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The Role of Corneal Donor Rim Fungal Cultures: Pro Side
Ritterband, David MD
doi : 10.1097/ICO.0000000000002718
September 2021 - Volume 40 - Issue 9 - p 1085-1086
Fungal infection after corneal transplantation is a rare but potentially devastating complication. It is of paramount concern for transplant surgeons and the eye banking community. The value of universal corneal rim cultures for keratoplasty remains controversial. In 2016, The Eye Bank Association for America reported an increasing trend in the incidence of post keratoplasty fungal infections and a higher incidence of post keratoplasty [penetrating keratoplasty and endothelial keratoplasty (EK)] fungal endophthalmitis cases. This increasing trend in rate over time from previous Eye Bank Association for America reports was disproportionately associated with EK and Candida species. Additionally, several studies confirmed a high correlation between positive corneoscleral donor rim fungal cultures and postoperative infections, and a higher risk to the mate eye of a cornea that had the positive fungal corneal rim culture and developed an infection. Positive fungal donor rim cultures-especially in the setting of interface keratitis after EK surgery-can raise the index of suspicion for a fungal cause and may help direct therapy, especially in the early stages, where the symptoms and signs of spread may not be obvious and obtaining direct cultures is inherently difficult without surgical intervention.
The Role of Donor Rim Fungal Cultures
Terry, Mark A. MD*,†,‡
doi : 10.1097/ICO.0000000000002522
September 2021 - Volume 40 - Issue 9 - p 1087-1088
Culturing all donor rims for fungus makes no sense. Only 1% of all cultures will be positive, and of those positive cultures, only 6% will also have a clinical infection. Prophylactically treating all positive cultures means 94% of patients will be treated unnecessarily. Fungal cultures do not reliably direct specific medication choice, and fungal infections of the interface in endothelial keratoplasty and deep anterior lamellar keratoplasty are nearly impervious to medical therapy. Suspected fungal infections of the deep stromal interface should be treated expeditiously with penetrating keratoplasty before peripheral spread or endophthalmitis occur.
Prevention of Fungal Infection After Keratoplasty: The Utility of Adding an Antifungal to the Storage Medium (Pro Side)
Jeng, Bennie H. MD
doi : 10.1097/ICO.0000000000002520
September 2021 - Volume 40 - Issue 9 - p 1089-1090
The Rush to Supplement: The Current Case Against Anti-Fungal Supplementation of Hypothermic Corneal Storage Media
Tu, Elmer Yuchen MD
doi : 10.1097/ICO.0000000000002628
September 2021 - Volume 40 - Issue 9 - p 1091-1092
Role of Antifungal Prophylaxis After Receipt of a Positive Donor Rim Fungal Culture: The Case for Treatment
Aldave, Anthony J. MD
doi : 10.1097/ICO.0000000000002523
September 2021 - Volume 40 - Issue 9 - p 1093-1095
The Role of Antifungal Prophylaxis After Receipt of a Positive Donor Rim Fungal Culture: The Case for Not Routinely Treating Prophylactically
Price, Francis W. Jr MD
doi : 10.1097/ICO.0000000000002505
September 2021 - Volume 40 - Issue 9 - p 1096-1097
Studies conducted in the United States suggest that 1% to 2% of corneal donor rims culture positive for fungus; the fungal agent is usually Candida, and the risk of an endothelial keratoplasty recipient developing an intraocular fungal infection is approximately 7% (1 in 15) if the donor rim was culture-positive. Routine culturing of corneal donor rims is useful because a positive fungal culture alerts the surgeon to carefully monitor the keratoplasty recipient for any signs of fungal infection. However, routine implementation of antifungal prophylaxis on receipt of a positive culture is problematic because there is a lack of definitive data regarding the optimal route of administration, necessary duration of prophylaxis, and relative efficacy of different antifungal agents. The use of topical prophylaxis alone has not been proven to be effective, and the systemic agents that are effective against Candida typically involve an azole, which has many side effects, including liver toxicity and potential interactions with other drugs. The data suggest that routine antifungal prophylaxis would needlessly expose 14 patients to systemic side effects for each person who would directly benefit. Treatment of postkeratoplasty fungal infection typically involves graft replacement, but selective removal of the involved area(s) has been used successfully with Descemet membrane endothelial keratoplasty.
Pneumatic Dissection for Large-Diameter (9-mm) Deep Anterior Lamellar Keratoplasty in Eyes With Previous Anterior Lamellar Keratoplasty
Yu, Angeli Christy MD*,†,‡; Myerscough, James FRCOphth†,‡,§; Galante, Giuditta MD*,†,‡; Furiosi, Luca MD*,†,‡; Socea, Sergiu MD†,‡,¶; Bovone, Cristina MD*,†,‡; Busin, Massimo MD*,†,‡
doi : 10.1097/ICO.0000000000002609
September 2021 - Volume 40 - Issue 9 - p 1098-1103
To evaluate the surgical and 3-year clinical outcomes of modified big-bubble 9-mm deep anterior lamellar keratoplasty (DALK) in eyes with previous ALK (ALK).
Fingerprick Autologous Blood in the Treatment of Severe Dry Eyes and Ocular Surface Disease
Erikitola, Ore-oluwa FRCOphth*,†; Williams, Olayinka MBChB†; Fern, Alasdair FRCOphth, FRCS (Ophth)*; Lyall, Douglas FRCOphth*
doi : 10.1097/ICO.0000000000002624
September 2021 - Volume 40 - Issue 9 - p 1104-1109
To evaluate the efficacy of autologous blood eye drops in patients diagnosed with severe ocular surface disease and dry eye who were unresponsive to conventional therapy and who would otherwise be considered for autologous serum eye drops.
Recovery of Contrast Sensitivity After Descemet Membrane Endothelial Keratoplasty
Gundlach, Enken MD*; Pilger, Daniel MD*; Brockmann, Tobias MD†; Dietrich-Ntoukas, Tina MD*; Joussen, Antonia M. MD*; Torun, Necip MD*; Maier, Anna-Karina B. MD*
doi : 10.1097/ICO.0000000000002686
September 2021 - Volume 40 - Issue 9 - p 1110-1116
To study the change in contrast sensitivities in eyes with Fuchs endothelial dystrophy and bullous keratopathy after Descemet membrane endothelial keratoplasty (DMEK).
Microthin Descemet Stripping Automated Endothelial Keratoplasty Versus Descemet Membrane Endothelial Keratoplasty: A Randomized Clinical Trial
Matsou, Artemis MD, FEBO, MRCP(UK)*; Pujari, Rathin MA(Cantab), MBBChir*; Sarwar, Hammad FCPS(Pak), FRCS(Glasg)*; Rana, Mrinal MRCOphth, FRCOphth*; Myerscough, James MSc, FRCOphth*; Thomson, Susan M. BSc(Hons), MCOptom*; Nandakumar, Girinath BA(Cantab)*; Zhang, Jufen PhD†; Rajan, Madhavan S. MD, FRCOphth*,†
doi : 10.1097/ICO.0000000000002601
September 2021 - Volume 40 - Issue 9 - p 1117-1125
To compare visual outcomes, complications, and vision-related quality of life (QoL) after microthin Descemet stripping automated endothelial keratoplasty (MT-DSAEK) versus Descemet membrane endothelial keratoplasty (DMEK) for the management of corneal endothelial dysfunction in Fuchs dystrophy.
Impact of Adherence (Compliance) to Oral Acyclovir Prophylaxis in the Recurrence of Herpetic Keratitis: Long-Term Results From a Pediatric Cohort
Luccarelli, Saverio V. MD*; Lucentini, Stefano MD*; Martellucci, Cecilia Acuti MD†; Marelli, Luca MD*; Sacchi, Matteo MD*; Nucci, Paolo MD, FEBO*,‡
doi : 10.1097/ICO.0000000000002578
September 2021 - Volume 40 - Issue 9 - p 1126-1131
To evaluate the long-term role of adherence to oral acyclovir prophylaxis in reducing the risk for recurrent herpes simplex virus keratitis (HSK) in children.
A Randomized Clinical Study (SEECASE) to Assess Efficacy, Safety, and Tolerability of NOV03 for Treatment of Dry Eye Disease
Tauber, Joseph MD*; Wirta, David L. MD†; Sall, Kenneth MD‡; Majmudar, Parag A. MD§; Willen, Daniela PhD¶; Kr?sser, Sonja PhD¶; for the SEECASE study group
doi : 10.1097/ICO.0000000000002622
September 2021 - Volume 40 - Issue 9 - p 1132-1140
NOV03 has a unique dual mode of action to address dry eye disease (DED) associated with meibomian gland dysfunction. SEECASE evaluated the efficacy, safety, and tolerability of NOV03 at 2 dosing regimens compared with a saline comparator in patients with DED.
Long-Term Results of P.E.R.F.E.C.T. for PTERYGIUM
Hirst, Lawrence MD, DSc, MPH*,†,‡
doi : 10.1097/ICO.0000000000002545
September 2021 - Volume 40 - Issue 9 - p 1141-1146
To identify the recurrence rate, complication rate, cosmetic results, and patient satisfaction after P.E.R.F.E.C.T. for PTERYGIUM more than 10 years after surgery.
Effect of Anticoagulant Therapy on the Outcome of Descemet Membrane Endothelial Keratoplasty
Loreck, Niklas MD*; Geries, Carla*; Schrittenlocher, Silvia MD*; Siebelmann, Sebastian MD, MHBA*; Matthaei, Mario MD*; Bachmann, Bj?rn MD, PhD*; Hayashi, Takahiko MD, PhD*,†; Cursiefen, Claus MD, PhD*
doi : 10.1097/ICO.0000000000002533
September 2021 - Volume 40 - Issue 9 - p 1147-1151
To analyze the effect of anticoagulant therapy (ACT) for systemic diseases on the outcome of Descemet membrane endothelial keratoplasty (DMEK).
Trends in Female Authorship in Cornea From 2007 to 2019
Amarasekera, Dilru C. MD*; Lam, Sophia S. BS†; Rapuano, Christopher J. MD‡; Syed, Zeba A. MD‡
doi : 10.1097/ICO.0000000000002598
September 2021 - Volume 40 - Issue 9 - p 1152-1157
To identify female authorship trends in first author and last author positions in Cornea from 2007 to 2019.
Risk Factors for Ocular Involvement in Pediatric Graft-Versus-Host Disease
Hébert, Mélanie MD*; Archambault, Cyril MD†; Doyon, Christelle MD†; Ospina, Luis H. MD†; Robert, Marie-Claude MD, MSc†,‡
doi : 10.1097/ICO.0000000000002659
September 2021 - Volume 40 - Issue 9 - p 1158-1164
To identify risk factors for ocular graft-versus-host disease (oGVHD) in children with graft-versus-host disease (GVHD).
CorNeat KPro: Ocular Implantation Study in Rabbits
Litvin, Gilad MD*; Klein, Ido BSc, MBA*; Litvin, Yoav PhD†; Klaiman, Guy PhD‡; Nyska, Abraham DVM§
doi : 10.1097/ICO.0000000000002798
September 2021 - Volume 40 - Issue 9 - p 1165-1174
The purpose of this study was to evaluate surgical feasibility and long-term integration of the CorNeat Keratoprosthesis (KPro), a novel synthetic cornea, in rabbits.
Dexamethasone-Eluting Contact Lens for the Prevention of Postphotorefractive Keratectomy Scar in a New Zealand White Rabbit Model
Soeken, Timothy A. MD*; Ross, Amy E. MS†; Kohane, Daniel S. MD‡; Kuang, Liangju PhD†; Legault, Gary L. MD*; Caldwell, Matthew C. MD*; Brundridge, Wesley L. DO*; Merkley, Michael B. MD*; Ciolino, Joseph B. MD†,‡,§; Townley, J. Richard MD*
doi : 10.1097/ICO.0000000000002711
September 2021 - Volume 40 - Issue 9 - p 1175-1180
To evaluate the safety and efficacy of an experimental dexamethasone-eluting contact lens (DCL) for the prevention of postphotorefractive keratectomy (PRK) corneal haze in a New Zealand White (NZW) rabbit model.
Keratoconus Management With Customized Photorefractive Keratectomy by Artificial Intelligence Ray-Tracing Optimization Combined With Higher Fluence Corneal Crosslinking: The Ray-Tracing Athens Protocol
Kanellopoulos, Anastasios John MD*,†
doi : 10.1097/ICO.0000000000002739
September 2021 - Volume 40 - Issue 9 - p 1181-1187
The aim of this study was to report novel ray-tracing customization of surface excimer laser ablation combined with higher fluence corneal crosslinking (CXL) in the stabilization and normalization of ectasia and visual rehabilitation of progressive keratoconus.
The Overlap Syndrome: A Case Report of Chronic Graft-Versus-Host Disease After the Development of a Pseudomembrane
Hayashi, Shunsuke MD*,†; Shimizu, Eisuke MD, PhD*; Uchino, Miki MD, PhD, MPH*; Yazu, Hiroyuki MD, PhD*,‡; Aketa, Naohiko MD, PhD*; Tsubota, Kazuo MD, PhD*; Ogawa, Yoko MD, PhD*
doi : 10.1097/ICO.0000000000002593
September 2021 - Volume 40 - Issue 9 - p 1188-1192
Ocular graft-versus-host disease (GVHD) is one of the most severe complications of hematopoietic stem cell transplantation. It manifests as an impairment of the ocular surface, such as severe dry eye disease, and deteriorates the recipient's visual function and quality of life. We encountered an “overlap syndrome” of ocular GVHD, which is characterized by the presence of both acute and chronic GVHD symptoms. In this report, we present the treatment progress of the overlap syndrome in a case with ocular GVHD.
Endothelial Biopsy for the Diagnosis and Management of Culture-Negative Retrocorneal Fungal Keratitis With the Assistance of Optical Coherence Tomography Imaging
Palioura, Sotiria MD, PhD*,†; Tsiampali, Chara MD‡; Dubovy, Sander R. MD*; Yoo, Sonia H. MD*
doi : 10.1097/ICO.0000000000002626
September 2021 - Volume 40 - Issue 9 - p 1193-1196
To report a case of a culture-negative deep fungal corneal infection that was diagnosed after histopathology of an anterior segment optical coherence tomography–guided endothelial biopsy.
Clinical and Histological Characterization of Toxic Keratopathy From Depatuxizumab Mafodotin (ABT-414), an Antibody-Drug Conjugate
Lee, Brian A. MD; Lee, Michael S. MD; Maltry, Amanda C. MD; Hou, Joshua H. MD
doi : 10.1097/ICO.0000000000002595
September 2021 - Volume 40 - Issue 9 - p 1197-1200
To report the histological findings and clinical course of 2 patients with microcyst-like epithelial keratopathy (MEK) associated with antibody-drug conjugate, depatuxizumab mafodotin.
Bilateral Descemet Membrane Endothelial Keratoplasty in an Infant With Congenital Hereditary Endothelial Dystrophy
Wu, Frances MD*; Oatts, Julius T. MD*; Schallhorn, Julie M. MD*,†
doi : 10.1097/ICO.0000000000002616
September 2021 - Volume 40 - Issue 9 - p 1201-1203
Descemet membrane endothelial keratoplasty (DMEK) has been reported in children but not in infants. We evaluate the outcomes and complications of DMEK for an infant with congenital hereditary endothelial dystrophy.
Anterior Scleritis Manifesting After Coronavirus Disease 2019: A Report of Two Cases
Feizi, Sepehr MD, MSc*; Meshksar, Aidin MD*; Naderi, Ali MD*; Esfandiari, Hamed MD†
doi : 10.1097/ICO.0000000000002795
September 2021 - Volume 40 - Issue 9 - p 1204-1206
The purpose of this study was to report 2 patients with anterior scleritis manifesting after coronavirus disease 2019 (COVID-19).
Interface Drainage and Antimicrobial Irrigation Avoid Repeat Keratoplasty for Post-DSAEK Cold Interface Abscess
Yu, Angeli Christy MD*,†,‡; Myerscough, James FRCOphth†,‡,§; Socea, Sergiu MD†,‡,¶; Furiosi, Luca MD*,†,‡; Spena, Rossella MD*,†,‡; Bovone, Cristina MD*,†,‡; Busin, Massimo MD*,†,‡
doi : 10.1097/ICO.0000000000002710
September 2021 - Volume 40 - Issue 9 - p 1207-1210
To describe a surgical technique for the diagnosis and treatment of post–Descemet stripping automated endothelial keratoplasty (DSAEK) infectious interface keratitis presenting as a cold abscess.
The “Two-Flaps” Technique for Descemet Stripping Only
Cohen, Eyal MD; Din, Nizar MD, BSc, FRCOphth; Mimouni, Michael MD; Trinh, Tanya MD, FRANZCO; Gouvea, Larissa MD; AlShaker, Sara MD, FRCSC; Chan, Clara C. MD, FRCSC, FACS; Slomovic, Allan R. MD, MSc, FRCSC
doi : 10.1097/ICO.0000000000002744
September 2021 - Volume 40 - Issue 9 - p 1211-1214
The success of Descemet stripping only (DSO) is optimized by performing a well-centered, accurately sized diameter of descemetorhexis with a smooth curvilinear border. To achieve this success, we describe a repeatable and relatively straightforward technique to optimize this descemetorhexis for DSO.
Novel Technique for Descemetorhexis Under Ophthalmic Viscosurgical Devices and Air
Coco, Giulia MD*,†; Pagano, Luca MD*,‡; Borgia, Alfredo MD*,‡; Kaye, Stephen B. MD*,§; Romano, Vito MD*,§,¶
doi : 10.1097/ICO.0000000000002769
September 2021 - Volume 40 - Issue 9 - p 1215-1217
The aim of this study was to describe a novel technique for descemetorhexis that combines the advantages of stable anterior chamber (AC) associated with ophthalmic viscosurgical devices and optimal surgical visualization seen with air to overcome the issues of poor Descemet membrane (DM) visibility or AC instability when each is used alone.
Comparison of DMEK and DSAEK in Eyes With Endothelial Decompensation After Previous Penetrating Keratoplasty
Kiel, Marian MD; Bu, Julia Bing MD; Gericke, Adrian MD; Vossmerbaeumer, Urs MD; Schuster, Alexander K. MD; Pfeiffer, Norbert MD; Wasielica-Poslednik, Joanna MD
doi : 10.1097/ICO.0000000000002786
September 2021 - Volume 40 - Issue 9 - p 1218-1224
Posterior lamellar keratoplasty is increasingly applied in patients with endothelial decompensation after penetrating keratoplasty (PK). The aim of this study was to compare the results of Descemet membrane endothelial keratoplasty (DMEK) and Descemet stripping automated endothelial keratoplasty (DSAEK) after PK.
Long-Term Outcome of Same-Day Split Corneal Transplantation in Hong Kong
Yeung, Tiffany L. M. FCOphth(HK), FHKAM(Ophth); Ho, Vivian BSc(Hons), MBChB, FRCOphth(UK), PGDip CRS; Li, Brian C. Y. FCOphth(HK), FHKAM(Ophth); Tang, Wilson W.T. MMed(Ophth)(Singapore), BMedSc(Hons), FRCSEd(Ophth), FCOphth(HK); Li, Kenneth K. W. FRCS(Ed), FRCOphth(UK)
doi : 10.1097/ICO.0000000000002765
September 2021 - Volume 40 - Issue 9 - p e16
Expanding the supply of donor grafts
Gadhvi, Kunal A. MBBS, FRCOphth*; Coco, Giulia MD*; Pagano, Luca MD*; Kaye, Stephen B. MD, FRCS, FRCOphth*,†; Ferrari, Stefano PhD‡; Levis, Hannah J. PhD†; Parekh, Mohit PhD§; Romano, Vito MD*,†
doi : 10.1097/ICO.0000000000002777
September 2021 - Volume 40 - Issue 9 - p e16-e17
Letter to the Editor: Immunohistochemical Study of SARS-CoV-2 Viral Entry Factors in the Cornea and Ocular Surface
Bhadani, Pushkar MBBS, DO, DNB*; Agarwal, Balmukund MBBS, MS†; Kalita, Sangeeta MBBS, MS†; Bhattacharjee, Harsha MBBS, MS, FRCP, FRCS‡; Das, Daisy Rani MBBS, MS†; Mohapatra, Shyam Sundar Das MBBS, DNB‡
doi : 10.1097/ICO.0000000000002792
September 2021 - Volume 40 - Issue 9 - p e17-e18
Femtosecond Laser-Assisted Cataract Surgery: Does It Improve Outcomes in Fuchs Endothelial Corneal Dystrophy?: Erratum
doi : 10.1097/ICO.0000000000002785
September 2021 - Volume 40 - Issue 9 - p e18
