Search

To evaluate the clinical implications of the different trypan blue dyeing techniques used during liquid bubble (LBT) and manual peel (MPT) DMEK lenticule preparation techniques. This study retrospectively compared the degree to which endothelial cells are preserved using selective Descemet Membrane (DM) staining (LBT) versus bath-staining (MPT) when performed by a single surgeon, sourced from a single eye bank. Endothelial cell density measured after the 3-month follow-up was 1805 and 1916 cells/mm2 respectively, differing significantly (p = 0.012). A double-scroll graft formation was found and maintained until implantation in 94% of preparations with bath staining and 50% of preparations using selective DM staining. Preoperative visual acuity was comparable between preparation techniques at 0.4 logMAR as well as postoperatively, at an average of 0.1 logMAR. Reducing chemical stress on the endothelium by avoiding any contact with trypan blue allows for a significantly higher degree of cell preservation. However, achieving the often-desired double-scroll graft formation was possible less frequently. It remains unclear which factors define the differences graft scrolling behavior observed between LBT and MPT. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effects of femtosecond laser‐assisted keratoplasty using a liquid patient interface (L‐PI) as opposed to an applanated interface (A‐PI) on graft quality and functionality markers. Methods: Pressure measurements during femtosecond laser‐assisted trephination were performed using two groups of 10 porcine eyes. Trephination was performed either in an L‐PI or in an A‐PI setting. Pressure sensor needles placed intravitreally continuously recorded intraocular pressure during trephination. Twenty paired human donor eyes were used to test the morphological quality of donor tissue after trephination in L‐PI and A‐PI settings. Optical coherence tomography (OCT) scans were performed before and after trephination. Images were processed using ImageJ and pixel2. Results: During trephination, pressure measurements with an L‐PI were significantly lower than with an A‐PI (p = 0.0121). Mean pressure during trephination was 78.1 mmHg ± 37.6 mmHg with L‐PI and 188.6 mmHg ± 17.7 mmHg with A‐PI. Trephination in A‐PI produced a significantly larger increase (p < 0.00001) in donor pachymetry than trephination in L‐PI. Significantly lower areas of Descemet folds were achieved in L‐PI trephination than in A‐PI trephination (p < 0.01). There was no significant difference in circularity between A‐PI and L‐PI (p = 0.27). Total time required for trephination was comparable between L‐PI and A‐PI (p = 0.45). Time taken to reach working vacuum was achieved significantly more quickly in L‐PI (p < 0.05). Conclusion: Femtosecond laser‐assisted L‐PI keratoplasty appears to be a promising method to decrease stress to donor and recipient tissue during femtosecond laser‐assisted trephination. Results showed favourable donor tissue morphology markers after L‐PI trephination. [ABSTRACT FROM AUTHOR]

Purpose: A stromal demarcation line (DL) after corneal cross-linking (CXL) has lately been suggested as a surrogate parameter for the success of CXL. The aim of this study was to investigate the correlation between depth of the central DL 1 month and the change in K values 12 months after CXL.Methods: Treatment-naive subjects with keratoconus were treated using an accelerated CXL protocol [A-CXL(9*10)]. Depth of the DL/relative depth of the DL (DL%) was measured using Visante OCT imaging 1 month postoperatively (OP). Kmax/K2.5 (preOP) and change in Kmax/K2.5 (preOP − 12 months postOP) were assessed using corneal tomography (Pentacam HR, Oculus GmBH).Results: Forty eyes were treated following the A-CXL(9*10). The mean DL depth was 200 ± 99 μm (range 71 to 479)/mean DL% = 42.70 ± 20.00% (range 17-90). There was no statistically significant correlation between stromal depth of the DL and change in Kmax or K2.5, respectively (Spearman rho DL/∆Kmax − 0.14 and DL/∆K2.5 − 0.14). Between DL% and the changes in maximum K values or K2.5, no statistically significant correlation was found as well (Spearman rho DL%/∆Kmax − 0.10 and DL%/∆K2.5 − 0.19). Mean change in Kmax after 12 months was − 0.68 ± 2.26 diopters (D) (median − 0.35 D) and − 0.82 ± 1.6 D (median − 0.65 D) for K2.5 (p = 0.07; p = 0.02).Conclusions: No statistically significant correlation was found between the stromal central depth of the DL and any outcome parameter for CXL after 12 months. Therefore, the interpretation of the DL as a predictive parameter for the effect of the procedure may not apply. [ABSTRACT FROM AUTHOR]

Describes the historical aspects of the procedure of international conciliation. United Nations charter stating the mandatory principle, existing in customary international law, that settlement of international disputes should be by peaceful means in such a manner that international peace and security and justice are not endangered.

Objective: To review the literature focusing on the effectiveness of amniotic membrane extract eye drops (AMEDs) in the treatment of ocular surface diseases., Methods: PubMed/MEDLINE, Scopus, and CENTRAL databases were searched until March 4, 2024. Overall, we identified 1,121 studies, 26 of which were selected for a full-text review. Twelve studies met the inclusion criteria and were analyzed for clinical improvements, time to resolution of corneal staining, adverse events, and preparation methods. Strength of clinical data was graded according to the Oxford Center for Evidence-Based Medicine., Results: Overall, AMED compounds were used in 296 eyes of 205 patients. Fifty-nine percent of eyes were treated for dry eye disease, 23% for an epithelial defect, and the rest (18%) for other corneal wound healing disorders. Three main types of eye drops preparation were described, that is, lyophilized, homogenized, and fresh AMED. Although the methods of outcome reporting were heterogeneous, all included studies showed various grades of improvement in both signs and symptoms. The overall incidence of ocular side effects was 2.3%., Conclusions: Despite the suboptimal quality of evidence, overall, the available literature suggests that AMED is a valuable tool in the treatment of ocular surface disorders., Competing Interests: The authors have no funding or conflicts of interest to disclose., (Copyright © 2024 Contact Lens Association of Ophthalmologists.)

Purpose: To evaluate the effect of decreasing barometric pressure on intracameral bubble size and intraocular pressure (IOP) in eyes with varying air fills in the anterior chamber., Methods: A total of 36 human donor eyes received 30%, 50%, or 90% anterior chamber air fill. The eyes were subjected to decreases in atmospheric pressure down to 750 hPa, equal to 2400 m in altitude, and were repeatedly imaged using anterior segment OCT while IOP was measured continuously., Results: Eyes with 30% air fill initially showed moderate increases in IOP yet rising to an average of 30.83 mm Hg at 850 hPa (mimicking 1400 m altitude) and 42.08 mm Hg at 750 hPa. Eyes with larger air bubbles showed more acute increases in IOP with increases to an average of 47.25 mm Hg in eyes with 50% air fill at 850 hPa and 63.33 mm Hg at 750 hPa. In eyes with 90% air fill in the anterior chamber, IOP readings with an average of 113.42 mm Hg were observed already at 850 hPa, at which point additional pressure reduction was not performed., Conclusions: While severe increases in IOP were observed with decreased atmospheric pressure in eyes with large air bubbles in the anterior chamber, small and moderately sized bubbles seem to allow for travel over modest changes in altitude., Competing Interests: The authors have no funding or conflicts of interest to disclose., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background/Aims: To investigate the effectiveness of an accelerated high-fluence peripheral crosslinking (pCXL) treatment protocol for corneal neovascularization (cNV) and the viability of optical coherence tomography angiography (OCTA) to monitor cNV dynamics. Methods: This pilot study included six eyes of six adult patients with cNV in at least one corneal quadrant who were treated with pCXL (7.2 J/cm 2 , 9 mW). The degree of cNV regression was monitored with slit lamp photography and anterior segment OCTA. The main outcome measure was total vessel area one and four weeks after treatment. Results: OCTA allowed for the objective monitoring of vascular metrics: The total vessel area declined from an average of 1025.4 mm 2 (min: 0.13 mm 2 ; max: 3637 mm 2 ) at the baseline evaluation to 382.4 mm 2 (min: 0.08 mm 2 ; max: 1528 mm 2 ) ( p = 0.096). The total vessel length lessened from an average of 107.1 mm (min: 2.8 mm; max: 321.1 mm) to 47 mm (min: 2.6 mm; max: 156.5 mm) ( p = 0.27). The average number of junctions at baseline decreased from 46.67 (min: 3; max: 166) to 26.5 (min: 0; max: 50) ( p = 0.23). The junction density decreased from an average of 10.75/mm 2 (min: 0.0002 /mm 2 ; max: 36.5056/mm 2 ) to 7.37/mm 2 (avg.) (min: 0; max 18.7356/mm 2 ) ( p = 0.24). PCXL was performed safely without adverse effects, but vascular occlusion was not complete in all eyes. Conclusions: High-fluence pCXL may represent a valuable treatment option to achieve cNV regression, whilst the optimal fluence dose still remains to be defined. Anterior segment OCTA is an innovative tool for non-invasive, objective, and quantitative cNV monitoring.