Efficacy and Safety of Moxifloxacin as an Additive in Optisol-GS a Preservation Medium for Corneal Donor Tissue

Abstract

Deep lamellar keratoplasty provides a safer and successful alternative to penetrating keratoplasty for keratoconus patients but remains a challenging procedure. Endothelial graft rejection is absent after DALKP. However, stromal graft rejection, although very rare, does occur.

Ceratectomia lamelar anterior profunda usando a técnica "big-bubble" em pacientes com ceratocone

“…Em relação à acuidade visual final, 79,7% dos pacientes apresentaram a BCVA melhor ou igual a 20/40, valores semelhantes aos relatados pela literatura internacional em relação à DALK até a data de publicação, com alguns estudos alcançando inclusive resultados melhores (1)(2)(3)(4)(5)12,(15)(16)(17) . Os valores da BCVA na DALK com a CP quando comparados apresentam discordâncias entre os estudos, mas a maioria deles demonstram semelhança entre os resultados a partir de 12 meses (1,2,5.11,17) .…”

Long-term comparison of full-bed deep anterior lamellar keratoplasty and penetrating keratoplasty in treating keratoconus

“…Moreover, the use of cryopreserved donor tissue for grafting in the full-bed DALK clearly contributed to the absence of postoperative rejection, since no live cells were retained in the cryopreserved donor tissue (Yao et al, 2002;Yao, 2008;Wu et al, 2012). Epithelial and stromal types of rejection may occur when fresh donor tissue is used in DALK for grafting (Al-Torbak et al, 2006;Jones et al, 2009;Feizi et al, 2010). The absence of allograft rejection in the full-bed DALK group was consistent with our previous studies (Yao et al, 2006;Yao, 2008;Wu et al, 2012) in which we treated other corneal diseases using the same technique of full-bed DALK grafting.…”

“…Techniques for performing DALK differed among these studies, creating different intraoperative and postoperative complications (Amayem and Anwar, 2000;Coombes et al, 2001;Watson et al, 2004;Al-Torbak et al, 2006;Funnell et al, 2006;Fontana et al, 2007;Bahar et al, 2008;Han et al, 2009;Jones et al, 2009;Feizi et al, 2010). In addition, many of the studies used fresh donor tissue for DALK grafting, which can cause stromal rejection and even graft failure after surgery (Al-Torbak et al, 2006;Jones et al, 2009;Feizi et al, 2010). We have developed a unique hooking-detaching technique for performing full-bed DALK, which helps to ensure thorough removal of the stroma from the DM in the full bed with few complications (Yao et al, 2006;Yao, 2008;Wu et al, 2012).…”

“…Two types of corneal transplantation can be used for treating keratoconus: penetrating keratoplasty (PK), which transplants full-layers of the donor cornea including the endothelium to the host eye (Sharif and Casey, 1991;Lim et al, 2000;Pramanik et al, 2006;Jensen et al, 2010), and deep anterior lamellar keratoplasty (DALK), which transplants donor corneal tissue to the host eye with the DM retained and intact (Amayem and Anwar, 2000;Coombes et al, 2001;Al-Torbak et al, 2006;Fontana et al, 2007;Feizi et al, 2010). In the advanced stage of keratoconus, as the DM is not involved, either DALK or PK can be used, but for the complication stage, PK may be the only option since tearing of the DM and scarring have occurred in the recipient cornea.…”

Techniques in the treatment of keratoconus patients with big-bubble deep anterior lamellar keratoplasty long-term results of operation

“…[13] Bizim çalışmamızda da amaç diğer tedavi metotları ile sonuç alınamayıp keratoplasti gerektiren hastalarda uzun yıllardan beri kullanılan ve cerrahi tedavi için ilk seçenek olan penetran keratoplasti ameliyatına alternatif olarak derin anterior lameller keratoplasti tekniğinin ameliyat sonrası sonuçlarını paylaşmaktır. [14][15][16][17] Çalışmamızda stromanın descement membranına kadar olan kısımlarının uzaklaştırılması için kullanılan yöntemlerden Anwar tarafından 2002 yılından tanım-lanan big-bubble tekniği kullanılmıştır. [18][19][20][21] Bu teknik ile yapılan derin anterior lamellar keratoplastinin gör-sel, refraktif sonuçları, komplikasyonları ve endotel hücre sayısına etkisi araştırılmıştır.…”