Aniridia and Boston KPro: Is It a Long-Term Option?
Abstract
Purpose of Review
Aniridia is a complex ocular disorder that causes limbal stem cell deficiency determining progressive aniridic keratopathy and the loss of corneal transparency. Allogeneic limbal stem cell transplantation followed by penetrating keratoplasty can stabilize the ocular surface but requires prolonged systemic immunosuppression. The type-1 Boston Keratoprosthesis can be a valid alternative allowing faster visual recovery without the need for systemic immunosuppression.
Recent Findings
...
Source: Current Ophthalmology Reports - July 11, 2016 Category: Opthalmology Source Type: research
Biomaterials: Impact on Keratoprosthesis Implantation
Abstract
Purpose of Review
The increasing demand for corneal tissue and clinical circumstances of severe corneal scarring and vascularization have stimulated a continued interest in developing an artificial cornea from innovative biomaterials. We review the latest findings on the variety of materials used for artificial corneas and keratoprostheses, focusing most heavily on the Boston keratoprosthesis, the AlphaCor, and the Osteo-odonto Keratoprosthesis.
Recent Findings
Advancement of ker...
Source: Current Ophthalmology Reports - July 3, 2016 Category: Opthalmology Source Type: research
What Can We Learn About MOOKP that We Can Apply to Future Prosthetic Devices?
Abstract
Purpose of Review
The purpose of this study is to explain the different types of keratoprosthesis depending on the material; biological or nonbiological, and in the mode of fixation; transcorneal, intracorneal, or epi-corneal fixation; to define the general indications depending on the characteristics of the ocular surface; if it is a wet blinking eye or a dry nonblinking eye; to report our experience with different kinds of keratoprosthesis defining the retention of the prosthesis as the gage of success; and to define the ideal keratoprosthesis for us.
...
Source: Current Ophthalmology Reports - July 3, 2016 Category: Opthalmology Source Type: research
Intravitreal Anti-VEGF Therapy in the Management of Diabetic Macular Edema
Abstract
Diabetic macular edema (DME), an ocular complication of diabetes mellitus, can potentially lead to devastating visual outcomes. Traditionally, laser photocoagulation has been the gold standard in the management of this condition. Over the recent years, however, several landmark clinical trials have shown beneficial effects of anti-VEGF agents over both sham injections and laser photocoagulation. These results have led to the wide adoption of intravitreal anti-VEGF therapy in DME treatment. Currently, two anti-VEGF agents, ranibizumab and aflibercept, are FDA approved in the United States for the ...
Source: Current Ophthalmology Reports - April 28, 2016 Category: Opthalmology Source Type: research
Effect of Intravitreal Anti-VEGF Therapy on the Severity of Diabetic Retinopathy
Abstract
Diabetic retinopathy is the most common complication of diabetes and a significant cause of preventable blindness throughout the world. It is characterized by increased vascular permeability, retinal ischemia, and the formation of neovascularization, which can lead to complications such as vitreous hemorrhage, retinal detachment, and macular edema. The current standard of care for treating diabetic retinopathy is pan-retinal photocoagulation (PRP). While highly effective, PRP is associated with several inherent disadvantages, including delayed onset of treatment effects. Within the past decade, a...
Source: Current Ophthalmology Reports - April 17, 2016 Category: Opthalmology Source Type: research
Laser Therapy in the Management of Diabetic Retinopathy
Abstract
Diabetic macular edema is the major cause of decreased vision in diabetic patients. This review explores laser treatment options beyond the established focal/grid laser photocoagulation protocol initially demonstrated in the Early Treatment of Diabetic Retinopathy Study. Subthreshold micropulse laser has been shown to be effective adjunctive therapy in conjunction with intravitreal anti-angiogenic injections in a subset of patients, specifically in those with a retinal thickness of less than 400 μm, without the risk of scotomas and potential vision loss, which can occur with conventional...
Source: Current Ophthalmology Reports - April 5, 2016 Category: Opthalmology Source Type: research
Intravitreal Steroid Therapy in the Management of Diabetic Macular Edema
Abstract
Diabetic macular edema (DME) accounts for most of the visual impairment related to diabetes mellitus. This review looks at the history and current state of corticosteroid treatment for DME, specifically intravitreal corticosteroids. It reviews the current ophthalmic literature, addresses the relative efficacy of corticosteroids compared to anti-VEGF medications and focal-grid laser for DME treatment, and discusses recently FDA-approved intravitreal extended-release corticosteroids. (Source: Current Ophthalmology Reports)
Source: Current Ophthalmology Reports - March 30, 2016 Category: Opthalmology Source Type: research
The Role of Systemic Risk Factors in Diabetic Retinopathy
This article examines the existing literature on the links between glycemic control, arterial hypertension, high cholesterol and hyperlipidemia, obesity, inflammatory markers, sleep-disordered breathing, and exercise with risk of diabetic retinopathy development and prevention. The literature shows benefit for good glycemic and blood pressure control. The effects of cholesterol, and lipid control, inflammatory markers, sleep-disordered breathing, obesity, and exercise are less well established. (Source: Current Ophthalmology Reports)
Source: Current Ophthalmology Reports - March 24, 2016 Category: Opthalmology Source Type: research
Vitrectomy in the Management of Diabetic Macular Edema
Abstract
The vitreous has been shown to be a contributing factor in the pathogenesis of tractional and non-tractional diabetic macular edema (DME). Modern techniques in pars plana vitrectomy (PPV) allow the safe removal of the vitreous with the posterior hyaloid which relieves vitreomacular traction and removes inflammatory factors believed to play a role in DME. Additional techniques such as endolaser, peeling of epiretinal membranes and the internal limiting membrane can also be performed at the time of PPV. Satisfactory visual and anatomic outcomes have been achieved in DME cases refractory to non-surg...
Source: Current Ophthalmology Reports - March 17, 2016 Category: Opthalmology Source Type: research
Surgical Management of Tractional Retinal Detachments in Proliferative Diabetic Retinopathy
Abstract
There have been significant recent advances in the management of diabetic tractional retinal detachments. Pre-operative intravitreal bevacizumab causes regression of active vessels and less intraoperative hemorrhage, small-gauge vitrectomy has dramatically changed how segmentation and delamination are performed, and bimanual surgery and viscodissection offer additional options. Intraoperative bevacizumab may decrease the incidence of postoperative vitreous hemorrhage. Single surgery success rates are generally >85 % with final anatomic success rates approaching 100 %. Useful vision (VA ≥Â...
Source: Current Ophthalmology Reports - March 14, 2016 Category: Opthalmology Source Type: research
Update in the Management of Macular Edema Following Retinal Vein Occlusions
Abstract
Retinal vein occlusion (RVO) is a common retinal vascular disease classified according to the anatomical location of the occlusion in central (CRVO) or branch (BRVO) retinal vein occlusion. RVO is an important cause of visual loss worldwide and frequently results in visual impairment and ocular complications. Major causes of vision loss in BRVO and CRVO include macular edema (ME), capillary nonperfusion, and neovascularization, causing glaucoma, vitreous hemorrhage, and/or tractional retinal detachment (The Branch Vein Occlusion Study Group in Am J Ophthalmol 98:271–82, 1984). Macular edema is ...
Source: Current Ophthalmology Reports - March 10, 2016 Category: Opthalmology Source Type: research
Uveitic Macular Edema: Treatment Update
Abstract
The aim of this review is to summarize recent developments in the treatment of uveitic macular edema (ME). ME represent a major cause of visual loss in uveitis and adequate management is crucial for the maintenance of useful vision in patients with chronic uveitis. (Source: Current Ophthalmology Reports)
Source: Current Ophthalmology Reports - February 18, 2016 Category: Opthalmology Source Type: research
Management of Vitreomacular Traction
Abstract
Vitreomacular adhesion (VMA) and vitreomacular traction (VMT) syndrome belong to a spectrum of macular diseases in which vision impairment is caused by posterior hyaloid traction at the vitreoretinal interface. In the past, the diagnosis of VMA and VMT depended upon the clinician’s ability to identify vitreomacular abnormalities on slit lamp biomicroscopy. Thus, often relatively advanced cases were visually identifiable biomicroscopically (Johnson in Trans Am Ophthalmol Soc 103:537–567, 2005; Sebag in Eye (Lond) 16(4):429–439, 2002; Schepens in Am J Ophthalmol 39(5):631–633, 1955; Johnson...
Source: Current Ophthalmology Reports - February 9, 2016 Category: Opthalmology Source Type: research
Dry Eye and Refractive Surgery Outcomes
Abstract
The purpose of this study is to review effective diagnostic and management strategies for dry eye disease (DED) and technological advances in refractive surgery for improving patient satisfaction and surgical outcomes. In addition to clinical examination and previously used diagnostic tools for DED, newer devices can now allow for earlier detection by measuring surrogate markers for DED and meibomian gland dysfunction. These markers include lipid layer thickness, tear film breakup time, tear osmolarity, and matrix metalloproteinase-9 levels. There continues to also be evolution of newer corneal r...
Source: Current Ophthalmology Reports - January 22, 2016 Category: Opthalmology Source Type: research
Posterior Corneal Astigmatism and Current Strategies for Optimizing Outcomes with Toric IOLs
Abstract
Traditionally when determining a patient’s astigmatism, only the curvature of the anterior cornea was measured. This was due to the relative ease of anterior measurement and assumptions that the posterior cornea did not play a significant role in refraction. However, new technologies have been developed to measure the posterior corneal curvature, and outcome data have shown that including the posterior curvature in toric IOL power calculations reduces residual astigmatic error. Understanding the contribution of the posterior cornea to a patient’s astigmatism is a key in order to provide the b...
Source: Current Ophthalmology Reports - January 21, 2016 Category: Opthalmology Source Type: research
