Burn keratoplasty

Descemet membrane detachment (DMD) is a potential vision-threatening complication that occurs most commonly after cataract surgery. DMD has also been reported to occur in various other surgeries such as keratoplasty, iridectomy, vitrectomy, trabeculectomy, holmium laser sclerostomy, alkali burn, and viscocanalostomy. Major risk factors include advanced age, preexisting endothelial diseases like Fuchs dystrophy or abnormality in the Descemet membrane and stromal interface, hard cataract, prolonged surgical time, ragged clear corneal incisions, and inadvertent trauma with blunt instruments or phacoemulsification probe...

PURPOSE: The most commonly applied prosthetic devices for corneal blindness in the setting of severe cicatricial keratoconjunctivitis are the Boston keratoprosthesis type II and the modified osteo-odonto-keratoprosthesis, with these requiring either normal eyelid skin or a healthy cuspid tooth, respectively. For patients with neither attribute, we developed a new keratoprosthesis device combining positive aspects of both Boston keratoprosthesis type II and modified osteo-odonto-keratoprosthesis, which we have named the "Lux...

Purpose: To investigate the presence and role of fibroblast senescence in the dynamic process of corneal wound healing involving stromal cell apoptosis, proliferation, and differentiation. Methods: An in vivo corneal wound healing model was performed using epithelial debridement in C57BL/6 mice. The corneas were stained using TUNEL, Ki67, and α-smooth muscle actin (α-SMA) as markers of apoptosis, proliferation, and myofibroblastic differentiation, respectively...

The objective of our study was to define principal risk factors for graft failure in patients who underwent penetrating keratoplasty (PK).Retrospective data obtained from a cohort of 895 penetrating keratoplasties performed between 2001 and 2006 were analysed. Recipient related factors, graft characteristics, and surgical technique were assessed in a univariate analysis and with a multivariate proportional hazard model to detect principal risk factors for definitive graft failure.Multivariate analysis showed clear significance for diagnosis and number of previous grafts and border line significance for the oldest donor age group...

BACKGROUND: Ocular chemical burn is an ophthalmological emergency. Therefore, chemical injuries should be promptly addressed in order to initiate the appropriate treatment as soon as possible and optimize the visual prognosis. We present a retrospective study of ten cases with ocular chemical burn including one with superglue and one with a liquid plaster material injury and describe their clinical course. HISTORY AND SIGNS: Ten adult patients (34 - 92 years, 8 males) presented with moderate to severe alkali or neutral chemical burns in our emergency clinics...

BACKGROUND: Pediatric mycotic infections in the eye are uncommon. However, ophthalmic infections by several fungal species have been described in immunocompetent subjects. Mycotic keratitis with or without conjunctivitis (MK) may account for more than 50% of all cases, particularly in tropical and sub-tropical areas. The leading mechanism is trauma. Treatment of MK is managed by medical (antifungal agents) and/or surgical means. This is the first case report of a patient with MK by Fusarium spp...

PURPOSE: To report visual rehabilitation with a native Pintucci keratoprosthesis (KPro) after a severe ocular surface chemical burn in a male patient. CASE REPORT: A 41-year-old man experienced a bilateral severe chemical burn 5 years previously. Earlier penetrating keratoplasty and keratolimbal allografts were unsuccessful in both eyes, and neither of the eyes had vision better than light perception. Both corneas were opaque and conjunctivalized. Because of severe dry eye and total limbal stem cell deficiency, the left eye was considered for a Pintucci-type KPro...

PURPOSE: To compare the corneal graft survival rates after penetrating keratoplasty (PKP) in cases of post-PKP glaucoma managed by either trabeculectomy with mitomycin C or Ahmed glaucoma valve (AGV). METHODS: This study was a retrospective interventional comparative study that included 40 eyes of 40 patients. The included patients had undergone previous PKP for anterior segment reconstruction after microbial or fungal keratitis, chemical burns, trauma, or perforated corneal ulcer...

INTRODUCTION: Keratoprostheses offer a therapeutic alternative to patients with bilateral corneal blindness who cannot undergo corneal allograft. The goal of this work was to evaluate the indications and limitations of Boston keratoprosthesis. MATERIALS AND METHODS: Seven patients underwent unilateral implantation of a Boston type I keratoprosthesis between December 2012 and November 2016. The following data were collected: surgical indication, preoperative visual acuity, postoperative visual acuity at D1, D7, D30, 6 months and 12 months, complications and postoperative treatment...

Ocular chemical burns are common and serious ocular emergencies which require immediate and intensive evaluation and treatment. Loss of vision and disfigurement affect the victims, bringing great sufferings to themselves and their families. China is the biggest developing country in the world with a large number of such cases. The prevention of ocular chemical burns is emphasized in different aspects. After emergency treatment, proper care of chemical burns is started by control of inflammation with corticosteroids...

Purpose: Evaluation of the indications, anatomical and functional results, and complications of total penetrating keratoplasty (TPK) in disorders involving whole cornea. Materials and Methods: We analyzed outcomes of the surgical treatment of 47 eyes of 46 patients that underwent TPK. Indications were infectious keratitis, autoimmune disease, injury of the eyeball (mainly chemical burns), and other combined disorders. The surgical technique involved dissection of affected tissues with a margin of 1...

The severe worldwide shortage of donor organs, and severe pathologies placing patients at high risk for rejecting conventional cornea transplantation, have left many corneal blind patients untreated. Following successful pre-clinical evaluation in mini-pigs, we tested a biomaterials-enabled pro-regeneration strategy to restore corneal integrity in an open-label observational study of six patients. Cell-free corneal implants comprising recombinant human collagen and phosphorylcholine were grafted by anterior lamellar keratoplasty into corneas of unilaterally blind patients diagnosed at high-risk for rejecting donor allografts...

PURPOSE: This study aimed to report the long-term outcomes of autologous Simple Limbal Epithelial Transplantation (SLET) performed for unilateral limbal stem cell deficiency (LSCD) following chemical burn at a tertiary eye center in North India. METHODS: This was a single-center prospective interventional case series of patients who developed unilateral LSCD after suffering from ocular surface burns and who underwent SLET between October 2012 and May 2016 with a follow-up period of at least 6 months...

PurposeTo describe a novel use of fibrin glue in managing leaking blebs and leaking wounds following trauma or surgery.MethodsInterventional case series.ResultsWe report eight patients, including three where intra-operative or immediate post-penetrating keratoplasty recalcitrant leaks from the graft-host junction and/or openings created by the needle pass, were noted. All three had thin recipient beds in the sector of leak. This was managed by intra-cameral injection of fibrin glue in the affected quadrant...

Ocular chemical burns are an ophthalmic emergency and are responsible for 11.5%-22.1% of ocular injuries. Immediate copious irrigation is universally recommended in acute ocular burns to remove the offending agent and minimize damage. Conventional medical therapy consists of the use of agents that promote epithelialization, minimize inflammation, and prevent cicatricial complications. Biological fluids such as autologous serum, umbilical cord blood serum, platelet-rich plasma, and amniotic membrane suspension are a rich source of growth factors and promote healing when used as adjuncts to conventional therapy...

PURPOSE: To evaluate the midterm outcomes of penetrating keratoplasty (PKP) after cultivated oral mucosal epithelial transplantation (COMET) in patients with bilateral total limbal stem cell deficiency (LSCD) due to chemical burn. METHODS: In this prospective interventional nonrandomized case series, optical PKP was performed in patients with severe stromal opacity after successful COMET. Main outcome measures were stability of the ocular surface, visual acuity improvement and corneal graft survival...

AIMS: To evaluate outcomes of deep anterior lamellar keratoplasty (DALK) in pediatric eyes with unilateral severe chemical injury which have undergone autologous simple limbal epithelial transplant (SLET). SETTINGS AND DESIGN: The study design was a retrospective case series. MATERIALS AND METHODS: This retrospective, case series of all children <16 years of age that have undergone DALK following autologous SLET procedure in unilateral severe chemical injury evaluates the outcomes and complications in the setting of a tertiary care center in North India...

PURPOSE: To describe the indications, visual acuity outcomes, and graft survival after penetrating keratoplasty (PKP) in Addis Ababa, Ethiopia. METHODS: The medical records of patients who underwent PKP at Menelik II Hospital between September 2000 and September 2013 were retrospectively reviewed. The prespecified outcomes were graft survival, visual acuity, and complication rates. RESULTS: A total of 321 patients underwent PKP during the study period and were included in the analysis...

PURPOSE: To investigate if a suspension made with amniotic membrane could have a beneficial effect on ocular surface diseases. METHODS: In the Imola branch of the Eye Bank of Emilia Romagna, the authors prepared a suspension containing homogenized amniotic membrane previously conserved at -80 degrees Celsius. Subsequently, the authors gave this preparation to 21 patients: 8 had undergone lamellar keratoplasty, 4 had undergone penetrating keratoplasty, 2 had undergone photorefractive keratectomy with a delay of epithelialization, 3 had neurotrophic corneal ulcers, 2 had corneal burning, 1 had torpid corneal ulcer, and 1 had Sjogren syndrome...

An 11-year-old girl presented to our tertiary eye care centre with a 9-month-old history of lime injury in the left eye in 1999 with vision of counting fingers close to the face. She initially underwent superficial keratectomy with amniotic membrane graft in 1999. Subsequently, cultivated limbal epithelial transplantation was performed in 2001 which improved her vision to 20/400. Following development of pannus and symblepharon in the left eye, she underwent pannus resection and conjunctival limbal autograft in 2002 and, a month later, optical penetrating keratoplasty (PK) following which her vision improved to 20/125...