Peripheral Ulcerative Keratitis: Clinical Characteristics, Differential Diagnoses and Therapeutic Concepts.

Peripheral ulcerative keratitis (PUK) is an inflammatory disease of the peripheral cornea, which may frequently be associated with several rare, but potentially life-threatening systemic diseases. The inflammatory pathogenesis of PUK results from humoral and cell-mediated inflammation. The diagnosis is usually based on the typical clinical findings and always requires detailed diagnostic testing to identify a potential systemic underlying disease.

Atopic Keratoconjunctivitis: Pathophysiology, Clinic, and Potential New Therapeutic Concepts.

Atopic dermatitis (AD) is a chronic recurrent inflammatory skin disease with a bipolar age distribution in childhood, adolescence and middle adulthood. Up to 50% of AD patients show ocular involvement, which can be potentially sight threatening. Clinically, the majority of cases present with atopic blepharo(kerato)conjunctivitis or atopic keratoconjunctivitis (AKC); other clinical variants from this group of inflammatory ocular surface diseases are keratoconjunctivitis vernalis in childhood and adolescence and allergic conjunctivitis.

Quality Control in the Corneal Bank with Artificial Intelligence: Comparison of a New Deep Learning-based Approach with Conventional Endothelial Cell Counting by the "Rhine-Tec Endothelial Analysis System".

Endothelial cell density (ECD) is a crucial parameter for the release of corneal grafts for transplantation. The Lions Eye Bank of Baden-Württemberg uses the "Rhine-Tec Endothelial Analysis System" for ECD quantification, which is based on a fixed counting frame method considering only a small sample of 15 to 40 endothelial cells. The measurement result therefore depends on the frame placement and manual correction of the cells counted within the frame.

Descemet Membrane Endothelial Keratoplasty in Eyes with an Artificial Iris.

The purpose of this study is to report the outcome of Descemet membrane endothelial keratoplasty (DMEK) in three eyes with a complex anterior segment and an artificial iris. A retrospective chart review of three cases was performed and clinically meaningful patient characteristics, clinical events, and therapeutic interventions were outlined. A literature search was performed and the clinical course of the three cases was discussed in the context of the published literature.

[The 2021 Activity Report of the Tissue Transplantation and Biotechnology Section of the German Ophthalmological Society].

The Section on Tissue Transplantation and Biotechnology of the German Ophthalmologic Society presented its 11th annual report for the year 2021. The number of corneal samples has still risen in comparison to former years. Nevertheless, there is still a need for import of transplants from abroad.

[Keratoconus: biomechanics ex vivo].

Background: Keratoconus is associated with an impairment in corneal biomechanics. Using nanoindentation, spatially resolved measurement of biomechanical properties can be performed on corneal tissue. The aim of this study is to assess the biomechanical properties of corneas with keratoconus in comparison to healthy controls.

Current Practice in the Treatment of Epithelial and Melanocytic Tumours with Interferon-α2b: A Survey of Tertiary Eye Centres in Germany.

Purpose: To evaluate the standard of care, in particular the use of topical or subconjunctival interferon-2b, in treating ocular surface squamous neoplasia or melanocytic tumours in tertiary eye centres in Germany.

Methods: A survey containing 14 questions was sent to 43 tertiary eye centres in Germany. The questions addressed the surgical and medical management of ocular surface squamous neoplasia and melanocytic tumours (primary acquired melanosis and malignant melanoma), as well as the clinical experiences and difficulties in prescribing off-label interferon-2b eye drops and subconjunctival injections.

On the Current Care Situation and Treatment of Ocular Mucous Membrane Pemphigoid in Germany.

Background: Ocular involvement in mucous membrane pemphigoid (MMP) is relatively rare, with a prevalence of 25 cases per million population, equating to approx. 2,100 patients throughout Germany. Diagnosis can be difficult - especially in cases of isolated ocular involvement - and treatment can be complex and lengthy.

Cataract Surgeries in Patients with Fuchs Endothelial Dystrophy.

Patients with Fuchs endothelial dystrophy often develop visual symptoms between 50 - 60 years of age, which is the same time that the first symptoms of a developing cataract start to appear. On the other hand, in patients with a clinically significant cataract, corneal guttata may be detected by chance during a routine clinical workup. In both situations, the surgeon has to decide whether DMEK or cataract surgery should be performed alone or in combination.

Intrastromal Keratolimbal Epithelial Cysts: Congenital and Postsurgical.

Two very rare cases of intrastromal keratolimbal epithelial cysts are reported. Firstly, an enlarging congenital cyst in a 9-year-old boy, and secondly, a recurrent postsurgical cyst in an 18-year-old female patient. Both cases presented with a limbal cyst, continuing into the corneal stroma as a whitish mass up to the optical axis.

The Development and Status of Eye Banking with Special Focus on the Commitment of LIONS Clubs.

Background: Ever since the first successful keratoplasty in 1905, there has been a need to store corneas for transplantation. R. Townley Paton founded the first eye bank in New York in 1944.

Survey of Rejection Prophylaxis Following Suture Removal in Penetrating Keratoplasty in Germany.

Background: Penetrating keratoplasty (PK) gets more and more reserved to cases of increasing complexity. In such cases, ocular comorbidities may limit graft survival following PK. A major cause for graft failure is endothelial graft rejection.

Scrolling of the Donor Cornea in Dependence of Temperature and Osmolarity for Descemet Membrane Endothelial Keratoplasty.

Background: After preparation of a graft for Descemet membrane endothelial keratoplasty (DMEK), the diameter of the graft's scroll varies significantly. In particular, narrow scrolls may complicate DMEK surgery. In this study we investigated how temperature, osmolarity, and deswelling of the donor tissue influence scrolling diameter.

Gelatinous Drop-Like Corneal Dystrophy - 2 Clinical Cases.

Gelatinous drop-like corneal dystrophy is a very rare autosomal recessive disease classified as an epithelial and subepithelial corneal dystrophy. Patients typically present under the age of 20 with drop-like corneal lesions showing high corneal fluorescein uptake. Their disease course is typically protracted and prone to frequent relapses.

[The 2018 Activity Report of the Tissue Transplantation and Biotechnology Section of the German Ophthalmological Society].

The Section on Tissue Transplantation and Biotechnology presented its 9th annual report. On the one hand, the number of cornea samples has risen to 10,840, of which 7168 have been transplanted. On the other hand, 1340 transplants have still been imported from abroad and more than 3300 patients were waiting for a transplant at the end of the year.

[Keratoplasty in Germany: Systematic Analysis of the Quality Reports of German Hospitals between 2006 and 2017].

Background: Keratoplasty is considered the most frequently performed type of transplantation in humans. Traditionally, penetrating keratoplasty has been the most common procedure. However, over the last 15 years, the importance of posterior lamellar keratoplasty has increased for the treatment of Fuchs endothelial dystrophy and bullous keratopathy.

[Automated Cell Counting Using "Deep Learning" in Donor Corneas from Organ Culture Achieves High Precision and Accuracy].

Background: Human corneal grafts from organ culture need to have more than 2000 endothelial cells/mm to be suitable for transplantation. Measurement of the endothelial cell density is complicated by invisible cell borders in phase contrast microscopy, as well as by limited areas for counting due to folds in the Descemet membrane of the swollen corneal grafts. To date, no automated counting method for measuring the endothelial cell density exists.

[Corneal Biomechanics and Measurement of Intraocular Pressure Measurement in Pathological Corneas].

Measuring the intraocular pressure in eyes with corneal diseases or after corneal interventions often results in false values due to abnormal corneal biomechanics. Many different approaches are used to compensate for these abnormal corneal biomechanic properties, with varying measuring methods. There are differences when these alternative measuring methods are compared to the gold standard, applanation tonometry according to Goldmann.

[Perioperative/Postoperative Anti-Inflammatory Therapy During/After Corneal Surgery/Transplantation].

Surgical trauma, and foreign material - such as sutures or implants or antigens during tissue transplantation - may cause inflammatory reactions. Inflammatory reactions after surgical interventions distant from the vascularised limbus and without opening of the anterior chamber of the eye are usually very muted, because of the corneal immune and angiogenic privilege. A milestone in the therapy and prophylaxis of inflammation after corneal surgery has been the use of topical glucocorticoids since the 1950s.