Corneal manifestations and treatment among patients with COVID-19-associated rhino-orbito-cerebral mucormycosis

Purpose: TO report the corneal manifestations in patients with COVID?19?associated rhino?orbito?cerebral mucormycosis (ROCM). Methods: This study was a retrospective, observational, and record?based analysis of patients of ROCM with corneal involvement. Results: A total of 220 patients were diagnosed with ROCM over a period of 3 months. Thirty?two patients had developed corneal manifestations. The mean age at diagnosis was 52.84 ± 12.8 years. The associated risk factors were systemic mucormycosis, uncontrolled diabetes, recent COVID?19 infection, and injudicious use of systemic steroids. Twenty?nine patients were known diabetics, 32 had recent COVID?19 infection, and 13 gave a history of injudicious use of steroids. The right eye (RE) was affected in nine patients, the left eye (LE) in 20 patients, and both eyes in three patients. Nine patients had a round?oval corneal ulcer. One patient each had a perforated corneal ulcer with uveal prolapse, sealed perforated corneal ulcer, spontaneously healed limbal perforation, diffuse corneal haze with hyphemia, panophthalmitis, diffuse corneal stromal abscess, limbal ischemia, anterior uveitis with posterior synechiae, inferior corneal facet, and filamentary keratitis. Three patients each had a corneal melt and inferior conjunctival xerosis with chemosis. Orbital exenteration was performed in six patients. Five patients with corneal ulcers healed. Topical eye drops of amphotericin (0.5 mg/ ml) cycloplegic, antiglaucoma medications, and lubricant eye drops were started along with systemic antifungals. Conclusion: Central corneal ulcer was the most common manifestation of mucormycosis. A concentration as low as 0.5 mg/ml of amphotericin eye drops was effective in the treatment.

Evaluation of striate keratopathy after manual small-incision cataract surgery and its final outcomes in a tertiary hospital

Purpose: To study the demographic profile, contributing and precipitating factors, the severity of striate keratopathy and its relation with endothelial cell count, and evaluate the final treatment outcome of striate keratopathy. Methods: This observational analytical cohort study was conducted on 75 patients developing striate keratopathy after MSICS in the immediate postoperative period. Demographic profile, preoperative risk factors, and intraoperative complications were evaluated retrospectively. Postoperatively, slit-lamp grading of striate keratopathy was done, and specular microscopy of both eyes was taken. Treatment of striate keratopathy was initiated, and patients were followed up for 6 to 10 weeks for improvement. Results: Striate keratopathy was most commonly associated with surgeries performed by resident surgeons (92%), longer duration of surgery, associated predisposing factors, and intraoperative or postoperative complications. On postoperative day 1, the majority of patients had moderate and severe striate keratopathy (66% and 32%, respectively). It was associated with significant endothelial cell loss (ECL) at the final follow-up (P = 0.0016). Striate keratopathy resolved in 97.3% of patients, irrespective of the treatment with hypertonic saline. At 6 to 10 weeks, 92% of patients achieved a BCVA of ?6/9. Conclusion: A careful preoperative evaluation, adequate training of resident surgeons, meticulous surgical technique, and prompt management of postoperative complications can lead to a decrease in the incidence of striate keratopathy in the majority of cases. The use of hypertonic saline eye drops does not change the final outcome, and most cases resolve spontaneously during follow-up

Rituximab: alternativa eficaz para la querotopatía ulcerativa periférica / Rituximab: effective alternative for peripheral ulcerative kerotopathy

El desarrollo de los fármacos biológicos ha permitido controlar de manera óptima las manifestaciones oftalmológicas de las enfermedades autoinmunes, el conocimiento de nuevas vías patogénicas y de nuevas dianas terapéuticas lo que está suponiendo una revolución en el tratamiento médico de numerosas entidades y donde la oftalmología no es una excepción. Se presenta el caso clínico de una paciente con artritis reumatoide con mal control y afectación multisistémica que presentó una queratopatía ulcerativa periférica de mal control que respondió con tratamiento biológico diferente al tradicionalmente usado: el rituximab(AU)

The development of biological drugs has allowed optimal control of the ophthalmologic manifestations of autoimmune diseases, the knowledge of new pathogenic pathways and new therapeutic targets, which is leading to a revolution in the medical treatment in numerous entities and where ophthalmology is no exception. We present the clinical case of a patient with poorly controlled rheumatoid arthritis and multisystemic condition. The patient presented a poorly controlled peripheral ulcerative keratopathy that responded to a different biological treatment than the one traditionally used: rituximab(AU)

Clinical profile and demographic distribution of band shaped keratopathy in India: A study of 8801 patients

Purpose: To describe the clinical profile and demographic distribution of band?shaped keratopathy (BSK) in patients presenting to a multitier ophthalmology hospital network in India. Methods: This cross?sectional hospital?based study included 2,664,906 new patients presenting between January 2011 and January 2021 (10?year period). Patients with a clinical diagnosis of BSK in at least one eye were included as cases. The data were collected using an electronic medical record system. Results: Overall, 8801 (0.33%) patients were diagnosed with BSK. The prevalence rates were 0.47% in children (age: <16 years) and 0.31% in adults. The majority of patients were males (62.87%) with unilateral affliction (85.21%). The mean age of the patients was 40.43 ± 23.14 years. The majority (16.93%) of the patients were in the age bracket of 11–20 years. A larger proportion of the patients were from higher socioeconomic status (60.46%) and the urban region (45.9%). Of the 10,103 eyes affected with BSK, the common ocular comorbidities were status post?vitreoretinal surgery (20.55%) and uveitis (12.7%) in children and corneal scar (41.23%) and spheroidal degeneration (13.7%) in adults. Most of the eyes had mild or no visual impairment (24.74%). Among the eyes that needed surgical intervention, chelation with ethylenediaminetetraacetic acid (EDTA) was the most performed surgical procedure (1.68%) along with phototherapeutic keratectomy (0.32%). Conclusion: BSK commonly affects adult males and is unilateral in nature. The majority of the patients in this cohort belonged to higher socioeconomic strata and urban geography. At initial presentation, visual impairment was mild to moderate in a vast majority of the patients, and the most common surgical intervention performed was chelation with EDTA during the study period.

Research progress of oxidative stress in diabetic keratopathy / 国际眼科杂志(Guoji Yanke Zazhi)

@#It is estimated that currently, about 46%-64% of patients with diabetes mellitus(DM)suffer from diabetic keratopathy(DK). With the increasing prevalence of DM, DK has gradually been concerned by ophthalmologists. Nevertheless, its pathogenesis is not yet clear. Oxidative stress is a pathological process that causes excessive production of reactive oxygen species(ROS)and reactive nitrogen species(RNS)in the body, which damages tissues and cells. It participates in the occurrence and development of many diseases, including the ocular complications of DM. This study aims to review the research progress of oxidative stress in the pathogenesis and the treatment of diabetic corneal lesions, thus providing references for clinical diagnosis and treatment of DK.

Role of NLRP3 inflammasome signaling pathway in the occurrence and development of diabetic keratopathy / 中华实验眼科杂志

Diabetic keratopathy is a chronic complication of diabetes caused by abnormal metabolites accumulation, oxidative stress, abnormal inflammation and corneal neuropathy.It can result in delayed corneal epithelial healing and decreased corneal sensitivity under the stimulation of ocular trauma or surgery which bring great challenges to clinicians.Activation of nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) inflammatory is one of the factors that cause chronic complications of diabetes, and is also an important factor for delaying the healing of diabetic wounds.The NLRP3 inflammatory signaling pathway is closely related to corneal oxidative stress, delayed epithelium healing and development of corneal neuropathy.In this paper, the research status and prospects of NLRP3 inflammatory signaling pathway and diabetic keratopathy were reviewed to provide new ideas for studying the mechanism and treatment of diabetic keratopathy.

Role of mitophagy in diabetic corneal endothelial lesion / 中华实验眼科杂志

Diabetic keratopathy is one of the common ocular complications of diabetes, and diabetic patients are often accompanied by changes in the morphological structure of the corneal endothelium.Oxidative stress, inflammation, apoptosis, glucose metabolism disorders, mitochondrial injury, and endoplasmic reticulum stress are the main mechanisms of the occurrence and progression of diabetic keratopathy.Studies have shown that advanced glycation end products can activate and induce the formation of a large number of reactive oxygen species (ROS), which in turn causes cell damage and even apoptosis.Mitochondria are the source of ROS, which will be damaged when a large amount of ROS accumulate, and mitochondrial autophagy will be formed when the body removes damaged mitochondria.Mitophagy refers to the process of eliminating aging, dysfunctional, damaged mitochondria through selective autophagy, which is a key mechanism for mitochondria to maintain function.The decrease in the level of mitophagy will lead to the destruction of the hexagonal structure of the diabetic corneal endothelium and its dysfunction, and upregulating the level of mitophagy can play a protective role on corneal endothelium in oxidative stress.The role of mitophagy in diabetic corneal endothelial lesions were reviewed in this article.

Múltiplas camadas na membrana de descemet / Multiple layers on the Descemet membrane

RESUMO Relato de caso não descrito na literatura oftalmológica nacional de múltiplas camadas da membrana de Descemet. Mulher de 59 anos, pseudofácica, com diagnóstico de ceratopatia bolhosa, foi submetida à ceratoplastia penetrante em olho direito, sendo encontrado achado incomum de multiplicidade de camadas da membrana de Descemet, variáveis em forma e espessura, além de corpos ovoides com coloração de metamina de prata de Gocott-Gomori (GMS) negativa. Como a membrana de Descemet tem no seu desenvolvimento um período fetal e outro pós-natal que frequentemente é bem identificável nos cortes histológicos em adultos. No caso apresentado, em que outras camadas estão presentes, há evidência de corpos esféricos que poderiam significar que a potencialidade de produzir outras camadas pode permanecer na fase adulta mais tardia.

ABSTRACT To relate a case not described previously in the national multilateral ophthalmological literature of Descemet's membrane. A 59-year-old pseudophakic woman diagnosed with bullous keratopathy underwent penetrating keratoplasty with an unusual finding of multiple layers of Descemet's membrane, which were variable in shape and thickness. In addition, ovoid bodies with negative Gocott-Gomori (GMS) color were present. Discussion and Conclusion: As Descemet's membrane has a fetal and a postnatal period in its development, it is frequently and well identifiable in histological sections in adults. In the case presented, in which other layers are present, there is evidence of spherical bodies that could mean that the potential to produce other layers may remain into later adulthood.

Lagoftalmo na hanseníase: experiência clínica em centro de referência amazonense / Lagophthalmos in leprosy: clinical experience in an Amazon reference center

RESUMO Objetivo: O presente trabalho teve por objetivo caracterizar o perfil epidemiológico e clínico de pacientes com lagoftalmo associado à hanseníase, atendidos no ambulatório de oftalmologia da Fundação Alfredo da Matta, Manaus, Amazonas. Métodos: Trata-se de estudo retrospectivo realizado por meio da análise dos prontuários clínicos dos pacientes incluídos no estudo. Sexo, idade, forma clínica, grau de incapacidade no diagnóstico e desfecho foram obtidos dos prontuários. Início, tipo de comprometimento (unilateral ou bilateral), grau de intensidade do lagoftalmo e alterações oculares associadas também foram compilados. Resultados: Foram incluídos 65 pacientes; 66,1% eram do sexo masculino e 53,8% tinham idade superior a 60 anos. Em relação à classificação operacional da hanseníase, a maioria dos pacientes (81,5%) era multibacilar: 33,8% na forma de hanseníase borderline e 47% virchowiana. 36,9% casos apresentavam sequelas oculares associadas ao lagoftalmo: opacidade corneana, epífora, ceratopatia em faixa, e neovascularização corneana.41,6% evoluíram para a cegueira. O lagoftalmo foi conduzido de forma clínica em 23 pacientes e a abordagem cirúrgica foi indicada em 42. Em relação ao tratamento cirúrgico consistiu principalmente no implante de peso de ouro e na cantoplastia de Tessier. Discussão: O lagoftalmo nessa casuística acometeu mais homens idosos, esteve relacionado à forma multibacilar, com hanseníase do tipo virchowiano como relatado na literatura. O diagnóstico de lagoftalmo foi tardio na maioria dos casos, explicando o grande número de sequelas incluindo a cegueira. Conclusão: O presente estudo reforça a necessidade de acompanhamento oftalmológico precoce para que as potenciais e graves sequelas associadas a essa condição sejam evitadas.

ABSTRACT Objective: The present study aimed to characterize the epidemiological and clinical profile of patients with lagophthalmos associated with leprosy, seen at the ophthalmology outpatient clinic of Fundação Alfredo da Matta, Manaus, Amazonas. Methods: This is a retrospective study carried out by analyzing the medical records of the patients included in the study. Sex, age, clinical form, degree of disability in diagnosis and outcome were obtained from medical records. Onset, type of impairment (unilateral or bilateral), degree of intensity of lagophthalmos and associated eye changes were also compiled. Results: 65 patients were included; 66.1% were male and 53.8% were older than 60 years. Regarding the operational classification of leprosy, most patients (81.5%) were multibacillary: 33.8% in the form of borderline leprosy and 47% virchowian. 36.9% of cases had ocular sequelae associated with lagophthalmos: corneal opacity, epiphora, band keratopathy, and corneal neovascularization.41.6% progressed to blindness. Lagophthalmos was performed clinically in 23 patients and the surgical approach was indicated in 42. Regarding surgical treatment, it consisted mainly of gold weight implantation and Tessier's canthoplasty. Discussion: Lagophthalmos in this sample affected more elderly men, was related to the multibacillary form, with leprosy-like leprosy as reported in the literature. The diagnosis of lagophthalmos was delayed in most cases, explaining the large number of sequelae including blindness. Conclusion: The present study reinforces the need for early eye care so that the potential and serious sequelae associated with this condition are avoided.

Research advance in the correlation between diabetes mellitus and the non-retinal eye diseases / 国际眼科杂志(Guoji Yanke Zazhi)

@#Diabetes mellitus(DM)is a chronic metabolic disease characterized by sustained hyperglycemia, which can cause systemic macrovascular, microvascular and nervous system complications. The eye is one of the main organs affected by this disease. The ocular complications of DM include DR, however, non-retinal complications are also contained. This review provides an overview of the non-retinal eye diseases associated with DM, including diabetic keratopathy, dry eye, iridocyclitis, glaucoma, cataract, refractive error, optic neuropathy, iridocyclitis, asteroid hyalosis and so on. These ocular diseases may also lead to vision loss and should be taken seriously in diabetic patients.

Correlation between corneal neuropathy and ocular surface flora in type 2 diabetes / 中华内分泌代谢杂志

Objective:To explore the changes of corneal neuropathy and ocular surface flora in patients with type 2 diabetes, and the correlation between corneal neuropathy and ocular surface flora changes.Methods:According to the results of fundus fluorescein angiography, 65 patients with type 2 diabetes (130 eyes in total) who were treated with insulin alone and without comorbid retinopathy in the Department of Endocrinology, Henan People′s Hospital from March to June 2019 were selected. Sixty-five age-matched normal glucose tolerance subjects (130 eyes in total) were also enrolled. Confocal microscopy was performed and conjunctival sac secretions were collected. Through 16S rRNA analysis and sequencing and PICRUSt bacterial gene function prediction, the relationship between patients with type 2 diabetes and the difference in the degree of corneal neuropathy and the composition of ocular surface flora and function prediction in healthy people were explored, and the correlation between corneal neuropathy and ocular surface flora was analyzed as well.Results:Compared with healthy people, patients with type 2 diabetes have more severe corneal neuropathy, and it was related to the changes in ocular surface flora. Brevibacillus and paenibacillus were significantly positively correlated with the degree of corneal neuropathy ( P<0.05), and enhydrobacter and proteobacteria were significantly negatively correlated with the degree of corneal neuropathy ( P<0.05). PICRUSt analysis showed that the degree of enrichment of metabolism-related genes in the ocular surface flora of patients with type 2 diabetes was significantly changed compared with healthy people. Conclusion:Patients with type 2 diabetes present with more severe corneal neuropathy. The diversity of ocular surface flora and metabolic function have significant changes. The degree of severity corneal neuropathy is related to brevibacillus, paenibacillus, enhydrobacter, and proteobacteria.

Queratoplastia penetrante con y sin terapia antiviral en la queratopatía herpética / Penetrating keratoplasty with and without antiviral therapy in herpetic keratopathy

RESUMEN Objetivo: Identificar el resultado óptico o terapéutico de la queratoplastia penetrante en pacientes con queratopatía herpética. Métodos: Se realizó una investigación descriptiva, transversal, donde se expusieron los resultados del alcance de la queratoplastia penetrante por queratopatía herpética, operados en el Hospital Clínico Quirúrgico "Hermanos Ameijeiras", de La Habana. Resultados: La muestra fue de 33 queratoplastias penetrantes. Con fines ópticos sumaron 24 (72,7 por ciento) y tectónicas 9 (27,3 por ciento). En 5 de estas la agudeza visual fue menor o igual a 0,3. En el total de la muestra, 9 opacificaron, 11 sufrieron complicaciones posquirúrgicas, 8 recurrieron en queratoplastias penetrantes ópticas y 6 en queratoplastias penetrantes terapéuticas. Se rechazaron 7 queratoplastias penetrantes ópticas (33,3 por ciento) y 4 queratoplastias penetrantes terapéuticas (4 por ciento). Presentaron complicaciones 5 (25 por ciento) con queratoplastias penetrantes ópticas y 6 (55,6 por ciento) con queratoplastias penetrantes terapéuticas. En el posquirúrgico 22 (66,6 por ciento) tenían agudeza visual mayor o igual a 0,3 (p= 0,0000). Conclusiones: La inactividad de la enfermedad viral corneal beneficia el pronóstico del injerto por queratopatía herpética en las opacidades de las queratoplastias con fines ópticos. Queda demostrado que el uso de antivirales pre y posoperatorios disminuye la recidiva de la enfermedad herpética sobre el injerto y el rechazo, al lograr mejor agudeza visual y mayor viabilidad. La severidad inflamatoria posquirúrgica se asocia con la enfermedad viral activa o afección de origen inmune al realizar el trasplante, conexos a las complicaciones post queratoplastia(AU)

ABSTRACT Objective: Identify the optical or therapeutic outcome of penetrating keratoplasty in patients with herpetic keratopathy. Methods: A descriptive cross-sectional study was conducted in which a presentation was made of the results of the scope of penetrating keratoplasties for herpetic keratopathy performed at Hermanos Ameijeiras Clinical Surgical Hospital in Havana. Results: The sample was 33 penetrating keratoplasties: 24 optical (72.7 percent) and 9 tectonic (27.3 percent). Visual acuity was lower than or equal to 0.3 in 5 of them. Of the total sample, 9 opacified, 11 had postoperative complications, 8 recurred in optical penetrating keratoplasties, and 6 in therapeutic penetrating keratoplasties. Rejection occurred in 7 optical penetrating keratoplasties (33.3 percent) and 4 therapeutic penetrating keratoplasties (4%). Complications were observed in 5 (25 percent) optical penetrating keratoplasties and 6 (55.6 percent) therapeutic penetrating keratoplasties. In the postoperative period 22 (66.6 percent) had a visual acuity greater than or equal to 0.3 (p= 0.0000). Conclusions: Inactivity of corneal viral disease benefits the prognosis of grafting due to herpetic keratopathy in opacities of optical keratoplasties. Pre- and postoperative antivirals were found to reduce the recurrence of herpetic disease on the graft and rejection, achieving better visual acuity and greater viability. Postoperative inflammatory severity is associated to an active viral disease or an immune disorder at the time of the grafting resulting in post keratoplasty complications(AU)

Actualización terapéutica de la queratopatía bullosa pseudoafáquica / Therapeutic update on pseudophakic bullous keratopathy

RESUMEN La queratopatía bullosa pseudoafáquica o edema corneal crónico pseudoafáquico del paciente operado por cataratas con implante de lente intraocular es un proceso en el que la córnea se edematiza y pierde su función óptica, con síntomas dolorosos e irritativos de lagrimeo, ojo rojo, probabilidad de inflamación y ulceración corneal por infección secundaria. Se observan en esta afección multicausal dos grupos de pacientes. En uno de ellos el daño estructural corneal y ocular ha sido excesivo y no existe expectativa de mejora visual. El otro grupo aún conserva la potencialidad de recuperación de la agudeza visual. En el intento de solucionar esta afección se han empleado diversos tratamientos con fundamentos diferentes y resultados acordes con el desarrollo técnico y científico en que fueron aplicados. Es propósito de esta actualización describir y adecuar las posibilidades que los oftalmólogos puedan aplicar como terapéutica en sus respectivos niveles de actuación(AU)

ABSTRACT Pseudophakic bullous keratopathy or chronic pseudophakic corneal edema in patients undergoing cataract surgery with intraocular lens implantation is a process in which the cornea edematizes and loses optical function, with painful and irritating lacrimation symptoms, red eye, probable inflammation and corneal ulceration due to secondary infection. Sufferers of this multicausal condition are divided into two groups: In one of them structural corneal and ocular damage has been extreme and no visual improvement is expected, whereas in the other visual acuity recovery is still possible. In an attempt to heal this condition various treatments have been used with different rationales and results according to the scientific and technological development of the setting where they were applied. The present update is aimed at describing and adjusting the possible therapies that ophthalmologists may use in their respective fields of activity(AU)

Queratoplastia en perforación corneal / Keratoplasty in corneal perforation

RESUMEN La perforación corneal es una emergencia médica que por su gravedad puede poner en peligro la integridad del globo ocular. Se informan los resultados en una serie de 25 pacientes y sus 25 ojos con perforación corneal de diversas etiologías, los cuales constituyen el mayor porcentaje de pacientes con queratopatía herpética a quienes se les realizó queratoplastias primarias terapéuticas, así como dos retrasplantes ópticos, en el Hospital Clínico Quirúrgico "Hermanos Ameijeiras". El 83,4 por ciento de los ojos fueron conservados con agudeza visual desde 0,05 a 0,8 con corrección óptica(AU)

ABSTRACT Corneal perforation is a medical emergency whose severity may jeopardize the integrity of the eyeball. Results are presented of a series of 25 patients and their 25 eyes with corneal perforation of varying etiologies. This group constitutes the largest percentage of patients with herpetic keratopathy undergoing primary therapeutic keratoplasties. Two of them underwent optical retransplantation at Hermanos Ameijeiras Clinical Surgical Hospital. Of the total eyes, 83.4 percent were preserved, with a visual acuity of 0.05 to 0.8 with optical correction(AU)

Research progress in pathogenesis of diabetic keratopathy / 国际眼科杂志(Guoji Yanke Zazhi)

@#Diabetic keratopathy is one of the common complications of diabetes in the eye, the main clinical manifestations include dry eye diseases, punctate keratitis, slow regeneration of cornea epithelial, recurrent epiththelial erosions, degeneration of corneal sensitivity and corneal edema. The main pathogenesis is AGES, polyol pathway, the changes of proteinases, <i>etc.</i> This article mainly reviews the pathogenesis of its main clinical manifestations,expect to provide new ideas for clinical treatment.

Manual Preparation of Donor Lenticule Using Artificial Anterior Chamber for Descemet's Membrane Stripping Endothelial Keratoplasty

PURPOSE: To report a patient with a pseudophakic bullous keratopathy (PBK) who underwent Descemet's membrane stripping endothelial keratoplasty (DSEK) with manual preparation of the donor corneal graft.CASE SUMMARY: A 61-year-old female presented with visual disturbance in her right eye. Five months prior, she was treated with phacoemulsification and intraocular lens exchange surgery of the right eye, and a very severe corneal edema was revealed by slit-lamp examination. We diagnosed PBK and planned DSEK with manual preparation of a donor corneal graft because of the non-availability of a microkeratome or a femtosecond laser. After making the corneal graft using an artificial anterior chamber, crescent knife and cornea dissector, the keratoplasty proceeded using the graft. Three months after surgery, her graft was well-maintained on the right eye. The patient's visual acuity was 0.3, and the corneal endothelial cell count was 1,844/mm².CONCLUSIONS: Manual preparation of the donor corneal graft for DSEK is suitable as a second choice treatment method when the availability of surgical devices is limited.

Research progress on the risk factors and pathogenesis of climatic droplet keratopathy / 国际眼科杂志(Guoji Yanke Zazhi)

@#Climatic droplet keratopathy(CDK), an acquired corneal degenerative disease, is characterized by oil droplet deposits and banded opacity in the pre-corneal elastic layer and stroma layer, which can severely affect the visual acuity of patients. Recently, many studies have indicated that various factors caused the occurrence and development of CDK. However, the pathogenesis and specific pathogenesis of the disease remain unclear. So this article aims to summarize four aspects of the CDK, including the epidemiological characteristics, the morphology of corneal lesions, the composition of corneal deposits and the ocular surface micro-environment, and then provide a reference for ophthalmologists to acknowledge and explore CDK deeply.

Surgical techniques and clinical observation of Descemet's stripping automated endothelium keratoplasty in bullous keratopathy / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate the clinical effects and safety of surgical techniques in Descemet stripping automatic endothelial keratoplasty(DSAEK)in bullous keratopathy.<p>METHODS: A retrospective analysis of 10 patients with bullous keratopathy treated in our hospital from December 2018 to December 2019 in our hospital, including 4 males(4 eyes), 6 females(6 eyes). Descemet stripping automatic endothelial keratoplasty(DSAEK)was performed with every patient. In addition to the conventional surgical procedures, the surgical technique such as the setting of the anterior chamber perfusion tube, the design of the incision, and the peripheral corneal puncture during the operation were performed. Follow-up for 6mo, the recovery of corneal grafts and postoperative dislocations, double anterior chambers, and other complications were observed, including best corrected visual acuity(BCVA), anterior segment optical coherence tomography, corneal endothelial cell count and incidence of postoperative complications.<p>RESULTS: All patients had smooth surgery, no intraoperative complications occurred, and no postoperative dislocations or interlaminar effusions occurred; postoperative intraocular pressure was normal, and the BCVA was improved to different degrees than before surgery. The symptoms such as tearing and photophobia gradually reduced from 1d after surgery, and completely relieved after 2wk. Corneal stroma edema decreased within 1mo after operation, and the central corneal thickness(596.8±19.11μm)was significantly thinner than that before operation(874.0±58.64μm). During the follow-up period, all patients were stable and the corneal grafts remained transparent, but the corneal endothelial counts were reduced to varying degrees.<p>CONCLUSION: The application of surgical techniques in DSAEK can significantly reduce intraoperative and postoperative complications, improve the safety of surgery, and has clinical value in bullous keratopathy.

Influencia de la diabetes mellitus en la superficie ocular / Influence of diabetes mellitus in the ocular surface

RESUMEN La diabetes mellitus (DM) es una de las enfermedades sistémicas más comunes a nivel mundial con una prevalencia en incremento y una elevada tasa de mortalidad. La retinopatía diabética es una de las principales causas de ceguera en todas las latitudes del mundo. Aunque otras enfermedades oculares secundarias a diabetes también causan ceguera, su influencia en la superficie ocular es poco estudiada; sin embargo, el 73,6 por ciento de los pacientes diabéticos tipo 2 sufren de complicaciones corneales o de la superficie ocular. Se realizó una revisión de la bibliografía actualizada en idiomas español e inglés, a la que se pudo acceder, disponible en textos completos y resúmenes en bases de datos como PubMed, Ebsco, Google Académico y Scielo. Además, se consultaron novedosos artículos en prestigiosas revistas especializadas, con el objetivo de brindar información actualizada sobre la influencia de la diabetes en la superficie ocular. La diabetes mellitus tiene un impacto adverso en la superficie ocular. La gravedad de la neuropatía corneal diabética se correlaciona con la neuropatía periférica diabética. El estudio de la superficie ocular, así como de la retina, es importante para el tratamiento óptimo de la diabetes. Se han introducido novedosas opciones terapéuticas, pero todavía hay muchas en fase investigativa para los trastornos de la superficie ocular asociados con la diabetes(AU)

ABSTRACT Diabetes mellitus (DM) is one of the most common systemic diseases worldwide with an increasing prevalence and a high mortality rate. Diabetic retinopathy is one of the leading causes of blindness in all the latitudes of the world. Although other eye diseases secondary to diabetes also cause blindness, such influence on the ocular surface is poorly studied; however, 73.6 percent of type 2 diabetic patients suffer from corneal or ocular surface complications. A review of the available updated bibliography in Spanish and English languages; was carried out from full texts and abstracts in databases such as PubMed, Ebsco, Google Scholar, and Scielo. In addition, novel articles were consulted in prestigious specialized journals, with the aim of providing updated information on the influence of diabetes on the ocular surface. Diabetes mellitus has an adverse impact on the ocular surface. The severity of diabetic corneal neuropathy correlates with diabetic peripheral neuropathy. The study of the ocular surface, as well as the retina, is important for the optimal treatment of diabetes. Novel therapeutic options have been introduced, but there are still many in the investigative phase for ocular surface disorders associated with diabetes(AU)