Case of post Descemet stripping endothelial keratoplasty retrocorneal fibrous membrane

Young, Alvin L; Tam, Patrick MK; Lau, Teresa TY; Cheng, Lulu L; Rao, Srinivas K; Lam, Philip TH

doi:10.1111/j.1442-9071.2009.02050.x

Cited by 9 publications

(2 citation statements)

References 5 publications

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“…After corneal allotransplantation, its development has been reported after failed penetrating keratoplasty (18), Descemet stripping endothelial keratoplasty (19,20), and Descemet membrane endothelial keratoplasty (21). The reported incidence varies considerably from 17% to 83% (22–24).…”

Section: Discussionmentioning

confidence: 99%

Development of retrocorneal membrane following pig‐to‐monkey penetrating keratoplasty

Lee

Mammen

Dhaliwal

et al. 2016

Xenotransplantation

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Introduction Recent reports of long-term survival after wild-type (WT) pig-to-monkey corneal xenotransplantation are encouraging. We experienced the rapid development of retrocorneal membranes, a rare complication after corneal allotransplantation (though seen in infants and young children). The original specific aim of the study was to determine the factors associated with successful (young) pig corneal transplantation in monkeys. However, when it was obvious that retrocorneal membranes rapidly developed, our aims became to determine the factors involved in its development after both WT and GE pig corneal xenotransplantation and to investigate the characteristics of the retrocorneal membrane. Methods Rhesus monkeys were recipients of penetrating keratoplasty using WT and GE pigs (n=2, respectively, 1–3 months-old). Local/systemic steroids were administered for 3 months. Grafts were evaluated by slit-lamp for corneal transparency, edema, and neovascularization. Hematoxylin and eosin, Masson trichrome staining, and immunohistochemical analysis were performed. Gal staining was also carried out to distinguish the origin of the membrane. Results All penetrating keratoplasty recipients developed fibrous retrocorneal membranes in the early post-transplantation period, regardless of whether the graft was from a WT or GE pig. There were no features of rejection, with no cell infiltrate in the graft or anterior chamber during the 3 months follow-up. There was no difference in the clinical course between the two groups (WT or GE corneas). Immunohistochemistry indicated that the retrocorneal membranes were CK-negative, α-SMA-positive, and vimentin-positive, suggesting that they were of fibrous (keratocytic) origin. Also, the membrane was Gal positive, suggesting that it is derived from pig cornea. Conclusions Following pig-to-monkey corneal xenotransplantation, we report that retrocorneal membranes are derived from donor pig keratocytes. Prevention of retrocorneal membranes will be necessary to achieve successful corneal xenotransplantation.

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Section: Discussionmentioning

confidence: 99%

Development of retrocorneal membrane following pig‐to‐monkey penetrating keratoplasty

Lee

Mammen

Dhaliwal

et al. 2016

Xenotransplantation

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“…Thus, we propose that anterior synechiae may affect the success rate and prognosis of the xenotransplant. RCM is another complication that affects corneal transparency and occurs after allogeneic PKP [43], DSAEK [44,45], and DMEK, with an incidence ranging from 17% to 83% [46][47][48][49]. RCM develops from hemorrhage, exudative precipitates with entrapped inflammatory cells that undergo organization or induce endothelial fibrous metaplasia, displaced proliferative iris stromal melanocytes, or adherent proliferating lens epithelial remnants [50][51][52][53].…”

Section: Discussionmentioning

confidence: 99%

Local Immunosuppression in Wuzhishan Pig to Rhesus Monkey Descemet’s Stripping Automated Endothelial Keratoplasty: An Innovative Method to Promote the Survival of Xenografts

Li¹,

Huang²,

Liang³

et al. 2021

Ophthalmic Res

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Corneal xenotransplantation is an effective solution for the shortage of human corneas. We investigated the feasibility and efficacy of different postoperative protocols on xeno-Descemet's stripping automated endothelial keratoplasty (DSAEK) grafts. Thirty rhesus monkeys were randomly divided into three groups: control group (C), only Descemet's membrane (DM) stripping; DSAEK 1 (D1) and DSAEK 2 (D2) groups, DM stripping followed by endothelial keratoplasty. Betamethasone 3.5 mg was subconjunctival injected in groups control and D1 postoperatively, while animals in group D2 were treated with topical 0.1% tacrolimus and topical steroids. All groups were evaluated by slit-lamp microscopy, anterior segment OCT and LSCM for at least nine months. A total of 24 monkeys (24 eyes) met the inclusion criteria. Nine months after DSAEK surgery, all xenografts showed good attachment, and most corneas were transparent. Graft rejection occurred in 25% of the cases in group D1 and 28.57% of those in group D2 (P > 0.05). The corneal endothelium density in the DSAEK groups was 2715.83±516.20/mm² (D1) and 2220.00 ± 565.13/mm² (D2) (P > 0.05). Xenogeneic corneal endothelial grafts can survive and function in rhesus monkey eyes for a long time with subconjunctival steroid or topical tacrolimus and steroid treatment.

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Clinicopathologic Correlations of Retrocorneal Membranes Associated With Endothelial Corneal Graft Failure

Naranjo

Pirakitikulr

Pelaez

et al. 2021

American Journal of Ophthalmology

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Case of post Descemet stripping endothelial keratoplasty retrocorneal fibrous membrane

Cited by 9 publications

References 5 publications

Development of retrocorneal membrane following pig‐to‐monkey penetrating keratoplasty

Development of retrocorneal membrane following pig‐to‐monkey penetrating keratoplasty

Local Immunosuppression in Wuzhishan Pig to Rhesus Monkey Descemet’s Stripping Automated Endothelial Keratoplasty: An Innovative Method to Promote the Survival of Xenografts

Clinicopathologic Correlations of Retrocorneal Membranes Associated With Endothelial Corneal Graft Failure

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