Management of Mustard Gas-Induced Limbal Stem Cell Deficiency and Keratitis

Javadi, Mohammad Ali; Jafarinasab, M R; Feizi, Sepehr; Karimian, Farid; Negahban, Kambiz

doi:10.1016/j.ophtha.2010.11.012

Cited by 59 publications

(67 citation statements)

References 25 publications

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“…In patients with KLAL rejection who require repeat OSST, lr-CLAL is ideal if possible because of the ability to perform HLA matching and the reduced risk of rejection. In a study by Javadi et al, 14 32 eyes had lr-CLAL and 40 eyes had KLAL performed for mustard gasinduced LSCD. They found that the rejection-free graft survival rate was 39.1% in the lr-CLAL group and 80.7% in the KLAL group, 40 months postoperatively.…”

Section: Risk Factors For Rejectionmentioning

confidence: 99%

“…Unfortunately, many patients have bilateral ocular surface disease from conditions such as congenital aniridia, chemical injury, and Stevens-Johnson syndrome and require allograft transplantation. Allograft transplantation can be from a deceased donor keratolimbal allograft (KLAL), 1-10 living-related conjunctival limbal allograft (lr-CLAL), [11][12][13][14] or a combination of lr-CLAL/KLAL (the Cincinnati procedure). 15 A further option is transplantation of ex vivo cultured stem cells.…”

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confidence: 99%

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Ocular Surface Stem Cell Transplantation Rejection

Ang

Chan

Biber

et al. 2013

Cornea

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Section: Risk Factors For Rejectionmentioning

confidence: 99%

mentioning

confidence: 99%

Ocular Surface Stem Cell Transplantation Rejection

Ang

Chan

Biber

et al. 2013

Cornea

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“…Ophthalmic examination shows microscopic corneal abrasion, ischemic limbal area and sometimes aberrant blood vessels in the corneal periphery (pannus). [42126272829]…”

Section: Introductionmentioning

confidence: 99%

Clinical practice guidelines for prevention, diagnosis and management of early and delayed-onset ocular injuries due to mustard gas exposure

Rajavi

Safi

Javadi

et al. 2017

J Ophthalmic Vis Res

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Purpose:To develop clinical practice guidelines (CPGs) for prevention, diagnosis, treatment and follow-up of ocular injuries caused by exposure to mustard gas.Methods:The clinical questions were designed by the guideline team. Websites and databases including National Guidelines Clearinghouse, National Institute for Clinical Excellence, Cochrane, and PubMed were searched to find related CPGs and explore possible answers to the clinical questions. Since there were no relevant CPGs in the literature, related articles in Persian and English languages were extracted. Each article along with its level of evidence was summarized. Additionally, hand search was performed by looking the reference list of each article. Consequently, recommendations were developed considering the clinical benefits and side effects of each therapeutic modality. The recommendations were re-evaluated in terms of customization criteria. All recommendations along with the related evidence were scored from 1 to 9 by experts from all medical universities of Iran. The level of agreement among the experts was evaluated by analyzing the given scores.Results:The agreement was achieved for all recommendations. The experts suggested a number of minor modifications which were applied to the recommendations. Finally, CPGs were developed with 98 recommendations under three major domains including prevention of injury, diagnosis and management of the acute and delayed-onset mustard gas ocular injuries.Conclusion:Considering the lack of CPGs for the prevention, diagnosis, and management of mustard gas-induced keratitis, these recommendations would be useful to prevent the serious ocular complications of mustard gas and standardize eye care services to the affected individuals.

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“…Other speciic etiologies of corneal neovascularization include persistent corneal edema as in chronic hydrops of keratoconus and bullous keratopathy as well as corneal allograft rejection. Less common causes of corneal neovascularization are corneal foreign bodies and exposure to chemical toxins including mustard gas, radiation, or sun [19][20][21]. Intrastromal corneal ring implants, loose sutures, suture knots, and broken sutures seem to provide a stimulus for corneal vascularization …”

Section: Physiologic and Pathologic Angiogenesis -Signaling Mechanismmentioning

confidence: 99%

Corneal Angiogenesis: Etiologies, Complications, and Management

Feizi¹

2017

Physiologic and Pathologic Angiogenesis - Signaling Mechanisms and Targeted Therapy

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A large subset of corneal pathologies involves the formation of new blood vessels, leading to compromised visual acuity. Additionally, neovascularization of the cornea worsens the prognosis of subsequent penetrating keratoplasty, keeping the patient in a vicious circle of poor prognosis. Ocular angiogenesis results from the upregulation of proangiogenic and downregulation of antiangiogenic factors. There is a tremendous need for developing efective measures to prevent and/or treat corneal neovascularization. Topical steroid medication, cautery, argon and yellow dye laser, and ine needle diathermy have all been advocated with varying degrees of success. The process of corneal neovascularization is primarily mediated by the vascular endothelial growth factor family of proteins, and current therapies are aimed at disrupting the various steps in this pathway. This article aims to review the clinical causes and presentations of corneal neovascularization caused by diferent etiologies. Moreover, this chapter reviews diferent complications caused by corneal neovascularization and summarizes the most relevant treatments available so far.

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Management of Mustard Gas-Induced Limbal Stem Cell Deficiency and Keratitis

Cited by 59 publications

References 25 publications

Ocular Surface Stem Cell Transplantation Rejection

Ocular Surface Stem Cell Transplantation Rejection

Clinical practice guidelines for prevention, diagnosis and management of early and delayed-onset ocular injuries due to mustard gas exposure

Corneal Angiogenesis: Etiologies, Complications, and Management

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