IFT provides superior outcomes compared to SIP and, hence, could be considered as the surgical modality of choice in large MH. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:236-240.].
Decellularized corneas
obtained from other species have gained
intense popularity in the field of tissue engineering due to its role
to serve as an alternative to the limited availability of high-quality
donor tissues. However, the decellularized cornea is found to evoke
an immune response inspite of the removal of the cellular contents
and antigens due to the distortion of the collagen fibrils that exposes
certain antigenic sites, which often lead to graft rejection. Therefore,
in this study we tested the hypothesis that cross-linking the decellularized
corneas with chondroitin sulfate may help in restoring the distorted
conformationation changes of fibrous matrix and thus help in reducing
the occurrence of graft rejection. Cross-linking of the decellularized
cornea with oxidized chondroitin sulfate was validated by ATR-FTIR
analysis. An in vitro immune response study involving healthy monocytes
and differentiated macrophages with their surface marker analysis
by pHrodo red, Lysotracker red, ER tracker, and CD63, LAMP-2 antibodies
confirmed that the cross-linked decellularized matrices elicited the
least immune response compared to the decellularized ones. We implanted
three sets of corneal scaffolds obtained from goat, i.e., native,
decellularized, and decellularized corneas conjugated with chondroitin
sulfate into the rabbit stroma. Histology analysis, three months after
implantation into the rabbit corneal stromal region, confirmed the
restoration of the collagen fibril conformation and the migration
of cells to the implanted constructs, affirming proper graft integration.
Hence we conclude that the chondroitin sulfate cross-linked decellularized
corneal matrix may serve as an efficient alternative to the allograft
and human cadaveric corneas.
Purpose:To compare clinical outcomes of patients undergoing macular hole surgery with heads-up three-dimensional (3D) viewing system and conventional microscope.Methods:In all, 50 eyes of 50 patients with stage 3 or 4 macular hole were randomized and macular hole surgery [inverted internal limiting membrane (ILM) flap technique] was performed in 25 eyes using 3D viewing system and 25 eyes using conventional microscope. All surgeries were performed by a single surgeon. Patients were followed up for a period of 3 months. Logarithm of the minimum angle of resolution (logMAR) visual acuity, macular hole index, intraoperative parameters such as total surgical time, total ILM peel time, number of flap initiations, duration of Brilliant Blue G dye exposure, illumination intensity, postoperative logMAR visual acuity, and macular hole closure rates were recorded and compared between the two groups.Results:The mean age was 67.92 ± 7.95 and 67.96 ± 4.78 years in both groups, respectively (P = 0.98). Gender (P = 0.38) and right versus left eye (P = 0.39) were also comparable. Preoperative and postoperative best-corrected visual acuity (P = 0.86, 0.92), macular hole index (P = 0.96), total surgical time (P = 0.56), total ILM peel time (P = 0.49), number of flap initiations (P = 0.11), and macular hole closure rates (P = 0.61) were not statistically significant when compared between the two groups. Illumination intensity of microscope (100% vs 45%) and endoillumination (40% vs 13%) were significantly less in the 3D viewing system.Conclusion:The clinical outcomes of macular hole surgery using 3D viewing system are not inferior to that of conventional microscopes, and it has the added advantages of better ergonomics, reduced phototoxicity, peripheral visualization, magnification, and less asthenopia, and it serves as a good educational tool.
BACKGROUND AND OBJECTIVE:
To evaluate long-term outcomes of inverted internal limiting membrane (ILM) stuffing into the optic disc pit for optic disc pit maculopathy (ODP-M) compared with vitrectomy with ILM peeling alone.
PATIENTS AND METHODS:
Twelve eyes of 12 patients who underwent vitrectomy for ODP-M and followed up more than 12 months were included. We retrospectively analyzed outcomes of inverted ILM flap stuffing into ODP (group 1, n = 6) with ILM peeling alone (group 2, n = 6).
RESULTS:
At 12 months, both groups showed significant improvement in best-corrected visual acuity and central macular thickness. On comparison, significantly faster resolution of maculoschisis was found in group 1 compared with group 2 (
P
= .012).
CONCLUSIONS:
Pars plana vitrectomy (PPV) with ILM peeling and PPV with inverted ILM stuffing are effective treatment modalities for ODP-M, with inverted ILM stuffing showing faster resolution of maculoschisis.
[
Ophthalmic Surg Lasers Imaging Retina
. 2018;49:e226–e232.]
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