Challenges in management of the Boston Keratoprosthesis Type 1
Purpose of review
The Boston Keratoprosthesis Type 1 was pioneered by Claes Dohlman several decades ago. Since its inception, the device has undergone multiple revisions to address challenges associated with retroprosthetic membrane formation, retention, extrusion, stromal melt and endophthalmitis. Although visual outcomes and retention rates have improved, challenges, especially glaucoma, remain.
Recent findings
The Boston Keratoprosthesis Type I device has seen an increase in popularity because of the improvement in rates of retention and visual rehabilitation. Recent outcome studies have allowed clinicians to...
Source: Current Opinion in Ophthalmology - June 10, 2021 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research
The role of environment in the pathogenesis of keratoconus
This study was conducted to demonstrate the importance of the environment in keratoconus (KC) genesis.
Recent findings
Genetic-related connective tissue disorders demonstrate the inconsistency of theories regarding KC pathogenesis since no corneal steepening was observed in the majority of these patients. Despite recent advances and decades of research into the genetics of KC, the identification of disease-causing KC genes has been frustrating. Variants found based on genome-wide and next-generation sequencing only seem to account for a small number of cases or play a limited role in KC pathogenesis.
Summary
...
Source: Current Opinion in Ophthalmology - June 10, 2021 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research
The role of imaging technologies for ocular surface tumors
Purpose of review
This review will discuss the utility of high-resolution anterior segment optical coherence tomography (HR-OCT), in-vivo confocal microscopy (IVCM) and ultrasound biomicroscopy (UBM) in characterizing and diagnosing various ocular surface tumors, namely ocular surface squamous neoplasia (OSSN), conjunctival lymphoma and conjunctival melanoma. The strengths and limitations of each imaging modality will be discussed along with the characteristics findings of each lesion on each imaging platform.
Recent findings
HR-OCT can consistently be utilized in the clinic setting to distinguish between epithe...
Source: Current Opinion in Ophthalmology - June 10, 2021 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research
The management of neurotrophic keratitis
Purpose of review
The management of neurotrophic keratitis (NK) has evolved in the last decade. The present article reviews updated management guidelines of this entity, as well as future innovations in the field.
Recent findings
The advent of confocal microscopy has allowed for the first time to image corneal nerves. In addition, multiple novel topical treatments such as nerve growth factor have improved the prognosis of this disease, with many other in the pipeline. Finally, corneal nerve restoration is now possible with corneal neurotization procedures.
Summary
Many novel treatments based on agents tha...
Source: Current Opinion in Ophthalmology - June 10, 2021 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research
Alternative therapies for dry eye disease
Purpose of review
Dry eye disease (DED) is a multifactorial disease affecting approximately 5–50% of individuals in various populations. Contributors to DED include, but are not limited to, lacrimal gland hypofunction, meibomian gland dysfunction (MGD), ocular surface inflammation, and corneal nerve dysfunction. Current DED treatments target some facets of the disease, such as ocular surface inflammation, but not all individuals experience adequate symptom relief. As such, this review focuses on alternative and adjunct approaches that are being explored to target underlying contributors to DED.
Recent findings
...
Source: Current Opinion in Ophthalmology - June 10, 2021 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research
Update on corneal collagen crosslinking for ectasia
Purpose of review
Corneal collagen crosslinking (CXL) is a minimally invasive treatment that can stabilize corneal ectatic disorders including keratoconus, pellucid marginal degeneration, or postrefractive surgery ectasia. The benefits of CXL have been well documented. New research is focused on modifying current treatment protocols with the goals of maximizing corneal stability while also shortening overall procedure time.
Recent findings
Accelerated CXL protocols have the goal of delivering the same ultraviolet A intensity as conventional protocols, but over a shorter time period. Accelerated protocols have sh...
Source: Current Opinion in Ophthalmology - June 10, 2021 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research
Updated safety precautions and guidance on eye banking procedures during the coronavirus disease 2019 pandemic
Purpose of review
severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly infectious coronavirus causing the COVID-19 pandemic. Although airborne spread through infectious respiratory droplets is the primary source of transmission, recent literature has suggested the ocular surface may be able to harbor viral particles. Here, we aim to discuss how SARS-CoV-2 affects the ocular surface and updated guidance on how SARS-CoV-2 transmission should be considered in the setting of eye banking and corneal transplantation procedures.
Recent findings
SARS-CoV-2 RNA can be found on the ocular surface, whic...
Source: Current Opinion in Ophthalmology - June 10, 2021 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research
Advances in corneal graft rejection
Purpose of review
Immune rejection after corneal transplantation is a major risk for graft failure. We aim to summarize recent advances in the understanding and management of graft rejection.
Recent findings
Immune rejection remains the leading cause of graft failure in penetrating keratoplasty (PKP). While ABO blood type and sex match between donor and recipient may reduce rejection, human leucocyte antigens class II matching in a randomized study did not reduce the risk of rejection in high-risk PKP. Compared with PKP, deep anterior lamellar keratoplasty, descemet stripping automated endothelial keratoplasty, ...
Source: Current Opinion in Ophthalmology - June 10, 2021 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research
What's trending: a review of social media in ophthalmology
Purpose of review
With social media use continuing to increase in popularity, ophthalmologists use social media daily for interactions with patients, colleagues, and the academic community.
Recent findings
The potential reach of social media is overwhelmingly encouraging, but academic organizations have much work to do in order to compete for viewership on social media platforms, and users need to remain vigilant of easily spread misinformation. Individual ophthalmology practices can tailor their social media presence to attract and educate patients. Using hashtags to supplement the experience of academic confer...
Source: Current Opinion in Ophthalmology - June 10, 2021 Category: Opthalmology Tags: REFRACTIVE SURGERY: Edited by Jimmy K. Lee Source Type: research
Pharmacological strategies for treating presbyopia
Purpose of review
Presbyopia is the normal progressive loss of accommodation, which leads to the inability to focus clearly on objects located at different distances. Some of the accepted methods for treating this condition are glasses, contact lenses, and surgery. Pharmacological treatments are a new and promising noninvasive option for dealing with presbyopia. The aim of this review is to provide an update on some recent advances in this field.
Recent findings
Currently, there are three different strategies for the pharmacological treatment of presbyopia. The first one aims to produce miosis and increase depth...
Source: Current Opinion in Ophthalmology - June 10, 2021 Category: Opthalmology Tags: REFRACTIVE SURGERY: Edited by Jimmy K. Lee Source Type: research
Neurotrophic keratopathy and refractive surgery
Purpose of review
Corneal nerve function is an important consideration for the refractive surgeon. In patients without a history of neuropathy, refractive surgery can lead to destruction of corneal nerves and may predispose to keratopathy. The purpose of this review is to provide an update on the effect of refractive surgery on corneal nerve function and the potential for an increased risk of neurotrophic keratopathy development.
Recent findings
Recent studies have reinforced that refractive surgery can cause anatomical and functional changes in corneal nerve function. Among the most commonly performed refractiv...
Source: Current Opinion in Ophthalmology - June 10, 2021 Category: Opthalmology Tags: REFRACTIVE SURGERY: Edited by Jimmy K. Lee Source Type: research
Postrefractive infectious keratitis: prevention, diagnosis, management, and prognosis
Purpose of review
Improve outcomes from an elective procedure by preventing a rare but sight-threatening complication.
Recent findings
Advancement in anti-infective prophylaxis, and therefore shift in the causative organism permits better diagnostic and empiric management.
Summary
Infectious keratitis presents in different patterns depending on the refractive procedure. Atypical causative organisms may respond poorly to empiric therapy and impair vision. Therefore, microbial identification is of utmost importance and therapy is adjusted accordingly. (Source: Current Opinion in Ophthalmology)
Source: Current Opinion in Ophthalmology - June 10, 2021 Category: Opthalmology Tags: REFRACTIVE SURGERY: Edited by Jimmy K. Lee Source Type: research
Editorial introductions
No abstract available (Source: Current Opinion in Ophthalmology)
Source: Current Opinion in Ophthalmology - June 10, 2021 Category: Opthalmology Tags: EDITORIAL INTRODUCTIONS Source Type: research
Uveal melanoma: laboratory advances and new frontiers in patient care
Purpose of review
To review recent advancements in the genetic understanding, diagnosis, prognosis, and treatment of uveal melanoma (UM).
Recent findings
UM is a molecularly distinct melanocytic malignancy driven by mutations in GNAQ or GNA11, with mitogen-activated protein kinase pathway upregulation. Earlier diagnosis and treatment are important factors for improving life prognosis. These goals can be aided by more objective multimodal imaging risk factors for the prediction of malignant nevus transformation and novel treatment strategies such as customized radiation fields and nanoparticle therapy to reduce v...
Source: Current Opinion in Ophthalmology - March 31, 2021 Category: Opthalmology Tags: TRANSLATIONAL RESEARCH: Edited by Jason Hsu and Sunir J. Garg Source Type: research
Emerging treatments for geographic atrophy in age-related macular degeneration
Purpose of review
This review describes therapeutic research programs for geographic atrophy (GA) due to age-related macular degeneration (AMD). We highlight clinical trial data from phase I, II, and III studies.
Recent findings
There are currently no treatments for GA, a form of advanced AMD that causes significant visual morbidity. Currently, therapeutic candidates are being developed to delay further progression of GA or even attempt to reverse some of the damage. The approaches to therapy range from molecular targets to cell transplantation. Studies of these novel treatment approaches have demonstrated varyi...
Source: Current Opinion in Ophthalmology - March 31, 2021 Category: Opthalmology Tags: TRANSLATIONAL RESEARCH: Edited by Jason Hsu and Sunir J. Garg Source Type: research
