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[PMID]:29357819
[Au] Autor:Kodama-Takahashi A; Fukuda M; Sugioka K; Kobayashi A; Shimomura Y
[Ad] Endereço:Department of Ophthalmology, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama City, Osaka, 589-8511, Japan. akodama@med.kindai.ac.jp.
[Ti] Título:Spontaneous reattachment of dislocated endothelial graft after non-Descemet stripping automated endothelial keratoplasty: a case report.
[So] Source:BMC Ophthalmol;18(1):14, 2018 Jan 22.
[Is] ISSN:1471-2415
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Graft detachment is a complication of non-Descemet stripping automated endothelial keratoplasty (nDSAEK). We report a case of spontaneous reattachment of an extensively dislocated graft after nDSAEK. CASE PRESENTATION: A 54-year-old male underwent penetrating keratoplasty (PKP) for keratoconus in his left eye in 2001. Following graft opacity due to rejection, a second PKP was implemented in May 2014. The graft was kept in good condition after the reoperation and yet, visual acuity (VA) declined due to cataract. PEA+IOL was then performed in May 2015. Because edema appeared in the graft 6 months after the PEA+IOL, nDSAEK was carried out in May 2016. Although the donor graft well attached immediately after the nDSAEK, the graft was almost completely dislocated 3 h later except a temporal part. Air was reinjected into the anterior chamber on the following day and the detachment was resolved. Despite of the treatment, about 1/5 of the graft remained detached and the detachment deteriorated to 3/4 of the graft 9 days later. Because the patient could not decide whether to undergo another operation immediately, we decided to follow him up first and found that the partially detached graft reattached spontaneously 1 month later during the follow-up. Although the cornea had a mild edema remaining in the superior temporal area, his BCVA improved to 1.0. Three months later, the graft remained in position and the cornea kept its transparency. CONCLUSIONS: Spontaneous reattachment was observed during the follow-up in a case that had shown a comparatively extensive graft dislocation after nDSAEK.
[Mh] Termos MeSH primário: Ceratoplastia Endotelial com Remoção da Lâmina Limitante Posterior/efeitos adversos
Sobrevivência de Enxerto
Ceratocone/cirurgia
Complicações Pós-Operatórias/diagnóstico
[Mh] Termos MeSH secundário: Câmara Anterior
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Remissão Espontânea
Estudos Retrospectivos
Falha de Tratamento
Acuidade Visual
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180124
[St] Status:MEDLINE
[do] DOI:10.1186/s12886-018-0684-7


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[PMID]:29206654
[Au] Autor:Ang M; Sng CCA
[Ad] Endereço:Singapore National Eye Centre, Singapore Eye Research Institute.
[Ti] Título:Descemet membrane endothelial keratoplasty and glaucoma.
[So] Source:Curr Opin Ophthalmol;29(2):178-184, 2018 Mar.
[Is] ISSN:1531-7021
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE OF REVIEW: The aim of this review is to describe the relationship between Descemet membrane endothelial keratoplasty (DMEK) and glaucoma. RECENT FINDINGS: Glaucoma after DMEK is a serious complication that may cause permanent visual loss, affect donor endothelial cells and graft survival. The mechanisms of raised intraocular pressure (IOP) after DMEK include reverse pupillary block in the early postoperative period, and steroid response in the late phase. The reduced risk of immunogenic graft rejection after DMEK necessitates a shorter duration of steroids, which may in turn reduce the risk of steroid response. On the other hand, eyes with preexisting glaucoma that undergo DMEK may have a poorer prognosis than those without glaucoma. SUMMARY: Early recognition and treatment of raised IOP is important after DMEK. Accurate IOP measurements after DMEK may be difficult to obtain because of the presence of an air bubble, corneal oedema, and corneal irregularities. A prophylactic peripheral iridectomy is recommended to prevent reverse pupillary block. Patients should posture face-up and be evaluated in the early postoperative period, as patients may be asymptomatic despite raised IOP. In order to reduce the risk of steroid response, weaker steroids may be prescribed after 1-3 months without adverse effects on DMEK outcomes.
[Mh] Termos MeSH primário: Ceratoplastia Endotelial com Remoção da Lâmina Limitante Posterior/efeitos adversos
Glaucoma/etiologia
Complicações Pós-Operatórias
[Mh] Termos MeSH secundário: Glaucoma/fisiopatologia
Glaucoma/prevenção & controle
Glucocorticoides/administração & dosagem
Seres Humanos
Pressão Intraocular/fisiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Glucocorticoids)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180223
[Lr] Data última revisão:
180223
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE
[do] DOI:10.1097/ICU.0000000000000454


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[PMID]:28742620
[Au] Autor:Ampazas P; Droutsas K; Giallouros E; Schroeder FM; Sekundo W
[Ad] Endereço:*Department of Ophthalmology, Philipps University of Marburg, Marburg, Germany; and †First Department of Ophthalmology, National and Kapodistrian University of Athens-Faculty of Medicine, Athens, Greece.
[Ti] Título:Comparison of 5% Sulfur Hexafluoride Versus 100% Air Tamponade in Descemet Membrane Endothelial Keratoplasty.
[So] Source:Cornea;36(10):1189-1194, 2017 Oct.
[Is] ISSN:1536-4798
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To compare the rebubbling rate and clinical outcomes of Descemet membrane endothelial keratoplasty (DMEK) with 5% sulfur hexafluoride (SF6) gas versus 100% air as a tamponade for graft attachment. METHODS: Retrospective, comparative, interventional case series including 368 consecutive pseudophakic eyes with Fuchs endothelial dystrophy or pseudophakic bullous keratopathy that underwent DMEK in a tertiary referral center between October 2010 and August 2015 using either air (group 1, 191 eyes) or 5% SF6 (group 2, 177 eyes) as a tamponade. The rebubbling rate, complications, best-corrected distance visual acuity (BCVA), manifest refraction, and endothelial cell density were analyzed before and at 1 week, 1, 3, 6, 12, 24, and 36 months after surgery. RESULTS: The rebubbling rate was 20.4% (39/191, group 1) versus 6.8% (12/177, group 2; P < 0.001). Complications included cystoid macular edema (n = 5, group 1, and n = 10, group 2; P = 0.14) and 1 case of presumed allograft rejection (n = 1, group 2). The follow-up period was 12 ± 8 months for group 1 and 6 ± 4 months for group 2. BCVA (logarithm of the minimum angle of resolution) had improved after 12 months from 1.43 ± 0.63 to 0.18 ± 0.26 (group 1, P < 0.001) and from 1.8 ± 0.63 to 0.18 ± 0.17 (group 2, P < 0.001). The percentage of eyes with BCVA ≥0.2 logarithm of the minimum angle of resolution at 12 months was 70.9% (90/127, group 1) and 78.4% (40/51, group 2; P = 0.3). Endothelial cell loss at 12 months after DMEK was 44 ± 18% (group 1) versus 33 ± 15% (group 2, P = 0.07). CONCLUSIONS: The use of a tamponade with 5% SF6 yielded a significantly lower incidence of graft detachment requiring surgical reintervention with no detrimental effect on graft endothelial cells. Thus, routine use of 5% SF6 for a graft tamponade in DMEK is recommended.
[Mh] Termos MeSH primário: Ar
Perda de Células Endoteliais da Córnea/prevenção & controle
Ceratoplastia Endotelial com Remoção da Lâmina Limitante Posterior
Tamponamento Interno/métodos
Rejeição de Enxerto/prevenção & controle
Hexafluoreto de Enxofre/administração & dosagem
Aderências Teciduais
[Mh] Termos MeSH secundário: Idoso
Contagem de Células
Feminino
Distrofia Endotelial de Fuchs/cirurgia
Seres Humanos
Masculino
Refração Ocular/fisiologia
Estudos Retrospectivos
Doadores de Tecidos
Acuidade Visual/fisiologia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
WS7LR3I1D6 (Sulfur Hexafluoride)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180209
[Lr] Data última revisão:
180209
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170726
[St] Status:MEDLINE
[do] DOI:10.1097/ICO.0000000000001299


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[PMID]:28742617
[Au] Autor:Dimitry MES; Lewis AD; Zacharaki F; Chandran M; Robson D; Menon G; Poole TRG
[Ad] Endereço:The Eye Dept, Frimley Park Hospital, Frimley Health NHS Foundation Trust, Surrey, United Kingdom.
[Ti] Título:Simple Single-Pass Technique for Ultrathin Descemet Stripping Automated Endothelial Keratoplasty: A Pilot Study.
[So] Source:Cornea;36(10):1178-1183, 2017 Oct.
[Is] ISSN:1536-4798
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To assess intraoperative and postoperative graft thickness (GT) after donor deturgescence for ultrathin Descemet stripping automated endothelial keratoplasty and to evaluate visual outcomes, endothelial cell density, and patient satisfaction at 1 year. METHODS: Prospective interventional case series of patients with Fuchs endothelial dystrophy, Fuchs endothelial dystrophy and cataract, and pseudophakic bullous keratopathy (n = 12 grafts). The donor cornea was allowed to thin out by simple evaporation on an artificial anterior chamber, to the required precut thickness, before a single microkeratome pass. GT after microkeratome cut, at 1 week, 1, 3, 6, and 12, months was measured. Early Treatment Diabetic Retinopathy Study (ETDRS) best-corrected visual acuity, Pelli-Robson contrast sensitivity, endothelial cell density, and score on the visual function questionnaire (VFQ-25) were assessed. RESULTS: Mean intraoperative postmicrokeratome cut GT was 78.9 ± 33.3 µm. Mean GT at 1 week, 1, 3, 6, and 12 months was 70.7, 70.9, 62.8, 66.5, and 58.9 µm, respectively. Mean initial donor corneal thickness was 647 ± 67 µm, and mean precut thickness was 526 ± 4.5 µm (mean thinning time: 17 min). Best-corrected visual acuity at 1 week, 1, 3, 6, and 12 months was 68.8, 76.9, 76.3, 76.9, and 78.6 letters with 9-letter gain at 12 months (P = 0.02). Mean endothelial cell loss at 3, 6, and 12 months was 36.8% ± 6.75%, 37.2% ± 8%, and 37.9% ± 9.75% loss, respectively. At 1 year, 83.3% of patients achieved ≥20/40 (6/12) and 66.7% of patients achieved ≥20/32 (6/9.5). VFQ-25 testing showed an improvement in the visual function. CONCLUSIONS: This pilot study demonstrates a simple graft deturgescence technique that reproducibly creates ultrathin grafts without donor wastage.
[Mh] Termos MeSH primário: Ceratoplastia Endotelial com Remoção da Lâmina Limitante Posterior/métodos
Distrofia Endotelial de Fuchs/cirurgia
[Mh] Termos MeSH secundário: Idoso
Sensibilidades de Contraste/fisiologia
Paquimetria Corneana
Epitélio Posterior/patologia
Epitélio Posterior/transplante
Feminino
Seres Humanos
Período Intraoperatório
Masculino
Meia-Idade
Projetos Piloto
Período Pós-Operatório
Estudos Prospectivos
Doadores de Tecidos
Tomografia de Coerência Óptica
Acuidade Visual/fisiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180209
[Lr] Data última revisão:
180209
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170726
[St] Status:MEDLINE
[do] DOI:10.1097/ICO.0000000000001273


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[PMID]:29252983
[Au] Autor:Li S; Liu L; Wang W; Huang T; Zhong X; Yuan J; Liang L
[Ad] Endereço:State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
[Ti] Título:Efficacy and safety of Descemet's membrane endothelial keratoplasty versus Descemet's stripping endothelial keratoplasty: A systematic review and meta-analysis.
[So] Source:PLoS One;12(12):e0182275, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Based on current evidence, the efficiency and safety of Descemet's membrane endothelial keratoplasty (DMEK) was compared with that of Descemet's stripping endothelial keratoplasty (DSEK). METHODS: Pubmed, Embase, Web of Science, the Cochrane Database and conference abstracts were comprehensively searched for studies that compared the efficacy and safety of DMEK and DSEK. The efficacy outcome was the postoperative best-corrected visual acuity (BCVA). The safety outcomes included the postoperative endothelial cell density (ECD) and complications such as graft detachment, graft rejection, graft failure, postoperative elevated intraocular pressure (IOP), tissue loss, etc. The outcomes were pooled using random-effects models with Stata 13.0 software. Heterogeneity was qualified with Q statistic and I2/H2 statistic. Publication bias was assessed using funnel plot, Begg rank correlation test, and Egger or Horbard linear regression. RESULTS: 19 articles were eligible, and 1124 eyes and 1254 eyes were included in the DMEK and DSEK groups, respectively. The overall pooled estimates showed a significantly better postoperative BCVA, a comparable ECD and an increased graft detachment rate in the DMEK group compared with the DSEK group (BCVA: mean difference (MD) = -0.15, 95% CI = -0.19 to -0.11, P<0.001; ECD: MD = 14.88, 95% CI = -181.50 to 211.27, P = 0.882; graft detachment rate: OR = 4.56, 95% CI = 2.43 to 8.58, P<0.001). Except for the postoperative ECD, which was changed to be higher in the DSEK group than the DMEK group, the learning curve did not have a marked effect on the comparison outcome of the BCVA and graft detachment rate based on the estimates pooled from studies that collected data during the DMEK learning phase (ECD (learning curve): MD = -361.24, 95% CI = -649.42 to -73.07, P = 0.014). CONCLUSION: Although DMEK is a more technically difficult and challenging procedure, it may represent a safe and more efficient alternative to DSEK for the treatment of corneal endothelial diseases, even during its learning curve.
[Mh] Termos MeSH primário: Lâmina Limitante Posterior/cirurgia
Ceratoplastia Endotelial com Remoção da Lâmina Limitante Posterior/efeitos adversos
Células Endoteliais/patologia
[Mh] Termos MeSH secundário: Contagem de Células
Lâmina Limitante Posterior/fisiopatologia
Seguimentos
Rejeição de Enxerto/etiologia
Seres Humanos
Pressão Intraocular
Cuidados Pós-Operatórios
Complicações Pós-Operatórias/etiologia
Viés de Publicação
Resultado do Tratamento
Acuidade Visual
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171219
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0182275


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[PMID]:29190797
[Au] Autor:Hayashi T; Yamaguchi T; Yuda K; Kato N; Satake Y; Shimazaki J
[Ad] Endereço:Department of Ophthalmology, Yokohama Minami Kyosai Hospital, Kanagawa, Japan.
[Ti] Título:Topographic characteristics after Descemet's membrane endothelial keratoplasty and Descemet's stripping automated endothelial keratoplasty.
[So] Source:PLoS One;12(11):e0188832, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To investigate the topographic characteristics of the posterior corneal surface after Descemet's endothelial membrane keratoplasty (DMEK) and Descemet's stripping automated endothelial keratoplasty (DSAEK) and their effects on postoperative visual acuity. METHODS: Nineteen eyes of 19 patients after DMEK, 23 eyes of 23 patients after DSAEK, and 18 eyes of 18 control subjects were retrospectively analyzed. Best spectacle-corrected visual acuity (BSCVA), aberration factors (higher-order aberrations [HOAs], spherical aberrations [SAs], and coma aberrations [Comas] at 6.0 mm) were evaluated preoperatively and at 1, 3, and 6 months postoperatively. The posterior refractive pattern of the topography map was classified into 5 grades (0-5) (posterior color grade) using anterior segment optical coherence tomography. Correlations between BSCVA and some factors (abbreviation factors, posterior color grade) were analyzed. RESULTS: BSCVA was significantly better after DMEK than after DSAEK (P < 0.001). Posterior HOAs, SAs, and Comas after each type of endothelial keratoplasty were significantly greater compared to control (P < 0.01). Posterior HOAs, total/anterior/posterior SAs, and posterior color grade were significantly lower in the DMEK group than in the DSAEK group at 3 months (P < 0.024 [posterior HOAs], P = 0.047 [total SA], P < 0.001 [anterior SAs], P = 0.021 [posterior SAs], and P < 0.001 [posterior color grade]) and 6 months postoperatively (P = 0.034 [posterior HOAs], P < 0.001 [total SAs], P < 0.001 [anterior SAs], P = 0.013 [posterior SAs], and P = 0.004 [posterior color grade]). BSCVA was significantly correlated with HOAs, SAs, and posterior color grade (P < 0.001 for all except anterior HOAs [P = 0.004]). CONCLUSIONS: High posterior color grades were associated with larger aberration factors and had a negative effect on visual function after endothelial keratoplasty. Rapid improvement of visual function after DMEK may be attributed to less change at the posterior surface.
[Mh] Termos MeSH primário: Automação
Topografia da Córnea
Ceratoplastia Endotelial com Remoção da Lâmina Limitante Posterior/métodos
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Estudos de Casos e Controles
Seres Humanos
Cuidados Pós-Operatórios
Estudos Retrospectivos
Acuidade Visual
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171226
[Lr] Data última revisão:
171226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171201
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0188832


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[PMID]:28456826
[Au] Autor:Gabbay IE; Bahar I; Nahum Y; Livny E
[Ad] Endereço:Department of Ophthalmology, Rabin Medical Center, 39 Jabotinsky St., 49100, Petach Tikva, Israel. igabbay@gmail.com.
[Ti] Título:Comparison of Descemet stripping under continuous air flow, manual air injection and balanced salt solution for DMEK: a pilot study.
[So] Source:Graefes Arch Clin Exp Ophthalmol;255(8):1605-1611, 2017 Aug.
[Is] ISSN:1435-702X
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Descemet's membrane endothelial keratoplasty (DMEK) involves removal of the recipient's Descemet membrane (DM) prior to transplanting the donor's DM. When using balanced salt solution (BSS) or ophthalmic viscosurgical devices (OVDs), visualization of the host's DM during its stripping may be inadequate and may result in Descemet remnants and could lead to sub-optimal surgical results. Previous articles described excellent visualization when utilizing air injection but this requires repeated air injection into the anterior chamber (AC). We present a pilot study that compares different techniques under which DM stripping can be performed: with continuous automated air infusion, with manual air infusion, and with BSS. METHODS: We retrospectively compared video footage of DM stripping with BSS, with continuous air and with manual injection of air into the AC to determine DM stripping duration and the number of times the surgeon had to insert and retrieve a surgical instrument from the AC. RESULTS: Thirty videos of 10 consecutive cases of the three DM stripping techniques were evaluated. DM stripping duration was 3.26 (±1.32), 3.92 (±1.2) and 12.9 (±3.98) minutes for BSS, continuous air flow, and manual air injection, respectively. Frequency of instrument retrieval (FIR) was 3.6 (±1.71), 1.5 (±0.71) and 15.1 (±3.28) for BSS, continuous air flow, and manual air injection, respectively. Continuous air flow and BSS were both statistically different than manual air injection into the AC (p < 0.05), but did not differ from one another statistically. CONCLUSION: DM stripping during posterior lamellar surgery is imperative for favorable post-operative results and prevention of complications. Performing this step under air in the AC contributes to better visualization and an efficient surgery.
[Mh] Termos MeSH primário: Ceratoplastia Endotelial com Remoção da Lâmina Limitante Posterior/métodos
Distrofia Endotelial de Fuchs/cirurgia
Cloreto de Sódio/administração & dosagem
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Ar
Câmara Anterior
Feminino
Seguimentos
Distrofia Endotelial de Fuchs/diagnóstico
Seres Humanos
Injeções
Masculino
Meia-Idade
Projetos Piloto
Estudos Retrospectivos
Acuidade Visual
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; VIDEO-AUDIO MEDIA
[Nm] Nome de substância:
451W47IQ8X (Sodium Chloride)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170501
[St] Status:MEDLINE
[do] DOI:10.1007/s00417-017-3675-0


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[PMID]:27777123
[Au] Autor:Schwarz C; Aldrich BT; Burckart KA; Schmidt GA; Zimmerman MB; Reed CR; Greiner MA; Sander EA
[Ad] Endereço:Department of Biomedical Engineering, University of Iowa, Iowa City, IA, USA.
[Ti] Título:Descemet membrane adhesion strength is greater in diabetics with advanced disease compared to healthy donor corneas.
[So] Source:Exp Eye Res;153:152-158, 2016 Dec.
[Is] ISSN:1096-0007
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Descemet membrane endothelial keratoplasty (DMEK) is an increasingly popular surgical procedure for treating ocular diseases that require a corneal transplant. Previous studies have found that tissue tearing during surgical preparation is more likely elevated in eyes from donors with a history of diabetes mellitus. To quantify these potential differences, we established an experimental technique for quantifying the force required to separate the endothelium-Descemet membrane complex (EDM) from stroma in human donor corneal tissue, and we assessed differences in adhesion strength between diabetic and non-diabetic donor corneas. Transplant suitable corneas were obtained from 23 donors 50-75 years old with an average preservation to assay time of 11.5 days. Corneas were classified from a medical records review as non-diabetic (ND, n = 9), diabetic without evidence of advanced disease (NAD, n = 8), or diabetic with evidence of advanced disease (AD, n = 10). Corneas were sectioned into 3 mm wide strips and the EDM peeled from the stroma. Using the force-extension data obtained from mechanical peel testing, EDM elastic peel tension (T ), elastic stiffness (S ), average delamination tension (T ), and maximum tension (T ) were calculated. Mean T , S , T , and T values for ND corneas were 0.78 ± 0.07 mN/mm, 0.37 ± 0.05 mN/mm/mm, 0.78 ± 0.08 mN/mm, and 0.94 ± 0.17 mN/mm, respectively. NAD values did not differ significantly. However, AD values for T (1.01 ± 0.18 mN/mm), T (1.09 ± 0.21 mN/mm), and T (1.37 ± 0.24 mN/mm) were greater than ND and NAD corneas (P < 0.05). S did not differ significantly between groups. These findings provide proof of the concept that chronic hyperglycemia from diabetes mellitus results in a phenotypically more adhesive interface between Descemet membrane and the posterior stroma in donor corneal tissue. Results of this study provide a foundation for further investigations into the impact of diabetes on the posterior cornea, eye banking, and keratoplasty.
[Mh] Termos MeSH primário: Doenças da Córnea/cirurgia
Lâmina Limitante Posterior/fisiologia
Ceratoplastia Endotelial com Remoção da Lâmina Limitante Posterior/métodos
Diabetes Mellitus
Doadores de Tecidos
[Mh] Termos MeSH secundário: Idoso
Doenças da Córnea/fisiopatologia
Bancos de Olhos
Sobrevivência de Enxerto
Seres Humanos
Meia-Idade
Reprodutibilidade dos Testes
Coleta de Tecidos e Órgãos
[Pt] Tipo de publicação:JOURNAL ARTICLE; VIDEO-AUDIO MEDIA
[Em] Mês de entrada:1706
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161105
[St] Status:MEDLINE


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[PMID]:28977017
[Au] Autor:Bhogal M; Lwin CN; Seah XY; Murugan E; Adnan K; Lin SJ; Peh G; Mehta JS
[Ad] Endereço:Singapore Eye Research Institute, Singapore, Singapore.
[Ti] Título:Real-time assessment of corneal endothelial cell damage following graft preparation and donor insertion for DMEK.
[So] Source:PLoS One;12(10):e0184824, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To establish a method for assessing graft viability, in-vivo, following corneal transplantation. METHODS: Optimization of calcein AM fluorescence and toxicity assessment was performed in cultured human corneal endothelial cells and ex-vivo corneal tissue. Descemet membrane endothelial keratoplasty grafts were incubated with calcein AM and imaged pre and post preparation, and in-situ after insertion and unfolding in a pig eye model. Global, macroscopic images of the entire graft and individual cell resolution could be attained by altering the magnification of a clinical confocal scanning laser microscope. Patterns of cell loss observed in situ were compared to those seen using standard ex-vivo techniques. RESULTS: Calcein AM showed a positive dose-fluorescence relationship. A dose of 2.67µmol was sufficient to allow clear discrimination between viable and non-viable areas (sensitivity of 96.6% with a specificity of 96.1%) and was not toxic to cultured endothelial cells or ex-vivo corneal tissue. Patterns of cell loss seen in-situ closely matched those seen on ex-vivo assessment with fluorescence viability imaging, trypan blue/alizarin red staining or scanning electron microscopy. Iatrogenic graft damage from preparation and insertion varied between 7-35% and incarceration of the graft tissue within surgical wounds was identified as a significant cause of endothelial damage. CONCLUSIONS: In-situ graft viability assessment using clinical imaging devices provides comparable information to ex-vivo methods. This method shows high sensitivity and specificity, is non-toxic and can be used to evaluate immediate cell viability in new grafting techniques in-vivo.
[Mh] Termos MeSH primário: Perda de Células Endoteliais da Córnea/etiologia
Ceratoplastia Endotelial com Remoção da Lâmina Limitante Posterior/métodos
Doadores de Tecidos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Animais
Células Cultivadas
Ceratoplastia Endotelial com Remoção da Lâmina Limitante Posterior/efeitos adversos
Feminino
Fluoresceínas
Seres Humanos
Masculino
Microscopia de Fluorescência
Meia-Idade
Modelos Animais
Suínos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Fluoresceins); 148504-34-1 (calcein AM)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171031
[Lr] Data última revisão:
171031
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171005
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0184824


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[PMID]:28936052
[Au] Autor:Khairallah AS
[Ad] Endereço:Department of Surgery (Ophthalmology), College of Medicine, King Khalid University, Abha, Saudi Arabia.
[Ti] Título:Outcome of Descemet Stripping Automated Endothelial Keratoplasty in Failed Penetrating Keratoplasty.
[So] Source:Middle East Afr J Ophthalmol;24(2):87-90, 2017 Apr-Jun.
[Is] ISSN:0975-1599
[Cp] País de publicação:India
[La] Idioma:eng
[Ab] Resumo:PURPOSE: The purpose of this study was to report the outcomes of descemet stripping automated endothelial keratoplasty (DSAEK) surgeries in eyes with failed penetrating keratoplasty (PKP). METHODS: This was a retrospective, noncomparative, descriptive case series. Patients who underwent DSAEK following PKP from January 2007 to December 2012 were reviewed. Data were collected on best-corrected visual acuity (BCVA) before and 1 week, 1 month, 3 months, 6 months, 1 year, and 2 years following DSAEK. Intra- and post-operative complications, changes in intraocular pressure (IOP) were also documented. Demographics were associated with the visual outcomes. RESULTS: Fifteen eyes of 15 patients with failed PKP comprised the study group. BCVA improved by 2 or more lines at 6 months after DSAEK in ten (66.6%) eyes. In the five eyes that did not experience an increase in BCVA, four had complications; detached lenticule (2 eyes), rejection (1 eye), and dislocation of the graft (1 eye). One eye had ocular comorbidity causing poor vision. The mean IOP at 12-15 weeks postoperatively was 17.4 ± 6.8 mmHg. CONCLUSION: DSAEK for failed PKP resulted in improved vision in two-third of cases. Selection of cases for this repeat surgery seems to be a key in successful outcomes.
[Mh] Termos MeSH primário: Doenças da Córnea/cirurgia
Lâmina Limitante Posterior/cirurgia
Ceratoplastia Endotelial com Remoção da Lâmina Limitante Posterior/métodos
Ceratoplastia Penetrante/efeitos adversos
Complicações Pós-Operatórias
Acuidade Visual
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Seres Humanos
Masculino
Meia-Idade
Reoperação
Estudos Retrospectivos
Falha de Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171004
[Lr] Data última revisão:
171004
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170923
[St] Status:MEDLINE
[do] DOI:10.4103/meajo.MEAJO_248_15



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