ABSTRACT
PURPOSE: To report the outcomes after Descemet membrane endothelial keratoplasty (DMEK) in vascularized eyes. METHODS: Consecutive cases of DMEK in vascularized eyes (involving ≥2 vascularized quadrants) were selected from a prospective database. Best corrected visual acuity, endothelial cell density (ECD), central corneal thickness, corneal transplant rejection episode, graft survival, and area of neovascularization (quantified using image analysis software) were evaluated. RESULTS: In this study, 24 eyes of 24 patients were selected [mean age, 65.0 years; mean follow-up duration, 14.8 months (6-36 months)], which consists of 14 vascularized eyes after failed penetrating keratoplasty and 10 vascularized eyes with bullous keratopathy. Best corrected visual acuity improved from 1.60 ± 1.02 LogMAR preoperatively to 0.47 ± 0.37 LogMAR 12 months postoperatively (P < 0.001). Central corneal thickness decreased from 824 ± 193 µm preoperatively to 544 ± 48 µm 12 months postoperatively (P = 0.001). The donor ECD decreased from 2272 ± 723 cells/mm2 preoperatively to 1570 ± 279 cells/mm2 12 months postoperatively. The total loss of ECD at the last visit was 40.7% ± 13.0%. Eight of 24 eyes (33.3%) required rebubbling, which resulted in final attachment. The corneal neovascularization area significantly regressed from 4.68% ± 3.26% preoperatively to 2.28% ± 1.58% (n = 18, P = 0.021). Corneal transplant rejection episodes occurred in 1 eye of 24 patients (4.2%). There was no primary graft failure. CONCLUSIONS: DMEK is a feasible option to treat endothelial dysfunction in vascularized eyes.
Subject(s)
Corneal Diseases/surgery , Corneal Neovascularization/complications , Descemet Stripping Endothelial Keratoplasty , Aged , Aged, 80 and over , Cell Count , Corneal Diseases/physiopathology , Corneal Endothelial Cell Loss/diagnosis , Corneal Neovascularization/physiopathology , Corneal Pachymetry , Endothelium, Corneal/pathology , Female , Follow-Up Studies , Graft Survival/physiology , Humans , Male , Middle Aged , Prospective Studies , Treatment Outcome , Visual Acuity/physiologySubject(s)
Burns, Chemical/complications , Corneal Edema/surgery , Descemet Stripping Endothelial Keratoplasty/methods , Eye Burns/complications , Sulfuric Acids/adverse effects , Adult , Burns, Chemical/diagnosis , Corneal Edema/chemically induced , Corneal Edema/diagnosis , Eye Burns/chemically induced , Eye Burns/diagnosis , Female , Humans , Slit Lamp Microscopy , Tomography, Optical CoherenceABSTRACT
MOTIVATION: In recent years, structural genomics and ab initio molecular modeling activities are leading to the availability of a large number of structural models of proteins whose biochemical function is not known. The aim of this study was the development of a novel software tool that, given a protein's structural model, predicts the presence and identity of active sites and/or ligand binding sites. RESULTS: The algorithm implemented by ligand binding site recognition application (LIBRA) is based on a graph theory approach to find the largest subset of similar residues between an input protein and a collection of known functional sites. The algorithm makes use of two predefined databases for active sites and ligand binding sites, respectively, derived from the Catalytic Site Atlas and the Protein Data Bank. Tests indicate that LIBRA is able to identify the correct binding/active site in 90% of the cases analyzed, 90% of which feature the identified site as ranking first. As far as ligand binding site recognition is concerned, LIBRA outperforms other structure-based ligand binding sites detection tools with which it has been compared. AVAILABILITY AND IMPLEMENTATION: The application, developed in Java SE 7 with a Swing GUI embedding a JMol applet, can be run on any OS equipped with a suitable Java Virtual Machine (JVM), and is available at the following URL: http://www.computationalbiology.it/software/LIBRAv1.zip.
