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Corneal Disorders
Published in Ching-Yu Cheng, Tien Yin Wong, Ophthalmic Epidemiology, 2022
Darren S. J. Ting, Rashmi Deshmukh, Daniel S. W. Ting, Marcus Ang
First, the database can facilitate the examination of the availability and utilization of donor corneas, as well as the trends in the types and indications of corneal transplantation.91,92 Understanding the reasons for unutilized donor corneas (i.e., retrieved but not transplanted) allows introduction of effective changes to improve the utilization rate of donor corneas.8793,94 For instance, Ting et al.87 demonstrated a significant improvement in the utilization rate of donor corneas by 14% in the North East of England, UK, following refinement of the serological testing methods adopted by the UK eye bank system. In terms of the types of keratoplasty, regional/national studies have shown a paradigm shift from penetrating (full-thickness) keratoplasty to lamellar (partial-thickness) keratoplasty over the past decades in many countries, with FECD, keratoconus, and PBK being the main indications.91,92,95–97
The Special Sense Organs and Their Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
Disorders of the visual senses are usually referred to a specialist in treating eye disorders. An ophthalmologist or oculist is a physician who specializes in diseases and surgery of the eye. An optometrist is qualified to examine the eyes for vision problems and eye disorders and to prescribe lenses and other optical aids. The specialist who fills prescriptions for lenses, dispenses the eyeglasses, and makes and fits contact lens is an optician. Radial keratotomy (kerat = cornea, -otomy = incision) is a commonly used corrective surgical technique. A newer method utilizes a laser device and is referred to as photoreflective keratotorny. A keratoplasty, sometimes called a corneal transplant, involves replacing a section of diseased cornea with a normal one.
Surgical Management of Mycotic Keratitis
Published in Mahendra Rai, Marcelo Luís Occhiutto, Mycotic Keratitis, 2019
Tadeu Cvintal, Diego Casagrande, Victor Cvintal
In summary, surgical intervention is the only effective treatment for medically unresponsive mycotic keratitis. The best timing of surgical procedures remains uncertain but must precede deep corneal infection for decreasing subsequent surgical complications and preventing poor visual outcomes. Although therapeutic penetrating keratoplasty remains the traditional procedure in severe clinical cases, other efficacious alternatives have been successfully reported and are described here.
Disparities in Access to Corneal Tissue in the Developing World
Published in Seminars in Ophthalmology, 2023
Catherine Liu, Hajirah N. Saeed
While the vast majority of corneal blindness is preventable, there still exist 10 million people afflicted with bilateral corneal blindness worldwide.5 Corneal transplantation, in particular penetrating keratoplasty, remains the primary intervention to treat corneal blindness. The results of a global survey conducted by Gain et al. estimated global keratoplasty demand at 12.7 million cases. Of these, up to 7 million are needed in India and 2 million in China. However, there is a considerable shortage of corneal graft tissue worldwide, with only one cornea available for every 70 needed. The countries with some of the greatest need for cornea tissue do not have the infrastructure and trained healthcare professionals necessary for successful corneal transplantation programs. Based on the same survey, the median wait time for transplantation is 6.5 months in countries that are deemed to be in the “exporter”, “self-sufficient”, “almost self-sufficient”, or “adequate” categories. The US is an exception with immediate availability of cornea tissue.1,20 Scarce data exist for countries that perform fewer corneal transplants. While one-third of the world’s population have satisfactory access to corneal transplantation, more than half have no access.5
Assessment of patient-reported outcome measures used in corneal transplantation: a systematic review
Published in Clinical and Experimental Optometry, 2022
Mallika Prem Senthil, Ranjay Chakraborty, Jeremiah Lim
The retrieved articles were categorised into three groups: (1) Studies on penetrating keratoplasty (PKP), (2) studies on anterior lamellar keratoplasty and (3) studies on posterior lamellar keratoplasty. The reason for categorising the studies based on the surgical techniques is because PKP is decreasing in popularity whilst lamellar keratoplasty is seeing increased use over the past decade. The PROMs identified in the studies were categorised into 1) corneal transplant-specific, 2) ophthalmic but non-disease specific and 3) generic. Corneal transplant-specific PROMs were defined as PROMs specifically developed for corneal transplantation, ophthalmic but non-disease-specific as PROMs developed for eye conditions other than corneal transplantation and generic PROMs as those developed for non-ophthalmic conditions to measure broader health outcomes.
The Spectrum of Ocular Manifestations in Patients with Waldenström’s Macroglobulinemia
Published in Ocular Immunology and Inflammation, 2022
Rosanna Dammacco, Walter Lisch, Tero T. Kivelä, Evangelos Terpos, Efstathios Kastritis, Dario Sisto, Alberto Mavilio, Roberto Ria, Giovanni Alessio, Angelo Vacca, Franco Dammacco
The two patients with paraproteinemic keratopathy (#4 and #17), although diagnosed 45 months apart from each other, were treated with the same R-BEN regimen. Patient #4 achieved a complete hematological response and a remarkable visual improvement, both of which were maintained until the latest follow-up. In patient #17, however, only a partial hematological response and minimal visual improvement were achieved. The detection of unequivocal signs of WM relapse in this patient, 11 months later, led to a switch to an R-IBR regimen, which induced a very good partial response of the WM; the exception was the visual acuity, which remained significantly impaired due to persistent protein deposits in both corneas. Left penetrating keratoplasty with cataract extraction was therefore performed and resulted in the restoration of good visual acuity. At the last follow-up, almost 2 years after keratoplasty, both the hematological and ophthalmological improvements had not changed substantially.