Paradigm Shift in Eye Banking: From Tissue Retrieval to Cellular Harvesting and Bioengineering.

An integrated cell, tissue, and eye bank is vital to meet the evolving needs of ocular transplant therapies. In addition to traditional corneal transplant tissues, it encompasses processing and delivery of transplant materials for newer treatments like cell-based therapies and gene-modified products, adhering to rigorous standards, optimizing tissue utilization with comprehensive services for surgeons.

Evaluation of adjuvant role of topical cyclosporine 1% in acute Stevens-Johnson syndrome: a randomised control trial.

Purpose: To evaluate the role of topical cyclosporine A 1% (CsA) as an adjuvant therapy in patients with acute Stevens-Johnson syndrome (SJS).

Methods: This is a randomised controlled trial in which 44 patients (88 eyes) with acute SJS, presenting within 3 months from the onset of the disease, were enrolled and randomised. Group A (n=44 eyes) patients received treatment with topical CsA 1% along with standard therapy consisting of topical corticosteroids, antibiotics and lubricants.

Novel trocar assisted intraocular lens and capsular bag complex fixation.

Purpose: To describe the innovative technique of trocar-assisted intraocular lens (IOL) and capsular bag complex fixation.

Methods: In this technique, initial pupil dilatation is achieved either with intracameral adrenaline or with the help of iris hooks. Automated anterior vitrectomy is performed in cases with vitreous prolapse.

Capsular phimosis with intraocular lens tilt and decentration.

A 34-year-old woman with quiescent bilateral intermediate uveitis maintained on once-daily dexamethasone 0.1% eyedrops, complicated by left cataract and glaucoma controlled with a single antiglaucoma medication, presented for cataract surgery. Her left corrected distance visual acuity (CDVA) was 20/40 because of a posterior subcapsular lens opacity.

Chronic ocular sequelae in Stevens-Johnson syndrome: a genetic association study.

Purpose: This study sought to investigate the association of molecular markers with chronic ocular sequelae in Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN).

Methods: One hundred SJS/TEN patients (200 eyes) with confirmed diagnosis were enrolled between July 2011 and July 2015 from a tertiary eye-care hospital, and their clinical histories were noted. Each eye was scored for severity of manifestation on a scale of 0-5.

Management of corneal perforations in dry eye disease: Preferred practice pattern guidelines.

Corneal perforations in eyes with dry eye disease (DED) are difficult to manage due to the interplay of several factors such as the unstable tear film, surface inflammation, and the underlying systemic disease affecting the wound healing process, and the eventual outcome. A careful preoperative examination is required to identify the underlying pathology, and status of ocular surface and adnexa, rule out microbial keratitis, and order appropriate systemic workup in addition to assessing the perforation itself. Several surgical options are available, which include tissue adhesives, multilayered amniotic membrane grafting (AMT), tenon patch graft (TPG), corneal patch graft (CPG), and penetrating keratoplasty (PK).

Graft rejection in component keratoplasty.

Among the various indications for keratoplasty, failed graft is one of the commonest indications in many published series. It is well known that the major cause of graft failure is endothelial rejection. In the last two decades, there has been a major paradigm shift in the surgical management of corneal diseases, and component keratoplasty has emerged from the concept of replacing the layer that is actually diseased, rather than replacing the full-thickness cornea with the traditional penetrating keratoplasty.

Novel nucleus management technique in hypermature morgagnian cataracts with liquified cortex during phacoemulsification.

Purpose: To describe a novel nucleus management technique of variable size mobile nucleus in Hypermature Morgagnian cataracts.

Methods: In this technique, under topical anesthesia, temporal tunnel incision and capsulorhexis were performed, and the capsular bag was inflated with 2% w/v hydroxypropylmethylcellulose. A chopper and phacoemulsification probe were used to consciously nudge the nucleus towards the capsular periphery (fornix) to immobilize the floating nucleus against the capsular bag recess.

Clinical, Biochemical, Genetic, and Therapeutic Profile of Patients with Epidermal Necrolysis: A Descriptive Study.

Background: Epidermal necrolysis (SJS/TEN) is a rare but acute severe drug reaction associated with high morbidity and mortality rates.

Aims: To describe the clinical, molecular, biochemical, and therapeutic profile of these patients.

Methods: A total of 24 acute SJS/TEN patients were recruited during their hospital stay and detailed clinical history and treatment course recorded.

Infectious crystalline keratopathy following Descemet's stripping automated endothelial keratoplasty.

Introduction: We describe this first case of causing infectious crystalline keratopathy (ICK) following Descemet stripping endothelial keratoplasty (DSAEK), that resolved after 5 weeks of topical antibiotic and corticosteroid treatment.

Case Description: An 80-year-old woman presented with blurred vision, redness, and ocular pain 9 months after successful DSAEK. Slit lamp examination revealed the presence of white, non-suppurative, deep-branching stromal infiltrates, and a clinical diagnosis of ICK was made.

Tuck-in deep anterior lamellar keratoplasty for the management of post-radial keratotomy keratectasia.

Purpose: To evaluate the outcomes of tuck-in deep anterior lamellar keratoplasty (DALK) for the management of post-radial keratotomy (RK) keratectasia.

Setting: Institution.

Design: Retrospective.

Volcano explosion in the eye: Expulsive choroidal haemorrhage.

Background: This video shows the dreaded complication of expulsive suprachoroidal haemorrhage in a penetrating keratoplasty . It teaches the various measures that help in preventing and managing the challenge peri-operatively.

Purpose: This video is intended to sensitize the corneal surgeons about this rare complication using real-time surgical video and prepare them to face this challenge by demonstrating the preventive and mitigating strategies.

Post-penetrating keratoplasty astigmatism.

Postoperative astigmatism is one of the common complications affecting visual outcomes after a penetrating keratoplasty. It can result from various factors related to host, donor and surgical technique, resulting in suboptimal visual outcome. While some of the measures taken during preoperative planning and during actual surgery can reduce the magnitude of postoperative astigmatism, postoperative correction of astigmatism is often required in cases with high degrees of astigmatism.

Prognostic significance of matrix metalloproteinase 9 in COMET operated chronic ocular Stevens-Johnson syndrome.

Purpose: Molecular pathogenesis underlying persistent ocular surface inflammation in chronic Stevens-Johnson syndrome (SJS) still remains largely unexplored. The present study investigates the expression of matrix metalloproteinase 2 (MMP2), MMP3, MMP9, MMP11 and TIMP1 (tissue inhibittor of matrix metalloproteinase 1) in pannus tissues of chronic ocular SJS undergoing cultivated oral mucosal epithelial transplantation (COMET) and their prognostic relevance.

Methods: In this prospective study, 45 eyes with chronic SJS underwent COMET for visual and anatomical rehabilitation.

"Chopper Shield" Technique to Protect Corneal Endothelium During Phacoemulsification Surgery for Rock Hard Cataracts.

Purpose: To describe an innovative technique of using a chopper as a shield for preventing mechanical corneal endothelial trauma that can occur during the phacoemulsification of brunescent cataracts.

Methods: This prospective study included patients with hard cataracts (grade nuclear opalescence 4 and above on LOCS III) who underwent phacoemulsification surgery. The chopper shield technique was performed in 48 eyes of 44 patients.

A Comparison of Refractive Accuracy Between Conventional and Femtosecond Laser Cataract Surgery Techniques Using Modern IOL Formulas.

Purpose: To compare the refractive outcome prediction accuracy between conventional (CCS) and femtosecond laser assisted (FLACS) cataract surgery techniques using optimized lens constants for modern intraocular lens (IOL) formulas.

Patients And Methods: Our retrospective, comparative, interventional case series, compared data from 196 eyes undergoing CCS and 456 eyes undergoing FLACS with Acrysof IOL (Alcon laboratories, Inc) implantation. After optimizing IOL constants, the predicted refractive outcome was calculated for all formulas for each case.

Laser-assisted corneal transplantation surgery.

Corneal transplant surgeries have a broad range of indications with outcomes largely dependent on surgeon experience. Traditional manual techniques have certain limitations pertaining to the preparation of donor tissue and the recipient bed that might affect the predictability of visual outcomes. Use of lasers for keratoplasty procedures not only improves the repeatability and consistency of the technique, but also enables the surgeon to control the thickness and shape of the transplant tissue tailored to the specific condition.

Graft detachments in endothelial keratoplasty.

Graft detachment is the most common complication of endothelial keratoplasty. With the ongoing advancements in the field of endothelial keratoplasty, our understanding of risk factors of graft detachments and its management has been evolving. Various prevention measures have been described in literature including presoaking the donor graft, anterior chamber tamponade, venting incisions, sutures to prevent dislocation of graft.

Impact of corneal refractive surgery on the precorneal tear film.

Corneal refractive surgeries are one of the commonly performed procedures for correction of refractive errors. Tear film abnormality is the most common postoperative complication of corneal refractive surgeries. Consequently, these procedures represent a clinically significant cause of dry eye disease.

Outcomes of Cultivated Oral Mucosal Epithelial Transplantation in Eyes With Chronic Stevens-Johnson Syndrome Sequelae.

Purpose: To study the outcomes of cultivated oral mucosal epithelial transplantation (COMET) in eyes with chronic Stevens-Johnson syndrome (SJS) sequelae.

Design: Prospective interventional case series.

Methods: Forty-five eyes of 41 patients with chronic SJS sequelae were recruited and evaluated from 2013 to 2017 in an institutional setting.

Techniques of noncircular corneal transplantation.

Purpose Of Review: The management of peripheral corneal diseases, including Mooren's ulcer, Terrien's marginal degeneration, peripheral ulcerative keratitis and pellucid marginal degeneration is challenging. Circular grafts must either be very large, resulting in the excision of healthy tissue, or eccentric, leading to high levels of astigmatism. This review summarizes the range of noncircular keratoplasty procedures available to surgeons, in addition to their indications, and surgical techniques.

Shaped corneal transplantation surgery.

Since its inception in 1905, keratoplasty techniques have continuously evolved. Shaped keratoplasty procedures have allowed corneal surgeons to use complex graft-host junctions and non-circular graft designs to optimise wound strength and healing, facilitate early suture removal and expedite visual rehabilitation. While this was initially limited to penetrating procedures, shaped lamellar keratoplasty techniques have since emerged.