4,082 results match your criteria: "Corneal Graft Rejection"

Corneal stromal opacities can severely impact visual acuity if they are located in the visual axis. Homologous penetrating keratoplasty (HPK) is usually the preferred surgical option in such clinical circumstances. However, autologous penetrating keratoplasty (APK) could be an immunologically safer alternative.

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Big-bubble DALK: A technique in evolution.

Ocul Surf

October 2024

IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Ophthalmology Unit, Dipartimento di Scienze Mediche e Chirurgiche, Alma Mater StudiorumUniversity of Bologna, Bologna, Italy. Electronic address:

Article Synopsis
  • - Deep anterior lamellar keratoplasty (DALK) is a surgical technique for treating corneal disorders without affecting the endothelium, which helps prevent rejection and late graft failure compared to traditional penetrating keratoplasty (PK).
  • - The introduction of the big-bubble technique (BBT) improved the efficiency and consistency of DALK by using air to separate corneal layers, resulting in high-quality grafts comparable to PK.
  • - Understanding the anatomy behind BB formation, including the significance of Dua's layer, is essential for successful DALK procedures; ongoing improvements in BBT are increasing its use in corneal transplants with healthy endothelium.
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Article Synopsis
  • The study compares the effectiveness of two surgical approaches—Descemet membrane endothelial keratoplasty (DMEK) and Descemet stripping only (DSO)—for treating Fuchs endothelial corneal dystrophy (FECD) in a clinical trial called DETECT II.
  • A total of 60 patients will be randomly assigned to receive either DMEK with a placebo or DSO with a drug called ripasudil, and the main goal is to evaluate visual improvement after 12 months.
  • The trial aims not only to assess visual outcomes but also to explore other factors like cost-effectiveness and the incidence of adverse events, with findings planned for dissemination in scientific publications and conferences.
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Background: EndoArt® (Eye Yon Medical, Ness Ziona, Israel) is a novel artificial corneal inner layer transplant and an innovative treatment alternative for patients at high risk for graft failure after posterior lamellar corneal transplantation (EK).

Aim Of The Study: We present the initial results of the EndoArt® implantation in patients with glaucoma drainage devices (GDD).

Patients And Surgical Procedure: In this study 12 eyes with GDD were retrospectively evaluated.

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Despite tremendous developments in the field of laboratory testing in transplantation, the rules of eligibility for corneal transplantation still do not include typing of human leukocyte antigens (HLAs) in the donor and recipient or detection of donor-specific antibodies (DSAs) in the patient. The standard use of diagnostic algorithms is due to the cornea belonging to immunologically privileged tissues, which usually determines the success of transplantation of this tissue. A medical problem is posed by patients at high risk of transplant rejection, in whom the immune privilege of the eye is abolished and the risk of transplant failure increases.

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Article Synopsis
  • The study examines the difficulties faced in managing persistent graft rejections in a patient with Macular Corneal Dystrophy (MCD) who had Penetrating Keratoplasty (PKP) surgeries and also suffers from CREST syndrome, a form of systemic sclerosis.
  • A 47-year-old female patient underwent multiple surgical procedures and treatments over 13 years, which included both surgical interventions and immunosuppressive therapy, yet faced numerous graft failures and a significant decrease in vision.
  • The findings emphasize the detrimental effects of systemic autoimmune disorders on surgical outcomes, suggesting a need for careful systemic assessments and potentially stronger immunosuppressive approaches to improve graft survival in similar cases.
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Assessment of Corneal Graft Outcomes in a Murine Model of Endothelial Keratoplasty.

J Clin Med

August 2024

Laboratory of Ocular Immunology, Transplantation and Regeneration, Schepens Eye Research Institute, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA 02114, USA.

: In this study, we establish a protocol for evaluating the outcomes of endothelial keratoplasty, including graft survival, rejection, or failure. Additionally, we also evaluate the alloimmune response in graft recipients. : We performed EK using C57BL/6 (allogeneic) and BALB/c (syngeneic) as donors and BALB/c mice as recipients.

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Background: This study aims to evaluate the clinical outcomes and efficacy of a modified tectonic corneoscleral graft (TCG) in patients suffering from devastating corneoscleral infections.

Methods: Thirty-eight eyes from 38 patients who underwent the modified TCG were included in this study. The outcomes measured were recurrence rates, best-corrected visual acuity (BCVA), ocular surface stability, postoperative complications, and graft survival.

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A chimeric anti-vascularization immunomodulator prevents high-risk corneal transplantation rejection via ex vivo gene therapy.

Mol Ther

November 2024

Department of Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA; Gene Therapy Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; Bedrock Therapeutics, Raleigh, NC 27613, USA. Electronic address:

Corneal blindness affects more than 5 million individuals, with over 180,000 corneal transplantations (CTs) performed annually. In high-risk CTs, almost all grafts are rejected within 10 years. Here, we investigated adeno-associated virus (AAV) ex vivo gene therapy to establish immune tolerance in the corneal allograft to prevent high-risk CT rejection.

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Results of Lucia Keratoprosthesis Implantation in Severe Corneal Disease.

Am J Ophthalmol

December 2024

From the Instituto de Oftalmologia Fundacion Conde de Valenciana IAP (G.O.-M., G.R.V.-D., D.J.-C., J.A.R., K.A.R., J.L.D.-H., C.A.M.-M., A.N., A.R.-M., E.O.G.-H.), Mexico City, Mexico. Electronic address:

Purpose: Describe complications, functional success, and retention of the Lucia Keratoprosthesis (KPro).

Design: Retrospective interventional case series METHODS: The demographic data, baseline characteristics, complications, functional success, and retention were analyzed for Lucia KPro at the Instituto de Oftalmologia Conde de Valenciana in Mexico City from 2021 to 2023. Multivariate regression analysis and Kaplan-Meier plots were performed to identify associations with functional failure.

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Article Synopsis
  • T helper 1 (Th1)-mediated immune rejection is the main reason for graft failure after transplantation, influenced by interactions between different types of dendritic cells, particularly CD11b+ DC2 and CD103+ DC1.
  • In non-inflamed corneal beds, migratory CD103+ DC1 cells maintain a tolerogenic function that helps suppress harmful immune responses and promote graft survival through mechanisms like IL-10 and the PD-L1/PD-1 pathway.
  • In contrast, in inflamed corneal beds, Th1 cells switch CD103+ DC1 cells to an immunostimulatory state, leading to graft failure; however, transferring tolerogenic CD103+ DC1s can inhibit this negative
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Purpose: Dermoid excision combined with lamellar keratoplasty was one of the most common surgical techniques for corneal dermoid. Due to the huge shortage of corneal donors, small incision lenticule extraction (SMILE) derived lenticules might be the novel and feasible corneal grafts instead of traditional corneal donors. Therefore, we tried to use FG boned multi-layer lenticules as grafts in the treatment of corneal dermoid.

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Article Synopsis
  • An ideal adhesive hydrogel should have strong tissue adhesion, be biocompatible and biodegradable, and match the mechanical properties of surrounding tissues.
  • Researchers developed a double-network hydrogel using polysaccharides and nanosized dendrimers, improving its mechanical performance and adhesive qualities for better biological function.
  • This advanced hydrogel shows great potential for use in corneal surgeries, offering a viable alternative to sutures and reducing risks associated with graft rejection in tissue engineering.
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Article Synopsis
  • The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has impacted not only the respiratory system but also various eye-related conditions, demonstrating a range of ocular symptoms.
  • Important eye manifestations of COVID-19 include conjunctivitis, scleritis, uveitis, and retinopathy, making it crucial for eye care practitioners to monitor these signs as potential early indicators of the disease.
  • The review also discusses how the virus interacts with ocular tissues and examines vaccine-related ocular side effects, highlighting the necessity for continued research on vaccine safety and effective eye examinations for COVID-19 patients.
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Granular polyrotaxane microgels as injectable hydrogels for corneal tissue regeneration.

Biomater Sci

September 2024

Department of Complex Tissue Regeneration, Maastricht University, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht, the Netherlands.

Corneal diseases, a leading cause of global vision impairment, present challenges in treatment due to corneal tissue donor scarcity and transplant rejection. Hydrogel biomaterials in the form of corneal implants for tissue regeneration, while promising, have faced obstacles related to cellular and tissue integration. This study develops and investigates the potential of granular polyrotaxane (GPR) hydrogels as a scaffold for corneal keratocyte growth and transparent tissue generation.

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Corneal dystrophies are phenotypically and genetically heterogeneous, often resulting in visual impairment caused by corneal opacification. We investigated the genetic cause of an autosomal dominant corneal stromal dystrophy in a pedigree with eight affected individuals in three generations. Affected individuals had diffuse central stromal opacity, with reduced visual acuity in older family members.

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A surgical alternative of fusiform penetrating keratoplasty for the management of severe infectious keratitis.

Int J Ophthalmol

August 2024

Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250021, Shandong Province, China.

Aim: To describe the surgical procedure of fusiform penetrating keratoplasty (FPK) using multiple trephines of different sizes for treating patients with severe infectious keratitis.

Methods: Fourteen eyes underwent FPK, and 15 eyes received conventional penetrating keratoplasty (PK) were included in the study. The best-corrected visual acuity (BCVA), refractive outcomes, endothelial cell density, and postoperative complications were recorded.

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Corneal inflammatory hem- and lymphangiogenesis significantly increase the risk for immune rejection after subsequent allogeneic corneal transplantation. The purpose of this study was to analyze the impact of temporary selective inhibition of lymphangiogenesis after transplantation on graft survival. Allogeneic transplantation from C57BL/6 mice to BalbC mice was performed as "high-risk" keratoplasty in a prevascularized corneal host bed (suture-induced inflammatory corneal neovascularization).

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Potential applications of mesenchymal stem cells in ocular surface immune-mediated disorders.

Surv Ophthalmol

August 2024

Department of Ophthalmology, Campus Bio-Medico University, Rome, 00128, Italy; Cornea Rare Diseases Center, Fondazione Policlinico Campus Bio-Medico, Rome, 00128, Italy. Electronic address:

Article Synopsis
  • This text examines how mesenchymal stem/stromal cells (MSCs) interact with the immune system of the cornea and their potential to treat eye disorders.
  • It discusses the immune privilege of the cornea, highlighting key immunomodulatory substances and the regenerative properties of MSCs.
  • The article focuses on MSCs' effectiveness in treating various corneal diseases, showing promise in promoting healing and reducing inflammation based on both preclinical and clinical studies.
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The progress and future of corneal endothelial transplantation.

Jpn J Ophthalmol

September 2024

Department of Ophthalmology, Department of Visual Sciences, Nihon University School of Medicine, Itabashi, Tokyo, Japan.

Endothelial transplantation has recently been accepted worldwide, in the long history of corneal transplantation. The introduction of endothelial keratoplasty (Descemet stripping automated endothelial keratoplasty and Descemet membrane endothelial keratoplasty) has enabled us to expand the surgical indications owing to the low incidence of rejection and quick recovery of visual function. New technologies have been developed to ensure stable postoperative outcomes with a shorter learning curve, such as transplantation using cultured human endothelial cells and induced pluripotent stem cells (iPS) or new devices such as artificial endothelium.

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We report the case of corneal transplant rejection in a 77-year-old male receiving durvalumab as consolidative therapy for stage IIIB non-small cell lung cancer (NSCLC). Following successful chemoradiation and initiation of durvalumab, the patient underwent a right corneal transplant for corneal dystrophy. Six months after an initially stable post-transplant course, he developed progressive visual decline culminating in graft failure 1 year later despite treatment with prednisone eye drops.

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High-risk (HR) corneal transplantation presents a formidable challenge, with over 50% of grafts experiencing rejection despite intensive postoperative care involving frequent topical eyedrop administration up to every 2 h, gradually tapering over 6-12 months, and ongoing maintenance dosing. While clinical evidence underscores the potential benefits of inhibiting postoperative angiogenesis, effective antiangiogenesis therapy remains elusive in this context. Here, we engineered controlled-release nanomedicine formulations comprising immunosuppressants (nanoparticles) and antiangiogenesis drugs (nanowafer) and demonstrated that these formulations can prevent HR corneal transplantation rejection for at least 6 months in a clinically relevant rat model.

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