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Clinical Updates in Corneal Transplantation
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Clinical Updates in Corneal Transplantation

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

Deadline for manuscript submissions: 15 September 2024 | Viewed by 1542

Special Issue Editor

Prof. Dr. Zisis Gatzioufas

E-Mail Website
Guest Editor
Department of Ophthalmology, University Hospital Basel, Mittlere Strasse 91, 4056 Basel, Switzerland
Interests: cornea; corneal transplantation; cataract surgery; refractive surgery

Special Issue Information

Dear Colleagues,

Corneal transplantation has been revolutionized over the last 15 years. The introduction and refinement of lamellar transplantation techniques, technological innovations in surgical instrumentation, as well as eye banking advancements in corneal tissue preparation have improved the clinical outcomes of corneal transplantation. Moreover, the employment of modern technology such as the use of excimer laser or femtosecond laser, together with technological innovations including intraoperative optical coherence tomography or 3D head-up surgery, provide increased precision and safety, particularly in complex keratoplasty cases. Finally, translational research has contributed enormously to the development of innovative corneal cell transplantation techniques, while corneal tissue engineering is progressing rapidly, aiming to generate artificial corneal transplants.

Accordingly, this Special Issue, entitled “Clinical Updates in Corneal Transplantation”, aims to collect original research and systematic reviews related to indications, clinical outcomes, surgical techniques, and complications, as well as advances and innovations in corneal transplantation.

Prof. Dr. Zisis Gatzioufas
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

  • penetrating keratoplasty (PKP)
  • deep anterior lamellar keratoplasty (DALK)
  • descemet stripping automated endothelial keratoplasty (DSAEK)
  • descemet membrane endothelial keratoplasty (DMEK)
  • descemetorhexis without endothelial keratoplasty (DWEK)
  • high-risk keratoplasty
  • corneal endothelial cell transplantation
  • corneal tissue engineering
  • artificial corneal transplant
  • innovations in corneal transplantation

Published Papers (3 papers)

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Research

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9 pages, 202 KiB  
Article
Surgical Outcomes of Different Deep Anterior Lamellar Keratoplasty Techniques—A Single-Centre UK Study
by Mohamed Elalfy, Ahmed Negm, Shady Soliman, Hasan Naveed, Samer Hamada, Artemis Matsou, Mansour Hassan, Ahmed Atef, Zisis Gatzioufas and Waleed Mahran
J. Clin. Med. 2024, 13(13), 3644; https://doi.org/10.3390/jcm13133644 - 21 Jun 2024
Viewed by 360
Abstract
Background: Anterior lamellar keratoplasty (ALK) is a less invasive procedure than PK, and thus avoids many of the intraocular complications associated with PK. DALK can be performed using several different techniques, with either a manual dissection, a keratome or femtosecond-laser assisted dissection, or [...] Read more.
Background: Anterior lamellar keratoplasty (ALK) is a less invasive procedure than PK, and thus avoids many of the intraocular complications associated with PK. DALK can be performed using several different techniques, with either a manual dissection, a keratome or femtosecond-laser assisted dissection, or with a big bubble technique. To analyse the outcomes and compare the results of three deep anterior lamellar keratoplasty (DALK) techniques. Methods: This study included 105 DALK cases performed at Queen Victoria Hospital, East Grinstead, UK, in the period between January 2016 and May 2022. Cases were classified into four groups based on technique: BB-DALK, manual DALK, FS-DALK and ‘converted to PK group’. Results: There was significant improvement in VA and Kmax compared to the preoperative values in all groups. There was no significant difference detected in VA and Kmax between all groups. Conclusions: Performing DALK surgery with any suitable technique (manual, big-bubble or femtosecond-assisted) is effective and causes significant improvements in VA and Kmax, even in cases where a conversion to penetrating keratoplasty is required. However, every technique has its pros and cons and should be tailored according to surgeon preference and individual case pathology. Full article
(This article belongs to the Special Issue Clinical Updates in Corneal Transplantation)
8 pages, 530 KiB  
Article
No Evidence of Chronic Infection in a Metagenomic Sequencing Study of the Keratoconus Corneal Epithelium
by Pritpal Kaur, Loren Moon, Divya Srikumaran, Steven L. Salzberg, Jennifer Lu, Patricia J. Simner and Uri S. Soiberman
J. Clin. Med. 2024, 13(12), 3399; https://doi.org/10.3390/jcm13123399 - 11 Jun 2024
Viewed by 365
Abstract
Objectives: This study aims to assess the presence of pathogenic microorganisms in the corneal epithelial layer of keratoconus patients. Methods: DNA was extracted from corneal epithelial samples procured from ten individual keratoconus eyes and three healthy controls. Metagenomic next-generation sequencing (mNGS) was performed [...] Read more.
Objectives: This study aims to assess the presence of pathogenic microorganisms in the corneal epithelial layer of keratoconus patients. Methods: DNA was extracted from corneal epithelial samples procured from ten individual keratoconus eyes and three healthy controls. Metagenomic next-generation sequencing (mNGS) was performed to detect ocular microbiota using an agnostic approach. Results: Metagenomic sequencing revealed a low microbial read count in corneal epithelial samples derived from both keratoconus eyes (average: 530) and controls (average: 622) without a statistically significant difference (p = 0.29). Proteobacteria were the predominant phylum in both keratoconus and control samples (relative abundance: 72% versus 79%, respectively). Conclusions: The overall low microbial read count and the lack of difference in the relative abundance of different microbial species between keratoconus and control samples do not support the hypothesis that a chronic corneal infection is implicated in the pathogenesis of keratoconus. These findings do not rule out the possibility that an acute infection may be involved in the disease process as an initiating event. Full article
(This article belongs to the Special Issue Clinical Updates in Corneal Transplantation)
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14 pages, 1855 KiB  
Systematic Review
Postoperative Astigmatism after Keratoplasty: A Systematic Review Meta-Analysis Based on PRISMA
by Magdalena Kijonka, Anna Nowińska, Edward Wylęgała, Adam Wylęgała, Ewa Wróblewska-Czajka, Katarzyna Kryszan, Bogdan Dugiełło and Bogusława Orzechowska-Wylęgała
J. Clin. Med. 2024, 13(11), 3306; https://doi.org/10.3390/jcm13113306 - 4 Jun 2024
Viewed by 358
Abstract
Background: The number of corneal transplants is rising, with the aim to treat a spectrum of diseases ranging from dystrophies to corneal opacities caused by trauma or chemical burns. Refractive outcomes after this procedure are often impossible to predict and associated with [...] Read more.
Background: The number of corneal transplants is rising, with the aim to treat a spectrum of diseases ranging from dystrophies to corneal opacities caused by trauma or chemical burns. Refractive outcomes after this procedure are often impossible to predict and associated with high levels of astigmatism. However, there are many techniques that affect the reduction of astigmatism and improve the quality of life of patients. Objectives: The aim was to compare the improvement in postoperative visual acuity (logMAR) and amount of corneal astigmatism (Diopters) after corneal keratoplasty in patients who additionally underwent a surgical procedure, which affects the reduction in postoperative astigmatism, and to determine the most effective method. Search Methods and Selection Criteria: A thorough search was carried out across online electronic databases including PubMed, Embrase, Ovid MEDLINE, Scopus, and Web of Science, using combinations containing the following phrases: postoperative astigmatism, post-keratoplasty astigmatism, anterior lamellar keratoplasty (ALK), deep anterior lamellar keratoplasty (DALK), posterior lamellar keratoplasty, endothelial keratoplasty (EK), penetrating keratoplasty (PK), corneal transplant, keratoplasty, refractive surgery, kerato-refractive surgery, laser in situ keratomileusis (LASIK), and femtosecond LASIK. This was to determine all English-language publications that discuss refractive operations for postoperative or post-keratoplasty astigmatism. These bibliographies were searched for English-language publications published between 2010 and 2023. We proceeded to review each detected record’s reference list. Data Extraction: Study characteristics such as study design, sample size, participant information, operations performed, and clinical outcomes were all extracted. Data Statistical Analyses: The Comprehensive Meta-Analysis software (version 3.3.070, 2014) was used to perform the analysis. The threshold of 0.05 for p-values was considered statistically significant. All effect sizes are reported as standardized differences (Std diff) in means with a 95% confidence interval (CI) and visualized graphically as forest plots. Publication bias is presented as a funnel plot of standard error by Std diff in means. Four methods were used to evaluate the heterogeneity among the studies: Q-value, I2, chi-square (χ2), and tau-squared. Main Results: We included 21 studies that randomized 1539 eyes that underwent corneal transplantation surgery either by PKP, DALK, or DSEAK techniques. The results showed the most significant improvement in the visual acuity and significant decrease in the corneal astigmatism after laser surgery procedures, like femtosecond-assisted keratotomy after DALK and PKP and LASIK after DSEAK. Full article
(This article belongs to the Special Issue Clinical Updates in Corneal Transplantation)
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