1,721,088 research outputs found
Alpha-Glycerylphosphorylcholine and D-Panthenol Eye Drops in Patients Undergoing Cataract Surgery
Full text linkCataract surgery is widespread. The surgical procedure is associated with damage to the epithelial barrier and interruption of the corneal innervation. In addition, pathological events sustain signs and symptoms that may persist for a long time. Recently, a fixed combination of alpha-glycerylphosphorylcholine and D-Panthenol (Oftassiale) has been available as eye drops. The present study investigated the effects of an Oftassiale therapy in 20 patients undergoing cataract surgery. A comparison group included 20 patients treated with topical hyaluronic acid. Standard prophylactic and anti-inflammatory treatment was prescribed to all patients. Clinical signs and symptoms were assessed over time. In vivo confocal microscopy (IVCM) was performed accordingly. Oftassiale treatment significantly reduced clinical features and improved IVCM outcomes. In addition, therapy was well-tolerated, and no clinically significant adverse events occurred. In conclusion, this study confirmed that IVCM helps assess the tunnel after cataract surgery due to its ability to provide microscopic details in vivo. Topical therapy with alpha-glycerylphosphorylcholine and D-Panthenol eye drops promoted and stabilized the reepithelialization process. This fixed combination also accelerated and modulated the repair of the corneal innervation. Moreover, this treatment was well-tolerated and safe
Deep lamellar keratoplasty with trypan blue intrastromal staining
No full textThis technique was developed to facilitate removal of the deep stromal layers during deep lamellar keratoplasty. A trypan blue 0.02% solution is injected into the stromal fibers, enabling the surgeon to visualize and remove the posterior stromal layers. This decreases the risk of perforation of Descemet's membrane and the endothelium. © 2002 ASCRS and ESCRS
Temporary Kerato-Prosthesis to Resolve Traumatic Loss of a Healed Corneal Button
Full text linkThe aim of this study is to report a rare case of traumatic complete loss of a donor corneal button successfully resolved by a 24-h implantation of a temporary kerato-prosthesis. A healthy 30-year-old man with a history of prior penetrating keratoplasty (PKP) presented with an open globe following accidental contusive trauma with a ball, while he was playing football. At slit-lamp evaluation, complete dehiscence of the wound at the graft-host junction and complete corneal button loss was evident. The patient was immediately taken to the operating room, but a donor cornea was not available; therefore, a vitreo-retinal temporary kerato-prosthesis was implanted to close the eyeball until a new donor cornea was available. In case of complete dehiscence of the donor-host junction after PKP with corneal button loss, it is possible to use a temporary kerato-prosthesis to stabilize the eye and contain the intraocular structures. We recommend the availability of temporary vitreo-retinal kerato-prosthesis in the operating theatres of Corneal Surgical Units
Biochemical characterization of saponins in transgenic Medicago truncatula plants and their role on apoptosis
No full textLamellar Keratoplasty
No full textLamellar corneal surgery was conceived in the first years of the 20th century. Despite the intuition of decreasing the possibility of allograft rejection, this technique was given up on account of bad visual results, if compared with penetrating keratoplasty, due to inadequate techniques and instruments. In the eighties, the development of refractive surgery techniques, causes a new attention in this kind of surgery and the ideation of deep lamellar keratoplasty (DLK). In the last few years a new lamellar technique, Deep Lamellar Endothelial Kerato-plasty, was developed in order to correct endothelial diseases such as bullous keratopathy. In this article we will describe some of the most important anterior and posterior lamellar techniques
Stage 4 diffuse lamellar keratitis after laser in situ keratomileusis Clinical, topographical, and pachymetry resolution 5 years later.
No full textIn March 1999, a 35-year-old woman had uneventful laser in situ keratomileusis in both eyes on the same day. Five days postoperatively, slitlamp biomicroscopy of the left eye showed an appearance similar to haze after photorefractive keratectomy, with greater density at the center and striae convergent toward the infiltrate (stage 4 diffuse lamellar keratitis [DLK]). The patient received treatment with dexamethasone 0.2% eyedrops every 2 hours. After 2 weeks, visual acuity was better and improvement was evident on topography, pachymetry, and slitlamp photography. The improvements were more marked at 6 months and 1 year. There was a progressive increment in corneal thickness and consequent improvement in corneal transparency, curvature, and regularity. This case, in which continuous morphologic adaptation of the cornea occurred, indicates that observation, rather than intervention, is a valid therapeutic option for stage 4 DLK
Keratoconus Therapeutic Guidelines based on staging: from CrossLinking to Penetrating Keratoplasty : Linee guida basate sullo staging del cheratocono: dal cross-link corneale alla cheratoplastica
No full textIl cheratocono rappresenta la più comune e frequente distrofia “ectasica” della cornea a carattere degenerativo. Generalmente la malattia ha esordio in età puberale, è bilaterale, asimmetrica ed è contraddistinta dalla presenza di una astigmatismo irregolare associato a riduzione dello spessore corneale. In circa il 20% dei casi il cheratocono evolutivo necessita di una cheratoplastica lamellare e/o perforante a seconda dello stadio e della compliance del paziente alle lenti corneali. I progressi tecnologici a servizio dell’Oftalmologia e l’uso quasi routinario della topografia e della pachimetria corneale in chirurgia rifrattiva hanno messo in luce una grande quantità di cheratoconi non ancora diagnosticati pertanto, nella nostra esperienza, l’incidenza della malattia è realmente ben superiore (1 caso su 450 pazienti) rispetto a quella riportata in letteratura (1 caso su 2000). Il cheratocono in Italia ed in Europea è la prima causa di trapianto corneale e ciò desta non poche preoccupazioni in particolare per l’impatto sociale e sanitario dovuto al coinvolgimento di pazienti sempre più giovani. Alla luce delle nuove possibilità terapeutiche ad “indirizzo patogenetico” come il Crosslinking corneale, oggi non si può accettare né una diagnosi tardiva né una scelta terapeutica non adeguatamente ponderata la quale deve essere basata sulla corretta stadiazione clinico-strumentale della malattia, sulla sua evolutività, sulla compliance alle lenti a contatto, sull’età del paziente e sulla sua qualità di vita.
La moderna terapia del cheratocono è diretta in tre direzioni principali: prevenzione o rallentamento della progressione in fase rifrattiva; correzione o riduzione del difetto rifrattivo e delle aberrazioni; sostituzione della cornea ectasica in fase avanzata in pazienti non suscettibili di miglioramento contattologico. Questa Review si propone di descrivere le attuali possibilità terapeutiche del cheratocono basate sullo stadio della malattia fornendo utili e pratiche linee guida basate sulla osservazione e sul trattamento di migliaia di casi da parte degli Autori.Keratoconus is one of the most frequently encountered types of ectatic dystrophic degeneration of the cornea. It generally has its onset in adolescence, is bilateral, asymmetric and characterized by irregular astigmatism associated with thinning of the cornea. In approximately 20% of cases keratocornus requires lamellar and/or perforating keratoplasty, depending on the stage of the condition and the patient’s compliance with contact lenses. Technical advances in ophthalmology and widespread use of corneal topography and pachymetry in refractive surgery have revealed a considerable number of undiagnosed cases of keratoconus. In our experience, its real incidence is far higher (1 in 450 patients) than that reported in the literature (1 in 2000 patients). In Italy and elsewhere in Europe, keratoconus is the primary reason for corneal transplantation and has raised concern about its social and medical impact owing to the increasing number of younger patients seeking treatment. Advanced pathogenetic-based therapeutic options such as corneal crosslinking now permit prompt diagnosis and adequate treatment based on correct clinico-diagnostic staging of the condition, its natural history, compliance with contact lenses, patient age and quality of life. There are three basic approaches to treatment: prevention or slowing down of progression during the refractive stage; correction or reduction of the refractive defect of aberrations; replacement of the ectatic cornea in the advanced stage in keratocornus recalcitrant to lens treatment. This review article describes current therapies according to the stage of the disease and provides useful practical guidelines derived from observation and treatment of thousands of cases from the authors’ clinical series
Air-guided manual deep anterior lamellar keratoplasty: long-term results and confocal microscopic findings
No full textPURPOSE: To evaluate the long-term results of air-guided manual deep anterior lamellar keratoplasty (DALK) and to perform confocal microscopy on postoperative DALK corneas.
METHODS: Seven postoperative consecutive DALK corneas were evaluated 1 year after suture removal. All patients underwent a complete ophthalmologic examination evaluating visual acuity, astigmatism, corneal thickness, and endothelial cell count. Confocal microscopy was performed to examine the corneas of the seven eyes and to obtain the measured interface depth.
RESULTS: Eighteen months after surgery, the mean postoperative uncorrected visual acuity was 20/38 and the mean best-corrected visual acuity was 20/23. Postoperative mean value of residual recipient stroma thickness was 65.57 microm +/- 28.74.
CONCLUSIONS: Maximum depth DALK can lead to significant advantages for quality of vision when compared to other types of anterior lamellar keratoplasty. Still, it remains a challenging procedure. These results show that a deep dissection without baring Descemet membrane makes good visual results possible, preventing corneal perforation and conversion to penetrating graft
Cloning of the carrot top1 gene and analysis of the expression patterns in different plant tissues
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