Tenon's patch graft to the rescue during COVID-19 pandemic.

Objective: To report a case of bilateral Mooren's ulcer with impending corneal perforation in the right eye and perforated peripheral corneal ulcer in the left eye which successfully underwent Tenon's patch graft (TPG) with multilayered amniotic membrane grafting (AMG) as globe salvaging procedure during COVID-19 pandemic. Methods: Conjunctival resection was done on both the eyes followed by autologous Tenon's grafting with overlay amniotic membrane grafting in the left eye with perforation and multilayered AMG with AMG overlay in the right eye with impending perforation. Post-operatively topical antibiotics and steroids were prescribed. Results: At one month follow-up, the Tenon's graft and multilayered AMG were well-integrated with the surrounding healthy cornea with a good anatomical and visual outcome. Conclusion: Autologous Tenon's patch graft is a simple and cost-effective alternative to preserve globe integrity and prevent complications in emergency cases when immediate access to cornea transplantation is practically challenging.

Obstacles to Post-mortem Cornea Donation: A Study From a Tribal Region in Eastern India.

PURPOSE: Studying the cognizance and hindrances of eye benefactors amongst relatives of post-mortem cases in an Indian tertiary referral centre. METHODS: This prospective study was executed at a tertiary hospital. In this examination, the relatives had been approached and counselled systematically. The responses had been noted in a predesigned proforma. Data regarding demographic details, socioeconomic status, prior knowledge of eye benefactor, willingness and reasons for refusing eye benefactor, literacy level, relationship with the deceased patient, and so on were collected. RESULTS: One hundred fifty-six potential donors had been identified from 845 post-mortem cases. Among these potential donors were 63 women and 93 men. Thirty-eight next of kin had been seen as already cognizant regarding eye benefactor; however, other 118 families were unaware. A total of 109 families refused to donate eyes while other 47 showed willingness for the procedure. It was seen that there was no influence on literacy status, socioeconomic status and prior knowledge regarding the concept of willingness to donate. CONCLUSION: Counselling for eye benefactor exercises a crucial role in procuring corneas. Socioeconomic status, literacy and prior understanding of eye donation had no link with donor corneal tissue procurement in our study. Even in families with no prior knowledge and poor socioeconomic status, active counselling can be successful.

Pirfenidone as a potential antifibrotic injectable for Dupuytren's disease.

Dupuytren's disease is a progressive fibrotic condition of the hand that causes contracture of fingers in later stages. Our previous in vitro studies suggest that the transformation of fibroblasts to myofibroblasts induced by transforming growth factor-beta can be inhibited by the addition of the antifibrotic drug, pirfenidone (PFD). We hypothesize that the local delivery of PFD directly to nodules can potentially prevent the progression to cords and, furthermore, that injection of PFD after the resection of cords can limit the recurrence of the disease. The purpose of this research was to develop a PFD injectable solution and to assess its safety in mice. Based on preformulation observations, a sterile solution containing up to 8 mg/0.4 mL of PFD was prepared in a phosphate buffer with and without 15%v/v N-methyl-2-pyrrolidone. Accelerated stability studies suggested that the product should be kept at refrigerated temperature (2-8 °C) for long-term storage. Safety studies involving subcutaneous administration to mice showed that 2-4 mg of PFD in 0.4 mL aqueous buffer did not elicit a significant inflammatory reaction. However, 4 mg PFD in 0.4 mL (FB) of buffer: NMP cosolvent system led to a significant increase in the influx of inflammatory cells and 8 mg PFD (FA) in the cosolvent system was lethal to the animals.