, G.A.

    1990-01-01

    The authors examined the effects of ultraviolet (UV) irradiation on the release of prostaglandin E 2 (PGE 2 ) by rabbit corneal stromal cells in culture. Considerable amounts of PGE 2 were present in the media of control corneal cultures following 1, 2, 4, 8 and 24 hr of incubation. Irradiation with UV-A (320-400 nm) for 30 min resulted in more than a 50% increase in PGE 2 release. Dexamethasone inhibited PGE 2 release by corneal stromal cells. It was, however, ineffective in protecting the cells from the UV-induced release of PGE 2 . (author)

  8. N-Isopropylacrylamide-co-glycidylmethacrylate as a Thermoresponsive Substrate for Corneal Endothelial Cell Sheet Engineering

    Directory of Open Access Journals (Sweden)

    Bernadette K. Madathil

    2014-01-01

    Full Text Available Endothelial keratoplasty is a recent shift in the surgical treatment of corneal endothelial dystrophies, where the dysfunctional endothelium is replaced whilst retaining the unaffected corneal layers. To overcome the limitation of donor corneal shortage, alternative use of tissue engineered constructs is being researched. Tissue constructs with intact extracellular matrix are generated using stimuli responsive polymers. In this study we evaluated the feasibility of using the thermoresponsive poly(N-isopropylacrylamide-co-glycidylmethacrylate polymer as a culture surface to harvest viable corneal endothelial cell sheets. Incubation below the lower critical solution temperature of the polymer allowed the detachment of the intact endothelial cell sheet. Phase contrast and scanning electron microscopy revealed the intact architecture, cobble stone morphology, and cell-to-cell contact in the retrieved cell sheet. Strong extracellular matrix deposition was also observed. The RT-PCR analysis confirmed functionally active endothelial cells in the cell sheet as evidenced by the positive expression of aquaporin 1, collagen IV, Na+-K+ ATPase, and FLK-1. Na+-K+ ATPase protein expression was also visualized by immunofluorescence staining. These results suggest that the in-house developed thermoresponsive culture dish is a suitable substrate for the generation of intact corneal endothelial cell sheet towards transplantation for endothelial keratoplasty.

  9. Investigation on fibrous collagen modifications during corneal laser welding by second harmonic generation microscopy

    Science.gov (United States)

    Matteini, Paolo; Ratto, Fulvio; Rossi, Francesca; Cicchi, Riccardo; Stringari, Chiara; Kapsokalyvas, Dimitrios; Pavone, Francesco S.; Pini, Roberto

    2009-02-01

    The structural modifications in the collagen lattice of corneal stroma induced by near-infrared laser welding were investigated with second-harmonic generation (SHG) imaging. The corneal laser welding procedure is performed by staining the wound edges with a saturated water solution of Indocyanine Green (ICG) followed by irradiation with a 810 nm diode laser operated in continuous (CWLW: continuous wave laser welding) or pulsed (PLW: pulsed laser welding) mode. Both these procedures can provide closure of corneal wounds by inducing different structural modifications in the extracellular matrix. SHG imaging of native corneal stroma revealed collagen bundles composed of many regularly aligned collagen fibrils. After CWLW the regular lamellar arrangement was lost; collagen bundles appeared densely packed with an increasing disordered arrangement toward the welded cut. The weld was characterized by a loss of details; nevertheless, the observation of the second harmonic signal at this site indicated the lack of collagen denaturation. By contrast, PLW mode produced welding spots at the interface between donor and recipient corneal layers, which were characterized by a severe loss of the SHG signal, suggesting the occurrence of a complete collagen denaturation. SHG imaging appeared to be a powerful tool for visualizing the supramolecular morphological modifications in the collagen matrix after laser welding.

  10. Correlating Corneal Biomechanics and Ocular Biometric Properties with Lamina Cribrosa Measurements in Healthy Subjects.

    Science.gov (United States)

    Pérez Bartolomé, Francisco; Martínez de la Casa, Jose María; Camacho Bosca, Irene; Sáenz-Francés, Federico; Aguilar Munoa, Soledad; Martín Juan, Alberto; Garcia-Feijoo, Julian

    2018-01-01

    To examine interrelations between corneal biomechanics, ocular biometric variables and optic disc size (ODS), lamina cribosa depth (LCD) or thickness (LCT) in a healthy population. In a cross-sectional case-control study, the following measurements were made in 81 eyes of 81 participants: axial length, anterior chamber depth, lens thickness, and central corneal thickness using the optical biometer Lenstar LS900; and corneal hysteresis (CH), corneal resistance factor (CRF), Goldman-correlated intraocular pressure (IOPg), and corneal-compensated IOP (IOPcc) using the Ocular Response Analyzer. Serial horizontal enhanced depth imaging optical coherence tomography (EDI OCT) B-scans of the optic nerve head were obtained in each participant. Mean ODS, mean LCD, and mean LCT were measured in 11 equally spaced horizontal B-scans, excluding the LC insertion area under Bruch's membrane and scleral rim. LCD was measured in 74 of 81 eyes (91.36%); LCT in 60/81 (75.3%); ODS in 81/81 (100%). CRF was poorly, but significantly, correlated with LCT (Pearson's R = 0.264; P = 0.045). IOPcc, IOPg, CH, and ocular biometrics variables were poorly (non-significantly) correlated with LCD, LCT, and ODS. CRF was poorly but directly correlated with LCT. No association was detected between CH or ocular biometric variables and ODS, LCD, or LCT.

  11. Changing indications and techniques for corneal transplantations at a tertiary referral center in Turkey, from 1995 to 2014

    Directory of Open Access Journals (Sweden)

    Altay Y

    2016-06-01

    Full Text Available Yesim Altay, Ayse Burcu, Gozde Aksoy, Evin Singar Ozdemir, Firdevs Ornek Department of Ophthalmology, Ankara Training and Research Hospital, Ankara, Turkey Background: Indications for corneal transplantation in developed and developing nations differ according to the different spectrum of corneal disease in each country. Objective: The purpose of this study is to analyze the changing indications and surgical techniques for corneal transplantation over the past 20 years at a tertiary referral center in Turkey. Methods: We retrospectively reviewed the records of patients who underwent keratoplasty from January 1995 to December 2014 (between 1995 and 2004, period 1, and between 2005 and 2014, period 2. Patients’ demographic data, indications for corneal transplantation, and the type of surgery were recorded. Results: The number of keratoplasties performed ranged from 548 in period 1 to 782 in period 2. Between 1995 and 2004, the leading indications were keratoconus (34.1%, bullous keratopathy (17%, and non-herpetic corneal scar (13.3%, and between 2005 and 2014, they were keratoconus (33.8%, corneal stromal dystrophy (14.2%, and bullous keratopathy (12.7%. All the keratoplasties performed in the 1995–2004 period were penetrating keratoplasty (PKP. During the period 2005–2014, PKP accounted for 93%, automated lamellar keratoplasty 5.8%, and deep anterior lamellar keratoplasty 1.2% of all corneal transplantations. Conclusion: Keratoconus was the leading indication for keratoplasty in both periods. In the 2005–2014 period, corneal stromal dystrophy increased significantly. All the keratoplasties performed in period 1 and 93% of all keratoplasties performed in period 2 were PKP. Keywords: corneal transplantation, indication, keratoconus, keratoplasty technique, pene­trating keratoplasty

  12. Anti-inflammatory effect of topical administration of tofacitinib on corneal inflammation.

    Science.gov (United States)

    Sakimoto, Tohru; Ishimori, Akiko

    2016-04-01

    We evaluated an anti-inflammatory effect of topical administration of tofacitinib, janus kinase (JAK) blocker, on corneal inflammation. Topical instillation of either tofacitinib or PBS was applied after wounding BALB/c mice corneas with alkali burn. Topical instillation was performed until day 14 after injury and injured eye was analyzed. The vascularized area in the alkali burned cornea was significantly reduced in the tofacitinib group compared with that in the PBS group. The immunoreactivity of Gr-1, F4/80, IFN-γ, and phosphorylated STAT(signal transducer and activator of transcription)1 in corneal stroma was diminished significantly in the tofacitinib group. Using laser capture microdissection system and quantitative PCR array analysis, the expression levels of CXCL9, CXCL5, CCL7, CCL2, MMP(matrix metalloproteinase)-9, and STAT1 in corneal stroma were down-regulated in the tofacitinib group. In in vitro study, human fibroblast pretreated by IFN-γ showed phosphorylation of STAT1, and this phosphorylation was down-regulated by adding tofacitinib to the culture medium. These results indicate the topical application of JAK inhibitor causes down-regulation of JAK- or IFN-γ-related molecules. Therefore, we deduce that application of JAK inhibitor for topical instillation may contribute to the treatment of corneal inflammation. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Trehalose treatment accelerates the healing of UVB-irradiated corneas. Comparative immunohistochemical studies on corneal cryostat sections and corneal impression cytology

    Czech Academy of Sciences Publication Activity Database

    Čejková, Jitka; Čejka, Čestmír; Luyckx, J.

    2012-01-01

    Roč. 27, č. 8 (2012), s. 1029-1040 ISSN 0213-3911 Institutional research plan: CEZ:AV0Z50390512 Keywords : Trehalose * UVB rays * Corneal healing Subject RIV: FF - HEENT, Dentistry Impact factor: 2.281, year: 2012

  14. Past and present of corneal refractive surgery

    DEFF Research Database (Denmark)

    Vestergaard, Anders Højslet

    Surgical correction of refractive errors is becoming increasingly popular. In the 1990s, the excimer laser revolutionized the field of corneal refractive surgery with PRK and LASIK, and lately refractive lenticule extraction (ReLEx) of intracorneal tissue, using only a femtosecond laser, has become...

  15. Accelerated Development of Supramolecular Corneal Stromal-Like Assemblies from Corneal Fibroblasts in the Presence of Macromolecular Crowders.

    Science.gov (United States)

    Kumar, Pramod; Satyam, Abhigyan; Fan, Xingliang; Rochev, Yury; Rodriguez, Brian J; Gorelov, Alexander; Joshi, Lokesh; Raghunath, Michael; Pandit, Abhay; Zeugolis, Dimitrios I

    2015-07-01

    Tissue engineering by self-assembly uses the cells' secretome as a regeneration template and biological factory of trophic factors. Despite the several advantages that have been witnessed in preclinical and clinical settings, the major obstacle for wide acceptance of this technology remains the tardy extracellular matrix formation. In this study, we assessed the influence of macromolecular crowding (MMC)/excluding volume effect, a biophysical phenomenon that accelerates thermodynamic activities and biological processes by several orders of magnitude, in human corneal fibroblast (HCF) culture. Our data indicate that the addition of negatively charged galactose derivative (carrageenan) in HCF culture, even at 0.5% serum, increases by 12-fold tissue-specific matrix deposition, while maintaining physiological cell morphology and protein/gene expression. Gene analysis indicates that a glucose derivative (dextran sulfate) may drive corneal fibroblasts toward a myofibroblast lineage. Collectively, these results indicate that MMC may be suitable not only for clinical translation and commercialization of tissue engineering by self-assembly therapies, but also for the development of in vitro pathophysiology models.

  16. Effect of transfer of donor corneal tissue from McCarey–Kaufmann medium to Optisol-GS on corneal endothelium

    Directory of Open Access Journals (Sweden)

    Neha Kapur

    2018-01-01

    Full Text Available Purpose: The purpose of this study is to evaluate the effect of transfer of donor corneal tissue from McCarey–Kaufmann (MK medium to Optisol-GS on corneal endothelium. Methods: This was a prospective, randomized comparative study. Twenty paired human donor corneal tissues of optical quality were retrieved. One tissue of the pair was preserved in Optisol-GS preservative medium (Group A and other tissue of the pair in MK medium (Group B at the time of corneoscleral disc excision. Within 12 h of retrieval, each cornea was evaluated using slit-lamp biomicroscopic examination and specular microscopic analysis. Group B corneas were transferred to Optisol-GS medium within 48–53 h of retrieval. Specular analysis of the paired corneas was repeated 3 h after transferring to Optisol-GS. On day 7 of storage, specular analysis of both the tissues was repeated. Results: The average age of the donor at the time of death was 29 years (16–68 years. The reduction in endothelial cell count, from baseline, in Groups A and B was 5.5% and 5.8% (P = 0.938 on the 3rd day and 8.2% and 12.6% (P = 0.025 on the 7th day, respectively, postretrieval. The coefficient of variation (CV increased by 36% (P = 0.021 and hexagonality reduced by 19% (P = 0.007 on day 7. All tissues retained an endothelial cell density higher than the accepted critical level for penetrating keratoplasty. Conclusion: Significant endothelial cell loss was noted while transferring tissues from one medium to another, necessitating the need for reevaluation of transferred tissues before utilization.

  17. Hyperosmolar Tears Induce Functional and Structural Alterations of Corneal Nerves: Electrophysiological and Anatomical Evidence Toward Neurotoxicity.

    Science.gov (United States)

    Hirata, Harumitsu; Mizerska, Kamila; Marfurt, Carl F; Rosenblatt, Mark I

    2015-12-01

    In an effort to elucidate possible neural mechanisms underlying diminished tearing in dry eye disease, this study sought to determine if hyperosmolar tears, a ubiquitous sign of dry eye disease, produce functional changes in corneal nerve responses to drying of the cornea and if these changes correlate with alterations in corneal nerve morphology. In vivo extracellular electrophysiological recordings were performed in rat trigeminal ganglion neurons that innervated the cornea before, and up to 3 hours after, the ocular application of continuous hyperosmolar tears or artificial tears. In corollary experiments, immunohistochemical staining was performed to compare corneal nerve morphology in control and in eyes treated with hyperosmolar solutions. Our previous studies identified a population of corneal afferents, dry-sensitive neurons that are strongly excited by corneal dessication ("dry response"), a response thought to trigger the lacrimation reflex. In the present study, we found that the dry responses of corneal dry-sensitive neurons were depressed or even completely abolished by hyperosmolar tears in a time- (30 minutes to 3 hours) and dose (450- to 1000-mOsm solutions)-dependent manner. Furthermore, eyes treated with hyperosmolar tears for 3 hours contained large numbers of morphologically abnormal (granular, fragmented, or prominently beaded) subbasal nerves that appeared to be undergoing degeneration. These results demonstrate that tear hyperosmolarity, considered to be a "core" mechanism of dry eye disease, significantly decreases physiological sensitivity and morphologic integrity of the corneal nerves important in tear production. These alterations might contribute to the diminished tearing seen clinically in dry eye patients.

  18. Crystalline color superconductivity

    International Nuclear Information System (INIS)

    Alford, Mark; Bowers, Jeffrey A.; Rajagopal, Krishna

    2001-01-01

    In any context in which color superconductivity arises in nature, it is likely to involve pairing between species of quarks with differing chemical potentials. For suitable values of the differences between chemical potentials, Cooper pairs with nonzero total momentum are favored, as was first realized by Larkin, Ovchinnikov, Fulde, and Ferrell (LOFF). Condensates of this sort spontaneously break translational and rotational invariance, leading to gaps which vary periodically in a crystalline pattern. Unlike the original LOFF state, these crystalline quark matter condensates include both spin-zero and spin-one Cooper pairs. We explore the range of parameters for which crystalline color superconductivity arises in the QCD phase diagram. If in some shell within the quark matter core of a neutron star (or within a strange quark star) the quark number densities are such that crystalline color superconductivity arises, rotational vortices may be pinned in this shell, making it a locus for glitch phenomena

  19. Small-Molecule Induction Promotes Corneal Epithelial Cell Differentiation from Human Induced Pluripotent Stem Cells

    Directory of Open Access Journals (Sweden)

    Alexandra Mikhailova

    2014-02-01

    Full Text Available Human induced pluripotent stem cells (hiPSCs offer unique opportunities for developing novel cell-based therapies and disease modeling. In this study, we developed a directed differentiation method for hiPSCs toward corneal epithelial progenitor cells capable of terminal differentiation toward mature corneal epithelial-like cells. In order to improve the efficiency and reproducibility of our method, we replicated signaling cues active during ocular surface ectoderm development with the help of two small-molecule inhibitors in combination with basic fibroblast growth factor (bFGF in serum-free and feeder-free conditions. First, small-molecule induction downregulated the expression of pluripotency markers while upregulating several transcription factors essential for normal eye development. Second, protein expression of the corneal epithelial progenitor marker p63 was greatly enhanced, with up to 95% of cells being p63 positive after 5 weeks of differentiation. Third, corneal epithelial-like cells were obtained upon further maturation.

  20. Corneal Densitometry as a Tool to Measure Epithelial Ingrowth After Laser In Situ Keratomileusis.

    Science.gov (United States)

    Adran, Daniel; Vaillancourt, Louis; Harissi-Dagher, Mona; Kruh, Jonathan N; Syed, Zeba A; Robinson, Steven; Melki, Samir

    2017-04-01

    This study evaluates the correlation between corneal densitometry and epithelial ingrowth (EI) after laser in situ keratomileusis (LASIK). Corneal densitometry of 3 patients who developed EI after LASIK was measured with the Oculus Pentacam. Corneal densitometry readings of each patient were obtained preoperatively and postoperatively after ingrowth was discovered. Densitometry was recorded at the central nest of opacity and at the leading edges of EI. For all patients, the most severe stages of EI observed on slit-lamp photographs correlated with the highest densitometry readings, with peak densitometry ranging from 73.3 to 95.1. These values were much higher than preoperative densitometry readings, which ranged from 21.8 to 27.2. In 2 cases, the Pentacam densitometry map revealed progression of EI toward the visual axis that was only faintly detectable or not detectable at all on the corresponding slit-lamp photographs. Corneal densitometry seems to be an objective measure of the severity and progression of EI after LASIK.

  1. Parametric fitting of corneal height data to a biconic surface.

    Science.gov (United States)

    Janunts, Edgar; Kannengießer, Marc; Langenbucher, Achim

    2015-03-01

    As the average corneal shape can effectively be approximated by a conic section, a determination of the corneal shape by biconic parameters is desired. The purpose of the paper is to introduce a straightforward mathematical approach for extracting clinically relevant parameters of corneal surface, such as radii of curvature and conic constants for principle meridians and astigmatism. A general description for modeling the ocular surfaces in a biconic form is given, based on which an implicit parametric surface fitting algorithm is introduced. The solution of the biconic fitting is obtained by a two sequential least squares optimization approach with constrains. The data input can be raw information from any corneal topographer with not necessarily a uniform data distribution. Various simulated and clinical data are studied including surfaces with rotationally symmetric and non-symmetric geometries. The clinical data was obtained from the Pentacam (Oculus) for the patient having undergone a refractive surgery. A sub-micrometer fitting accuracy was obtained for all simulated surfaces: 0,08 μm RMS fitting error at max for rotationally symmetric and 0,125 μm for non-symmetric surfaces. The astigmatism was recovered in a sub-minutes resolution. The equality in rotational symmetric and the superiority in non-symmetric surfaces of the presented model over the widely used quadric fitting model is shown. The introduced biconic surface fitting algorithm is able to recover the apical radii of curvature and conic constants in principle meridians. This methodology could be a platform for advanced IOL calculations and enhanced contact lens fitting. Copyright © 2014. Published by Elsevier GmbH.

  2. Corneal allograft rejection: Risk factors, diagnosis, prevention, and treatment

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    Dua Harminder

    1999-01-01

    Full Text Available Recent advances in corneal graft technology, including donor tissue retrieval, storage and surgical techniques, have greatly improved the clinical outcome of corneal grafts. Despite these advances, immune mediated corneal graft rejection remains the single most important cause of corneal graft failure. Several host factors have been identified as conferring a "high risk" status to the host. These include: more than two quadrant vascularisation, with associated lymphatics, which augment the afferent and efferent arc of the immune response; herpes simplex keratitis; uveitis; silicone oil keratopathy; previous failed (rejected grafts; "hot eyes"; young recipient age; and multiple surgical procedures at the time of grafting. Large grafts, by virtue of being closer to the host limbus, with its complement of vessels and antigen-presenting Langerhans cells, also are more susceptible to rejection. The diagnosis of graft rejection is entirely clinical and in its early stages the clinical signs could be subtle. Graft rejection is largely mediated by the major histocompatibility antigens, minor antigens and perhaps blood group ABO antigens and some cornea-specific antigens. Just as rejection is mediated by active immune mediated events, the lack of rejection (tolerance is also sustained by active immune regulatory mechanisms. The anterior chamber associated immune deviation (ACAID and probably, conjunctiva associated lymphoid tissue (CALT induced mucosal tolerance, besides others, play an important role. Although graft rejection can lead to graft failure, most rejections can be readily controlled if appropriate management is commenced at the proper time. Topical steroids are the mainstay of graft rejection management. In the high-risk situations however, systemic steroids, and other immunosuppressive drugs such as cyclosporin and tacrolimus (FK506 are of proven benefit, both for treatment and prevention of rejection.

  3. Expectativas en la cirugía de triple procedimiento versus doble procedimiento quirúrgico en afecciones corneales Expectations of triple procedure versus double procedure surgery in corneal diseases

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    Emilio Kuri Cienfuegos

    2007-12-01

    Full Text Available Se realizó un estudio retrospectivo y descriptivo con el propósito de evaluar el comportamiento de los procedimientos quirúrgicos doble y triple, en pacientes operados de enfermedades de la córnea en el Servicio de Oftalmología del Hospital Clínicouirúrgico “Hermanos Ameijeiras” de Ciudad de La Habana, desde julio de 2003 hasta diciembre de 2005. La muestra estuvo constituida por 45 ojos operados de trasplante de córnea entre enero de 1988 y junio de 2003 en el Servicio de Oftalmología del Hospital Clínicoquirúrgico “Hermanos Ameijeiras” de Ciudad de La Habana. Las variables estudiadas fueron: edad, sexo, antecedentes personales oculares, enfermedad corneal previa, retrasplante, viabilidad del injerto corneal, complicaciones ocurridas durante la cirugía y después de esta, agudeza visual prequirúrgica y posquirúrgica, error de cálculo de la lente intraocular y de refracción. Se obtuvo como resultado: predominio del sexo masculino (51,1%, edad promedio 60,27 años, la enfermedad ocular asociada más frecuente en el doble y triple procedimiento fue el glaucoma con 22,7 % y 26,1 % respectivamente, la enfermedad corneal más común fue la distrofia epitelio-endotelial de Fuchs en ambos procederes (72,7 % y 52,2 %; no tuvieron complicaciones transquirúgicas 90,9 % y 95,5 %, respectivamente. Las complicaciones posquirúrgicas fueron de 9,1 % en el doble procedimiento y de 26,1 en el triple. La opacidad corneal posoperatoria se presentó en el doble proceder en 9,1 % y en el triple en 17,4 %. Hubo más retrasplantes en el triple procedimiento (17,4 %. El error refractivo final en el doble procedimiento presentó mayor cantidad emétropes y menos hipermétropes que el triple, mientras que en relación con los miopes se encontró, solo en el doble procedimiento, mejor agudeza visual en el doble procedimiento. El error de cálculo de lente intraocular fue mayor en el triple procedimiento.A retrospective descriptive study was

  4. Topical versus subconjunctival anti-vascular endothelial growth factor therapy (Bevacizumab, Ranibizumab and Aflibercept for treatment of corneal neovascularization

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    Tariq Al-Debasi

    2017-04-01

    Anti-VEGF agents (Bevacizumab, Ranibizumab and Aflibercept seem to have a higher efficiency and efficacy for corneal NV treatment. Both subconjunctival therapy and topical therapy of bevacizumab prohibit corneal NV, while early treatment with subconjunctival administration of ranibizumab may successfully reduce corneal NV. Therefore, establishment of safe doses is highly important before these drugs can be involved in the clinical setting. Further investigations and studies are highly warranted to adjust the dose and route of administration for the antibodies directed against VEGF to be the key therapeutic agents in the corneal NV treatment.

  5. Simultaneous topography-guided PRK followed by corneal collagen cross-linking after lamellar keratoplasty for keratoconus

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    Spadea L

    2012-11-01

    Full Text Available Leopoldo Spadea,1 Marino Paroli21University of L’Aquila, Department of Biotechnological and Applied Clinical Sciences, Eye Clinic, L’Aquila, 2La Sapienza University, Department of Biotechnology and Medical-Surgical Sciences, Latina, ItalyBackground: The purpose of this paper is to report the results of using combined treatment of customized excimer laser-assisted photorefractive keratectomy (PRK and prophylactic corneal collagen crosslinking (CXL for residual refractive error in a group of patients who had previously undergone lamellar keratoplasty for keratoconus.Methods: The study included 14 eyes from 14 patients who had originally been treated for keratoconus in one eye by excimer laser-assisted lamellar keratoplasty (ELLK, and subsequently presented with residual ametropia (-6.11 D ± 2.48, range -2.50 to -9.50. After a mean 40.1 ± 12.4 months since ELLK they underwent combined simultaneous corneal regularization treatment with topographically guided transepithelial excimer laser PRK (central corneal regularization and corneal CXL induced by riboflavin-ultraviolet A.Results: After a mean 15 ± 6.5 (range 6–24 months, all eyes gained at least one Snellen line of uncorrected distance visual acuity (range 1–10. No patient lost lines of corrected distance visual acuity, and four patients gained three lines of corrected distance visual acuity. Mean manifest refractive spherical equivalent was -0.79 ± 2.09 (range +1 to -3.0 D, and topographic keratometric astigmatism was 5.02 ± 2.93 (range 0.8–8.9 D. All the corneas remained clear (haze < 1.Conclusion: The combination of customized PRK and corneal CXL provided safe and effective results in the management of corneal regularization for refractive purposes after ELLK for keratoconus.Keywords: corneal collagen crosslinking, excimer laser-assisted lamellar keratoplasty, photorefractive keratectomy

  6. Optical patient interface in femtosecond laser-assisted cataract surgery: contact corneal applanation versus liquid immersion.

    Science.gov (United States)

    Talamo, Jonathan H; Gooding, Philip; Angeley, David; Culbertson, William W; Schuele, Georg; Andersen, Daniel; Marcellino, George; Essock-Burns, Emma; Batlle, Juan; Feliz, Rafael; Friedman, Neil J; Palanker, Daniel

    2013-04-01

    To compare 2 optical patient interface designs used for femtosecond laser-assisted cataract surgery. Optimedica Corp., Santa Clara, California, USA, and Centro Laser, Santo Domingo, Dominican Republic. Experimental and clinical studies. Laser capsulotomy was performed during cataract surgery with a curved contact lens interface (CCL) or a liquid optical immersion interface (LOI). The presence of corneal folds, incomplete capsulotomy, subconjunctival hemorrhage, and eye movement during laser treatment were analyzed using video and optical coherence tomography. The induced rise of intraocular pressure (IOP) was measured in porcine and cadaver eyes. Corneal folds were identified in 70% of the CCL cohort; 63% of these had areas of incomplete capsulotomies beneath the corneal folds. No corneal folds or incomplete capsulotomies were identified in the LOI cohort. The mean eye movement during capsulotomy creation (1.5 sec) was 50 μm with a CCL and 20 μm with an LOI. The LOI cohort had 36% less subconjunctival hemorrhage than the CCL cohort. During suction, the mean IOP rise was 32.4 mm Hg ± 3.4 (SD) in the CCL group and 17.7 ± 2.1 mm Hg in the LOI group. Curved contact interfaces create corneal folds that can lead to incomplete capsulotomy during laser cataract surgery. A liquid interface eliminated corneal folds, improved globe stability, reduced subconjunctival hemorrhage, and lowered IOP rise. Copyright © 2013 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  7. Simultaneous topography-guided PRK followed by corneal collagen cross-linking after lamellar keratoplasty for keratoconus.

    Science.gov (United States)

    Spadea, Leopoldo; Paroli, Marino

    2012-01-01

    The purpose of this paper is to report the results of using combined treatment of customized excimer laser-assisted photorefractive keratectomy (PRK) and prophylactic corneal collagen crosslinking (CXL) for residual refractive error in a group of patients who had previously undergone lamellar keratoplasty for keratoconus. The study included 14 eyes from 14 patients who had originally been treated for keratoconus in one eye by excimer laser-assisted lamellar keratoplasty (ELLK), and subsequently presented with residual ametropia (-6.11 D ± 2.48, range -2.50 to -9.50). After a mean 40.1 ± 12.4 months since ELLK they underwent combined simultaneous corneal regularization treatment with topographically guided transepithelial excimer laser PRK (central corneal regularization) and corneal CXL induced by riboflavin-ultraviolet A. After a mean 15 ± 6.5 (range 6-24) months, all eyes gained at least one Snellen line of uncorrected distance visual acuity (range 1-10). No patient lost lines of corrected distance visual acuity, and four patients gained three lines of corrected distance visual acuity. Mean manifest refractive spherical equivalent was -0.79 ± 2.09 (range +1 to -3.0) D, and topographic keratometric astigmatism was 5.02 ± 2.93 (range 0.8-8.9) D. All the corneas remained clear (haze PRK and corneal CXL provided safe and effective results in the management of corneal regularization for refractive purposes after ELLK for keratoconus.

  8. Analysis of biological characteristics of corneal endothelium in old patients with high myopia

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    Ya-Qiong Chen

    2014-11-01

    Full Text Available AIM: To analyze quantitatively the biological characteristics of corneal endothelium in old patients of high myopia with non-contact automatic corneal endothelial microscope.METHODS:A total of 189 old patients(197 eyeswere divided into the high myopia group and the normal control group according to refractive diopter, in which the former 98 cases(103 eyes, the latter 91 cases(94 eyes. The hexagonal cell(6A, the coefficient of variation(CV, the average cell area(AVE, the average cell density(CDand the central corneal thickness(CCTwere measured by non-contact automatic corneal endothelium. SPSS 14.0 software was used to analyze their percentage. Z-test was used to compare the mean and Chi-square test was used to compare the rate in between. RESULTS: The average cell density in high myopia patients decreased, but there were 14 eyes >3 000/mm2, 11 eyes 2 and 78 eyes in the 2 000~3 000/mm2, there were each 0 eye, 3 eyes and 91 eyes respectively in the normal control group. There was statistically significant difference between high myopia group and control(χ2=19.11, PPP>0.05. CONCLUSION: There will provide a reference valuable for clinical surgeon. Because according to the changes of parameters and morphology of the corneal endothelial cells, we can understand the repair ability, to predict the consequence of the treatment, in order to determine the design and the choice of a surgical.

  9. Caveolin-1 as a novel indicator of wound-healing capacity in aged human corneal epithelium.

    Science.gov (United States)

    Rhim, Ji Heon; Kim, Jae Hoon; Yeo, Eui-Ju; Kim, Jae Chan; Park, Sang Chul

    2010-01-01

    Excess caveolin-1 has been reported to play a role in age-dependent hyporesponsiveness to growth factors in vitro. Therefore, we hypothesized that caveolin-1-dependent hyporesponsiveness to growth factors in aged corneal epithelial cells might be responsible for delayed wound healing in vivo. To test this hypothesis, we evaluated corneal wound-healing time by vital staining using fluorescein after laser epithelial keratomileusis (LASEK). We compared wound-healing times in young, middle-aged and elderly patients. We also examined caveolin-1 levels and other aging markers, such as p53 and p21, in the corneal epithelium. Elderly patients generally had higher caveolin-1 levels in the corneal epithelia than young patients. There were, however, variations among individuals with increased caveolin-1 in some young patients and decreased levels in some elderly patients. Wound-healing time after LASEK correlated well with the corneal caveolin-1 status. Therefore, we suggest that caveolin-1 status might be responsible for delayed wound healing in elderly patients after LASEK. Caveolin-1 status might be a regulator for wound-healing capacity and a novel target for in vivo adjustment.

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

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    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

  11. Short-term corneal changes with gas-permeable contact lens wear in keratoconus subjects: a comparison of two fitting approaches.

    Science.gov (United States)

    Romero-Jiménez, Miguel; Santodomingo-Rubido, Jacinto; Flores-Rodríguez, Patricia; González-Méijome, Jose-Manuel

    2015-01-01

    To evaluate changes in anterior corneal topography and higher-order aberrations (HOA) after 14-days of rigid gas-permeable (RGP) contact lens (CL) wear in keratoconus subjects comparing two different fitting approaches. Thirty-one keratoconus subjects (50 eyes) without previous history of CL wear were recruited for the study. Subjects were randomly fitted to either an apical-touch or three-point-touch fitting approach. The lens' back optic zone radius (BOZR) was 0.4mm and 0.1mm flatter than the first definite apical clearance lens, respectively. Differences between the baseline and post-CL wear for steepest, flattest and average corneal power (ACP) readings, central corneal astigmatism (CCA), maximum tangential curvature (KTag), anterior corneal surface asphericity, anterior corneal surface HOA and thinnest corneal thickness measured with Pentacam were compared. A statistically significant flattening was found over time on the flattest and steepest simulated keratometry and ACP in apical-touch group (all p<0.01). A statistically significant reduction in KTag was found in both groups after contact lens wear (all p<0.05). Significant reduction was found over time in CCA (p=0.001) and anterior corneal asphericity in both groups (p<0.001). Thickness at the thinnest corneal point increased significantly after CL wear (p<0.0001). Coma-like and total HOA root mean square (RMS) error were significantly reduced following CL wearing in both fitting approaches (all p<0.05). Short-term rigid gas-permeable CL wear flattens the anterior cornea, increases the thinnest corneal thickness and reduces anterior surface HOA in keratoconus subjects. Apical-touch was associated with greater corneal flattening in comparison to three-point-touch lens wear. Copyright © 2014 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

  12. Noninvasive spectroscopic diagnosis of superficial ocular lesions and corneal infections

    Energy Technology Data Exchange (ETDEWEB)

    Mourant, J.R.; Bigio, I.J.; Johnson, T.; Shimada, T. [Los Alamos National Lab., NM (United States); Gritz, D.C.; Storey-Held, K. [Texas Univ. Health Science Center, San Antonio, TX (United States). Dept. of Ophthalmology

    1994-02-01

    The potential of a rapid noninvasive diagnostic system to detect tissue abnormalities on the surface of the eye has been investigated. The optical scatter signal from lesions and normal areas on the conjunctival sclera of the human eye were measured in vivo. It is possible to distinguish nonpigmented pingueculas from other lesions. The ability of the system to detect malignancies could not be tested because none of the measured and biopsied lesions were malignant. Optical scatter and fluorescence spectra of bacterial and fungal suspensions, and corneal irritations were also collected. Both scattering and fluorescence show potential for diagnosing corneal infections.

  13. Análisis de una nueva variante fenotípica de distrofia del estroma corneal

    OpenAIRE

    Varela Conde, Yago

    2016-01-01

    Las distrofias corneales son un conjunto de enfermedades hereditarias de la córnea con base genética demostrable y sin afectación sistémica. Su nomenclatura y clasificación han sido revisadas recientemente, prescindiendo de ciertas patologías y agrupando las distrofias en nuevas categorías. Se ha hallado una variante fenotípica atípica con afectación del estroma corneal, por lo que sólo se han revisado las distrofias corneales localizadas a ese nivel (epiteliales-estromales y estromales). ...

  14. Clinical Outcomes of SMILE With a Triple Centration Technique and Corneal Wavefront-Guided Transepithelial PRK in High Astigmatism.

    Science.gov (United States)

    Jun, Ikhyun; Kang, David Sung Yong; Reinstein, Dan Z; Arba-Mosquera, Samuel; Archer, Timothy J; Seo, Kyoung Yul; Kim, Tae-Im

    2018-03-01

    To comparatively investigate the clinical outcomes, vector parameters, and corneal aberrations of small incision lenticule extraction (SMILE) with a triple centration technique and corneal wavefront-guided transepithelial photorefractive keratectomy (PRK) for the correction of high astigmatism. This retrospective, comparative case series study included 89 eyes (89 patients) that received treatment for myopia with high astigmatism (≥ 2.50 diopters) using SMILE with a triple centration technique (SMILE group; 45 eyes) and corneal wavefront-guided transepithelial PRK (transepithelial PRK group; 44 eyes). Visual acuity measurement, manifest refraction, slit-lamp examination, autokeratometry, corneal topography, and evaluation of corneal wavefront aberration were performed preoperatively and at 1, 3, and 6 months after surgery. The safety, efficacy, vector parameters, and corneal aberrations at 6 months after surgery were compared between the two groups. At 6 months after surgery, the transepithelial PRK and SMILE groups exhibited comparable mean uncorrected distance visual acuities (-0.06 ± 0.07 and -0.05 ± 0.07 logMAR, respectively), safety, efficacy, and predictability of refractive and visual outcomes. There was a slight but statistically significant difference in the correction index between the transepithelial PRK and SMILE groups (0.96 ± 0.11 and 0.91 ± 0.10, respectively). Whereas the transepithelial PRK group exhibited increased corneal spherical aberration and significantly reduced corneal coma and trefoil, no changes in aberrometric values were noted in the SMILE group. Both SMILE with a triple centration technique and corneal wavefront-guided transepithelial PRK are effective and provide predictable outcomes for the correction of high myopic astigmatism, although slight undercorrection was observed in the SMILE group. The triple centration technique was helpful in astigmatism correction by SMILE. [J Refract Surg. 2018;34(3):156-163.]. Copyright 2018

  15. Related research on corneal higher-order aberrations after different ways refractive surgery

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    Shu-Xi He

    2015-08-01

    Full Text Available AIM:To evaluate the changes of corneal high-order aberration(including Coma, Spab, RMShafter laser in situ keratomileusis(LASIKwith femtosecond laser, sub-Bowman keratomileusis(SBKand laser epithelial keratomileusis(LASEK.METHODS: Of 82 myopic patients(164 eyes, 31 patients(62 eyeswere treated by FS-LASIK, 31 patients(62 eyeswere treated by SBK, 20 patients(40 eyeswere treated by LASEK. Sirius system was used for measuring the coma aberration, spherical aberration, and high order aberration at 1, 15d,1, 3mo after surgery.RESULTS: 1Vision: The uncorrected visual acuity of the three groups had no differences(P>0.05. 2Corneal aberrations: Three kinds of surgical procedure for patients with corneal aberration had significant impact. The C7, C8, C12 and RMSh of three groups were increased significantly(P0.05. The C7, C8, C12 and RMSh were not recovered to preoperative levels after 3mo. But the increase of patients after FS-LASIK was smaller than the other two groups, with statistical significance(P0.05.CONCLUSION: Compared with SBK and LASEK,FS-LASIK has better visual acuity in the early postoperative and corneal higher-order aberrations increase is relatively small.

  16. Femtosecond laser's application in the corneal surgery

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    Shu-Liang Wang

    2015-10-01

    Full Text Available With the rapid development over the past two decades,femtosecond(10-15slasers(FShas become a new application in ophthalmic surgery. As laser power is defined as energy delivered per unit time, decreasing the pulse duration to femtosecond level(100fsnot only increases the power delivered but also decreases the fluence threshold for laser induced optical breakdown. In ablating tissue, FS has an edge over nanosecond lasers as there is minimal collateral damage from shock waves and heat conduction during surgical ablation. Thus, application of FS has been widely spread, from flap creation for laser-assisted in situ keratomileusis(LASIKsurgery, cutting of donor and recipient corneas in keratoplasty, creation of pockets for intracorneal ring implantation. FS applied in keratoplasty is mainly used in making graft and recipient bed, and can exactly cut different tissue of keratopathy. FS can also cut partial tissue of cornea, even if it is under the moderate corneal macula and corneal edema condition.

  17. Bilateral Keratectasia 34 Years after Corneal Transplant

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    Xavier Valldeperas

    2010-07-01

    Full Text Available We report the clinical findings of a patient with severe bilateral keratectasia 34 years after a penetrating keratoplasty (PK in both eyes. An otherwise healthy 67-year-old man complained of deterioration of the eyesight in both eyes over the last 6 months. The patient was diagnosed with bilateral keratoconus at the age of 32 years, and he underwent a bilateral PK. At presentation, visual acuity was 20/200 in the right eye and light perception in the left eye. A Pentacam pachymetric map revealed a central pachymetry of 720 µm in the right eye and of 710 µm in the left eye, as well as an average paracentral pachymetry of 436 and 270 µm in the 9-mm zone in the right and the left eye, respectively. Corneal topography revealed bilateral irregular and asymmetric bowing with generalized steepening and high corneal power. We describe a case of bilateral keratectasia 34 years after PK in a patient who was originally diagnosed with bilateral keratoconus.

  18. Area and depth of surfactant-induced corneal injury predicts extent of subsequent ocular responses.

    Science.gov (United States)

    Jester, J V; Petroll, W M; Bean, J; Parker, R D; Carr, G J; Cavanagh, H D; Maurer, J K

    1998-12-01

    To correlate area and depth of initial corneal injury induced by surfactants of differing type and irritant properties with corneal responses and outcome in the same animals over time by using in vivo confocal microscopy (CM). Six groups of six adult rabbits were treated with anionic, cationic, and nonionic surfactants that caused different levels of ocular irritation. Test materials included slight irritants: 5% sodium lauryl sulfate (SLS), polyoxyethylene glycol monoalkyl ether (POE), and 5% 3-isotridecyloxypropyl-bis(polyoxyethylene) ammonium chloride (ITDOP); mild irritants: 5% 3-decyloxypropyl-bis(polyoxyethylene) amine (DOP) and sodium linear alkylbenzene sulfonate (LAS); and a moderate irritant: a proprietary detergent (DTRGT). Ten microliters surfactant were directly applied to the cornea of one eye of each rabbit. Ten untreated rabbits served as control subjects. Area and depth of initial injury was determined by using in vivo CM to measure epithelial thickness, epithelial cell size, corneal thickness, and depth of stromal injury in four corneal regions at 3 hours and at day 1. Area and depth of corneal responses to injury were evaluated at various times from days 3 through 35 by macroscopic grading and quantitative confocal microscopy through-focusing (CMTF). In vivo CM revealed corneal injury with slight irritants to be restricted to the epithelium, whereas the mild and moderate irritants caused complete epithelial cell loss with increasing anterior stromal damage: DOP < LAS < DTRGT. With the slight ocular irritants there was little or no change in corneal thickness or the CMTF intensity profiles. Three hours after treatment, mild and moderate ocular irritants caused a significant increase in corneal thickness, which peaked at day 1 with DOP (483.3+/-80.1 microm) and LAS (572.3+/-60.0 microm) and day 3 with DTRGT (601.4+/-68.7 microm); returning to normal (similar to control values) by day 7 with DOP and day 35 with LAS and DTRGT. The CMTF intensity

  19. RNA aptamers targeted for human αA-crystallin do not bind αB-crystallin, and spare the α-crystallin domain.

    Science.gov (United States)

    Mallik, Prabhat K; Shi, Hua; Pande, Jayanti

    2017-09-16

    The molecular chaperones, α-crystallins, belong to the small heat shock protein (sHSP) family and prevent the aggregation and insolubilization of client proteins. Studies in vivo have shown that the chaperone activity of the α-crystallins is raised or lowered in various disease states. Therefore, the development of tools to control chaperone activity may provide avenues for therapeutic intervention, as well as enable a molecular understanding of chaperone function. The major human lens α-crystallins, αA- (HAA) and αB- (HAB), share 57% sequence identity and show similar activity towards some clients, but differing activities towards others. Notably, both crystallins contain the "α-crystallin domain" (ACD, the primary client binding site), like all other members of the sHSP family. Here we show that RNA aptamers selected for HAA, in vitro, exhibit specific affinity to HAA but do not bind HAB. Significantly, these aptamers also exclude the ACD. This study thus demonstrates that RNA aptamers against sHSPs can be designed that show high affinity and specificity - yet exclude the primary client binding region - thereby facilitating the development of RNA aptamer-based therapeutic intervention strategies. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Prevalence of corneal astigmatism in Tohono O'odham Native American children 6 months to 8 years of age.

    Science.gov (United States)

    Harvey, Erin M; Dobson, Velma; Miller, Joseph M; Schwiegerling, Jim; Clifford-Donaldson, Candice E; Green, Tina K; Messer, Dawn H

    2011-06-21

    To describe the prevalence of corneal astigmatism in infants and young children who are members of a Native American tribe with a high prevalence of refractive astigmatism. The prevalence of corneal astigmatism was assessed by obtaining infant keratometer (IK4) measurements from 1235 Tohono O'odham children, aged 6 months to 8 years. The prevalence of corneal astigmatism >2.00 D was lower in the 1- to <2-year-old age group when compared with all other age groups, except the 6- to <7-year-old group. The magnitude of mean corneal astigmatism was significantly lower in the 1- to <2-year age group than in the 5- to <6-, 6- to <7-, and 7- to <8-year age groups. Corneal astigmatism was with-the-rule (WTR) in 91.4% of astigmatic children (≥1.00 D). The prevalence and mean amount of corneal astigmatism were higher than reported in non-Native American populations. Mean astigmatism increased from 1.43 D in 1-year-olds to nearly 2.00 D by school age.