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BACKGROUND: The traditional surgical treatment for stromal corneal dystrophy is penetrating keratoplasty. In recent years, more and more doctors are considering using deep lamellar keratoplasty to treat stromal corneal dystrophy. Few studies comparing penetrating keratoplasty and deep lamellar keratoplasty for stromal corneal dystrophy have been reported in China. OBJECTIVE: To compare the clinical efficacy of deep lamellar keratoplasty and penetrating keratoplasty in the treatment of stromal corneal dystrophy. METHODS: Fifty-seven patients (57 eyes) diagnosed with stromal corneal dystrophy and admitted at the General Hospital of Northern Theater Command from January 2000 to January 2018 were selected, including 18 males and 39 females, aged (52.9±20.0) years. They were divided into two groups based on the surgical procedure: 21 cases (21 eyes) in the deep lamellar keratoplasty group and 36 cases (36 eyes) in the penetrating keratoplasty group. A 12-month followup was conducted to observe the best-corrected visual acuity, corneal endothelial cell density, corneal graft transparency, intraoperative and postoperative complications, and recurrence of the original disease. RESULTS AND CONCLUSION: Visual acuity at 1, 3, 6, and 12 months postoperatively was higher than preoperatively in both groups (P < 0.05). The postoperative best-corrected visual acuity between the two groups showed no significant difference (P > 0.05). With the prolongation of postoperative time, the corneal endothelial cell density gradually decreased in the two groups, and the annual loss rate of corneal endothelial cell density in the penetrating keratoplasty group was higher than that of the deep lamellar keratoplasty group at 6 and 12 months postoperatively (P < 0.05), while there was no significant difference in corneal graft transparency between the two groups at 12 months postoperatively (P > 0.05). There were six cases of complications in the deep lamellar keratoplasty group and 14 cases of complications in the penetrating keratoplasty group. There was no recurrence in 57 cases within 12 months after surgery, and the difference in recurrence rates between the two groups at 5 years after surgery was not significant (P > 0.05). The graft survival rates at 5 years after surgery in the penetrating keratoplasty group and the deep lamellar keratoplasty group were 83% and 86%, respectively, and there was no significant difference between the two groups (P > 0.05). To conclude, deep lamellar keratoplasty could be considered as an alternative to penetrating keratoplasty in the treatment of stromal corneal dystrophy. [ABSTRACT FROM AUTHOR]

BACKGROUND: Amniotic membrane transplantation has been used to treat chemical burns of the eyes at various stages. It promotes corneal epithelialization, reduces inflammation, and restores the integrity of the ocular surface, preventing thawing of the ocular tissue. OBJECTIVE: To analyze the efficacy of amniotic membrane transplantation in ocular alkali chemical burns in the acute phase (7 days after injury) and in the repair phase (8-21 days) and to compare the effects of amniotic membrane transplantation in ocular alkali chemical burns with different degrees, in order to explore the optimal timing and mechanism of amniotic membrane transplantation for ocular alkali chemical burns. METHODS: A retrospective analysis was performed in 47 cases (59 eyes) undergoing amniotic membrane transplantation for ocular alkali chemical burns in the General Hospital of Northern Theater Command, China from November 2015 to December 2021. There were 26 patients (35 eyes), 0.5 hours-7 days (including 7 days) after injury, in acute phase group and 21 patients (24 eyes), 8-21 days after injury, in repair period group. Of the 59 eyes, 39 eyes were grade II-III (moderate burns) and 20 eyes were grade IV-VI (severe burns). Patients from both groups underwent amniotic membrane transplantation the next day after admission. The corneal epithelial defect healing rate, vision, corneal clarity, degree of ocular surface inflammation, degree of corneal vascularization, and symblepharon were observed and recorded at preoperative and postoperative 3 weeks, 1 month, 2 months, and 3 months in the two groups. Statistical analyses were then performed. RESULTS AND CONCLUSION: The acute phase group was superior to the repair period group in terms of average epithelial defect area, corneal epithelialization rate, average complete epithelial healing time, best corrected visual acuity at 3 months after operation, postoperative corneal transparency grading, incidence of symblepharon, degree of corneal vascularization, and success rate after operation (P < 0.05). By the end of the follow-up, the success rate of amniotic membrane transplantation was significantly higher in the moderate burn group than the severe burn group (P < 0.05). Most of the patients with failed amniotic membrane transplantation (65.2%) suffered from severe ocular alkali chemical burns, accompanied by a large area of limbal ischemia. The ocular surface could not be stabilized after repeated amniotic membrane transplantation, corneal conjunctivization appeared with central corneal neovascular infiltration and severe symblepharon, and visual acuity was reduced to manual. To conclude, the acute phase is the optimal timing to apply amniotic membrane transplantation for ocular alkali chemical burns. For patients with severe corneal epithelium defects who suffer from severe ocular alkali chemical burns, amniotic membrane transplantation needs to be performed multiple times in the early stage, thereby supporting wound repair. For patients with severe ocular alkali chemical burns who still have persistent epithelial defect after a series of amniotic membrane transplantation and have a tendency to dissolve the cornea and conjunctiva, amniotic membrane transplantation should be terminated, and permanent blepharoplasty or conjunctival flap masking should be used. After stabilization, second-phase ocular surface reconstruction should be conducted. [ABSTRACT FROM AUTHOR]