Contact lens wear can influence the levels and dynamics of various mediators in the tears of patients with KC that might have an impact on the progression of the disease.
Purpose. To determine associations between mediators in tears in the whole spectrum of keratoconus (KC); to explore connections between mediators and Scheimpflug parameters; to examine correlations between Scheimpflug parameters and bronchial asthma. Methods. Tear samples were collected from 69 patients and 19 controls. Concentrations of mediators—IL-6, -10; CXCL8, CCL5; MMP-9, -13; TIMP-1; t-PA, PAI-1—were measured by Cytometric Bead Array. Measured Pentacam parameters include keratometry values (K 1, K 2, K max), corneal thickness (Pachy Pupil, Apex, Min), and elevations and indices (including Belin-Ambrósio deviation (BAD-D)). Results. A number of significant positive associations were observed between pairs of mediator concentrations. Significant positive correlations were found between BAD-D and CXCL8/MMP-9 and K 2 and MMP-9. Significant negative associations were explored between Pachy Min and CXCL8/t-PA. Significant associations were found between pairs of mediators (IL-6 and CXCL8; CCL5 and CXCL8/MMP-9; TIMP-1 and MMP-9/-13/t-PA; t-PA and CXCL8/CCL5/PAI-1) and the severity of KC. Significant positive correlation between asthma and the severity of KC was explored. Conclusion. Cooperation of different mediators in tears all taking part in the complex pathomechanism of keratoconus was revealed. Our research verifies that inflammation plays a crucial role in the pathogenesis of KC. Additionally this study confirms the effect of bronchial asthma on keratoconus.
SummaryBackground Corneal transparency is a useful indicator for corneal function. Our aim was to investigate central corneal endothelial cells and corneal thickness in transplanted corneas at an average of 5.4 years after penetrating keratoplastyPatients and methods The study involved 68 perforated keratoplasty patients with at least a 1 year followup. Post-operatively, the central corneal endothelial layer was observed using a contact specular microscope. Central endothelial cell density, corneal thickness and the coefficient of variation of endothelial size were statistically analysed.Results The post-operative follow-up time was ranging from 12 months to 23 years. Endothelial cell density (ECD) was 1,501 ± 249 cell/mm 2 . The average cell size was 673.6 ± 98.3 μm 2 , and the coefficient of variation of cell size was 0.61 ± 0.11. No difference in ECD was detected between diagnostic groups. Corneal thickness was 0.56 ± 0.06 mm. Correlation between ECD and post-operative time was not significant (r = 0.02; p = 0.85).Conclusion Our study concluded that ECD showed a higher rate of decrease after penetrating keratoplasty with no relation to pre-operative diagnosis.Keywords Endothelial cell loss · graft survival · penetrating keratoplasty · specular microscope Bestimmung der Endothelzelldichte und der Hornhautdicke in Hornhauttransplantaten circa 5 Jahre nach einer penetrierenden Keratoplastik Zusammenfassung Hintergrund Die Transparenz der Cornea ist ein nütz-licher Indikator der Funktion der Hornhaut. Das Ziel unserer Studie war es, die zentralen Endothelzellen der Cornea sowie die Dicke der Hornhaut in transplantierten Hornhäuten circa 5,4 (im Durchschnitt) Jahre nach penetrierender Keratoplastik zu untersuchen.Patienten und Methoden In die Studie wurden 68 Patienten nach perforierter Keratoplastik aufgenommen, die zumindest 1 Jahr nachuntersucht worden waren. Postoperativ wurde die zentrale Endothelschicht der Hornhautmittel seines Kontakt-Spekular Mikroskops untersucht. Die Dichte der zentralen Endothelzellen, die Dicke der Hornhaut und der Variations-Koeffizient der Größe des Endothels wurden statistisch analysiert.Ergebnisse Der Zeitpunkt der postoperativen Kontrollen variierte von 12 Monaten bis 23 Jahren. Die Endothelzelldichte (EZD) lag bei 1501 ± 249 Zelle/mm 2 . Der Mittelwert der Zellgröße war 673,6 ± 98,3 μm 2 und der Variationskoeffizient 0,61 ± 0,11. Es gab keinen Unterschied in der EZD zwischen den nach Diagnosen eingeteilten Gruppen. Die Korrelation zwischen der EZD und dem Zeitabstand zur Operation war nicht kant (r = 0,02; p = 0,85).Schlussfolgerung Unsere Studie zeigt unabhängig von der präoperativen Diagnose eine abfallende Tendenz der EZD nach penetrierender Keratoplastik.
Epiphora, an abnormal overflow of tears, is commonly caused by tear drainage system anomalies including nasolacrimal duct obstruction. To assess morphologic abnormalities, dacryocystography by CT is used when CT contrast material is syringed into the lacrimal drainage system. To evaluate the function of the system, dacryoscintigraphy is the most readily available noninvasive method. In the case presented, a 43-year-old man was referred to our clinic with an 8 months' history of indefinite left side epiphora. After performing dacryoscintigraphy, we acquired SPECT/CT images during dacryocystography by CT to establish the surgical indication.
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