Recurrence of Keratoconic Pathology in Penetrating Keratoplasty Buttons Originally Transplanted for Keratoconus

Brookes, Nigel H; Niederer, Rachael L; Hickey, Doron; McGhee, Charles N J; Sherwin, Trevor

doi:10.1097/ico.0b013e3181967024

Cited by 18 publications

(19 citation statements)

References 32 publications

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“…The question of recurrence of keratoconus has been investigated by examining and characterising the pathology of keratoconus in a series of corneal buttons removed during repeat penetrating keratoplasty. This study confirmed little sign of recurrence of keratoconus in corneal allograft tissue, providing further weight to the argument that keratoconus is induced in the tissue of genetically susceptible individuals with associated environmental factors rather than manifesting in transplanted tissue …”

Section: New Zealand Laboratory Studies Of the Pathophysiology Of Kersupporting

confidence: 71%

Understanding keratoconus: what have we learned from the New Zealand perspective?

Patel

McGhee

2013

Clinical and Experimental Optometry

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Although first described more than 150 years ago, keratoconus is still an enigmatic disease that remains an area of wide-ranging, dynamic, international research. This review considers data from New Zealand/Aotearoa, where keratoconus is both relatively common and extensively studied. New Zealand researchers have made several significant contributions to the international literature in this field, including identifying a higher prevalence of keratoconus in New Zealand per se and within Maori and Polynesian populations compared to many international studies. As reported in other studies, a higher proportion of asthma, allergy and eczema as potential risk co-factors are present in New Zealand subjects with keratoconus compared with estimates from the general population. The rates of family history of keratoconus are typically higher than those reported internationally, with higher rates in Asian, Pacific and Maori ethnicities. Interestingly, such a positive family history has been associated with less severe keratoconus on computerised topographic analysis. Investigations of corneal microstructure have revealed dramatic alterations in the keratoconic cornea, with reduced density and abnormal morphology of the corneal sub-basal nerve plexus and decreased keratocytic density. Laboratory studies of keratoconic corneal buttons have also furthered our understanding of the pathophysiology of this disease, demonstrating elevated levels of cathepsin enzymes and localised disruptions in Bowman's layer with incursion of cellular processes from anterior keratocytes. Over the past two decades keratoconus has consistently remained the leading indication for corneal transplantation in New Zealand, accounting for over 40 per cent of cases. Indeed, New Zealand appears to have the highest reported proportion of transplantation surgery for keratoconus worldwide. Current and future studies of keratoconus in New Zealand highlight an emphasis on elucidating the genetics of, and investigating novel therapeutic interventions for, this relatively common corneal disease.

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Section: New Zealand Laboratory Studies Of the Pathophysiology Of Kersupporting

confidence: 71%

Understanding keratoconus: what have we learned from the New Zealand perspective?

Patel

McGhee

2013

Clinical and Experimental Optometry

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“…[15][16][17] Bourges et al proposed that movement of host keratocytes into the donor tissue set the scene for keratoconus to become established in the donor button. 15 The view that recurrence of keratoconus is orchestrated by cell migration from host to donor tissue is echoed by retrospective studies involving multiple cases of regrafts.…”

Section: Discussionmentioning

confidence: 99%

Recurrence or Re-emergence of Keratoconus – What is the Evidence Telling Us? Literature Review and Two Case Reports

et al. 2014

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“…In addition, susceptibility to rubbing‐related mechanisms for corneal trauma may be exacerbated when there is heating and massage of unprotected eyes in the treatment of Meibomian gland dysfunction . The development of keratoconus in grafted eyes has been a rare occurrence in eyes transplanted for keratoconus . It is possible that such cases of development of keratoconus are, at least partly, a consequence of post‐graft exposure to environmental factors, such as rubbing and associated trauma to a cornea involved in surgery‐related wound healing …”

mentioning

confidence: 99%

Eye rubbing type and prevalence including contact lens ‘removal‐relief’ rubbing

McMonnies

2016

Clinical and Experimental Optometry

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Rubbing-related trauma occurring before contact lens insertion may predispose the cornea to wound healing activities and greater levels of adverse response to contact lens wear. Such adverse responses could predispose the cornea to greater trauma, which occurs in response to rubbing on removal of contact lenses. Strong counselling to avoid eye rubbing is often not an adequate form of management for a significant number of patients with keratoconus. Evidence of relapses indicates the need for better methods of counselling and for them to be repeated regularly. Apart from keratoconus, any other keratectasia, corneal disease or wound healing (including post-surgical) may increase susceptibility to corneal rubbing trauma. Such cases also appear to warrant counselling on avoidance of rubbing.

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Recurrence of Keratoconic Pathology in Penetrating Keratoplasty Buttons Originally Transplanted for Keratoconus

Abstract: This study has highlighted the rarity of recurrence of KC in transplanted donor corneas and the corresponding difficulty in detecting early signs of the disease.

Cited by 18 publications

References 32 publications

Understanding keratoconus: what have we learned from the New Zealand perspective?

Understanding keratoconus: what have we learned from the New Zealand perspective?

Recurrence or Re-emergence of Keratoconus – What is the Evidence Telling Us? Literature Review and Two Case Reports

Eye rubbing type and prevalence including contact lens ‘removal‐relief’ rubbing

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