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Intraoperative Optical Coherence Tomography: Game-Changing Technology
Price, Francis W. Jr MD
doi : 10.1097/ICO.0000000000002629
Cornea: June 2021 - Volume 40 - Issue 6 - p 675-678
Intraoperative optical coherence tomography (OCT) has the potential to revolutionize lamellar corneal surgery and facilitate many other types of ocular surgery because it readily visualizes ocular structures that can be difficult to discern with a coaxial microscope, particularly through a cloudy cornea. Systems that can provide a high-quality image on demand in the surgeon's oculars, rather than just on an adjacent monitor, are the most useful because they allow the surgeon to rely on the OCT image while operating, without having to look away from the surgical field. Useful applications in lamellar corneal surgery include assessing graft attachment with Descemet stripping endothelial keratoplasty and discerning graft orientation with Descemet membrane endothelial keratoplasty, which otherwise could be challenging in an eye with a cloudy cornea. Intraoperative OCT is particularly helpful when performing deep anterior lamellar keratoplasty in cases in which a big bubble should not be attempted or cannot be achieved because it enables better intraoperative control of the incision depth and allows the surgeon to assess the uniformity of the dissection plane to optimize visual outcomes. Intraoperative OCT is also useful when judging the depth of a scar for a lamellar dissection, when evaluating intraocular lens positioning in the capsular bag, or when locating and removing retained nuclear fragments from an eye with a poor view because of a cloudy cornea. The primary barrier to the adoption of this valuable technology is cost.
Short-Term Outcomes of Pediatric Keratoprosthesis With the Near-Complete Conjunctival Flap
Bawany, Mohammad H. BS*; Kudla, Callais BSN-RNC†; Khan, Faraaz A. MD†; Chung, Mina M. MD†; Aquavella, James V. MD†
doi : 10.1097/ICO.0000000000002685
Cornea: June 2021 - Volume 40 - Issue 6 - p 679-684
The Boston keratoprosthesis (KPro) has been used for certain indications in pediatric patients with congenital corneal opacities. Here, we describe the use of a near-complete conjunctival flap at the time of Boston type 1 KPro surgery in pediatric patients, with the goal of improving pediatric KPro outcomes.
Descemet Membrane Endothelial Keratoplasty in Vascularized Eyes: Outcome and Effect on Corneal Neovascularization
Hayashi, Takahiko MD, PhD*,†; Zhang, Wei MD*; Hos, Deniz MD, PhD*,‡; Schrittenlocher, Silvia MD*; Nhat Hung Le, Viet MD, PhD*,§; Siebelmann, Sebastian MD, MHBA*; Matthaei, Mario MD*; Bock, Felix PhD*; Bachmann, Bj?rn MD, PhD*; Cursiefen, Claus MD, PhD*,‡
doi : 10.1097/ICO.0000000000002502
Cornea: June 2021 - Volume 40 - Issue 6 - p 685-689
To report the outcomes after Descemet membrane endothelial keratoplasty (DMEK) in vascularized eyes.
Anatomical Changes in the Anterior Chamber Volume After Descemet Membrane Endothelial Keratoplasty
Onouchi, Hiromi MD, PhD*; Hayashi, Takahiko MD, PhD†,‡; Shimizu, Toshiki MD†; Matsuzawa, Akiko MD, PhD§; Suzuki, Yasuyuki MD, PhD*; Kato, Naoko MD, PhD*,†
doi : 10.1097/ICO.0000000000002535
Cornea: June 2021 - Volume 40 - Issue 6 - p 690-695
To evaluate changes in the anterior chamber of eyes that have undergone Descemet membrane endothelial keratoplasty (DMEK) and to identify factors that affect these changes.
Changes of Contamination Rate and Microorganism Evaluation in Organ-Cultured Human Corneas: A 14-Year Review From a French Regional Eye Bank
Fabre, Laura MD*; Puyraveau, Marc MD†; Jeanvoine, Audrey MD‡; Thibaud, Garcin MD, PhD§; Pizzuto, Joëlle MD¶; Pouthier, Fabienne MD, PhD¶; Delbosc, Bernard MD, PhD?; Gauthier, Anne Sophie MD, PhD?
doi : 10.1097/ICO.0000000000002618
Cornea: June 2021 - Volume 40 - Issue 6 - p 696-703
This study aimed to assess how the contamination rate of organ-cultured corneas has evolved and to analyze the evolution of microorganisms involved.
Proteus mirabilis Keratitis: Risk Factors, Clinical Features, Treatment Outcomes, and Microbiological Characteristics
Mo, Shelley MD*; Durrani, Asad F. MD*,†; Safiullah, Zaid MD*; Kowalski, Regis P. MS, M(ASCP)*,‡; Jhanji, Vishal MD, FRCS (Glasgow), FRCOphth*,‡
doi : 10.1097/ICO.0000000000002469
Cornea: June 2021 - Volume 40 - Issue 6 - p 704-709
To characterize the risk factors, clinical presentations, management choices, and outcomes of Proteus mirabilis keratitis.
Tissue Loss, Processing Time, and Primary Graft Failure in Eye Bank–Prepared Descemet Membrane Endothelial Keratoplasty Grafts Before and After Prestripped to Preloaded Graft Transition
Duong, Andrew T. BA*; Mandel Foley, Lindsay MD†; Galloway, Joshua CEBT‡; Sales, Christopher S. MD, MPH*,‡; Tran, Khoa D. PhD‡
doi : 10.1097/ICO.0000000000002531
Cornea: June 2021 - Volume 40 - Issue 6 - p 710-714
To examine tissue loss rates, processing time, and primary graft failure (PGF) of “prestripped-only” Descemet membrane endothelial keratoplasty (DMEK) grafts at a single eye bank and how these parameters changed after the introduction of steps to preload tissue among experienced processors.
Corneal Folds After Descemet Membrane Endothelial Keratoplasty in Congenital Hereditary Endotheial Dystrophy
Fogla, Rajesh DNB, FRCS, FRCOphth, FACS*; Srinivasan, Bhaskar MS†
doi : 10.1097/ICO.0000000000002471
Cornea: June 2021 - Volume 40 - Issue 6 - p 715-719
To report a new clinical sign of corneal folds after Descemet membrane endothelial keratoplasty (DMEK) in the eyes with congenital hereditary endothelial dystrophy (CHED).
Penetrating Keratoplasty in Infants With Peters Anomaly: Visual and Graft Outcomes
Lin, Qi MD, PhD*; Li, Li MD, PhD*; Sun, Yajie MD†; Miao, Sen MD‡; Li, Xu MD§; Shi, Wei MD, PhD*; Pan, Zhiqiang MD, PhD§
doi : 10.1097/ICO.0000000000002669
Cornea: June 2021 - Volume 40 - Issue 6 - p 720-725
To determine the prevalence of survival of corneal grafts and visual outcomes of primary penetrating keratoplasty (PK) in infants with Peters anomaly (PA) in Beijing, China.
Corticosteroids Versus Cyclosporine for Subepithelial Infiltrates Secondary to Epidemic Keratoconjunctivitis: A Prospective Randomized Double-Blind Study
Gouider, Dhouha MD*,†; Khallouli, Asma MD*,†; Maalej, Afef MD*,†; Yousfi, Mohamed Ali PharmD†,‡; Ksiaa, Imen MD§; Bouguerra, Chaker MD†; Ajili, Faida MD†,¶; Khairallah, Moncef MD§
doi : 10.1097/ICO.0000000000002589
Cornea: June 2021 - Volume 40 - Issue 6 - p 726-732
To compare efficiency and tolerance between topical 0.5% cyclosporine A (CSA) and fluorometholone (FML) for subepithelial infiltrates (SEI) complicating epidemic keratoconjunctivitis.
Thickness and Curvature Changes of Human Corneal Grafts in Dextran-Containing Organ Culture Medium Before Keratoplasty
Hamon, Loïc MD*; Daas, Loay MD*; M?urer, Stephanie MS†; Weinstein, Isabel MD*; Quintin, Adrien MD*; Schulz, Katja AS‡; Langenbucher, Achim PhD†; Seitz, Berthold MD*
doi : 10.1097/ICO.0000000000002543
Cornea: June 2021 - Volume 40 - Issue 6 - p 733-740
To determine the changes of corneal thickness and curvature of human corneal grafts in organ culture medium II, containing dextran T500 6%, before keratoplasty.
Corneal Stromal Regeneration Therapy for Advanced Keratoconus: Long-term Outcomes at 3 Years
El Zarif, Mona OD, MSc*,†,‡,§; Ali?, Jorge L. MD, PhD, FEBOphth¶,†; Ali? del Barrio, Jorge L. MD, PhD, FEBOS-CR¶,†; Abdul Jawad, Karim BSc*; Palaz?n-Bru, Antonio PhD?; Abdul Jawad, Ziad OD*; De Miguel, Mar?a P. PhD**; Makdissy, Nehman PhD§
doi : 10.1097/ICO.0000000000002646
Cornea: June 2021 - Volume 40 - Issue 6 - p 741-754
To report the 3-year clinical outcomes of corneal stromal cell therapy consisting of the intrastromal implantation with autologous adipose-derived adult stem cells (ADASCs), and decellularized or ADASC-recellularized human donor corneal laminas in advanced keratoconus.
Single-Pass Mikrokeratome and Anterior Chamber Pressurizer for the Ultrathin Descemet-Stripping Automated Endothelial Keratoplasty Graft Preparation
Clerici, Riccardo MD*; Ceccuzzi, Roberto MD†; Fausto, Riccardo MD*; Tinelli, Carmine MD‡; Di Palma, Maria Rosaria MS†; Mantegna, Giuseppe MS†; Riva, Ivano MD§; Busin, Massimo MD¶,?,**; De Angelis, Giovanni PhD*; Quaranta, Luciano MD, PhD*,†
doi : 10.1097/ICO.0000000000002607
Cornea: June 2021 - Volume 40 - Issue 6 - p 755-763
To compare the reliability of microkeratome dissection with the anterior chamber pressurizer (ACP) system versus conventional pressurization for ultrathin Descemet-stripping automated endothelial keratoplasty (UT-DSAEK) graft preparation.
A Novel mRNA Modification Mutation in a Patient With Ligneous Conjunctivitis Coexisting With Heterozygous Familial Mediterranean Fever Mutation
Koseoglu, Neslihan D. MD*; Ceylaner, Serdar MD†; Yildirim, Nilgun MD*
doi : 10.1097/ICO.0000000000002702
Cornea: June 2021 - Volume 40 - Issue 6 - p 764-768
To describe a novel mRNA mutation associated with ligneous conjunctivitis (LC) in a patient with heterozygous familial Mediterranean fever (FMF) mutation.
Endotheliitis—A Presentation of Acanthamoeba Keratitis
Lakhani, Bansri K. MBChB, FRCOphth*; Thajudeen, Bushra MBBS, FRCOphth, MS, DO†; Jawaid, Imran BSc (Hons), MBChB (Hons), FRCOphth*; Attzs, Michelle S. BSc, MSc, MBBS, FRCOphth*; Maharajan, Veerabahu S. MBBS, DO, DNB, FRCSEd, FRCOphth, DM*
doi : 10.1097/ICO.0000000000002491
Cornea: June 2021 - Volume 40 - Issue 6 - p 769-773
To report endotheliitis as an early, key presenting sign of Acanthamoeba keratitis in patients who are soft contact lens wearers.
Diphtheroids as Corneal Pathogens in Chronic Ocular Surface Disease in Stevens–Johnson Syndrome/Toxic Epidermal Necrolysis
Shanbhag, Swapna S. MD*,†; Shih, Grace MD*; Bispo, Paulo J. M. PhD*,‡; Chodosh, James MD MPH*,‡; Jacobs, Deborah S. MD*; Saeed, Hajirah N. MD, MPH*
doi : 10.1097/ICO.0000000000002696
Cornea: June 2021 - Volume 40 - Issue 6 - p 774-779
To characterize diphtheroid corneal infections in eyes in the chronic phase of Stevens–Johnson syndrome/toxic epidermal necrolysis (SJS/TEN).
Successful Outcome of Simultaneous Allogeneic Simple Limbal Epithelial Transplantation With Therapeutic Penetrating Keratoplasty (PKP) for Limbal Stem Cell Deficiency and Sterile Keratolysis After Chemical Injury
Kunapuli, Anuradha MS, DNB*; Fernandes, Merle MS†
doi : 10.1097/ICO.0000000000002576
Cornea: June 2021 - Volume 40 - Issue 6 - p 780-782
To describe the successful outcome of simultaneous allogeneic simple limbal epithelial transplantation (SLET) combined with therapeutic penetrating keratoplasty (PKP) for limbal stem cell deficiency (LSCD) with sterile keratolysis after bilateral chemical injury.
Gundersen Flap Removal to Restore Eyesight Without Limbal Transplantation—A Case Report
Fogla, Rajesh DNB, FRCSEd, FRCOphth, FACS; Indumathy, Thazethaeveetil R. MS
doi : 10.1097/ICO.0000000000002530
Cornea: June 2021 - Volume 40 - Issue 6 - p 783-785
To report a case of Gundersen flap removal where the ocular surface was restored without the need for additional limbal stem cell transplantation.
Eye Bank Management of Irregular Descemet Stripping Automated Endothelial Keratoplasty Lenticules
Ruzza, Alessandro BSc*; Galeone, Alessandra MD†; Baruzzo, Mattia*; Favaro, Elisa*; Parekh, Mohit PhD‡; Ferrari, Stefano PhD*; Ponzin, Diego MD*
doi : 10.1097/ICO.0000000000002539
Cornea: June 2021 - Volume 40 - Issue 6 - p 786-789
To report the management of precut Descemet stripping automated endothelial keratoplasty (DSAEK) lenticules unsuitable for transplantation because of irregular anterior profile after microkeratome cutting.
Tectonic Mini-DSAEK Facilitates Closure of Corneal Perforation in Eyes With Healthy Endothelium
Seifelnasr, Mohamed MRCSed*,†; Roberts, Harry W. MSc, MD, FRCOphth*; Moledina, Malik MBBS*; Myerscough, James FRCOphth*,‡
doi : 10.1097/ICO.0000000000002712
Cornea: June 2021 - Volume 40 - Issue 6 - p 790-793
The purpose of this study was to report a surgical technique for closure of a traumatic corneal perforation in a patient with healthy endothelium.
Intrastromal Allogeneic Inclusions for the Management of Keratoconus: A Review of Current Literature
Garc?a de Oteyza, Gonzalo MD, FEBO*,†; Benedetti Sandner, M?nica MD†; Velazco Casap?a, Jorge MD‡; Trivi?o, Carmen MD‡; Salvador-Culla, Borja MD§; Garc?a-Albisua, Ana Mercedes MD†
doi : 10.1097/ICO.0000000000002658
Cornea: June 2021 - Volume 40 - Issue 6 - p 794-799
A new therapeutic alternative has been developed in the past 6 years to treat severe keratoconus in young patients. Those patients had only corneal transplantation as an option, but now a variety of surgical alternatives in the form of allogeneic corneal inclusions have bloomed and are becoming more popular. Although Bowman layer transplantation is the most studied technique, recent studies have described different options with very promising preliminary results. Mostly all the techniques described improve corneal curvature, visual acuity, pachymetry, contact lens tolerance, and foremost, manage to avoid or postpone corneal transplantation. Very few complications have been described so far, which makes these techniques not only feasible but also safe. Herein, we focus on reviewing recently published studies describing these techniques and their first results.
Efficacy of Immunosuppressants in High Rejection Risk Keratoplasty: A Meta-Analysis of Comparative Studies
Yu, Kang MD; Lian, Xiu-Fen MD; Jiang, Xiu-Ying MD; Zhou, Shi-You MD, PhD
doi : 10.1097/ICO.0000000000002709
Cornea: June 2021 - Volume 40 - Issue 6 - p 800-807
To evaluate the prophylactic effects of immunosuppressants in corneal graft rejection after high-risk penetrating keratoplasty.
Response to “YAG Laser Treatment for Epithelial Ingrowth in Descemet Membrane Endothelial Keratoplasty Interface”
Knutsson, Karl Anders MD; Paganoni, Giorgio MD; Rama, Paolo MD
doi : 10.1097/ICO.0000000000002645
Cornea: June 2021 - Volume 40 - Issue 6 - p e11
Letter to the Editor – Author’s Reply: YAG Laser Treatment for Epithelial Ingrowth in Descemet’s Membrane Endothelial Keratoplasty Interface
Jenkins, Sabrina G. BS; Jun, Albert S. MD, PhD; Woreta, Fasika A. MD, MPH; Srikumaran, Divya MD
doi : 10.1097/ICO.0000000000002668
Cornea: June 2021 - Volume 40 - Issue 6 - p e11-e12
