Neurotrophic keratitis: inflammatory pathogenesis and novel therapies.

Purpose Of Review: Neurotrophic keratitis is a rare degenerative disease characterized by decrease or absence of corneal sensation. Neurotrophic keratitis varies from mild forms with mild epitheliopathy to severe manifestations such as corneal ulceration, melting and perforation that can lead to irreversible visual loss. The cause of neurotrophic keratitis comprises a long list of diseases, medications, congenital or genetic conditions as well as trauma.

Ex vivo demonstration of canine corneal pre-Descemet's anatomy using pneumodissection as for the big bubble technique for deep anterior lamellar keratoplasty.

The recent discovery and characterization of pre-Descemet's layer (PDL; also termed the Dua's layer or the Dua-Fine layer) has advanced the understanding of various posterior corneal pathologies and surgeries in human. This study aimed to characterize the ultrastructure of the posterior stroma and interfacial zone of Descemet's membrane (DM) in canine eyes. Eighteen canine corneo-scleral discs were included.

Profiling ocular surface responses to preserved and non-preserved topical glaucoma medications: A 2-year randomized evaluation study.

Background: Use of topical glaucoma medications has been reported to cause ocular surface (OS) discomfort and inflammation. This study explores the profile of inflammatory cytokines and OS symptoms induced in response to preserved and non-preserved drops.

Methods: Prospective, randomized evaluation on 36 treatment-naïve patients over 24 months of three differently preserved glaucoma drop preparations: Preservative-free (PF), polyquad (PQ) and benzalkonium chloride (BAK).

Dynamics of big bubble formation in deep anterior lamellar keratoplasty by the big bubble technique: in vitro studies.

Purpose: To examine the movement of air injected in the cornea in simulated deep anterior lamellar keratoplasty (DALK), from the needle tip to the formation of different types of big bubbles (BB) and to ascertain how air travels through the stroma and pre-Descemet's layer [Dua's layer (PDL)] to create a type-1 (air between PDL and deep stroma) and type-2BB (air between PDL and Descemet's membrane).

Methods: Air was injected in 57 sclerocorneal discs and the passage recorded. Leaking points and sites of commencement of type-1 and type-2BB were examined by scanning electron microscopy.

Clinical evaluation and characterisation of corneal vascularisation.

Background/aims: To clinically characterise corneal neovascularisation (CVas) with a view to elaborate clinical presentations and to standardise descriptors for clinical evaluation and research.

Methods: Corneas of 165 patients with CVas due to a variety of corneal pathologies were observed clinically with the slit lamp biomicroscope and photography at different time points over the course of their disease. Parameters assessed included location, depth, length, branching pattern, colour, lipid leakage, nature of blood flow and presence of haemorrhage.

Calcified corneal nerves.

Purpose: To report a case of calcified corneal nerves in an eye with long-standing diabetic eye disease.

Methods: This is a case report where the clinical diagnosis was made using a slit-lamp biomicroscope and confirmed using in vivo confocal microscopy. Photoslit-lamp images were taken for both eyes, and nerve thickness measurements made using ImageJ software.

Big bubble deep anterior lamellar keratoplasty: the collagen layer in the wall of the big bubble is unique.

Purpose: In big bubble (BB), deep anterior lamellar keratoplasty intracorneal injection of air separates Descemet's membrane (DM) and the pre-Descemet's layer (Dua's layer [DL]) to create a type 1 BB. We tested the hypothesis that air injection after excision or ablation of DL will fail to produce a BB.

Methods: Nine human sclero-corneal discs were used.

Fine needle diathermy occlusion of corneal vessels.

Aims: To evaluate the efficacy of fine needle diathermy (FND) occlusion of corneal vessels in relation to defined clinical indications.

Methods: A retrospective, consecutive case series including all patients treated by FND for occlusion of corneal vessels between 2004 and 2012. Indications were lipid keratopathy, preparation for keratoplasty to reduce risk of rejection and treatment of recalcitrant corneal graft rejection associated with stromal vessels.

The collagen matrix of the human trabecular meshwork is an extension of the novel pre-Descemet's layer (Dua's layer).

Background: The trabecular meshwork (TM) located at the angle of the anterior chamber of the eye contributes to aqueous drainage. A novel layer in the posterior part of the human cornea has recently been reported (the pre-Descemet's layer (Dua's layer (PDL)). We examined the peripheral part of this layer in relation to the origin of the TM.

Atypical hydrops in keratoconus.

To report the clinical presentation, progress and management of atypical acute hydrops. A retrospective case study of three patients with keratoconus, two of whom had previously undergone penetrating keratoplasty. The patients underwent full ophthalmological examination and digital slit-lamp imaging of the cornea throughout the course of the condition.

Human corneal anatomy redefined: a novel pre-Descemet's layer (Dua's layer).

Purpose: To define and characterize a novel pre-Descemet's layer in the human cornea.

Design: Clinical and experimental study.

Participants: We included 31 human donor sclerocorneal discs, including 6 controls (mean age, 77.

Wavefront-optimized excimer laser in situ keratomileusis for myopia and myopic astigmatism: refractive outcomes and corneal densitometry.

Purpose: To determine the refractive outcomes of wavefront-optimized laser in situ keratomileusis (LASIK) treatments, in particular to measure corneal densitometry after LASIK using the densitometry function of the Pentacam Scheimpflug system.

Setting: Division of Ophthalmology and Visual Sciences, University of Nottingham, United Kingdom.

Design: Cohort study.

Profile of sight-threatening infectious keratitis: a prospective study.

Purpose: To prospectively study patients presenting with sight-threatening corneal ulcers with a view to identify the predisposing factors, causative organisms, clinical signs and treatment outcomes.

Methods: Prospectively, over 3-year period, all cases with serious infective keratitis presenting to Queens Medical Hospital in Nottingham, UK, were recruited. Detailed information on the aetiology, culture results, signs & symptoms, the treatment given and the patient's response was collected and statistically analysed.

The effect of gravitational force on limbal stem cell growth.

Aim: To evaluate the effect of gravity on corneal epithelial cell migration in vitro.

Methods: Fourteen donor peripheral corneoscleral rims were used. Twenty explants were chosen of which 10 were placed vertically and 10 were placed horizontally during culture.

In vivo confocal microscopic features of normal limbus.

Aim: To describe in vivo confocal microscopy (IVCM) features of the limbus in normal eyes as related to the palisades of Vogt's.

Methods: 46 eyes of 29 consecutive volunteers were recruited in this observational study. A detailed examination by IVCM was performed in addition to a routine slit-lamp biomicroscopy.