Allogeneic Limbal Epithelial Transplantation Modified With Solid Platelet-Rich Plasma for Bilateral Limbal Stem Cell Deficiency.

PURPOSE: To present successful management of bilateral limbal stem cell deficiency (LSCD) by using an allogeneic limbal epithelial stem cell transplantation together with solid activated platelet-rich plasma (PRP). METHODS: A 59-year-old man with a history of bilateral LSCD due to penicillin-induced Stevens-Johnson Syndrome suffered from a lime corneal burn in his right eye, leading to a total LSCD with severely reduced visual acuity. After stabilizing the ocular surface, we performed an allogeneic limbal epithelial transplantation from a cadaveric donor using an autologous clot of PRP to cover the limbal grafts to nourish the ocular surface microenvironment. RESULTS: At the first week after the procedure, the corneal epithelium had fully reepithelized. At month 3, visual acuity improved from hand motion to 20/70. CONCLUSIONS: In this case, this new modified procedure was a promising, easy-to-perform, apparently safe, and effective treatment option to enhanced epithelial wound healing in ocular surface diseases. To our knowledge, this is the first report describing the incorporation of solid PRP in limbal transplantation procedures.

Keratitis by Fusarium temperatum, a novel opportunist.

BACKGROUND: Fusarium species are among the most common fungi present in the environment and some species have emerged as major opportunistic fungal infection in human. However, in immunocompromised hosts they can be virulent pathogens and can cause death. The pathogenesis of this infection relies on three factors: colonization, tissue damage, and immunosuppression. A novel Fusarium species is reported for the first time from keratitis in an agriculture worker who acquired the infection from plant material of maize. Maize plants are the natural host of this fungus where it causes stalk rot and seeding malformation under temperate and humid climatic conditions. The clinical manifestation, microbiological morphology, physiological features and molecular data are described. METHODS: Diagnosis was established by using polymerase chain reaction of fungal DNA followed by sequencing portions of translation elongation factor 1 alpha (TEF1 α) and beta-tubulin (BT2) genes. Susceptibility profiles of this fungus were evaluated using CLSI broth microdilution method. RESULTS: The analyses of these two genes sequences support a novel opportunist with the designation Fusarium temperatum. Phylogenetic analyses showed that the reported clinical isolate was nested within the Fusarium fujikuroi species complex. Antifungal susceptibility testing demonstrated that the fungus had low MICs of micafungin (0.031 µg/ml), posaconazole (0.25 µg/ml) and amphotericin B (0.5 µg/ml). CONCLUSION: The present case extends the significance of the genus Fusarium as agents of keratitis and underscores the utility of molecular verification of these emerging fungi in the human host.

Use of irradiated human amnion as a matrix for limbal stem cell culture.

Several ocular diseases affect the corneal surface; the development of effective technologies for the treatment of corneal lesions has brought about an improvement in the quality of life of affected patients. The aim of this study is to culture and characterize limbal stem cells cultured on gamma ((60)Co) radiosterilized human amnion (RHA). Limbal stem cells were isolated from ten preserved samples of corneal transplant. The cells were cultured since primary culture until expanded cells on RHA and stained with monoclonal antibodies to establish their immunophenotype, after which cytokeratin 12 and Vimentin were positive by immunohistochemistry. The immunophenotype remained constant since primary culture until expanded cells in RHA. The RHA and cells construct were structurally integrated. Immunohistochemistry was cytokeratin 12, Vimentin positive, and cytokeratin 19 negative. In vitro limbal cells maintain a constant epithelial transition immunophenotype in culture up to primary culture until expanded cells on RHA.

Teratoma orbitario congénito. Presentación de un caso / Orbital congenital teratoma. Case report

Se presenta el caso clínico de paciente del sexo femenino de 24 horas de nacida, con teratoma de órbita izquierda, diagnosticada por su cuadro clínico radiológico característico y confirmado histopatológicamente, tratado quirúrgicamente con exenteración orbitaria, con seguimiento por nueve meses

Efecto analgésico y antiinflamatorio del diclofenaco tópico en la queratotomía radiada / Effect of topical diclofenac solution in pain after radial keratotomy

El dolor postoperatorio en la cirugía de la queratotomía radiada puede llegar a ser intenso, por lo que se probó un antiinflamatorio no esteroideo en forma tópica para disminuirlo. En este estudio prospectivo, multicéntrico y aleatorio se tomó un grupo de 78 pacientes en los que se realizó queratotomía radiada bilateral y se instilaron dos gotas de diclofenaco al 0.1 por ciento en uno de los ojos, sirviendo el otro de control. Los resultados indican que el 59 por ciento de los ojos tratados no tuvieron dolor, contra 6 por ciento de los ojos control. Ninguno de los ojos tratados mostró dolor intenso contra 20 por ciento de los no tratados que sí lo tuvieron. No se encontró ningún efecto adverso importante atribuible al diclofenaco. Se concluye que la administración de solución de diclofenaco al 0.1 por ciento es un buen método analgésico y antiinflamatorio en el postoperatorio inmediato de la queratotomía radiada.

Gnatostomiasis intraocular: caso anatomoclínico

La gnatostomiasis humana es una enfermedad rara, cuya frecuencia aumentó en los últimos años; es ocasionada por la infestación de un nematodo, Gnathostoma, el cual se adquiere por ingestión de pescado crudo. El presente trabajo describe el caso de una paciente de 27 años de edad, residente de Uxpanapa, Ver., a quien se le encontró una larva de 3er. estadio alojada en la cámara anterior del globo ocular derecho, que se extrajo quirúrgicamente con éxito; se identificó como Ghathostoma probablemente spinigerum.