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Corneal Disease & Transplantation
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Corneal Disease & Transplantation

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Ophthalmology".

Deadline for manuscript submissions: closed (15 February 2022) | Viewed by 15117

Special Issue Editors

Dr. Vito Romano

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Guest Editor
1. Department of Corneal and External Eye Diseases, St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK
2. Department of Eye and Vision Science, University of Liverpool, Liverpool, UK
Interests: cornea transplantation; keratoconus; endothelial dystrophy; cataract; refractive surgery; pterygium
Special Issues, Collections and Topics in MDPI journals
Dr. Giulia Coco

E-Mail
Guest Editor
Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
Interests: cornea; corneal infections; corneal neovascularization; corneal transplant; keratoconus; dry eye

Special Issue Information

Dear Colleagues,

Corneal diseases represent the third leading cause of blindness worldwide after cataract and glaucoma. Corneal transplantation aims at restoring corneal clarity and vision and is the most frequently performed transplant worldwide. Different corneal transplantation techniques have developed over the years, from full-thickness to lamellar grafts. Translational approaches are needed to guarantee visual rehabilitation and to achieve long-term graft survival. Strategies to improve refractive outcomes, rejection-free graft survival, and overall graft survival of corneal transplantations are of utmost importance. In addition, the availability of corneal donor tissue is limited worldwide, hence, new surgical and cell-based approaches have been developed to overcome the shortage of donor tissues.

The aim of this Special Issue is to include original studies as well as reviews on corneal diseases and transplantations. Authors should submit articles on themes including, but not limited to the following:

• Keratoconus
• Corneal scar
• Corneal infections
• Corneal dystrophies
• Fuchs’ endothelial dystrophy (FED)
• Penetrating keratoplasty (PK)
• Deep Anterior Lamellar Keratoplasty (DALK)
• Descemet Stripping Automated Endothelial Keratoplasty (DSAEK)
• Descemet Membrane Endothelial Keratoplasty (DMEK)
• Refractive surgery on corneal transplantation
• Parasurgical corneal treatment
• Tissue-engineered corneal transplant
• Endothelial cell culture/injection
• Rho-kinase inhibitors
• Gene therapy
• Eye banking

Dr. Vito Romano
Dr. Giulia Coco
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • corneal disease
  • corneal transplantation
  • para surgical corneal treatment
  • refractive surgery
  • tissue-engineered corneal transplant
  • endothelial cell culture
  • endothelial cell injection
  • eye banking 

Published Papers (5 papers)

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Editorial

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3 pages, 201 KiB  
Editorial
Corneal Disease & Transplantation
by Giulia Coco and Vito Romano
J. Clin. Med. 2022, 11(15), 4432; https://doi.org/10.3390/jcm11154432 - 29 Jul 2022
Cited by 1 | Viewed by 1139
Abstract
Corneal diseases represent the third leading cause of blindness worldwide, and corneal transplantation, which aims at restoring corneal clarity and vision, is the most frequently performed transplant worldwide [...] Full article
(This article belongs to the Special Issue Corneal Disease & Transplantation)

Research

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9 pages, 1673 KiB  
Article
Delayed Topographical and Refractive Changes Following Corneal Cross-Linking for Keratoconus
by Maryam Eslami, Farhad Ghaseminejad, Paul J. Dubord, Sonia N. Yeung and Alfonso Iovieno
J. Clin. Med. 2022, 11(7), 1950; https://doi.org/10.3390/jcm11071950 - 31 Mar 2022
Cited by 2 | Viewed by 1327
Abstract
Background: The aim of this study was to analyze the long-term topographic and refractive outcomes of corneal cross-linking (CXL) in keratoconus. Methods: We used a retrospective observational study of patients with keratoconus who underwent CXL with a minimum follow-up of 5 years. Patients’ [...] Read more.
Background: The aim of this study was to analyze the long-term topographic and refractive outcomes of corneal cross-linking (CXL) in keratoconus. Methods: We used a retrospective observational study of patients with keratoconus who underwent CXL with a minimum follow-up of 5 years. Patients’ refractive and topography data (corrected distance visual acuity, sphere, cylinder, average and maximum keratometry, and corneal aberrations) were collected. Results: A total of 112 patients/150 eyes (mean age: 33.2 ± 10.7 years; range: 13–61) were included. The mean follow-up was 5.87 ± 1.35 years (range: 5–10). At the last follow-up visit, an improvement in CDVA, spherical and cylindrical refraction, average and steepest keratometry, and corneal aberrations were observed (p < 0.05), with the exception of trefoil. At the last visit, 49 (34.8%) and 31 (22.0%) eyes had an improvement beyond 1D in their spherical and cylindrical power, respectively, and 43 (28.7%) eyes had a flattening of their steepest keratometry. Progressive improvement over time was observed for spherical refraction; max and mean-K; as well as corneal RMS, total, high, coma, and spherical aberrations (p < 0.05). More severe disease at the baseline correlated with an improvement in corneal aberrations over time. Conclusions: In addition to a progressive improvement in refractive and keratometric indices, corneal aberrations also demonstrate a steady decline with long-term follow-up after CXL, which was more pronounced in more severe patients. Full article
(This article belongs to the Special Issue Corneal Disease & Transplantation)
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11 pages, 5340 KiB  
Article
Cryopreservation in a Standard Freezer: −28 °C as Alternative Storage Temperature for Amniotic Membrane Transplantation
by Joana Witt, Luis Grumm, Sabine Salla, Gerd Geerling and Johannes Menzel-Severing
J. Clin. Med. 2022, 11(4), 1109; https://doi.org/10.3390/jcm11041109 - 19 Feb 2022
Cited by 4 | Viewed by 1714
Abstract
Human amniotic membrane (hAM) is usually stored at −80 °C. However, in many regions, cryopreservation at −80 °C is not feasible, making hAM unavailable. Therefore, the possibility of cryopreservation at −28 °C (household freezer) was investigated. hAMs (n = 8) were stored [...] Read more.
Human amniotic membrane (hAM) is usually stored at −80 °C. However, in many regions, cryopreservation at −80 °C is not feasible, making hAM unavailable. Therefore, the possibility of cryopreservation at −28 °C (household freezer) was investigated. hAMs (n = 8) were stored at −80 °C or −28 °C for a mean time of 8.2 months. hAM thickness, epithelial integrity and basement membrane were assessed histologically. The collagen content, concentration of hepatocyte growth factor (HGF) and basic fibroblast growth factor (bFGF) were determined. Elastic modulus and tensile strength were measured. The mean thickness of hAM stored at −28 °C was 33.1 ± 21.6 µm (range 9.7–74.9); thickness at −80 °C was 30.8 ± 14.7 µm (range 13.1–50.7; p = 0.72). Mean collagen content, epithelial cell number and integrity score showed no significant difference between samples stored at −28 °C or −80 °C. Basement membrane proteins were well preserved in both groups. Mean tensile strength and elastic modulus were not significantly different. Concentration of bFGF at −28 °C was 1063.2 ± 680.3 pg/g (range 369.2–2534.2), and 1312.1 ± 778.2 pg/g (range 496.2–2442.7) at −80 °C (p = 0.11). HGF was 5322.0 ± 2729.3 pg/g (range 603.3–9149.8) at −28 °C, and 11338.5 ± 6121.8 pg/g (range 4143.5 to 19806.7) at −80 °C (p = 0.02). No microbiological contamination was detected in any sample. The cryopreservation of hAM at −28 °C has no overt disadvantages compared to −80 °C; the essential characteristics of hAM are preserved. This temperature could be used in an alternative storage method whenever storage at −80 °C is unavailable. Full article
(This article belongs to the Special Issue Corneal Disease & Transplantation)
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Review

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20 pages, 2531 KiB  
Review
Post Penetrating Keratoplasty Ectasia: Incidence, Risk Factors, Clinical Features, and Treatment Options
by Antonio Moramarco, Lorenzo Gardini, Danilo Iannetta, Piera Versura and Luigi Fontana
J. Clin. Med. 2022, 11(10), 2678; https://doi.org/10.3390/jcm11102678 - 10 May 2022
Cited by 12 | Viewed by 3430
Abstract
BACKGROUND: Corneal transplantation in keratoconus (KC) patients is generally considered to be successful with a high grade of patient satisfaction. Long-term studies suggest a 6% to 11% probability of KC recurrence manifested by keratometric instability and progressive corneal ectasia. METHODS: We propose to [...] Read more.
BACKGROUND: Corneal transplantation in keratoconus (KC) patients is generally considered to be successful with a high grade of patient satisfaction. Long-term studies suggest a 6% to 11% probability of KC recurrence manifested by keratometric instability and progressive corneal ectasia. METHODS: We propose to review the frequency, risk factors for the development, and the surgical options for the correction of high irregular astigmatism due to late graft ectasia following penetrating keratoplasty (PK). RESULTS: Post-keratoplasty ectasia is characterized by increasing corneal steepening with myopic shift and high irregular astigmatism, developing years or decades after PK, mostly occurring in KC patients. Contact lenses may adequately improve the visual acuity; however, because these patients are often elderly and intolerant to hard contact lenses, ultimately a surgical correction is proposed to the patient. Compressive suture and corneal wedge resection may improve corneal astigmatism, but the outcomes are unpredictable and often temporary. For this reason, a larger PK graft is often proposed for surgical rehabilitation with the consequence of removing more of the recipient’s healthy endothelium and exposing the patient to a renewed immunogenic stimulus and short-term graft failure for endothelial decompensation. More recently, lamellar keratoplasty using various techniques has been proposed as an alternative to PK in order to maximize the visual outcomes and minimize the complications. CONCLUSIONS: Management of advanced corneal ectasia is a significant challenge for corneal surgeons. Many surgical approaches have been developed, so there is a large arsenal of surgical operations to correct post-PK ectasia. Among them, large-diameter anterior lamellar keratoplasty may be a viable, safer, and effective alternative to PK for the correction of post-keratoplasty ectasia. Full article
(This article belongs to the Special Issue Corneal Disease & Transplantation)
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20 pages, 1838 KiB  
Review
Update on Suture Techniques in Corneal Transplantation: A Systematic Review
by Luca Pagano, Haider Shah, Omar Al Ibrahim, Kunal A. Gadhvi, Giulia Coco, Jason W. Lee, Stephen B. Kaye, Hannah J. Levis, Kevin J. Hamill, Francesco Semeraro and Vito Romano
J. Clin. Med. 2022, 11(4), 1078; https://doi.org/10.3390/jcm11041078 - 18 Feb 2022
Cited by 10 | Viewed by 6691
Abstract
Effective suturing remains key to achieving successful outcomes in corneal surgery, especially anterior lamellar keratoplasty and full thickness transplantation. Limitations in the technique may result in complications such as wound leak, infection, or high astigmatism post corneal graft. By using a systematic approach, [...] Read more.
Effective suturing remains key to achieving successful outcomes in corneal surgery, especially anterior lamellar keratoplasty and full thickness transplantation. Limitations in the technique may result in complications such as wound leak, infection, or high astigmatism post corneal graft. By using a systematic approach, this study reviews articles and conducts content analysis based on update 2020 PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria). The aim of this paper is to summarize the state of the art of corneal suturing techniques for every type of corneal transplant and patient age and also their outcomes regarding astigmatism and complications. Future developments for corneal transplantation will be also discussed. This is important because especially the young surgeon must have knowledge of the implications of every suture performed in order to achieve consistent and predictable post-operative outcomes and also be aware of all the possible complications. Full article
(This article belongs to the Special Issue Corneal Disease & Transplantation)
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