Clinical efficacy of therapeutic keratoplasty using corneal xenografts in patients with corneal ulcers

Abstract

Objective. to assess the clinical efficacy of keratoplasty using a corneal xenograft in patients with corneal ulcers of various etiologies.Methods. A total of 46 patients (49 eyes) with complicated corneal ulcers (perforated or with impending perforation) have been operated. Freeze-dried corneal xenografts have been used for keratoplasty.Results. Our results showed that postoperative period after xenogeneic keratoplasty in patients with corneal ulcers was uneventful and the transplant underwent gradual resorption. In all patients with non-infected corneal erosions, ulcers healed completely and corneal fistulas were fully closed. The implanted corneal xenograft undergoes complete resorption between 2 to 3 months.Conclusions. Given the shortages of donor material, the demonstrated efficacy of using corneal xenografts in patients with complicated corneal ulcers requiring therapeutic keratoplasty allows recommending corneal xenografts for wide use to relieve inflammation and to preserve the eye.

Therapeutic and Tectonic Keratoplasty with Simple Cryopreserved Remnants of Donor Corneas: An 11 Year Retrospective Case Series

“…More recently, tectonic keratoplasty using femtosecond laser intrastromal lenticules 29 and therapeutic xenografts 30 have been proposed as new therapeutic modalities. Although lenticule size could be su cient to create tectonic grafts for keratoplasty, this modality is di cult to apply in cases with deep or large ulcerations due to limitations in the size and thickness of the lenticules 31 .…”

Corneal xenotransplantation: Where are we standing?

“…Although not registered as a clinical trial, two DPC clinical studies have also been reported in Ukraine ( Drozhzhyna et al, 2017 ; Turchyn et al, 2019 ). The authors used the same lyophilized cornea manufactured in Ukraine.…”

“…In one study, DPC was transplanted in 32 eyes with necrotizing keratitis but all the grafts were rejected ( Drozhzhyna et al, 2017 ). In the other study, DPC was transplanted in 49 eyes with complicated corneal ulcers ( Turchyn et al, 2019 ). They reported that the ulcers were healed in all patients although the xenografts were completely absorbed between 2 and 3 months ( Turchyn et al, 2019 ).…”

“…In the other study, DPC was transplanted in 49 eyes with complicated corneal ulcers ( Turchyn et al, 2019 ). They reported that the ulcers were healed in all patients although the xenografts were completely absorbed between 2 and 3 months ( Turchyn et al, 2019 ). Outcomes of the clinical studies from Ukraine were not as good as the ones from China.…”

Invited commentary on “Deep Anterior lamellar keratoplasty with Cross‐linked Acellular Porcine Corneal Stroma to Manage Fungal Keratitis”

“…Therefore, there are still unmet needs that require new interventions for corneal blind subjects. Since the 1st corneal xenotransplantation using fresh porcine corneal graft in human occurred in 1838, 2 several clinical trials have recently been reported using decellularized porcine cornea (DPC) in China and Ukraine 1,3‐6 . Although DPC is not a fresh tissue, evidences just emerged that DPC can be used as a clinically relevant biomaterial for some types of corneal transplantation.…”