Purpose: To evaluate the efficacy of preventive treatment against allograft rejection after endothelial keratoplasty (EK), we conducted a systematic review and meta-analysis.
Method: PubMed, Cochrane Library, Embase and ScienceDirect databases were searched until May 2021. We computed a random-effect meta-analysis on graft rejection rate stratified by the intervention (i.e. Descemet membrane EK (DMEK) and Descemet stripping (Automated) EK (DS(A)EK) or ultrathin (UT)-DSAEK), and postoperative treatment. Meta-regressions were performed to compare intervention, treatment and influence of putative confusion factors.
Results: We included 49 studies and 12 893 EK (6867 DMEK and 6026 DS(A)EK/UT-DSAEK). Topical steroids were merged in two efficacy regimens: standard steroids (prednisolone acetate 1% or dexamethasone 0.1%) and soft steroids (fluorometholone 0.1% or loteprednol etabonate 0.5%). Globally, DMEK had a lower graft rejection rate than DS(A)EK/UT-DSAEK (coefficient - 3.3, 95 CI, -4.60 to -1.90; p < 0.001). No significant differences were observed between standard and soft steroids to prevent graft rejection after DMEK. After EK, the rate of ocular hypertension was 20% (95 CI, 14 to 26%) with the use of standard steroids and 7% (5 to 9%) with soft steroids. Comparisons of treatments were not feasible in DS(A)EK/UT-DSAEK due to a lack of studies.
Conclusions: Descemet membrane endothelial keratoplasty (DMEK) has less risk of graft rejection compared with DS(A)EK/UT-DSAEK. Furthermore, soft steroids seemed to be a valuable alternative to standard steroids to prevent graft rejection after DMEK, involving a safe profile against ocular hypertension. Further studies are needed to compare other drugs in the prevention of graft rejection after EK.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/aos.15154 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Do transversus abdominis plane (TAP) blocks improve pain after laparoscopic bilateral inguinal hernia repairs beyond the recovery unit? A randomized control trial.
Hernia
January 2025
Department of Surgery, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1259, New York, NY, 10029, USA.
Purpose: While surgeons agree that perioperative field blocks should be performed for open inguinal hernia surgery, there lacks consensus in the minimally invasive context. Prior small-scale randomized trials study pain scores only up to 24 h postoperatively. Thus, we sought to investigate the analgesic benefits of a bupivacaine transversus abdominis plane (TAP) block in the first 4 postoperative days.
View Article and Find Full Text PDFCan We Maintain Muscle Mass on a Plant-Based Diet?
Curr Nutr Rep
January 2025
Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
Purpose Of Review: This review aims to determine whether muscle mass and function can be effectively maintained without relying on animal-based protein sources. We evaluate the quality, digestibility, and essential amino acid profiles of plant-based proteins to understand their potential in preventing and managing sarcopenia.
Recent Finding: Recent studies indicate that while animal-based proteins have traditionally been considered the gold standard for supporting muscle protein synthesis, certain plant-based protein blends, fortified with leucine or other essential amino acids, can produce comparable anabolic responses.
Giant encephalocele in newborns: prenatal diagnosis, management and outcome.
Childs Nerv Syst
January 2025
Department of Global Health, Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada.
Background: A giant encephalocele associated with Chiari malformation is a rare congenital anomaly from a cephalad neural tube defect. Early prenatal diagnosis and parental counseling are essential; as early surgical intervention can improve outcomes.
Methods: Between 2010 and 2023, twenty-seven newborns out of 43,815 delivered at our institution were diagnosed with encephaloceles, including seven cases of giant encephalocele associated with Chiari malformation type III.
Nutritional Strategies for Battling Obesity-Linked Liver Disease: the Role of Medical Nutritional Therapy in Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) Management.
Curr Obes Rep
January 2025
Dipartimento Psicologia e Scienze della Salute, Università Telematica Pegaso, Centro Direzionale Isola F2, Via Porzio, Naples, 80143, Italy.
Purpose Of Review: This narrative review explores the role of Medical Nutritional Therapy (MNT) in managing Metabolic-Associated Steatotic Liver Disease (MASLD), previously known as nonalcoholic fatty liver disease. It aims to examine the effectiveness of specific nutritional strategies in preventing and treating this obesity-linked liver disease.
Recent Findings: Emerging evidence underscores the benefits of the Mediterranean diet, low-carbohydrate diets, and intermittent fasting in reducing liver fat, improving insulin sensitivity, and mitigating inflammation.
Effects of different approaches of infraclavicular brachial plexus block on perfusion index and tissue perfusion.
Ann Med
December 2025
Department of Anesthesiology and Reanimation, Zonguldak Bülent Ecevit University Medicine Faculty, Zonguldak, Türkiye.
Background: Although both the lateral sagittal and costoclavicular approaches are applied at the cord level in the infraclavicular region, there is a major difference between the distributions of the two approaches. We aimed to investigate the effects of this different distribution on tissue perfusion and oxygenation.
Methods: Sixty patients undergoing elective elbow, forearm, wrist and hand surgery under infraclavicular brachial plexus block were included in the study.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!