Analysis of factors influencing refractive error in Fuchs eyes undergoing Descemet membrane endothelial keratoplasty triple procedure.

Purpose: To evaluate the accuracy of current intraocular lens (IOL) formulas and identify factors influencing mean error in eyes undergoing Descemet membrane endothelial keratoplasty (DMEK) triple procedure, that is, DMEK combined with cataract extraction and IOL placement for concurrent Fuchs endothelial corneal dystrophy (FECD) and cataracts.

Design: Retrospective cohort study.

Subjects: 90 eyes with FECD undergoing uncomplicated DMEK triple procedure at Wilmer Eye Institute.

TCF4 trinucleotide repeat expansions and UV irradiation increase susceptibility to ferroptosis in Fuchs endothelial corneal dystrophy.

Fuchs endothelial corneal dystrophy (FECD), the leading indication for corneal transplantation in the U.S., causes loss of corneal endothelial cells (CECs) and corneal edema leading to vision loss.

Tissue-specific TCF4 triplet repeat instability revealed by optical genome mapping.

Background: Fuchs endothelial corneal dystrophy (FECD) is the most common repeat-mediated disease in humans. It exclusively affects corneal endothelial cells (CECs), with ≤81% of cases associated with an intronic TCF4 triplet repeat (CTG18.1).

Emerging alternatives to keratoplasty for corneal endothelial cell dysfunction.

Purpose Of Review: While effective for treating endothelial dysfunction, keratoplasty has shortcomings including limited access to donor tissue for much of the world. Thus, alternative strategies are under development. This review explores the main advancements achieved in this field during 2022-2023.

Accuracy of intraocular lens formulas in combined phacovitrectomy.

Purpose: To assess the refractive accuracy of eight intraocular lens (IOL) formulas in eyes that underwent combined phacovitrectomy.

Methods: A retrospective chart review of 59 eyes that underwent uncomplicated phacovitrectomy between 2017 and 2020 at the Johns Hopkins Wilmer Eye Institute. Inclusion criteria were postoperative best corrected visual acuity of 20/40 or better within 6 months of surgery and IOL implantation in the capsular bag.

Outcomes and Early Complications Using an Endothelium-in Pull-Through Descemet Membrane Endothelial Keratoplasty Technique With Preloaded Versus Surgeon-Loaded Donor Tissue in Fuchs Patients.

Purpose: This study aimed to compare outcomes and early complications using an endothelium-in pull-through Descemet membrane endothelial keratoplasty (DMEK) technique with preloaded versus surgeon-loaded donor tissue.

Methods: Data from 163 eyes of 125 patients at the Wilmer Eye Institute diagnosed with Fuchs endothelial corneal dystrophy who underwent DMEK with or without cataract extraction using surgeon-loaded tissue (n = 83) or preloaded tissue (n = 80) were reviewed. Best-corrected visual acuity and early postoperative complications including small graft detachment (less than one third of the graft area), large graft detachment (more than one third), graft failure, and rebubbling were compared.

Distinguishing Glaucoma, Cataract, and Glaucoma Suspect Based on Visual Symptoms.

Prcis: Cataract, glaucoma, and glaucoma suspect patients report differing visual symptoms. Asking patients about their visual symptoms may provide useful diagnostic information and inform decision-making in patients with comorbid conditions.

Purpose: To compare visual symptoms in glaucoma, glaucoma suspect (controls), and cataract patients.

Recent advances in cell-based regenerative therapies for corneal disease.

Purpose Of Review: With limited access of more than half the world's population to corneal transplantation, regenerative medicine may represent a promising alternative. This review explores the main advancements achieved in cell-based therapies for corneal epithelium, stroma, and endothelium during 2021-2022.

Recent Findings: Multiple surgical techniques have been developed for epithelial limbal stem cell replacement.

Histological Comparative Analysis of Bowman Layer Grafts Procured Using 3 Different Techniques.

Purpose: The objective of this study is to perform a histological analysis of Bowman layer (BL) grafts.

Methods: BL grafts were procured from 13 human cadaver corneal tissues using 3 different donor preparation techniques. Subsequently, the grafts were fixed in 10% buffered formalin phosphate and embedded in paraffin.

Corneal reshaping: an experiment with a type I collagen-based vitrigel for remodeling porcine corneas.

Purpose: This study aimed to report an experiment designed to determine anatomical changes in porcine corneas following placement of a novel polymer implant into the cornea.

Methods: An ex vivo porcine eye model was used. A novel type I collagen-based vitrigel implant (6 mm in diameter) was shaped with an excimer laser on the posterior surface to create three planoconcave shapes.

Collagen type XII is undetectable in keratoconus Bowman's layer.

Purpose: Corneal biomechanical failure is the hallmark of keratoconus (KC); however, the cause of this failure remains elusive. Collagen type XII (), which localises to Bowman's layer (BL), is thought to function in stress-bearing areas, such as BL. Given the putative protective role of in biomechanical stability, this study aims to characterise expression in all corneal layers involved in KC.

Combined Temporary Pupilloplasty and DSEK in an Eye With a Hydrophilic Acrylic Intraocular Lens to Prevent Opacification: A Case Report.

Purpose: The aim of this study was to describe a case of temporary pupilloplasty during Descemet stripping endothelial keratoplasty to prevent opacification of a hydrophilic acrylic intraocular lens (IOL).

Methods: A 60-year-old man presented with corneal edema in the left eye after a traumatic cataract removal and scleral suture fixation of a hydrophilic acrylic IOL (Akreos, Bausch + Lomb, Bridgewater, NJ). Descemet stripping endothelial keratoplasty with temporary pupilloplasty was performed.

In situ transduction of cells in human corneal limbus using adeno-associated viruses: an ex vivo study.

This study aimed to evaluate the efficacy of in situ adeno-associated virus (AAV)-mediated gene delivery into the human corneal limbal region via targeted sub-limbal injection technique. Human cadaveric corneal tissues were fixed on an artificial anterior chamber. Feasibility of sub-limbal injection technique was tested using trypan blue and black India ink.

"Groove and Peel" Deep Anterior Lamellar Keratoplasty: How Deep Can You Go?

Purpose: The aim of the current research was to measure the thickness of the residual central corneal bed after performing the manual "Groove and Peel" deep anterior lamellar keratoplasty (GP-DALK) technique on human cadaveric eyes.

Methods: The manual GP-DALK technique was performed on 6 human cadaver eyes by an experienced corneal surgeon. After surgery, the eye globes were fixed in 10% buffered formalin and embedded in paraffin.

Integrated Stress Response Regulation of Corneal Epithelial Cell Motility and Cytokine Production.

Purpose: To investigate the effect of an active integrated stress response (ISR) on human corneal epithelial cell motility and cytokine production.

Methods: ISR agonists tunicamycin (TUN) and SAL003 (SAL) were used to stimulate the ISR in immortalized corneal epithelial cell lines, primary human limbal epithelial stem cells, and ex vivo human corneas. Reporter lines for ISR-associated transcription factors activating transcription factor 4 (ATF4) and XBP1 activity were generated to visualize pathway activity in response to kinase-specific agonists.

Corneal thinning following bevacizumab intrastromal injection for the treatment of idiopathic lipid keratopathy.

Purpose: To describe the occurrence of corneal thinning in a patient following intrastromal injection of bevacizumab to treat lipid keratopathy.

Observations: A 36-year-old female presented with decreased vision in her right eye with central posterior corneal haze and underwent a treatment regimen including artificial tears, cyclosporine 0.05% drops, prednisolone 1% and oral Valacyclovir 1g with no improvement.

Start codon disruption with CRISPR/Cas9 prevents murine Fuchs' endothelial corneal dystrophy.

A missense mutation of collagen type VIII alpha 2 chain () gene leads to early-onset Fuchs' endothelial corneal dystrophy (FECD), which progressively impairs vision through the loss of corneal endothelial cells. We demonstrate that CRISPR/Cas9-based postnatal gene editing achieves structural and functional rescue in a mouse model of FECD. A single intraocular injection of an adenovirus encoding both the Cas9 gene and guide RNA (Ad-Cas9-Col8a2gRNA) efficiently knocked down mutant expression in corneal endothelial cells, prevented endothelial cell loss, and rescued corneal endothelium pumping function in adult mutant mice.

Improvement of Multiple Generations of Intraocular Lens Calculation Formulae with a Novel Approach Using Artificial Intelligence.

Purpose: Cataract surgery is the most common eye surgery. Appropriate optimization of intraocular lens (IOL) calculation formulae can result in improved patient outcomes. The purpose of this article is to describe a methodology of optimizing existing IOL formulae and develop hybrid formulae based on artificial intelligence (AI).

Transcriptomic and Immunohistochemical Analysis of Progressive Keratoconus Reveal Altered WNT10A in Epithelium and Bowman's Layer.

Purpose: To identify global gene expression changes in the corneal epithelium of keratoconus (KC) patients compared to non-KC myopic controls.

Methods: RNA-sequencing was performed on corneal epithelium samples of five progressive KC and five myopic control patients. Selected results were validated using TaqMan quantitative PCR (qPCR) on 31 additional independent samples, and protein level validation was conducted using western blot analysis on a subset.

Descemet Membrane Endothelial Keratoplasty Using a Pull-Through Technique With Novel Infusion Forceps.

Purpose: To describe a surgical technique of Descemet membrane endothelial keratoplasty (DMEK) using an endothelium-in pull-through technique with novel infusion forceps and report 6-month clinical outcomes.

Methods: This is a retrospective case series of 33 cases with Fuchs endothelial corneal dystrophy who underwent either DMEK alone (n = 5), DMEK combined with phacoemulsification (n = 27), or DMEK combined with intraocular lens exchange (n = 1) performed by surgeons at the beginning of the DMEK learning curve. Best-corrected visual acuity (BCVA), manifest refraction, central corneal thickness, endothelial cell density, intraoperative and postoperative complications, and need for additional surgeries including rebubbling were evaluated through 6 months postoperatively.

A Small Molecule that Binds an RNA Repeat Expansion Stimulates Its Decay via the Exosome Complex.

Many diseases are caused by toxic RNA repeats. Herein, we designed a lead small molecule that binds the structure of the r(CUG) repeat expansion [r(CUG)] that causes myotonic dystrophy type 1 (DM1) and Fuchs endothelial corneal dystrophy (FECD) and rescues disease biology in patient-derived cells and in vivo. Interestingly, the compound's downstream effects are different in the two diseases, owing to the location of the repeat expansion.

Gelling hypotonic polymer solution for extended topical drug delivery to the eye.

Eye-drop formulations should hold as high a concentration of soluble drug in contact with ocular epithelium for as long as possible. However, eye tears and frequent blinking limit drug retention on the ocular surface, and gelling drops typically form clumps that blur vision. Here, we describe a gelling hypotonic solution containing a low concentration of a thermosensitive triblock copolymer for extended ocular drug delivery.