Background/Objectives To evaluate the clinical efficacy of topical tacrolimus 0.1% and cyclosporine 1% on high-risk penetrating keratoplasty (PKP) patients. Subjects/Methods A series of 49 high-risk PKP patients (49 eyes), 20 males, 29 females from the age of 4 months to 74 years of age with the mean of 32.5 from 2012 to 2017 were recruited in this study. The patients were randomly divided into two groups by receiving either topical tacrolimus 0.1% or cyclosporine 1% respectively. Twenty five patients were treated with topical tacrolimus 0.1% and 24 patients with topical cyclosporine 1%. The traditional baseline management on these two groups were Tobramycin and Dexamethasone eye drops in the first 3 weeks and then tapered off. Clinical procedures and postoperative follow-up were documented. Results After 6–54 months follow-up, with the average of 24 months, 11 of 24 high-risk patients (11 eyes) had graft rejection, the rejection rate was 45.8% in topical cyclosporine 1% group. The rejections occurred from 35 days to 20 months after PKP. Three patients had irreversible rejection. On topical tacrolimus 0.1% group, the rejection occurred in four patients (four eyes) with rejection rate of 16%, and no irreversible rejection was observed. The graft rejection episodes were documented between 23 days and 24 months. As compared with the topical cyclosporine 1%, topical tacrolimus 0.1%, a key immunosuppressant, significantly decreased corneal graft rejection rate ( p = 0.02). Conclusions Topical tacrolimus 01% on high-risk PKP patients significantly prevented corneal graft rejection, and it had less adverse effects and was very safe to high-risk patients as to topical cyclosporine 1%. Further case controlled randomized clinical trial studies are needed to establish the best management option for these high-risk patients.

This study demonstrates the presence of mesenchymal stem cell-like cells in the murine corneal stroma. Further analysis of these cells will aid elucidation of the mechanisms of some keratopathies, and these cells may be a source for bioengineering of corneal tissue and for cell-based therapeutics.

No abstract

Purpose To evaluate the effects of the vascular endothelial growth factor inhibitor conbercept (KH902) on corneal neovascularization and wound healing following penetrating keratoplasty in rabbits. Methods Conbercept was administered to New Zealand white rabbits through topical and subconjunctival routes. Corneal neovascularization and wound healing were examined by slit-lamp photography and histological analyses. The expressions of vascular endothelial growth factor inhibitor, α-smooth muscle actin, and keratocan in the corneal grafts were measured by real-time quantitative polymerase chain reaction (RT-qPCR). Results The anterior segment photographs demonstrated that corneal neovascularization started in the 2nd week. In the 4th week, histologically, the superficial corneal stroma layer showed disordered arrangement, and there were large numbers of dense inflammatory cells and blood vessels in the stroma layer. Vascular endothelial growth factor in the experimental groups was significantly decreased at all time points compared with the control group (both P = 0.001). Expression of α-smooth muscle actin in corneal grafts demonstrated an increase in time even it was lower in experimental groups, but the difference was not statistically significant (P equaled to 0.507 and 0.723, respectively). There were no significant differences with the expression of keratocan in all groups except that it significantly declined at the 4th week as to the second week in all groups and P values were 0.022, 0.020 and 0.014 in control (C), topical (E1), and subconjunctival (E2) group, respectively. Conclusion The study found that conbercept inhibited the formation of corneal neovascularization without affecting keratocan-mediated corneal wound healing and there were no significant differences between topical administration of different doses of conbercept on the rabbit corneal neovascularization after penetrating keratoplasty in this study.

Background: To investigate the therapeutic outcomes of two types of keratoplasties in patients with infectious keratitis.Methods: This retrospective cohort study enrolled 52 consecutive patients (52 eyes) with medically uncontrolled infectious keratitis who underwent deep lamellar keratoplasty (DLKP) (n=16 eyes) or penetrating keratoplasty (PKP) (n=36 eyes; 24 nonperforated ulcers; 12 perforated ulcers) with a follow-up of 12 to 36 months (mean follow-up duration: DLKP, 24.6 months; PKP: 25.7 months) between June 2014 and 2019 at the Department of Ophthalmology, The Third Hospital of Hebei Medical University. The clinical characteristics, preoperative, and postoperative best-corrected visual acuity (BCVA) outcomes, therapeutic success rate, graft rejection, management, and complications were assessed.Results: The postoperative BCVA increased by 93.8% (15/16 eyes) and 77.2% (27/36 eyes) at the one-year follow-up in the DLKP and PKP groups, respectively: the differences were not statistically significant (p=0.149). The therapeutic success rates did not differ (statistically) significantly between the DLKP (81.2%) and PKP (80.6%) groups (p=0.953). The incidence of secondary glaucoma was 6.25% and 33.33% in the DLKP and PKP groups, respectively, and the difference between them was statistically significant (p=0.037). The graft survival rates at the one-year follow-up differed significantly between the DLKP (12.5%) and PKP (42.9%) groups (p=0.033).Conclusion: Infectious keratitis is common in male farmers in northern China. Therapeutic keratoplasty is the most commonly performed vision-saving procedure for patients with severe serious infectious keratitis, which can improve the quality of life significantly. Bandage contact lenses were commonly used to protect the cornea and ameliorate pain. DLKP and PKP elicited good clinical outcomes with respect to visual recovery and therapeutic success. The frequencies of graft rejection and complications were lower with DLKP compared to PKP. Surgery should be considered at the early stage in patients with refractory infectious keratitis to improve the therapeutic success.