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Clinical Advances in Corneal and Ocular Surface Surgery
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Clinical Advances in Corneal and Ocular Surface Surgery

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

Deadline for manuscript submissions: closed (28 February 2024) | Viewed by 1801

Special Issue Editor

Dr. Marco Pellegrini

E-Mail Website
Guest Editor
Department of Ophthalmology, Ospedali Privati Forlì “Villa Igea”, Forlì, Italy
Interests: corneal surgery; cataract surgery; anterior segment surgery; vitreoretinal surgery

Special Issue Information

Dear Colleagues,

It is a pleasure to announce the coming Special Issue of Journal of Clinical Medicine on “Clinical Advances in Corneal and Ocular Surface Surgery”. Corneal disease is a leading cause of blindness affecting up to 12 million people worldwide. Corneal transplantation is the standard surgical management for advanced corneal diseases, representing the most frequently performed transplant procedure. In recent years, surgical techniques have evolved from full-thickness penetrating keratoplasty to lamellar grafts replacing only some layers of the cornea. In parallel, ocular surface reconstruction procedures via regenerative medicine are emerging as novel treatment methods for severe ocular surface disorders. Finally, new technological and cell-based alternatives to conventional keratoplasty are under study to overcome the shortage of donor corneas.

For this Special Issue, we invite researchers and clinicians to submit studies on corneal and ocular surface surgery, including issues related to corneal transplantation, eye banking, ocular surface diseases, and anterior segment imaging. Original research papers and review articles are welcome.

Dr. Marco Pellegrini
Guest Editor

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 surgery
  • keratoplasty
  • lamellar surgery
  • ocular surface diseases
  • ocular surface reconstruction

Published Papers (3 papers)

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Research

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10 pages, 1491 KiB  
Article
Changes in the Visual Field Test after Descemet Stripping Automated Endothelial Keratoplasty in Advanced Glaucoma
by Noriko Toyokawa, Kaoru Araki-Sasaki, Hideya Kimura and Shinichiro Kuroda
J. Clin. Med. 2024, 13(5), 1431; https://doi.org/10.3390/jcm13051431 - 1 Mar 2024
Viewed by 504
Abstract
Background: To evaluate changes in the visual field (VF) after Descemet stripping automated endothelial keratoplasty (DSAEK) in eyes with advanced glaucoma and previous trabeculectomy. Methods: Changes in VF, best-corrected visual acuity (BCVA), intraocular pressure (IOP), and number of glaucoma medications were [...] Read more.
Background: To evaluate changes in the visual field (VF) after Descemet stripping automated endothelial keratoplasty (DSAEK) in eyes with advanced glaucoma and previous trabeculectomy. Methods: Changes in VF, best-corrected visual acuity (BCVA), intraocular pressure (IOP), and number of glaucoma medications were analyzed before and after DSAEK in 19 eyes. The VFs were evaluated using the 10-2 program of the Humphrey Field Analyzer (HFA) and/or Goldmann perimetry (GP). Results: In nine eyes, the MD improved from −22.24 ± 6.5 dB to −18.36 ± 5.1 dB in HFA. In five out of nine eyes, postoperative MD improved >1 dB compared to preoperative MD. In GP testing, 10 out of 15 eyes showed an improvement, that is, greater than 20° in VF enlargement by the isopter of I-4e and/or new detection of a smaller or darker isopter. Overall, improvement in VF with the HFA and/or GP test was observed in 12/19 (63.2%) eyes after DSAEK. Postoperative BCVA improved by more than two lines in logMAR VA in 18 of 19 (94.7%) eyes. There were no significant differences between the preoperative and postoperative IOP and the number of glaucoma medications. Conclusions: DSAEK may produce subjective improvement in the visual field as well as improved visual acuity, even in advanced glaucomatous eyes. Full article
(This article belongs to the Special Issue Clinical Advances in Corneal and Ocular Surface Surgery)
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Review

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14 pages, 520 KiB  
Review
Insights on the Choice and Preparation of the Donor Nerve in Corneal Neurotization for Neurotrophic Keratopathy: A Narrative Review
by Pietro Luciano Serra, Giuseppe Giannaccare, Alberto Cuccu, Federico Bolognesi, Federico Biglioli, Marco Marcasciano, Filippo Tarabbia, Domenico Pagliara, Andrea Figus and Filippo Boriani
J. Clin. Med. 2024, 13(8), 2268; https://doi.org/10.3390/jcm13082268 - 14 Apr 2024
Viewed by 464
Abstract
The article introduces neurotrophic keratopathy (NK), a condition resulting from corneal denervation due to various causes of trigeminal nerve dysfunctions. Surgical techniques for corneal neurotization (CN) have evolved, aiming to restore corneal sensitivity. Initially proposed in 1972, modern approaches offer less invasive options. [...] Read more.
The article introduces neurotrophic keratopathy (NK), a condition resulting from corneal denervation due to various causes of trigeminal nerve dysfunctions. Surgical techniques for corneal neurotization (CN) have evolved, aiming to restore corneal sensitivity. Initially proposed in 1972, modern approaches offer less invasive options. CN can be performed through a direct approach (DCN) directly suturing a sensitive nerve to the affected cornea or indirectly (ICN) through a nerve auto/allograft. Surgical success relies on meticulous donor nerve selection and preparation, often involving multidisciplinary teams. A PubMed research and review of the relevant literature was conducted regarding the surgical approach, emphasizing surgical techniques and the choice of the donor nerve. The latter considers factors like sensory integrity and proximity to the cornea. The most used are the contralateral or ipsilateral supratrochlear (STN), and the supraorbital (SON) and great auricular (GAN) nerves. Regarding the choice of grafts, the most used in the literature are the sural (SN), the lateral antebrachial cutaneous nerve (LABCN), and the GAN nerves. Another promising option is represented by allografts (acellularized nerves from cadavers). The significance of sensory recovery and factors influencing surgical outcomes, including nerve caliber matching and axonal regeneration, are discussed. Future directions emphasize less invasive techniques and the potential of acellular nerve allografts. In conclusion, CN represents a promising avenue in the treatment of NK, offering tailored approaches based on patient history and surgical expertise, with new emerging techniques warranting further exploration through basic science refinements and clinical trials. Full article
(This article belongs to the Special Issue Clinical Advances in Corneal and Ocular Surface Surgery)
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Other

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7 pages, 2126 KiB  
Case Report
Endothelial Migration and Regeneration after Penetrating Trauma Injury in a Deep Anterior Lamellar Keratoplasty Graft: Case Presentation and Literature Overview
by Luca Pagano, Alfredo Borgia, Fadi Alfaqawi, Aruni Makuloluwa, Giulia Coco, Giuseppe Giannaccare, Marco Messina, Vito Romano and Kunal Gadhvi
J. Clin. Med. 2024, 13(5), 1424; https://doi.org/10.3390/jcm13051424 - 29 Feb 2024
Viewed by 509
Abstract
Background: Traumatic injuries in eyes previously treated with Deep Anterior Lamellar Keratoplasty (DALK) can lead to ruptures in the Descemet Membrane (DM) and damage to the corneal endothelium, a crucial layer for maintaining corneal clarity. Due to cell cycle constraints, the human [...] Read more.
Background: Traumatic injuries in eyes previously treated with Deep Anterior Lamellar Keratoplasty (DALK) can lead to ruptures in the Descemet Membrane (DM) and damage to the corneal endothelium, a crucial layer for maintaining corneal clarity. Due to cell cycle constraints, the human corneal endothelium cannot proliferate; instead, it compensates for injury through cell enlargement and migration from adjacent areas. Methods: This study examines a notable case of corneal endothelial cell migration following a penetrating eye injury in a patient previously treated with DALK for keratoconus, supplemented by a review of relevant literature to contextualize the regenerative response. Results: A 39-year-old male with a history of DALK suffered a traumatic eye injury, resulting in damage to the Descemet Membrane and loss of the crystalline lens. After primary repair and considerations for further surgery, the patient’s cornea cleared remarkably, with an improved visual acuity. This demonstrates the DM’s potential for self-repair through endothelial cell migration. Conclusions: The outcomes suggest that delaying corneal transplant surgery for up to 3 months following Descemet Membrane injury due to ocular trauma could be advantageous. Allowing time for natural healing processes might eliminate the need for further invasive surgeries, thereby improving patient recovery outcomes. Full article
(This article belongs to the Special Issue Clinical Advances in Corneal and Ocular Surface Surgery)
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