Corneal Scheimpflug Densitometry Following Photorefractive Keratectomy in Myopic Eyes.

PURPOSE: To evaluate the modification of corneal optical densitometry following photorefractive keratectomy (PRK) using Scheimpflug topography. METHODS: Corneal densitometry (0 to 100 grayscale units [GSU]), pachymetry, and keratometry were evaluated using a rotating Scheimpflug camera (Pentacam HR; Oculus Optikgeräte, GmbH, Wetzlar, Germany) at baseline and 1 and 3 months following PRK in myopic patients. Subjective refraction, uncorrected distance visual acuity, corrected distance visual acuity, and corneal haze (0 to 4 on common subjective scale) were evaluated preoperatively at baseline, 1 month, and 3 months. RESULTS: The study included 75 eyes (38 right eyes, 37 left). The preoperative mean spherical equivalent and cylinder were -2.28 ± 1.24 and 0.92 ± 0.65 diopters (D), respectively. Maximal corneal densitometry (central 4 mm) was 27.44 ± 1.93 GSU at baseline. At 1 month postoperatively, corneal haze with a mean clinical grade of 0.54 ± 0.45 (P < .0001) was observed, associated with corneal densitometry increased to 29.69 ± 5.16 GSU (P > .05). At 3 months postoperatively, mean clinical haze decreased to 0.11 ± 0.24 (P < .0001) and was associated with a significant decrease (P < .0001) in maximal densitometry (25.13 ± 3.42 GSU). CONCLUSIONS: Corneal densitometry could represent a useful objective measurement of postoperative mild corneal haze and aid in the rating and follow-up of refractive surgery. [J Refract Surg. 2016;32(11):788-791.].

Aggregatibacter aphrophilus chronic lacrimal canaliculitis: a case report.

BACKGROUND: Chronic canaliculitis is often misdiagnosed as conjunctivitis, delaying proper documentation and management. Aggregatibacter aphrophillus has not been implicated in chronic canaliculitis. CASE PRESENTATION: We report a case of unilateral chronic epiphora associated with chronic lacrimal canaliculitis resistant to prolonged topical antibiotic treatment in a 65-year-old woman without notable medical history. Canaculotomy, curettage with removal of concretions and tubing with silicone stent for six weeks resolved this chronic infection. Culturing lacrimal secretions and concretions yielded Aggregatibacter aphrophilus in pure culture. Histological analyses showed elongated seed clusters surrounded by neutrophils. Fluorescence in Situ Hybridization confirmed the presence of bacteria in two distinctive concretions. CONCLUSION: This first documented case of A. aphrophilus chronic lacrimal canaliculitis illustrates that optimal surgical management of chronic lacrimal canaliculitis allows for both accurate microbiological diagnosis and treatment.

Biocompatibility and functionality of a tissue-engineered living corneal stroma transplanted in the feline eye.

PURPOSE: Corneal tissue shortage has become a major concern worldwide, which has motivated the search for alternative solutions to eye bank human eyes for corneal transplantation. Minimally invasive lamellar transplantation and tissue engineering may offer new opportunities for the rehabilitation of diseased corneas. The aim of this study was to evaluate the biocompatibility and functionality of stromal lamellar grafts tissue-engineered (TE) in vitro and transplanted in vivo in the cornea of a feline model. METHODS: The corneal stromas were engineered in culture from corneal stromal cells using the self-assembly approach, without the addition of exogenous material or scaffold. Eight healthy animals underwent two intrastromal grafts in one eye and the contralateral eye was used as a control. Animals were followed with slit-lamp ophthalmic examination, corneal esthesiometry and optical coherent tomography. Confocal microscopy, immunofluorescence, histology, and transmission electron microscopy (TEM) were performed at 4 months. RESULTS: Four months after transplantation, the TE-stromal grafts were transparent, functional, and well tolerated by the eye. All grafts remained avascular, with no signs of immune rejection, despite a short course of low-dose topical steroids. Corneal sensitivity returned to preoperative level and reinnervation of the grafts was confirmed by confocal microscopy and immunofluorescence. Histology and TEM of the TE-grafts showed a lamellar stromal structure with regular collagen fibril arrangement. CONCLUSIONS: These results open the way to an entirely new therapeutic modality. Intracorneal filling using a biocompatible, transparent, and malleable TE-stroma could be the basis for multiple types of novel therapeutic options in corneal interventional surgery.