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1.
Zhonghua Yan Ke Za Zhi ; 57(2): 143-149, 2021 Feb 11.
Artigo em Chinês | MEDLINE | ID: mdl-33541057

RESUMO

Descemet's membrane detachment (DMD) is a complication of intraocular surgery and is more likely to be seen after cataract surgery. As an intraoperative event, DMD usually features wrinkles and edema on the posterior corneal surface or floating membranoid substance seen in the anterior chamber. Such edema is often seen as surgery-caused corneal edema and membranoid substance as the anterior capsule of the lens. Thus, DMD is easily clinically ignored, even though it is conveniently treated if timely observed. Serious consequences are not uncommon with any delayed diagnosis or treatment. Risk factors include advanced age, previous corneal endothelial lesions and glaucoma, as well as preoperative shallow anterior chamber. Clinical diagnosis is based upon intraoperative judgment, corneal edema diagnosed under a microscope or slit lamp and consequent floating Descemet's membrane. In serious cases, anterior segment OCT and UBM are required. Intracameral injections of air are traditionally adopted in the treatment. In less serious cases, patients see self-healing. (Chin J Ophthalmol, 2021, 57: 143-149).


Assuntos
Extração de Catarata , Doenças da Córnea , Edema da Córnea , Câmara Anterior , Doenças da Córnea/diagnóstico , Doenças da Córnea/cirurgia , Edema da Córnea/diagnóstico , Lâmina Limitante Posterior/diagnóstico por imagem , Lâmina Limitante Posterior/cirurgia , Humanos
2.
Vestn Oftalmol ; 137(1): 78-82, 2021.
Artigo em Russo | MEDLINE | ID: mdl-33610154

RESUMO

Persistent corneal graft erosion or persistent epithelial corneal defect is a frequent complication of penetrating keratoplasty. Its development can be contributed by the dry eye syndrome, rare blinking, lagophthalmos, symblepharon, viral infection, autoimmune aggression, and the use of epithelial-toxic eye drops. The article presents three clinical observations of patients who developed persistent corneal graft erosion after penetrating keratoplasty. Due to the ineffectiveness of local conservative therapy for more than 3 weeks, anterior stromal corneal micropuncture was performed. After the procedure, there was a gradual epithelial proliferation, complete healing of the corneal surface was observed 10-16 days after the manipulation, the follow-up period was at least 1 year. The mechanism of action of stromal micropuncture is associated with the creation of a porous surface with better adhesion properties, as well as with the activation of the production of extracellular matrix glycoproteins such as fibronectin, type IV collagen and laminin, which are necessary for stable adhesion of the epithelium. The use of stromal micropuncture of the donor flap in the treatment of post-keratoplasty persistent corneal epithelial defect was proposed for the first time.


Assuntos
Doenças da Córnea , Transplante de Córnea , Doenças da Córnea/diagnóstico , Doenças da Córnea/etiologia , Doenças da Córnea/cirurgia , Humanos , Ceratoplastia Penetrante/efeitos adversos , Soluções Oftálmicas , Punções
3.
Arq Bras Oftalmol ; 84(1): 87-90, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33470348

RESUMO

This is a rare case report of acute, paracentral corneal melting and perforation occurring 1 week after an uneventful cataract surgery, with discussions on possible pathogenetic mechanisms. Relevant literature was also reviewed. Herein, a case of an 86-year-old woman with acute, paracentral, and sterile corneal melting and perforation in her left eye at 1 week after an uncomplicated cataract extraction is described. This occurs at the base of ocular surface disorders due to previous radiation of her lower eyelid and cheeks for the treatment of cancer and previously undiagnosed rheumatoid arthritis. She underwent surgical treatment using Gundersen's conjunctival flap for the existing perforation due to low visual expectancies and reluctance to undergo corneal keratoplasty due to the risk of corneal graft rejection. The risk of coming across an acute corneal melting after an uncomplicated cataract surgery in the eyes with ocular surface disorders should always be considered.


Assuntos
Artrite Reumatoide , Extração de Catarata , Catarata , Doenças da Córnea , Radiação , Idoso de 80 Anos ou mais , Artrite Reumatoide/complicações , Doenças da Córnea/etiologia , Doenças da Córnea/cirurgia , Feminino , Humanos
6.
Zhonghua Yan Ke Za Zhi ; 56(12): 956-960, 2020 Dec 11.
Artigo em Chinês | MEDLINE | ID: mdl-33342123

RESUMO

Limbal Stem Cell Deficiency (LSCD) is an ocular surface disease caused by the decrease of the quantity and dysfunction of limbal stem cell, which is characterized by conjunctivalization and other signs of epithelial dysfunction. For sever LSCD, surgery is the main treatment way. Recently, plenty of researches published the outcomes of different operation methods. This article summarized five major operations, including conjunctival limbal autograft (CLAU), simple limbal epithelial transplantation (SLET), limbal allograft, cultivated limbal stem cell transplantation (CLET) and cultivated oral mucosal epithelial transplantation (COMET). (Chin J Ophthalmol, 2020, 56:956-960).


Assuntos
Doenças da Córnea , Transplante de Córnea , Epitélio Anterior , Limbo da Córnea , Transplante de Células , Doenças da Córnea/cirurgia , Humanos , Transplante de Células-Tronco , Transplante Autólogo
7.
Indian J Ophthalmol ; 68(11): 2368-2371, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33120619

RESUMO

Purpose: The purpose of this study was to discuss the guidelines and modification of practices with respect to corneal transplantation and eye banking during the COVID-19 pandemic lockdown period and beyond, at a network of tertiary care centers in India. Methods: Descriptive study of the challenges faced in eye banking during the lockdown, and practices adopted to overcome the critical aspects in the clinical care of patients who presented with emergency corneal diseases requiring keratoplasty. Results: Complete lockdown orders from the Indian government, as a strategy to control the Coronavirus pandemic, resulted in drastic reduction of all types of elective corneal transplants and eye banking activities from March 24, 2020 to May 31, 2020. The sudden cessation of eye banking resulted in an acute demand and supply imbalance of fresh donor corneas for transplants during this time. Our network of eye banks addressed this issue by adopting glycerol preservation of donor corneas, which were subsequently utilized for tectonic penetrating keratoplasty. The donor cornea retrieval was resumed in a strategized manner 3 weeks prior to the date of exit of the lockdown, with modified guidelines on donor suitability, screening, retrieval, processing, and harvesting from various sources. A triage of keratoplasty priority was formulated to tide over the post lockdown shortage of corneas. We performed 31 therapeutic keratoplasties during the nationwide lockdown among our network of tertiary eye care centers. Conclusion: The study highlights the approach and strategies to manage and tide over an unprecedented crisis situation faced by corneal surgeons in general and, specifically, the eye banking community.


Assuntos
Betacoronavirus , Doenças da Córnea/cirurgia , Transplante de Córnea/métodos , Infecções por Coronavirus/transmissão , Transmissão de Doença Infecciosa/prevenção & controle , Bancos de Olhos/métodos , Pneumonia Viral/transmissão , Quarentena/estatística & dados numéricos , Adolescente , Adulto , Idoso , Criança , Bancos de Olhos/estatística & dados numéricos , Feminino , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias , Guias de Prática Clínica como Assunto , Centros de Atenção Terciária , Doadores de Tecidos/provisão & distribução
8.
PLoS One ; 15(10): e0239939, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33057425

RESUMO

To provide the general information on corneal transplantation (CT) in China, China Cornea Society designed a questionnaire on CT from 2014 to 2018 and entrusted it to 31 committee members for implementation of the survey nationwide. This article presents the results of the survey and compares the indicators used in the survey and those in the annual statistical report released by the Eye Bank Association of America (EBAA). The number of corneal transplantations completed by the 64 hospitals from 2014 to 2018 was respectively 5377, 6394, 7595, 8270 and 8980, totally 36,616 (22,959 male and 13,657 female). The five largest hospitals by the number of corneal transplantations completed 15,994 surgeries in total, accounting for 43.68% of all the surgeries performed in the 64 hospitals. The most common indication for corneal transplantations was corneal leukoma (7683, 20.98%), followed by bacterial keratitis (4209, 11.49%), corneal dystrophies (4189, 11.44%), keratoconus (3578, 9.77%) and corneal perforation (2839, 7.75%). The main surgical techniques were penetrating keratoplasty (PK) (19,896, 54.34%), anterior lamellar keratoplasty (ALK) (13,869, 37.88%). The proportion of PK decreased from 57.97% in 2014 to 52.88% in 2018 while the proportion of ALK increased from 36.04% in 2014 to 37.92% in 2018. The geographical distribution of keratoplasties performed in China is unbalanced. PK and ALK were the main techniques of CT and corneal leukoma, bacterial keratitis and corneal dystrophies were the main indications for CT in China.


Assuntos
Córnea , Doenças da Córnea , Transplante de Córnea , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , China , Córnea/patologia , Córnea/cirurgia , Doenças da Córnea/epidemiologia , Doenças da Córnea/cirurgia , Transplante de Córnea/métodos , Transplante de Córnea/estatística & dados numéricos , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Inquéritos e Questionários , Adulto Jovem
9.
Zhonghua Yan Ke Za Zhi ; 56(10): 730-734, 2020 Oct 11.
Artigo em Chinês | MEDLINE | ID: mdl-33059417

RESUMO

Keratoprosthesis implantation as an effective therapeutic method has been a treatment strategy in end-stage corneal blindness, contributing to restore vision and reduce the prevalence of blindness, but it has been restricted because of its high surgical technique and devastating complications. There are a large number of patients with corneal blindness in China, and the rate of high-risk or end-stage corneal blindness is high. It is of great significance to improve the understanding of the indications and contraindications of different kinds of keratoprostheses, as well as relevant technologies and knowledge, cope with the problems and challenges in the development period, and conduct safe and efficient clinical applications and related research, so that the technology of keratoprosthesis implantation in our country can go to the world steadily. (Chin J Ophthalmol, 2020, 56: 730-734).


Assuntos
Doenças da Córnea , China , Córnea/cirurgia , Doenças da Córnea/cirurgia , Humanos , Próteses e Implantes , Implantação de Prótese
10.
Medicine (Baltimore) ; 99(40): e21892, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33019387

RESUMO

The aim of this study was to investigate the histopathological manifestations of congenital corneal staphyloma accompanied by anterior segment dysgenesis and evaluate the prognosis after penetrating keratoplasty with an ultralarge button graft.We retrospectively studied 8 pediatric patients with large congenital corneal staphylomas in the Department of Ophthalmology of Peking University Third Hospital, China, between September 2014 and December 2018. All patients underwent penetrating keratoplasty with ultralarge button grafts, as well as additional operations according to the abnormality of each eye. Pathological investigations of all samples obtained during penetrating keratoplasty were performed with hematoxylin and eosin staining.The main clinical characteristic of congenital corneal staphyloma was an extremely opaque and ectatic cornea. Histopathological examination showed abnormal corneal epithelia and stroma and an absence of Bowman membrane, Descemet membrane, and the endothelium. Different severities of anterior segment dysgenesis, presenting as various histopathological manifestations, were observed in all cases. Several postoperative complications occurred after penetrating keratoplasty in some of the patients; however, the complications were discovered and treated accordingly in a timely manner. Six patients achieved good visual outcomes and a satisfactory cosmetic appearance after penetrating keratoplasty. One patient eventually lost the transparency of the button because of corneal neovascularization, and 1 patient lost visual function because of retinal detachment.Congenital corneal staphyloma combined with anterior segment dysgenesis can exhibit various manifestations on histopathological examination. Penetrating keratoplasty with an ultralarge button graft seems to be a suitable treatment for congenital corneal staphyloma to obtain good functional and aesthetic prognoses.


Assuntos
Doenças da Córnea/cirurgia , Anormalidades do Olho/cirurgia , Ceratoplastia Penetrante/métodos , Doenças da Córnea/complicações , Doenças da Córnea/congênito , Doenças da Córnea/patologia , Anormalidades do Olho/complicações , Anormalidades do Olho/patologia , Feminino , Humanos , Lactente , Masculino , Estudos Retrospectivos
11.
Cornea ; 39(12): 1599-1603, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32947412

RESUMO

PURPOSE: Corneal transplantation is the most frequently performed transplant procedure. In much of the world, the demand for donor tissue heavily outstrips supply. With developments within lamellar corneal graft surgery, the use of split corneal donor tissue to increase donor tissue supply seems a pragmatic solution to reduce the supply and demand mismatch. This is especially important with tissue supply expected to be affected by the COVID-19 pandemic. METHODS: A literature review of techniques was performed, enabling multiple transplants to be derived from a single donor and simulation of a model to quantify the number of corneas potentially saved. RESULTS: Studies on splitting corneal donor tissue have demonstrated that up to 5 recipients may benefit from 1 donor scleral button. The impact of splitting donor tissue may provide a saving of up to 25.3% of donor graft tissue. CONCLUSIONS: Splitting and preparing the donor tissue within an eye bank will improve tissue validation and donor tissue availability and may increase surgeon efficiency.


Assuntos
Betacoronavirus , Doenças da Córnea/cirurgia , Transplante de Córnea , Infecções por Coronavirus/epidemiologia , Ceratoplastia Endotelial com Remoção da Lâmina Limitante Posterior , Bancos de Olhos/métodos , Ceratoplastia Penetrante , Pneumonia Viral/epidemiologia , Doadores de Tecidos , Humanos , Pandemias , Obtenção de Tecidos e Órgãos , Transplantados
13.
Medicine (Baltimore) ; 99(34): e21937, 2020 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-32846863

RESUMO

RATIONALE: Microspherophakia is characterized by a small, spherical crystalline lens with increased sagittal diameter. Because of the uncertainty about the outcome, as well as the complexity of the operation and development of complications, the management and timing of surgical intervention for microspherophakia are still debated. Lens extraction is effective for avoiding the risk of pupillary blockage, but the outcome after operation is controversial. The iTrace (Tracey, USA) report shows the influence of low-order aberrations (LOA) and high-order aberrations (HOA), which may be valuable in predicting postoperative outcome. Our report concerns a child with microspherophakia who underwent lens extraction via the analysis of visual quality by iTrace. PATIENT CONCERNS: Our report is on the case of a 7-year-old girl whose parents observed she had to bring her papers and books extremely close to her face to read. On examination, the girl was bilaterally diagnosed microspherophakia with a small tremble lens. The objective refraction was -15.0 diopter of spherical power (DS)/-1.00 diopter of cylindrical power (DC) × 180 right eye (OD) and -12.5 DS/-1.50 DC × 20 left eye (OS). The HOA of OD and OS were high up to 0.926 and 0.659, respectively by iTrace. The visual quality remained terrible after correcting LOA (high myopia and astigmatism). According to iTrace report, the patient would get a good visual quality by extracting the clear lens with HOA from cornea after correcting LOA. The girl's parent opted for surgery on the left eye. DIAGNOSIS: Due to the patient's symptoms, examination results, she was diagnosed with microspherophakia. INTERVENTIONS: The patient underwent clear lens extraction by ultrasonic phacoemulsification and intraocular lens implantation. OUTCOMES: The first day after operation, total HOA was decreased to 0.077. Total LOA was 0.713. Corrected distance visual acuity (CDVA) is 20/20. One week after surgery, HOA was 0.110 and LOA was 0.328. CDVA was 20/25. CDVA was still 20/25 one month after surgery. The total HOA was 0.110 and the LOA was 0.334 by iTrace. LESSONS: ITrace not only plays an important role in analyzing potential reasons of undesirable preoperative visual quality but also can predict postoperative outcomes. All these functions are helpful for determining surgical intervention of microspherophakia cases.


Assuntos
Aberrometria/instrumentação , Doenças da Córnea/cirurgia , Ectopia do Cristalino/cirurgia , Glaucoma/cirurgia , Iris/anormalidades , Implante de Lente Intraocular/métodos , Facoemulsificação/instrumentação , Ultrassom/métodos , Astigmatismo/cirurgia , Criança , Doenças da Córnea/diagnóstico , Topografia da Córnea/instrumentação , Ectopia do Cristalino/diagnóstico , Feminino , Glaucoma/diagnóstico , Humanos , Iris/cirurgia , Miopia/cirurgia , Resultado do Tratamento , Acuidade Visual
14.
Zhonghua Yan Ke Za Zhi ; 56(6): 401-408, 2020 Jun 11.
Artigo em Chinês | MEDLINE | ID: mdl-32842324

RESUMO

Since the founding of the People's Republic of China, the diagnosis and treatment technology of corneal diseases has developed rapidly. In the field of infectious keratopathy, China was the first country that discovered chlamydia trachomatis in the world, which promoted the study on the pathogenesis as well as the diagnosis and treatment of infectious keratitis, especially fungal keratitis. In the aspect of surgical technology, we have learned from other countries and innovated different types of transplantation surgeries suitable for patients with corneal diseases in China. Regarding the construction of eye banks, the cornea donation process and the operation techniques have been developed and standardized. In addition, to improve the cornea disease-related inspection level, new equipment such as specular microscopy and confocal microscopy has been introduced. These efforts have decreased corneal diseases from the first blinding eye disease to the second in our country. In the past 70 years, China's diagnosis and treatment technology in corneal diseases has achieved remarkable progresses, but there are still many shortcomings. Standing on the shoulders of the older generations of ophthalmologists, we should continue to serve the patients with corneal diseases wholeheartedly. We would like to send congratulations on the 70th anniversary of Chinese Journal of Ophthalmology with this article. ( Chin J Ophthalmol, 2020, 56: 401-408).


Assuntos
Doenças da Córnea/cirurgia , Transplante de Córnea , China , Córnea , Bancos de Olhos , Humanos
15.
Am J Ophthalmol ; 218: 288-295, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32619607

RESUMO

PURPOSE: The purpose of this study was to evaluate the long-term outcomes of Descemet membrane endothelial keratoplasty (DMEK) in eyes that had previously undergone trabeculectomy and/or drainage device implantation. DESIGN: Retrospective, noncomparative case series. METHODS: Medical records of 251 consecutive DMEK procedures performed by 1 surgeon (S.X.D.) from 2013 to 2017 were reviewed. Patients with ≥2 years of follow-up were divided into 3 groups: eyes with prior glaucoma surgery (ST), eyes with medically treated glaucoma (MT), and eyes without glaucoma (NG). Main outcomes measured were visual acuity, endothelial cell count (ECC), rates of secondary graft failure (SGF), and postoperative complications. RESULTS: Ninety procedures (87 eyes) met inclusion criteria. The mean follow-up period of all eyes was 38.4 ± 11.2 months (range, 24.2-64.4 months). At last follow-up, the proportion of eyes reaching a vision of ≥20/40 was higher than that before the DMEK procedure in each group (all P < .05). The rate of ECC loss was the highest in the ST group compared to that in the MT and NG groups (63.8% vs 47.6% vs 44.0%, respectively; P < .05) as well as the rate of SGF (41.6% vs 0% vs 2.4%, respectively; P < .05). The rate of SGF of repeat DMEK was higher than that of primary DMEK (P < .05). The rates of postoperative complications were similar among all groups (all P > .05). CONCLUSIONS: In eyes with prior glaucoma surgery, DMEK achieved good long-term visual outcomes but experienced a higher rate of SGF than eyes without such comorbidity.


Assuntos
Doenças da Córnea/cirurgia , Ceratoplastia Endotelial com Remoção da Lâmina Limitante Posterior , Implantes para Drenagem de Glaucoma , Glaucoma/cirurgia , Trabeculectomia , Idoso , Idoso de 80 Anos ou mais , Anti-Hipertensivos/uso terapêutico , Contagem de Células , Doenças da Córnea/fisiopatologia , Perda de Células Endoteliais da Córnea/diagnóstico , Epitélio Posterior/patologia , Feminino , Seguimentos , Sobrevivência de Enxerto/fisiologia , Humanos , Pressão Intraocular/fisiologia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Estudos Retrospectivos , Resultado do Tratamento , Acuidade Visual/fisiologia
16.
Eur J Ophthalmol ; 30(5): 1172-1178, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32525428

RESUMO

PURPOSE: To report how to manage a specific type of Descemet's membrane (DM) rupture during manual DALK with a concurrent donor-recipient disparity of curvature. METHODS: Case report of two patients that had DM rupture during manual DALK with a concurrent donor-recipient disparity of curvature; the recipient bed was flatter (post-infectious scar, case 1) and steeper (keratoglobus, case 2) than the donor. Preoperative diagnosis, clinical exam, and best spectacle correct visual acuity (BSCVA) have been reported. A subtotal full-thickness circular cut of the recipient bed was performed to resolve a persistent double AC in case 1 (recipient flatter than donor). A total full-thickness circular cut of the recipient bed, creating a graft made by a DALK allograft and a "DSEK autograft," was performed to avoid a refractory double AC in case 2 (recipient steeper than donor). Evaluated outcomes included postoperative BSCVA, endothelial cell count (ECC), graft clarity, rejection, and presence/absence of double AC. RESULTS: Surgery was successful in resolving/avoiding double AC. VA improved in both cases. No episodes of rejection were recorded. Graft remained clear at the last follow-up (6 years for case 1 and 4 years for case 2). CONCLUSION: The existence of a donor-recipient curvature disparity should be investigated as a possible underlying mechanism of refractory double AC. Total or subtotal full thickness recipient bed cut may be considered to repair donor-recipient curvature disparity in cases of DM rupture occurring during manual DALK. Repairing the DM rupture and avoiding a conversion to PK in high-risk transplant cases are crucial.


Assuntos
Transplante de Córnea/efeitos adversos , Lâmina Limitante Posterior/lesões , Complicações Intraoperatórias , Procedimentos Cirúrgicos Oftalmológicos , Ruptura/cirurgia , Adulto , Idoso , Doenças da Córnea/cirurgia , Opacidade da Córnea/cirurgia , Humanos , Masculino , Estudos Retrospectivos , Ruptura/etiologia , Doadores de Tecidos , Transplantados , Acuidade Visual/fisiologia
18.
Indian J Ophthalmol ; 68(7): 1412-1416, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32587179

RESUMO

Purpose: Due to the COVID-19 pandemic, most of the eye banks have limited/stopped corneal collection, as this is a highly contagious disease. This has led to shortage of donor corneas worldwide. Glycerol preservation of tissue remains a viable option in this scenario. The objective is to compare fresh corneal tissue (FCT) with glycerol-preserved cornea (GPC) in emergency corneal transplantation. Methods: This was a retrospective cohort study conducted in a tertiary care centre of Uttarakhand. Medical records of the patients who underwent therapeutic penetrating keratoplasty (TPK) were reviewed. FCT group included patients who underwent TPK with fresh corneal tissue and GPC group included patients who underwent TPK with glycerol preserved cornea. The indications and outcomes of TPK in the terms of therapeutic success were analysed and compared between both the groups. Results: A total of 94 eyes of 91 patients underwent TPK from October 2011 to August 2017. FCT group included 60 eyes of 57 patients and GPC group included 34 eyes of 34 patients. The primary indication of TPK was infectious keratitis in both the groups (FCT-81.6%; GPC - 91.2%) There was no significant difference in the therapeutic success in both the groups (P = 0.741, Odds ratio- 1.59 with 95% CI- 0.39-6.44). Complications included glaucoma (FCT-21.7%; GPC- 35.2%) graft infection (FCT- 18.33% GPC- 2.9%); graft rejection (FCT-11.66%, GPC- 0%); and graft failure (FCT-88.33%, GPC-100%). Conclusion: The GPC is comparable to FCTs in therapeutic transplant and can be a useful interim procedure in saving the eyes in cases of infective keratitis in the time of crisis.


Assuntos
Betacoronavirus , Doenças da Córnea/cirurgia , Infecções por Coronavirus/epidemiologia , Emergências , Glicerol/farmacologia , Pneumonia Viral/epidemiologia , Doadores de Tecidos , Preservação de Tecido/métodos , Doenças da Córnea/complicações , Transplante de Córnea/métodos , Infecções por Coronavirus/complicações , Crioprotetores/farmacologia , Feminino , Seguimentos , Sobrevivência de Enxerto , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/complicações , Estudos Retrospectivos , Acuidade Visual
20.
Curr Opin Ophthalmol ; 31(4): 293-301, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32412959

RESUMO

PURPOSE OF REVIEW: The management of peripheral corneal diseases, including Mooren's ulcer, Terrien's marginal degeneration, peripheral ulcerative keratitis and pellucid marginal degeneration is challenging. Circular grafts must either be very large, resulting in the excision of healthy tissue, or eccentric, leading to high levels of astigmatism. This review summarizes the range of noncircular keratoplasty procedures available to surgeons, in addition to their indications, and surgical techniques. RECENT FINDINGS: Noncircular grafts have been demonstrated to be useful in the management of peripheral corneal diseases. They are effective at providing tectonic support and also facilitate visual rehabilitation. Specifically, they produce favourable postoperative visual and astigmatic outcomes. The evidence relating to these procedures is largely limited to case reports and case series, with no large-scale studies available. SUMMARY: Noncircular keratoplasty procedures are useful in the management of peripheral corneal diseases, which is typically difficult. There is a need for larger studies to investigate the relative advantages and disadvantages of these procedures and further characterize their outcomes.


Assuntos
Córnea/cirurgia , Doenças da Córnea/cirurgia , Transplante de Córnea/métodos , Humanos
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