ABSTRACT
PURPOSE: The purpose of this study was to evaluate the feasibility of treating aniridia-associated keratopathy with a nonpenetrating artificial cornea in 2 patients with corneal blindness secondary to aniridia. METHODS: This was a prospective, nonrandomized, interventional study of 2 consecutive patients with corneal blindness caused by aniridia. Ophthalmological examination was performed before the nonpenetrating keratoprosthesis surgery and then repeated 1, 7, 15, 30, 90, and 180 days and subsequently every 90 days thereafter. Optical coherence tomography was performed 90 days postsurgery to assess the position of the implant. RESULTS: Visual acuity improved significantly after the KeraKlear surgery. Postoperative findings included periprosthetic corneal thinning, neovascularization, and retroprosthetic opacity. CONCLUSIONS: KeraKlear nonpenetrating artificial corneas represent a promising alternative to keratolimbal allografts and Boston keratoprosthesis for the treatment of aniridia-associated keratopathy.
Subject(s)
Aniridia , Artificial Organs , Corneal Diseases , Aniridia/complications , Aniridia/surgery , Cornea/surgery , Corneal Diseases/complications , Corneal Diseases/surgery , Follow-Up Studies , Humans , Lasers , Prospective Studies , Prostheses and Implants , Prosthesis Implantation , Retrospective StudiesABSTRACT
PURPOSE: To describe the outcomes of Descemet membrane endothelial keratoplasty (DMEK) performed in amblyopic aged (younger than 8 years) children. METHODS: This is a single-center retrospective study, including 11 eyes (7 congenital hereditary endothelial dystrophy and 4 congenital glaucoma) of 6 children in amblyopic age undergoing DMEK by a single surgeon (N.C.P.) at Sorocaba Eye Hospital from December 2015 to November 2017. Best spectacle-corrected visual acuity, biomicroscopy, pachymetry, endothelial cell density, and complications were evaluated. RESULTS: No intraoperative complications occurred. Graft detachment occurred in 1 eye (9.1%) and was successfully managed with rebubbling. No primary graft failure or pupillary block was observed. All pachymetric measurements improved, and the corneal edema clinically resolved in all eyes within 2 weeks after the procedure. At the last follow-up (mean 30 months), best spectacle-corrected visual acuity was ≥20/40 in 7 (77.8%) of 9 eyes from patients cooperative enough to assess vision. All children began visual stimulation therapy and amblyopic treatment within 1 month of surgery, and all grafts remained clear until the last follow-up. The mean preoperative donor endothelial cell density was 2588 ± 236 cells/mm, which decreased to 1726 ± 292 cells/mm 2 years after surgery, yielding a 33% reduction (P < 0.001). No immunologic graft reaction, secondary graft failure, or cataracts were observed during the follow-up period. CONCLUSIONS: In this series, DMEK was performed to successfully treat endothelial dysfunction in children. However, the procedure is more challenging, and more studies with more patients and longer follow-up are needed to confirm the superiority of DMEK in treating endothelial dysfunction in children.
Subject(s)
Corneal Dystrophies, Hereditary/surgery , Descemet Stripping Endothelial Keratoplasty/methods , Visual Acuity/physiology , Cell Count , Child , Child, Preschool , Corneal Dystrophies, Hereditary/physiopathology , Corneal Pachymetry , Endothelium, Corneal/pathology , Female , Graft Survival/physiology , Humans , Infant , Intraoperative Complications , Male , Microscopy, Acoustic , Postoperative Complications , Retrospective Studies , Treatment Outcome , Vision Disorders/rehabilitationABSTRACT
Purpose: To evaluate the ability of human immature dental pulp stem cells, which are mesenchymal stem cells of neural crest origin, to differentiate into the corneal epithelium for purposes of corneal transplantation and tissue engineering when cultured on de-epithelized amniotic membranes. Methods: We compared the immunophenotypes (ABCG2, K3/12, and vimentin) of cells grown on amniotic membranes or plastic surfaces under serum-free conditions or in culture media containing serum or serum replacement components. Results: Immature dental pulp stem cells grown on amniotic membranes under basal conditions are able to maintain their undifferentiated state. Our data also suggest that the culture medium used in the present work can modulate the expression of immature dental pulp stem cell markers, thus inducing epithelial differentiation of these cells in vitro. Conclusions: Our results suggest that the amniotic membrane is a good choice for the growth and transplantation of mesenchymal stem cells, particularly immature dental pulp stem cells, in clinical ocular surface reconstruction.
ABSTRACT
Purpose: To evaluate the ability of human immature dental pulp stem cells, which are mesenchymal stem cells of neural crest origin, to differentiate into the corneal epithelium for purposes of corneal transplantation and tissue engineering when cultured on de-epithelized amniotic membranes. Methods: We compared the immunophenotypes (ABCG2, K3/12, and vimentin) of cells grown on amniotic membranes or plastic surfaces under serum-free conditions or in culture media containing serum or serum replacement components. Results: Immature dental pulp stem cells grown on amniotic membranes under basal conditions are able to maintain their undifferentiated state. Our data also suggest that the culture medium used in the present work can modulate the expression of immature dental pulp stem cell markers, thus inducing epithelial differentiation of these cells in vitro. Conclusions: Our results suggest that the amniotic membrane is a good choice for the growth and transplantation of mesenchymal stem cells, particularly immature dental pulp stem cells, in clinical ocular surface reconstruction.
ABSTRACT
PURPOSE: To evaluate cytokine concentrations in amniotic membrane (AM) preserved in different preservation media, temperatures, and times and to compare them with those in fresh AM. METHODS: Placentas were harvested from 8 women undergoing cesarean delivery, with each then divided into 17 pieces for the following preservation methods: at 2 different temperatures (-80 and 0°C), in 2 different preservation media (dimethyl sulfoxide and enriched TC199; Ophthalmos), and for different time periods (for 1, 7, 60, and 180 days). Nonpreserved fresh AM was used as a control. An enzyme-linked immunosorbent assay was performed on the supernatant for detection of the following cytokines: epidermal growth factor, basic fibroblast growth factor, hepatocyte growth factor, keratinocyte growth factor, transforming growth factor-beta, and interleukins 4 and 10, and the findings were assessed by post hoc analysis of variance. RESULTS: AM preserved at -80°C showed less decrease in the concentration of 4 cytokines. Three cytokines showed less decrease in AM preserved in the TC199 medium, whereas 1 showed less decrease in AM preserved in dimethyl sulfoxide. After storage, 5 cytokine concentrations remained stable for up to 1 day, 3 remained stable for up to 7 days, and all showed significant loss thereafter. CONCLUSIONS: The AM storage temperature of -80°C was found optimal for maintaining the concentrations of most of the tested cytokines, and enriched TC199 medium was the optimal long-term storage medium for maintaining the concentration of 3 of the cytokines, and with less decrease. When possible, AM should be used within 1 to 7 days after harvesting.
