Fyodorov-Zuev keratoprosthesis implantation: long-term results in patients with multiple failed corneal grafts.

BACKGROUND: The long term results of the Fyodorov-Zuev keratoprosthesis are presented for ten patients with repeated graft failures. METHODS: The study took place at Dr Khodadoust Eye Hospital. The Fyodorov-Zuev keratoprosthesis was implanted in ten patients with repeated graft failures, including seven patients with old trachoma, two patients with chemical injury, and a patient with thermal injury. The outcome measures were visual acuity, retention, and complications of the keratoprosthesis. RESULTS: Preoperative best-uncorrected visual acuity (BUVA) ranged from counting fingers to light perception (median: light perception). The keratoprosthesis dramatically improved vision in most patients. Patients retained BUVA of 20/200-20/50 in 50%, 20/60-20/100 in 30%, 20/200 in 10% and 20/400 in 10%. Overall, 90% had 1 year postoperative vision of 20/200 or better. 70% of cases had BUVA of 20/200 or better at the last follow-up (average 52 months). Of ten keratoprosthesis implanted, three have been removed, and as a result, retention rate was 70% during average follow-up of 52 months .The most common postoperative complications were retroprosthetic membrane formation (40%), uveitis (20%), glaucoma (20%), tissue overgrowth (20%), early leakage (20%), late leakage (20%), aseptic necrosis (20%), retinal detachment (10%), endophthalmitis (10%), and granulation tissue growth (10%). CONCLUSIONS: Fyodorov-Zuev keratoprosthesis is an effective means of managing repeated corneal graft failure.

Brain-derived neurotrophic factor as a biomarker in primary open-angle glaucoma.

PURPOSE: To introduce a novel biomarker for screening of primary open-angle glaucoma (POAG) by detecting and measuring brain-derived neurotrophic factor (BDNF) in the serum of normal subjects and patients with early stage of glaucoma. METHODS: Twenty-five glaucoma patients as the case group and 25 age- and sex-matched normal persons as the control group were tested. The control group comprised 19 men and 6 women, with the mean age of 59.32 ± 11.8 years and without any apparent ocular or systemic diseases. The case group comprised 20 men and 5 women, with the mean age of 59.64 ± 11.56 years, who were assessed by routinely performed clinical and paraclinical investigations. BDNF levels in serum were determined by enzyme-linked immunosorbent assay using monoclonal antibodies specific for BDNF. RESULTS: The mean of BDNF levels in the serum was 27.16 ± 5.53 ng/mL in the control subjects and 18.42 ± 4.05 ng/mL in the subjects with the early stage glaucoma. A statistically significant difference was evident between the two groups (p < 0.05). We found no significant differences in serum BDNF levels according to the subjects' age, gender, duration of the glaucoma, mean intraocular pressure, and blood pressure (p > 0.05). Glaucoma patients who had lower serum BDNF concentration had disclosed a significant negative correlation with pattern standard deviations. CONCLUSIONS: We conclude that BDNF in the serum might be a useful biochemical marker for early detection of POAG. We also propose that this might be a reliable, time efficient, and cost-effective method for diagnosis, screening, and assessing the progression of POAG. However, more studies and trials are needed to investigate these factors in greater detail.