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Therapeutic Approach in Fungal Keratitis
Published in Mahendra Rai, Marcelo Luís Occhiutto, Mycotic Keratitis, 2019
Victoria Díaz-Tome, María Teresa-Rodríguez Ares, Rubén Varela-Fernández, Rosario Touriño-Peralba, Miguel González-Barcia, Laura Martínez-Pérez, María Jesús Lamas, Francisco J. Otero-Espinar, Anxo Fernández-Ferreiro
The type of surgical intervention depends on the microorganism, location and affected area by the keratitis. When the infection is limited to the corneal surface, lamellar keratoplasty may be performed to eliminate lesions. Deep Anterior Lamellar Keratoplasty (DALK) eliminates all the corneal stroma to Descemet’s membrane and does not penetrate the anterior chamber, minimizing the risk of endothelial rejection (Sabatino et al. 2017).
Special Senses
Published in Pritam S. Sahota, James A. Popp, Jerry F. Hardisty, Chirukandath Gopinath, Page R. Bouchard, Toxicologic Pathology, 2018
Kenneth A. Schafer, Oliver C. Turner, Richard A. Altschuler
Changes in Descemet’s membrane include tears (stria), anterior bulging due to deep corneal ulcer (descemetocele), thickening with age, and duplication or irregularity due to changes in the adjacent corneal endothelium (Kafarnik et al. 2009). Additionally, Descemet’s membrane may extend onto structures of the filtration angle (descemetization) or retain material from transcorneal injections.
Ocular media
Published in Fiona Rowe, Visual Fields via the Visual Pathway, 2016
These may be anterior (epithelial), stromal, posterior or ecstatic (keratoconus). They are often progressive and bilateral conditions affecting one of the layers of cornea. Anterior dystrophies can be due to recurrent erosions. Stromal dystrophies involve accumulation of deposits in the stromal layer, e.g. granular, macular and lattice dystrophies. Posterior dystrophies involve Descemet’s membrane and the endothelium, e.g. corneal guttata. Corneal dystrophy may be secondary to systemic disease, e.g. Fuchs dystrophy.
Rho-kinase inhibitors: Role in corneal endothelial disorders
Published in Seminars in Ophthalmology, 2023
Nimish Kumar Singh, Srikant Kumar Sahu
Corneal endothelium which is present on the inner surface of cornea plays a major role in maintaining corneal transparency through the endothelial pump mechanism. The endothelial cells do not have regenerative capacity and any loss in their number is compensated by migration of adjoining cells thereby decreasing their average density. Normal adult endothelial density ranges from 2000 to 2500 cells/mm.2 Decrease in endothelial density below 500–1000 cells/mm,2 due to various reasons, results in corneal edema and decompensation.4 Currently, posterior lamellar keratoplasties like Descemet stripping Endothelial Keratoplasty (DSEK) and Descemet Membrane Endothelial Keratoplasty (DMEK) are the only treatment options available for endothelial decompensation. Scarcity of appropriate donor cornea, perpetual risk of rejection, infection and side-effects of long-term corticosteroid use pose considerable hindrance in making these modalities available for all despite their high success rate.4 In such a scenario, the possible role of rho-kinase (ROCK) inhibitors in the treatment of endothelial disease can be a major breakthrough for restoring corneal transparency in such cases.
Canaloplasty – Efficacy and Safety in an 18-Month Follow Up Period, and Analysis of Outcomes in Primary Open Angle Glaucoma Pigmentary Glaucoma and Pseudoexfoliative Glaucoma
Published in Seminars in Ophthalmology, 2022
Monika Łazicka - Gałecka, Anna Kamińska, Tomasz Gałecki, Maria Guszkowska, Jacek Dziedziak, Jerzy Szaflik, Jacek P. Szaflik
The incidence of complications after canaloplasty was low and the complications were not vision threatening (Table 6). Three intraoperative adverse effects were observed (4%), i.e., three cases of peripheral Descemet’s membrane detachment; one of these cases was accompanied by intracorneal hemorrhage. None of the cases of detachment affected the visual axis. In two of these cases, the detachment regressed without a surgical intervention within 4 months postoperative. In the case of intracorneal hemorrhage, the clot was surgically evacuated 2 days after canaloplasty. This case involved incrustation of the cornea by hemosiderin which regressed by 9 months postoperative without any further surgical interventions. Final visual acuity was not affected.
Studies on the Effectiveness of Ozone Therapy on the Treatment of Experimentally Induced Keratitis with Candida albicans in Rabbits
Published in Seminars in Ophthalmology, 2022
Kemal Varol, Ayşe Nedret Koç, Latife Çakır Bayram, Hatice Arda, İhsan Keleş, Metin Ünlü, Vehbi Güneş, Gencay Ekinci, İlknur Karaca Bekdik, Mustafa Altay Atalay
On light microscopic examination, the cornea was observed to consist of five layers. Basal columnar cells, intermediate polygon cells, and superficial squamous cells were present in the multi-layer squamous nonkeratinized layer. Under the corneal epithelium (Bowman’s layer). Secondary propria consisted of collagen fibers and scattered spindle-shaped stromal cells arranged at regular intervals. The Descemet membrane was present just below the stroma and was covered by the endothelium of Descemet. Normal corneal morphology was observed in the negative control group. In this group, the lamellar structure of the stroma was regular. There was no change in the size and shape of the corneal epithelial cells. Keratocytes are neatly sorted. Keratin is not available (Figure 2. A.1).