ABSTRACT
Here we describe a new, non-human, ex-vivo model (goat eye model) for training surgeons in DMEK surgeons. In a wet lab setting, goat eyes were used to obtain a pseudo-DMEK graft of 8 mm from the goat lens capsule that was injected into another goat eye with the same maneuvers described for human DMEK. The DMEK pseudo-graft can be easily prepared, stained, loaded, injected, and unfolded into the goat eye model reproducing the similar maneuvers used for DMEK in a human eye, except for the descemetorhexis, which cannot be performed. The pseudo-DMEK graft behaves similar to human DMEK graft and useful for surgeons to experience and understand steps of DMEK early in learning curve. The concept of a non-human ex-vivo eye model is simple and reproducible and obviates the need for human tissue and the issues of poor visibility in stored corneal tissue.
ABSTRACT
ABSTRACT The purpose of this study is to report the clinical features and outcomes of ocular surface toxicity following depatuxizumab mafoditin (ABT-414) therapy for unresectable glioblastoma. Ocular signs and symptoms of three patients treated with ABT-414 during a phase III trial for glioblastoma multiforme were evaluated. Both eyes of all patients were damaged during the week after the first infusion of the ABT-414 molecule. In all patients, mild-to-moderate keratitis could be ascertained, along with decreased visual acuity and blurred vision, as well as foreign-body sensation and redness. Symptoms and visual acuity improved 4 weeks. In conclusion, ABT-414 therapy may cause transient ocular surface toxicity. The initiation of artificial tears and lubricant ointment was enough to control the ocular surface signs and symptoms. A multidisciplinary approach, complete ophthalmologic monitorization, and elaboration of protocols are required to adequately manage these patients.
RESUMO Nosso objetivo é relatar as características clínicas e os resultados da toxicidade na superfície ocular após a terapia com depatuxizumabe mafodotina (ABT-414) para glioblastoma irressecável. Os sinais e sintomas oculares de três pacientes que foram tratados com ABT-414 durante um estudo de fase III para glioblastoma multiforme foram avaliados. Ambos os olhos de todos os pacientes foram danificados durante a semana após a primeira infusão da molécula ABT-414. Em todos os pacientes, uma ceratite de leve a moderada pode ser verificada, juntamente com uma diminuição da acuidade visual e visão turva, bem como sensação de corpo estranho e vermelhidão. Os sintomas e a acuidade visual melhoraram em um período de 4 semanas. Em conclusão, a terapia com ABT-414 pode causar toxicidade transitória na superfície ocular. A iniciação com lágrimas artificiais e pomada lubrificante foi suficiente para controlar os sinais e sintomas na superfície ocular. Uma abordagem multidisciplinar, com acompanhamento oftalmológico completo e a elaboração de protocolos são necessários para o manejo adequado desses pacientes.
ABSTRACT
Purpose: To evaluate and compare the biomechanical properties of the eye bank?prepared and surgeon prepared Descemet stripping automated endothelial keratoplasty (DSAEK) tissues. Methods: In this laboratory study, corneal tissues for research were randomly allocated in the following groups: a) surgeon?cut DSAEK and b) eye bank?prepared (pre?cut and pre?loaded) DSAEK. Endothelial cell loss (ECL), immunostaining for tight junction protein ZO?1, elastic modulus, and adhesion force were investigated. Results: ECL was not found to be significantly different between surgeon?cut DSAEK (7.8% ±6.5%), pre?cut DSAEK (8.6% ±2.3%), and pre?loaded DSAEK (11.1% ±4.8%) (P = 0.5910). ZO?1 was expressed equally across all groups. Surgeon?cut DSAEK grafts showed a significantly higher elastic modulus compared to pre?cut and pre?loaded DSAEK groups (P = 0.0047 and P < 0.0001, respectively). Adhesion force was significantly greater in the surgeon?cut DSAEK compared to pre?cut (P < 0.0001) or pre?loaded DSAEK groups (P = 0.0101). Conclusion: The laboratory data on the biomechanics of DSAEK grafts suggests that surgeon?cut DSAEK grafts present higher elastic modulus and adhesion force compared to eye bank?prepared DSAEK grafts.
ABSTRACT
Aim: The intraocular silicone oil (SO) tamponades used in the treatment of retinal detachment (RD) have been associated with a difference ocular hypertension (OH) rate. To clarify, if this complication was associated to use of standard SO (SSO) versus heavy SO (HSO), we performed a systematic review and meta‑analysis of comparative study between two kind of SO (standard or light vs. heavy) for the treatment of RD and macular hole, without restriction to study design. Materials and Methods: The methodological quality of two randomized clinical trials (RCTs) were evaluated using the criteria given in the Cochrane Handbook for Systematic Reviews of Intervention, while three non‑RCTs were assessed with the Newcastle– Ottawa Scale and Strengthening the Reporting of Observational Studies in Epidemiology checklists. We calculated Mantel–Haenszel risk ratio (RR) with 95% confidence intervals (95% CIs). The primary outcome was the rate of patients with OH treated with SSO compared to HSO. Results: There were a higher number of rates of OH in HSO compared to SSO. This difference was statistically significant with the fixed effect model (Mantel–Haenszel RR; 1.55; 95% CI, 1.06–2.28; P = 0.02) while there was not significative difference with the random effect model (Mantel–Haenszel RR; 1.51; 95% CI, 0.98–2.33; P = 0.06). Conclusion: We noted a trend that points out a higher OH rate in HSO group compared to SSO, but this finding, due to the small size and variable design of studies, needs to be confirmed in well‑designed and large size RCTs.