Lamellar Keratoplasty Treatment of Fungal Corneal Ulcers With Acellular Porcine Corneal Stroma

Zhang, Mingchang; Liu, X.; Jin, Yan; Jiang, Dan; Wei, Xin; Xie, Hua-Tao

doi:10.1111/ajt.13096

Cited by 137 publications

(120 citation statements)

References 28 publications

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“…With the shortage of donor corneas for cornea transplantation, there is a critical need to find an ideal substitute . Compared to other materials, APCS has its own unique advantages and is more widely used clinically.…”

Section: Discussionmentioning

confidence: 99%

Short‐term results of acellular porcine corneal stroma keratoplasty for herpes simplex keratitis

Zheng

Huang

Zhang

et al. 2019

Xenotransplantation

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Background Corneal transplantation is a common surgical intervention for restoring vision loss due to corneal damages. However, for cultural reasons, there is a huge shortage of donor corneas in China. Acellular porcine corneal stromas (APCSs) can be used as corneal substitutes in lamellar keratoplasty for corneal ulcers. This study was conducted to analyze the results of APCS use for herpes simplex keratitis (HSK). Methods The study involved HSK patients who underwent keratoplasty with APCSs from February 2016 to October 2017 in the second affiliated hospital of Zhejiang University. Patient data were collected at 7 days, 1 month, 3 months, 6 months, and at the last follow‐up (7‐25 months) postoperative. The corneal transparency, neovascularization, visual acuity, and graft stability were observed. Results Thirteen patients with HSK including five patients with corneal perforation were included in this study, nine patients underwent deep anterior lamellar keratoplasty (DALK) and five perforation patients underwent double lamellar keratoplasty. There were nine men and four women with an average age of 62.5 ± 5.6 years old (ranging from 52 to 70 years old). The mean postoperative follow‐up duration was 15.1 ± 5.8 months (ranging from 7 to 25 months). At the last visit, visual acuity improved in nine patients (69.2%) compared with preoperative (P = 0.008).The grafts of seven individuals (53.8%) were completely transparent or slightly opaque; their corneal transparency score had improved significantly compared with before the surgery (P = 0.010). Various degrees of neovascularization were present in 11 of the 13 patients (84.6%), most neovascularization gradually stabilized. Graft dissolution occurred in three eyes (23.1%) during the observation period, two underwent regrafting, the other one became stable after treatment. Three patients underwent second allograft transplantation, two of which encountered APCS graft dissolution and one of the patients requested a human donor allograft transplantation due to transparency issues despite the absence of adverse issues. Conclusion Acellular porcine corneal stroma seems to be effective in the treatment of HSK and can be used in HSK with corneal perforation by using double lamellar keratoplasty in an emergency.

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Section: Discussionmentioning

confidence: 99%

Short‐term results of acellular porcine corneal stroma keratoplasty for herpes simplex keratitis

Zheng

Huang

Zhang

et al. 2019

Xenotransplantation

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“…Recently, Zhang et al (2015) reported the lamellar implantation of acellular porcine corneal stromas (APCS) to replace the anterior corneas of 47 patients diagnosed with corneal fungal ulcers resistant to routine antifungal drug therapy (Zhang et al, 2015). They reported that 41 of the implants became transparent over time and 34 patients (72%) showed vision improvement.…”

Section: Decellularized Corneas As Stromal Scaffoldsmentioning

confidence: 99%

Alternatives to eye bank native tissue for corneal stromal replacement

Brunette

Roberts

Vidal

et al. 2017

Progress in Retinal and Eye Research

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“…The shortage of human donor corneas is an emerging issue that has stimulated interest in corneal xenotransplantation, with porcine corneas being considered a feasible source. Although partial‐thickness acellular porcine corneal grafts have been used, there has been no clinical application of fresh (cellular) porcine corneas, which is considered true “xenotransplantation” by the World Health Organization (WHO) . However, recent progress in corneal xenotransplantation using nonhuman primates (NHPs) as recipients has led researchers to propose a clinical trial .…”

Section: Cornea‐specific Considerations For Preparing An Initial Cornmentioning

confidence: 99%

Standardization of the proceedings for preparing clinical trials of corneal xenotransplantation in South Korea

Choi

Hyon

Song

et al. 2018

Xenotransplantation

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Lamellar Keratoplasty Treatment of Fungal Corneal Ulcers With Acellular Porcine Corneal Stroma

Cited by 137 publications

References 28 publications

Short‐term results of acellular porcine corneal stroma keratoplasty for herpes simplex keratitis

Short‐term results of acellular porcine corneal stroma keratoplasty for herpes simplex keratitis

Alternatives to eye bank native tissue for corneal stromal replacement

Standardization of the proceedings for preparing clinical trials of corneal xenotransplantation in South Korea

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