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Burn keratoplasty technique

Katarzyna Krysik, Ewa Wroblewska-Czajka, Anita Lyssek-Boron, Edward A Wylegala, Dariusz Dobrowolski
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...
2018: Journal of Ophthalmology
Nidhi Gupta, Jagdish Joshi, Javed Hussain Farooqui, Umang Mathur
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...
January 2018: Indian Journal of Ophthalmology
Sayan Basu, Shraddha P Sureka, Swapna S Shanbhag, Abhinav R Kethiri, Vivek Singh, Virender S Sangwan
PURPOSE: This study describes the long-term clinical outcomes of autologous simple limbal epithelial transplantation (SLET), a relatively new technique of limbal stem cell transplantation. DESIGN: This was a single-center prospective interventional cases series. PARTICIPANTS: This study included 125 patients, 65 adults and 60 children who developed unilateral limbal stem cell deficiency (LSCD) after suffering with ocular surface burns and underwent SLET between 2010 and 2014...
May 2016: Ophthalmology
Jun Xiang, Jianguo Sun, Jiaxu Hong, Wentao Wang, Anji Wei, Qihua Le, Jianjiang Xu
Corneal disease is a common cause of blindness, and keratoplasty is considered as an effective treatment method. However, there is a severe shortage of donor corneas worldwide. This paper presents a novel T-style design of a keratoprosthesis and its preparation methods, in which a mechanically and structurally effective artificial cornea is made based on a poly(2-hydroxyethyl methacrylate) hydrogel. The porous skirt was modified with hyaluronic acid and cationized gelatin, and the bottom of the optical column was coated with poly(ethylene glycol)...
May 2015: Materials Science & Engineering. C, Materials for Biological Applications
Mohammad Zare, Mohammad-Ali Javadi, Bahram Einollahi, Alireza Baradaran-Rafii, Siamak Zarei Ghanavati, Mohammad-Reza Jamshidi Farsani, Parviz Mohammadi, Sepehr Feizi
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...
April 2010: Journal of Ophthalmic & Vision Research
Ting Huang, Xueyan Zhang, Yun Wang, Hong Zhang, Andina Huand, Na Gao
PURPOSE: To report clinical outcomes of deep anterior lamellar keratoplasty (DALK) using the big-bubble technique in various original diagnoses. DESIGN: Prospective interventional study. METHODS: Single hospital study of 115 unselected consecutive patients (131 eyes) with various diagnoses undergoing DALK using the big-bubble technique. The main outcome measures were intraoperative and postoperative complications, postoperative best spectacle-corrected visual acuity (BSCVA), and endothelial cell density (ECD)...
August 2012: American Journal of Ophthalmology
B Koller, T Neuhann, I Neuhann
BACKGROUND: The Boston keratoprosthesis (BKP) is a surgical therapeutic option in patients with corneal disease and poor prognosis for penetrating keratoplasty. The purpose of this study was to summarize our results with this surgical technique which we have employed at our institution since November 2009. METHODS: All patients who underwent the BKP procedure at our institution between November 2009 and August 2011 were identified retrospectively and the data were analyzed...
May 2012: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
Clara C Chan, Joseph M Biber, Edward J Holland
PURPOSE: To describe the technique and present the outcomes of combined conjunctival limbal autografts (CLAU) and keratolimbal allografts (KLAL) for the treatment of unilateral severe ocular surface failure. METHODS: Interventional case series. Eleven eyes of 11 patients who sustained chemical burns (4 alkali and 2 acid) and combined chemical/thermal burns (5 eyes) from firework explosions had combined CLAU/KLAL surgery. Keratoplasty was performed subsequently for residual corneal stromal scarring limiting visual acuity...
November 2012: Cornea
Philipp Eberwein, Daniel Böhringer, Johannes Schwartzkopff, Florian Birnbaum, Thomas Reinhard
OBJECTIVE: To present the technique and report the results of up to 36 months after allogenic central penetrating limbo-keratoplasty in conjunction with conjunctivoplasty, mitomycin C (MMC), and amniotic membrane (AM) transplantation in patients with bilateral limbal stem cell deficiency (LSCD). DESIGN: Retrospective, consecutive subject cohort study. PARTICIPANTS: Case records of 20 eyes from 20 patients who presented with bilateral LSCD due to aniridia, chemical/thermal burn, cicatrizing pemphigoid, and chronic ocular surface inflammation and who were treated at the University Eye Hospital, Freiburg...
May 2012: Ophthalmology
Li-jun Qu, Li-xin Xie
BACKGROUND: With the advancement of microsurgical techniques, lamellar keratoplasty (LK) has been more valued and performed to treat corneal blindness. This study aimed to evaluate the indications and changing trends for LK during the past 16 years in Shandong Eye Institute, an eye center in China. METHODS: A total of 1529 eyes, predominantly from male (70.7%) patients undergoing LK between January 1993 and December 2008, were enrolled in this study. Data were collected by reviewing patient medical records for demographic characteristics, clinical diagnosis, laboratory findings and risk factors...
November 2010: Chinese Medical Journal
Takahiro Nakamura, Chie Sotozono, Adams J Bentley, Sachiko Mano, Tsutomu Inatomi, Noriko Koizumi, Nigel J Fullwood, Shigeru Kinoshita
PURPOSE: To determine the long-term epithelial lineage of origin of surgically removed grafts after allogeneic cultivated corneal limbal epithelial transplantation (CLET). DESIGN: Interventional case reports. PARTICIPANTS: We studied 2 eyes from 2 patients with total corneal stem cell destruction; 1 eye was from a patient with Stevens-Johnson syndrome and 1 eye had sustained chemical injury. METHODS: Allogeneic cultivated corneal limbal epithelial sheets on human amniotic membrane (AM) were transplanted onto the ocular surface...
December 2010: Ophthalmology
Suk Kyue Choi, Jin Hyoung Kim, Doh Lee, Sae Hoon Oh
PURPOSE: To evaluate the feasibility of a femtosecond (FS) laser-assisted keratolimbal allograft (KLAL) technique. DESIGN: Interventional case series. METHODS: This study included 3 patients with extensive limbal stem cell deficiency. The donor cornea was dissected with an FS laser (IntraLase FS laser, 60 kHz) using a ring procedure, without outer side cutting for the limbal graft, after a penetrated dissection of the donor cornea prior to penetrating keratoplasty (PKP)...
August 2010: Cornea
Mozhgan Rezaei Kanavi, Atefeh Javadi, Mohammad Ali Javadi
PURPOSE: To specify histopathologic and immunohistochemical features of chronic and delayed mustard gas keratopathy. METHODS: Corneal buttons from patients with chronic and delayed mustard gas keratopathy were examined for routine histopathology, special histologic stainings, and immunohistochemistry for CD31 and CD68. RESULTS: Twenty-five corneal buttons from 25 patients with chronic and delayed mustard gas keratopathy were evaluated. Irregular epithelial thickness (100%), degenerative changes (24) (96%), thickened epithelial basement membrane (23) (92%), keratocytes loss (18) (72%), and destroyed Bowman layer (18) (72%) were predominant histopathologic features...
September 2010: European Journal of Ophthalmology
Alireza Baradaran-Rafii, Marzieh Ebrahimi, Mozhgan Rezaei Kanavi, Ehsan Taghi-Abadi, Nasser Aghdami, Medi Eslani, Pejman Bakhtiari, Bahram Einollahi, Hossein Baharvand, Mohammad-Ali Javadi
PURPOSE: To report the midterm outcomes of autologous limbal stem cell transplantation cultivated on amniotic membrane (AM) with or without subsequent penetrating keratoplasty (PKP) in patients with total unilateral limbal stem cell deficiency (LSCD). METHODS: Eight eyes of 8 consecutive patients with unilateral total LSCD underwent autologous limbal stem cell transplantation cultivated on AM. Four eyes underwent subsequent optical PKP. Main outcome measures were corneal vascularization and transparency...
May 2010: Cornea
Daniel Kook, Victor Derhartunian, Reinhold Bug, Thomas Kohnen
PURPOSE: To evaluate a novel technique for penetrating keratoplasty (PK) with the use of a new software algorithm for the femtosecond laser, designed to create penetrating cuts in a top hat configuration. DESIGN: Consecutive histomorphological case series. PATIENTS AND METHODS: Twelve eyes of 12 patients underwent penetrating keratoplasty by means of a 60-kHz femtosecond laser (IntraLase, Irvine, California) with a software specifically developed for corneal surgery...
August 2009: Cornea
Hung-Chi Jesse Chen, Hsiang-Ling Chen, Jui-Yang Lai, Chih-Chun Chen, Yueh-Ju Tsai, Ming-Tse Kuo, Pao-Hsien Chu, Chi-Chin Sun, Jan-Kan Chen, David Hui-Kang Ma
PURPOSE: To determine the expression of differentiation and progenitor cell markers in corneal tissues that previously underwent autologous cultivated oral mucosal epithelial transplantation (COMET). METHODS: Four eyes from three alkaline-injured patients and one thermally injured patient underwent COMET to promote re-epithelialization or corneal reconstruction. Between 10 and 22 months (mean, 14.2 +/- 5.5 months [SD]) after COMET, the corneal tissues were obtained after penetrating keratoplasty (n = 1) or autologous limbal transplantation (n = 3)...
October 2009: Investigative Ophthalmology & Visual Science
D H-K Ma, M-T Kuo, Y-J Tsai, H-C J Chen, X-L Chen, S-F Wang, L Li, C-H Hsiao, K-K Lin
PURPOSE: To access the feasibility of using cultivated oral mucosal epithelial cell transplantation (COMET) for the management of severe corneal burn. METHODS: COMET was performed to promote re-epithelialization in two eyes with acute alkaline burn and one eye with chronic alkaline burn, and to reconstruct the ocular surface in two eyes with chronic thermal burn. Autologous oral mucosal epithelial cells obtained from biopsy were cultivated on amniotic membrane. Immunoconfocal microscopy for keratins and progenitor cell markers was performed to characterize the cultivated epithelial sheet...
June 2009: Eye
S J Tuft, A J Shortt
Chemical and thermal burns can cause devastating injuries to the anterior segment. The consequences of alkali injuries are notoriously severe due to the rapid penetration of these agents into the ocular tissues. Denaturation of tissue, inflammation, and scarring leads to loss of function. An understanding of the pathogenesis of tissue damage has lead to a rational approach to treatment. Emergency irrigation of the eye is essential and there is a 'window of opportunity' during the first 7-10 days after injury when medical treatment can significantly limit the potentially blinding consequences...
October 2009: Eye
H Merle, M Gérard, N Schrage
Ocular or thermal burns account for 7.7%-18% of ocular trauma. The majority of victims are young. The burns occur in the setting of accidents at work or in the home, or during a physical attack. Chemical burns by strong acids or bases are responsible for the most serious injuries. Associated with the destruction of limbal stem cells, they present as recurrent epithelial ulcerations, chronic stromal ulcers, deep stromal revascularization, conjunctival overlap, or even corneal perforation. The initial clinical exam is sometimes difficult to perform in the presence of burning symptoms...
September 2008: Journal Français D'ophtalmologie
J Mendicute, A Bidaguren, I Martínez-Soroa, A Gibelalde
PURPOSE: To report a new surgical procedure for the treatment of ocular surface diseases associated with severe limbal insufficiency. METHODS: A retrospective review of four patients with severe ocular surface disease who required stem cell transplantation and keratoplasty for the correction of limbal insufficiencies. They underwent large diameter lamellar keratoplasty with microkeratome. When limbal dysfunction was associated with limited alteration of the ocular surface and transparent deep corneal stroma only the anterior corneal stroma was transplanted...
July 2008: European Journal of Ophthalmology
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