Central corneal haze after wedge resection following penetrating keratoplasty and photorefractive keratectomy

Pöschl, Eva Maria; El-Shabrawi, Yosuf; Ardjomand, Navid

doi:10.1038/eye.2013.27

Cited by 5 publications

(3 citation statements)

References 2 publications

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“…Besides, they are not exempt from complications. On the one hand, the main complication of photorefractive keratectomy (PRK) is corneal haze [14][15][16] due to deep tissue ablation. Reepithelization can be slower in PK cases, increasing the infectious risk.…”

Section: Discussionmentioning

confidence: 99%

Analysis of visual and refractive results after wedge resection for high astigmatism after penetrating keratoplasty in keratoconus

Oteyza

Borasio²,

Ruíz-Santos

et al. 2022

European Journal of Ophthalmology

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Purpose To analyze visual and refractive results after wedge resection to correct high astigmatism after penetrating keratoplasty (PK) for keratoconus. Setting Cornea Unit of the Centro de Oftalmología Barraquer Barcelona, Spain. Design A retrospective quasi-experimental, before and after study. Methods Patients who developed high astigmatism or ectasia in the graft-host junction after PK were treated with wedge resection. The following variables were studied before the surgery, 1-year after and at the final visit: uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), refractive and topographic astigmatism and spherical equivalent. Vectorial analysis of the astigmatism changes was performed. Results Fifty-one eyes were included with a mean follow-up of 4.19 ± 3.09 years. Mean refractive astigmatism was 11.47 ± 3.57 diopters (D) pre-operatively and 4.79 ± 3.32 D at the final follow-up (p < 0.001). The mean centroid changed from 2.65 ± 11.82 D at 23 degrees preoperatively to 0.35 ± 5.86 D at 127 degrees postoperatively. Concerning spherical equivalent, the mean preoperative value was −3.10 ± 4.15 D and the mean postoperative value was −1.55 ± 3.41 D (p = 0.002). Mean pre-operative and final follow-up UDVA were 1.25 ± 0.27 and 0.84 ± 0.50 (p < 0.001). Mean Pre-op and final follow-up CDVA were 0.27 ± 0.19 and 0.24 ± 0.24. Conclusions Wedge resection is a useful surgical procedure to correct high astigmatism. It is a safe technique with moderate efficacy and may be considered as initial procedure of choice in high astigmatism due to long-term ectasia in the graft-host junction after PK for keratoconus.

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Section: Discussionmentioning

confidence: 99%

Analysis of visual and refractive results after wedge resection for high astigmatism after penetrating keratoplasty in keratoconus

Oteyza

Borasio²,

Ruíz-Santos

et al. 2022

European Journal of Ophthalmology

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“…51 Postoperative course can be complicated by graft rejection due to inflammation induced by ablation. 52 Studies have reported regression of refractive cylinder 45 and corneal haze after PRK that limits its effectiveness 53,54 ; however, in recent years, mitomycin-C application, and improvement in lasers and postoperative care have reduced corneal haze after PRK (Table 1). 55,56 Table 1.…”

Section: Incisional Surgerymentioning

confidence: 99%

Management of post-keratoplasty ametropia

Bineshfar,

Tahvildari,

Feizi

2023

Ophthalmol Eye Dis

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Even after a successful corneal transplant, patients experience severe refractive errors, impeding their rehabilitation and satisfaction. Refractive errors can be caused by recipient pathology and corneal thickness, as well as intraoperative factors such as donor–host discrepancy, recipient’s eccentric trephination, vitreous length, wound apposition, technique of suturing, and suture material. Also, wound healing and the interim between keratoplasty and suture removal contribute to astigmatism. Lamellar keratoplasty outperforms penetrating keratoplasty in terms of endothelial cell loss and endothelial graft rejection, yet the risk of developing refractive errors is comparable. Nonsurgical interventions such as spectacles and lenses fail to provide desirable vision in cases with high astigmatism and corneal irregularity. When these limitations are encountered, surgical interventions including incisional keratotomy, wedge resection, laser refractive surgeries, intracorneal segments, and intraocular lens implantation are employed. However, occasionally, none of these approaches deliver the desired effects, leading to the need for a repeat keratoplasty.

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“…Currently, the solution to restore vision due to a dysfunctional endothelium is to replace it with a healthy donor endothelium by means of corneal endothelial transplantation (Shihadeh et al, 2010). However, all penetrating transplantations, including penetrating keratoplasty (PKP) (Inoue et al, 2000;Poschl et al, 2013;Sugar and Sugar, 2000), endothelial keratoplasty (Deep Lamellar Endothelial Keratoplasty [DLEK]) (Terry andOusley, 2001, 2003), Descemet's stripping with automated endothelial keratoplasty (DSAEK) (Gorovoy, 2006;Koenig and Covert, 2007;Lee et al, 2009), Descemet's membrane endothelial keratoplasty (DMEK), and Descemet's membrane automated endothelial keratoplasty (DMAEK) (Dapena et al, 2009;Dapena et al, 2011;Guerra et al, 2011;Maier et al, 2013a;Maier et al, 2013b;Naveiras et al, 2012;Parker et al, 2012;Terry, 2012), require a donor cornea, which is often difficult to obtain due to the global shortage of transplant-grade donor corneal tissue. In addition, in some cases after graft failure in young patients, limited regeneration has been observed (Teichmann et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

3D in vitro model for human corneal endothelial cell maturation

Hutcheon

Zieske

Guo

2019

Experimental Eye Research

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Corneal endothelium is a cellular monolayer positioned on the Descemet's membrane at the anterior cornea, and it plays a critical role in maintaining corneal clarity. Our present study examines the feasibility of utilizing our 3-dimensional (3D) corneal stromal construct, which consists of human corneal fibroblasts (HCF) and their self-assembled matrix, to observe the development and maturation of human corneal endothelial cells (HCEndoCs) in a co-culture model. Three-dimensional HCF constructs were created by growing the HCFs on Transwell membranes in Eagles' minimum essential medium (EMEM) + 10% FBS + 0.5mM Vitamin C (VitC) for about 4 weeks. HCEndoCs, either primary (pHCEndoC) or cell line (HCEndoCL), were either seeded in chamber slides, directly on the Transwell membranes, or on the 3D HCF constructs and cultivated for 5 days or 2 weeks. The HCEndoCs that were seeded directly on the Transwell membranes were exposed indirectly to HCF by culturing the HCF on the plate beneath the membrane. Cultures were examined for morphology and ultrastructure using light and transmission electron microscopy (TEM). In addition, indirect-immunofluorescence microscopy (IF) was used to examine tight junction formation (ZO-1), maturation (ALDH1A1), basement membrane formation (Laminin), cell proliferation (Ki67), cell death (caspase-3), and fibrotic response (CTGF). As expected, both pHCEndoCs and HCEndoCLs formed monolayers on the constructs; however, the morphology of the HCEndoCLs appeared to be similar to that seen in vivo, uniform and closely packed, whereas the pHCEndoCs remained elongated. The IF data showed that laminin localization was present in the HCEndoCs' cytoplasm as cell-cell contact increased, and when they were grown in the 3D co-culture, the beginnings of what appears to be a continuous DM-like structure was observed. In addition, in co-cultures, ALDH1A1-positive HCEndoCs were present, ZO-1 expression localized within the tight junctions, minimal numbers of HCEndoCs were Ki67-or Caspase-3-positive, and CTGF was positive in both the HCEndoCs cytoplasm and the matrix of the co-culture. Also, laminin localization was stimulated in HCEndoCs upon indirect stimuli secreted by HCF. The present data suggests our 3D co-culture model is useful for studying corneal endothelium maturation in vitro since the co-culture promotes new DM-like formation, HCEndoCs develop in vivo-like characteristics, and the fibrotic response is activated. Our current findings are applicable to understanding the implications of corneal

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Central corneal haze after wedge resection following penetrating keratoplasty and photorefractive keratectomy

Cited by 5 publications

References 2 publications

Analysis of visual and refractive results after wedge resection for high astigmatism after penetrating keratoplasty in keratoconus

Analysis of visual and refractive results after wedge resection for high astigmatism after penetrating keratoplasty in keratoconus

Management of post-keratoplasty ametropia

3D in vitro model for human corneal endothelial cell maturation

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