Comparison of repeat penetrating keratoplasty, DSAEK and DMEK for the management of endothelial failure of previous PK.

Purpose: To compare the clinical outcomes of repeat PK, DSAEK-on-PK or DMEK-on-PK for the management of endothelial failure of previous penetrating keratoplasty.

Design: Retrospective, interventional consecutive case series.

Participants: 104 consecutive eyes of 100 patients requiring a second keratoplasty for endothelial failure of their primary penetrating keratoplasty performed between September 2016 and December 2020.

Safety and clinical outcomes of omitting same and next day review after DMEK performed with an inferior peripheral iridotomy.

Background/objectives: To determine the incidence of day one postoperative complications after Descemet Membrane Endothelial Keratoplasty (DMEK) performed with intraoperative inferior peripheral iridotomy (PI), and whether their early detection influences postoperative intervention.

Subjects/methods: 70 eyes of 70 consecutive patients that underwent DMEK from August 2019 to August 2021 at a single UK centre were retrospectively analysed. Cases that did not have an inferior PI were excluded.

Analysis of microbial keratitis incidence, isolates and in-vitro antimicrobial susceptibility in the East of England: a 6-year study.

Background/objectives: To report the incidence, microbiological profile and in-vitro antimicrobial susceptibilities of microbial keratitis (MK) in the East of England (EoE) over a 6-year period.

Subjects/methods: A retrospective study of patients diagnosed with MK who underwent corneal scraping at participating trusts, within the EoE, between 01/01/2015-01/07/2020. Analysis was performed on MK isolate profiles, in-vitro anti-microbial sensitivities and trends over time.

A lack of an association between COVID-19 vaccination and corneal graft rejection: results of a large multi-country population based study.

Purpose: The aim of the study was to present the rates of corneal transplant rejection from 2018 to 2022 at both Moorfields Eye Hospital UK, and Ospedali Privati Forli (OPF) "Villa Igea", Italy and evaluate the purported association between COVID-19 vaccination and rejection.

Methods: We performed a retrospective review of rejection cases presenting to the two units. Monthly rates were correlated against regional vaccination programme rates.

'Posture-Less' DMEK: Is Posturing After Descemet Membrane Endothelial Keratoplasty Actually Necessary?

Purpose: To evaluate the clinical results of Descemet membrane endothelial keratoplasty (DMEK) without any intraoperative or postoperative posturing.

Design: Retrospective, noncomparative, and interventional case series.

Methods: One hundred thirty-four (134) consecutive eyes of 101 patients requiring DMEK for any cause of endothelial failure were included.

Early Endothelialization of Ab Interno Stromal Tectonic Patch in the Management of Corneal Perforation Secondary to Bacterial Keratitis.

Purpose: The purpose of this study was to describe a novel surgical technique using an ab interno stromal patch to treat corneal perforation and to present the histological findings of the patch after its removal during definitive mushroom keratoplasty.

Methods: The endothelium had already been removed with the submerged cornea using backgrounds away (SCUBA) technique.

Results: The patient was managed successfully with a sutureless ab interno stromal tectonic patch.

Sutureless Tectonic Mini-Descemet's Stripping Automated Endothelial Keratoplasty ("mini-DSAEK") for the management of corneal perforations.

Purpose: To report the outcomes of a new technique, pull-through sutureless 'mini-DSAEK', to manage corneal perforations secondary to different aetiologies including trauma, neurotrophic ulcer following penetrating keratoplasty (PK), herpes simplex keratitis and microbial keratitis.

Methods: In this retrospective case series, we report the clinical outcomes of five cases of sutureless tectonic mini-DSAEK performed in patients presenting with large corneal perforations to Southend University Hospital between November 2019 and October 2020. One corneal perforation was sufficiently peripheral for the tectonic mini-DSAEK graft to be successfully positioned outside of the central visual axis.

Factors predictive of cystoid macular oedema following endothelial keratoplasty: a single-centre review of 2233 cases.

Aims: To describe the incidence of postoperative cystoid macular oedema (CMO) after endothelial keratoplasty (EK) and to identify its contributory risk factors.

Methods: 2233 patients undergoing EK at Ospedali Privati Forlì 'Villa Igea', between January 2005 to October 2018 for Descemet stripping automated endothelial keratoplasty (DSAEK) and June 2014 to August 2018 for Descemet membrane endothelial keratoplasty (DMEK) with a minimum follow-up of 18 months were evaluated. Univariate and multivariate analyses were conducted to identify and quantify contributory risk factors.

Tectonic Mini-DSAEK Facilitates Closure of Corneal Perforation in Eyes With Healthy Endothelium.

Purpose: The purpose of this study was to report a surgical technique for closure of a traumatic corneal perforation in a patient with healthy endothelium.

Methods: A 69-year-old male patient presented to Southend University Hospital with a 2.5 mm round temporal corneal perforation caused by a metallic foreign body from an industrial accident.

Negative polymerase chain reaction for SARS-CoV-2 in aqueous sample of patient with confirmed SARS-CoV-2 and recurrence of herpetic stromal keratitis.

This case report describes a negative result for antigen testing for the SARS-CoV-2 virus in an aqueous sample taken during the management of suspected herpes simplex keratitis from a patient with confirmed SARS-CoV-2 based on antigen testing of high nasal swab. The implications of no viral load detectable in the aqueous sample are discussed in context of routine phacoemulsification surgery during the SARS-CoV-2 pandemic.

A randomised controlled trial comparing femtosecond laser-assisted cataract surgery versus conventional phacoemulsification surgery: 12-month results.

Aims: To report 12-month outcomes of randomised controlled trial comparing conventional phacoemulsification surgery (CPS) with femtosecond laser-assisted cataract surgery (FLACS).

Methods: This was a single-centre, prospective single-masked randomised case-controlled trial. Four hundred patients were randomised to CPS or FLACS with the LenSx platform (Alcon Laboratories Inc.

A matched case-control study of the clinical, economic, and patient-reported outcomes of cystoid macular edema complicating phacoemulsification surgery.

Purpose: To assess the visual outcomes of pseudophakic cystoid macular edema (CME) as compared with age- and copathology-matched control subjects, the costs of treatment and follow-up, and the patient-reported outcomes using the new Cat-patient-reported outcome measures (PROM) 5 questionnaire.

Setting: West Suffolk Hospital NHS Foundation Trust, United Kingdom.

Design: Matched case-control study.

Femtosecond laser-assisted cataract surgery: A review.

Purpose: Review scientific literature concerning femtosecond laser-assisted cataract surgery.

Methods: Following databases were searched: CENTRAL (Cochrane Eyes and Vision Trials Register; Cochrane Library: Issue 2 of 12, June 2019), Ovid MEDLINE without Revisions (1996 to June 2019), Ovid MEDLINE (1946 to June 2019), Ovid MEDLINE Daily Update June 2019, MEDLINE and MEDLINE Non-Indexed Items, Embase (1980-2019), Embase (1974 to June 2019), Ovid MEDLINE and Epub Ahead of Print, in-Process & Other Non-Indexed Citations and Daily (1946 to June 2019), Web of Science (all years), the metaRegister of Controlled Trials ( www.controlled-trials.

Risk-Adjusted CUSUM Analysis of the Learning Curve of Femtosecond Laser Assisted Cataract Surgery.

To determine the length of the learning curve of femtosecond laser-assisted cataract surgery (FLACS) by a risk-adjusted cumulative sum method. This was a retrospective review of the first 288 FLACS performed by three surgeons over a 12-month period. The learning curves were analyzed separately for each surgeon and as pooled data via risk-adjusted cumulative sum methods.

A randomized controlled trial comparing femtosecond laser-assisted cataract surgery versus conventional phacoemulsification surgery.

Purpose: To compare the clinical results of conventional phacoemulsification surgery (CPS) with femtosecond laser-assisted cataract surgery.

Setting: Guy's & St Thomas' NHS Foundation Trust, London, United Kingdom.

Design: Single-center prospective randomized interventional case-controlled trial.

Refractive outcomes after limbal relaxing incisions or femtosecond laser arcuate keratotomy to manage corneal astigmatism at the time of cataract surgery.

Purpose: To compare the results of manual limbal relaxing incisions (LRIs) performed during conventional phacoemulsification surgery with those of nonpenetrating femtosecond laser arcuate keratotomies performed during femtosecond laser-assisted cataract surgery to manage corneal astigmatism.

Setting: Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom.

Evaluation of a hub-and-spoke model for the delivery of femtosecond laser-assisted cataract surgery within the context of a large randomised controlled trial.

Aims: To test a hypothesis that cataract operating room (OR) productivity can be improved with a femtosecond laser (FL) using a hub-and-spoke model and whether any increase in productivity can offset additional costs relating to the FL.

Methods: 400 eyes of 400 patients were enrolled in a randomised-controlled trial comparing FL-assisted cataract surgery (FLACS) with conventional phacoemulsification surgery (CPS). 299 of 400 operations were performed on designated high-volume theatre lists (FLACS=134, CPS=165), where a hub-and-spoke FLACS model (1×FL, 2×ORs=2:1) was compared with independent CPS theatre lists.

Time and motion studies of National Health Service cataract theatre lists to determine strategies to improve efficiency.

Aim: To provide a quantitative assessment of cataract theatre lists focusing on productivity and staffing levels/tasks using time and motion studies.

Methods: National Health Service (NHS) cataract theatre lists were prospectively observed in five different institutions (four NHS hospitals and one private hospital). Individual tasks and their timings of every member of staff were recorded.

Late Stromal Rejection in Deep Anterior Lamellar Keratoplasty: A Case Series.

Purpose: To report a series of 4 cases (3 patients) with late stromal graft rejection 32 to 46 months after an uneventful deep anterior lamellar keratoplasty (DALK).

Methods: Three patients (4 eyes), who had undergone an uneventful DALK for keratoconus (3 eyes) and infectious keratitis (1 eye) 32 to 46 months previously presented with a history of ocular discomfort and redness, with reduced visual acuity in 3 eyes. In all cases, all sutures had been removed at least 18 months previously.

Visual Outcomes and Graft Thickness in Microthin DSAEK--One-Year Results.

Purpose: To evaluate visual outcomes, endothelial graft thickness, and complications in microthin Descemet stripping automated endothelial keratoplasty (DSAEK).

Methods: A prospective interventional cohort of 130 eyes of 114 consecutive patients underwent microthin DSAEK. Endothelial graft preparation included pachymetry-controlled stromal dehydration to reduce donor thickness between 550 and 530 μm by a custom airflow device, before a single-pass microkeratome dissection with a uniform cutting head of 350 μm to achieve microthin endothelial grafts (<130 μm).

A Review of Transplantation Practice of the Urologic Organs: Is It Only Achievable for the Kidney?

Transplantation is a viable treatment option for failure of most major organs. Within urology, transplantation of the kidney and ureter are well documented; however, evidence supporting transplantation of other urologic organs is limited. Failure of these organs carries significant morbidity, and transplantation may have a role in management.