The Ocular Surface and How It Can Influence the Outcomes of Keratoprosthesis
AbstractSevere ocular diseases may result in partial or complete limbal cell deficiency. Besides conservative options, treatment options include conjunctival replacement procedures and limbal autografting. Limbal allografts are an option in patients with bilateral limbal cell deficiency. In many of these cases, a keratoprosthesis (KPro) is the last option to restore functional vision in patients with severe corneal blindness with no other options. (Source: Current Ophthalmology Reports)
Source: Current Ophthalmology Reports - November 4, 2016 Category: Opthalmology Source Type: research
Evidence-Based Approaches to Glaucoma Management During Pregnancy and Lactation
This report provides a review of the current literature and offers effective strategies that will overcome the challenges in managing glaucoma during pregnancy and lactation. Practically, glaucoma management during pregnancy and lactation presents a unique challenge for the physician, as the benefit of any treatment must be weighed against the potential risks to the fetus. Prior to initiating or continuing treatment, the physician should be familiar with the various treatment options to manage intraocular pressure during pregnancy and lactation, including the safety of various anti-glaucoma medications as supported by the ...
Source: Current Ophthalmology Reports - October 11, 2016 Category: Opthalmology Source Type: research
Utility of Anterior Segment Optical Coherence Tomography in the Management of Corneal Transplantation
AbstractPurpose of ReviewAnterior segment optical coherence tomography (AS-OCT) is a new system to obtain high-resolution cross-sectional images of the cornea and anterior chamber. In eyes with corneal opacity, it is often difficult to observe and assess intraocular structures using slit-lamp microscopy. Because AS-OCT uses longer-wavelength infrared light, it enables deeper penetration with less reflection even in eyes with severe corneal opacity. Thus, AS-OCT is useful for imaging the cornea and anterior segment structures before and after corneal transplantation.Recent FindingsWe highlight the recent reports on AS-OCT i...
Source: Current Ophthalmology Reports - October 11, 2016 Category: Opthalmology Source Type: research
Imaging Modality in Diagnosis and Monitoring of Glaucoma: Spectral Domain Optical Coherence Tomography
AbstractPurpose of ReviewTo provide an overview of spectral domain optical coherence tomography (SDOCT) technology for clinical practice.Recent FindingsSince glaucoma is the leading cause of irreversible blindness, early diagnosis and detection of progression are important. Early treatment can be sight saving. Currently, SDOCT is the most commonly used high-resolution imaging modality in diagnosing and monitoring glaucoma. SDOCT focuses on three anatomic regions: the retinal nerve fiber layer, the optic nerve head, and the macular ganglion cell region. Each anatomic region can be objectively quantified, and many of these m...
Source: Current Ophthalmology Reports - October 11, 2016 Category: Opthalmology Source Type: research
Genetics, Diagnosis, and Monitoring of Pseudoexfoliation Glaucoma
AbstractPurpose of ReviewPseudoexfoliation is the most common identifiable cause of glaucoma. However, its precise mechanism remains unknown.Recent Findings Recent studies have shed new light on the genetic factors underlying pseudoexfoliation syndrome, increasing our understanding of the role of the lysyl oxidase-like 1 gene and its various polymorphisms as well as identifying new genetic associations. Recent years have brought new insight on how these genetic factors interact with other factors, including environmental, to confer risk to individuals and populations worldwide. All these findings may hold importance to the...
Source: Current Ophthalmology Reports - October 10, 2016 Category: Opthalmology Source Type: research
Surgical Management of SJS Sequelae: Outcomes and Alternatives
AbstractPurpose of ReviewTo enumerate and discuss the surgical options available for management of long term ocular sequelae of Stevens –Johnson syndrome (SJS).Recent FindingsAmniotic membrane application for appropriately chosen cases in acute SJS may have a beneficial effect in the long term. Improvements continue to be made in both cell based therapy and keratoprosthesis design, improving outcomes when used for visual improvement in chronic cases of SJS.SummaryStevens –Johnson syndrome can have devastating chronic cicatrizing consequences for the ocular surface. Appropriate acute phase management as well as use of a...
Source: Current Ophthalmology Reports - October 6, 2016 Category: Opthalmology Source Type: research
A Review of Mitomycin Use in Ophthalmic Surgery: Clarification of Safety Standards for Patients and Hospital Personnel
AbstractPurpose of ReviewThe aim of this article is to review the main indications for use of mitomycin in ophthalmology, the adverse effects after exposure, identify the mechanisms of accidental exposure to mitomycin by sanitary personnel and patients, and offer guidelines on safe handling of the drug.Recent FindingsVarious studies have revealed that repeated exposure to antineoplastic medications, such as mitomycin, can cause deleterious reproductive effects. Due to these concerns, several organizations have published official guidelines for safe handling of antineoplastic drugs, including mitomycin.SummaryMitomycin C is...
Source: Current Ophthalmology Reports - September 30, 2016 Category: Opthalmology Source Type: research
Intraoperative Optical Coherence Tomography in Lamellar Keratoplasties: Indications and Outcomes
AbstractPurpose of ReviewLamellar keratoplasties are evolving techniques to selectively replace diseased or opacified layers of the cornea. In recent years, the popularity of lamellar keratoplasties, especially Descemet membrane endothelial keratoplasty, Descemet stripping-automated endothelial keratoplasty and deep anterior lamellar keratoplasty, increased dramatically, since lamellar surgeries reduce intra- and postoperative complications and achieve faster visual recovery. Nonetheless, the surgical procedures are delicate.Recent FindingsNovel imaging techniques, as intraoperative optical coherence tomography (OCT), may ...
Source: Current Ophthalmology Reports - September 30, 2016 Category: Opthalmology Source Type: research
Cerebrospinal Fluid Pressure and Glaucoma
AbstractPurpose of ReviewGlaucoma is the second leading cause of blindness worldwide and remains a disease with a complex underlying pathophysiology. Primary open-angle glaucoma (POAG) is glaucoma in the absence of known causes and often is associated with elevated intraocular pressure (IOP).Recent FindingsRecent studies have focused on the role of cerebrospinal fluid pressure (CSFp) in the development of glaucoma based on the theory that the pressure difference between the intraocular pressure and the intracranial pressure, also known as the translaminar pressure difference (TLPD), is another important risk factor for dev...
Source: Current Ophthalmology Reports - September 26, 2016 Category: Opthalmology Source Type: research
20 Years of Advances in Keratoprosthesis
AbstractPurpose of ReviewKeratoprosthesis (KPro) has revolutionized the treatment of patients with severe corneal diseases who do not benefit from allogeneic corneal transplantation. Since the introduction of KPro over 200 years ago, numerous designs and techniques have been suggested. Of these, the Boston keratoprosthesis and osteo-odonto keratoprosthesis (OOKP) are the two most commonly used keratoprostheses worldwide.Recent FindingsOver the past few decades, various improvements in designs, surgical techniques, and postoperative care have expanded the indications for the Boston KPro. With better control of devastating o...
Source: Current Ophthalmology Reports - August 23, 2016 Category: Opthalmology Source Type: research
Infections in Ocular Prosthesis
AbstractPurpose of ReviewThere has been an exponential expansion of the types and application of ocular prostheses in the last 10 years. Patients with ocular prostheses in all forms are at increased risk for microbial infections. The true incidence and/or prevalence of ocular prosthesis-associated infections are unknown.Recent FindingsMillions of people worldwide are candidates in need of ocular prostheses for cosmesis, vision rehabilitation, and restoration. The presence of an ocular prosthesis carries a lifetime risk of infection and leads to ocular surface and microbiome dysbiosis.SummaryOphthalmologists should be awa...
Source: Current Ophthalmology Reports - August 3, 2016 Category: Opthalmology Source Type: research
Innovations in Management of Complications
AbstractPurpose of reviewBoston Keratoprosthesis (K-Pro) type 1 is the most widely used artificial cornea. K-Pro eyes require life-long follow-up by a multidisciplinary team involving a corneal specialist, a glaucoma specialist, and a retinal specialist. A deep understanding of potential complications and how to manage them is the key in achieving good outcomes.Recent findingsComplications may be related to the K-Pro itself or to other comorbidities frequently encountered in such complex eyes. The introduction of accurate protocols for preoperative planning, surgical technique, and postoperative follow-up has resulted in i...
Source: Current Ophthalmology Reports - July 31, 2016 Category: Opthalmology Source Type: research
Innovative Approaches to Glaucoma Management of Boston Keratoprosthesis Type 1
This report provides a review of the current literature and offers innovative strategies that will overcome the challenges in managing glaucoma in the setting of a Boston keratoprosthesis type 1 implant. < /p > < /span > < span class= " a-plus-plus abstract-section id-a-sec2 " > < h3 class= " a-plus-plus " > Recent Findings < /h3 > < p class= " a-plus-plus " > Patients with glaucoma have worse initial and late visual acuity outcomes after otherwise successful keratoprosthesis implantation. Management of glaucoma in the setting of a keratoprosthesis is challenging because of relatively rapid progression and an inability to ...
Source: Current Ophthalmology Reports - July 25, 2016 Category: Opthalmology Source Type: research
Retroprosthetic Membrane Formation After Boston Keratoprosthesis: Is It Truly a Benign Complication?
Abstract
Purpose of Review
Advances in Boston type 1 keratoprosthesis (K-Pro) technology and postoperative management have led to a decrease in postoperative complications and expanded indications in recent years. However, several challenges still remain, including the post-implantation development of fibrous tissue behind the device known as a retroprosthetic membrane (RPM). Herein, we review the epidemiology, pathophysiology, detection, treatment, prevention, and sequelae of RPM formation after keratoprosthesis implantation.
...
Source: Current Ophthalmology Reports - July 18, 2016 Category: Opthalmology Source Type: research
Boston Keratoprosthesis Type 1 in the Pediatric Population
Abstract
Purpose of Review
Pediatric corneal blindness is a worldwide problem that is very difficult to address. Traditional penetrating keratoplasty is considered a high-risk procedure in this population due to the host of complications that are often encountered. Even when anatomic success is achieved with penetrating keratoplasty, visual recovery is not guaranteed.
Recent Findings
Pediatric keratoprosthesis is an alternative procedure that offers rapid visual recovery in a quiet eye wi...
Source: Current Ophthalmology Reports - July 11, 2016 Category: Opthalmology Source Type: research
