Breaking News Related to Macular Degeneration, Cataract, Glaucoma, Corneal Disease and Other Eye Conditions » Cornea

Botox For Filamentary Keratitis

Dr. Ari Weitzner — Tue, 24 Apr 2012 18:08:52 +0000

April Archives: Yet another use for the miracle drug! Filamentary keratitis is a very annoying disease where plugs of mucuc get stuck on the cornea and cause light sensitivity, pain and foreign body sensation. It is often found in ptosis, dry eye, SLK and prolonged patching. It can be hard to treat. Researchers had the idea that it is mostly due to a mechanical problem of the lid rubbing against the eye, so they figured that by injecting a little Botox in the eyelid muscle and thus weaken it, they can improve the situation. Indeed, 88% of 33 eyes improved. So if the usual treatment- debridement, artificial tear/ointment and Mucomyst drops don’t work, it’s worth a try. And you can use the rest of the bottle on your crows feet.

What Are Risks of Cataract Surgery After Corneal Transplants?

Patient Letter to the Editor — Mon, 02 Apr 2012 21:55:07 +0000

Family member has lattice dystrophy in both eyes. 17 years ago both eyes had corneal transplants (albeit not a same time). 2 years ago right eye had another corneal transplant again. 1 month ago left eye cornea transplant again.

Right eye has developed cataracts to the point of cloudy vision. Left eye has a cataract also, but as the transplant surgery was only 3 weeks or so ago and so that eye is still healing and vision can’t be measured.

My question is: can cataract surgery be performed after someone has had corneal transplants? If so, what are the possible negatives in this situation? Will it prevent in any way future corneal transplants as they become necessary? Let me add that after right eye surgery the vision was crystal clear with a contact lens – but recently vision quickly degraded due to aggressive cataract.

We are advised by ophthalmologist that this aggressive and fast growing cataract issue was caused by the steroids/anti rejection drops.

Corneal Grafts Using DMEK Have Greater Survival Than DSEK Grafts

Dr. Ari Weitzner — Thu, 29 Mar 2012 09:02:51 +0000

Ophthalmology: Grafts using the DMEK technique (only transplanting Descemet’s membrane) had a lower graft failure rate (1% vs. 12% at 2 years) than DSEK (which includes a little stroma). At this rate, and with articles showing that eyes can clear up with no graft at all ( see last month’s post here at EyeDocNews), we’ll be grafting nothing but air in no time. Too bad these techniques are so difficult to learn, but I am sure, just like with phaco, the technology will get better and make things easier.

Ultra-High Resolution OCT Helpful in Surface Squamous

Dr. Ari Weitzner — Tue, 27 Mar 2012 09:51:32 +0000

Ophthalmology: Ultra-high OCT gives outrageously detailed view of tissue- it’s like looking at a histology slide. Researchers were able to very accurately distinguish pterygia from surface squamous neoplasia using this modality, which is critical as the latter requires a far different treatment approach. Too bad this gizmo is not widely available, but it would certainly come in handy before surgery if one has atypical pterygia.

PKP, DSEK or DMEK for Fuch’s Dystrophy?

Patient Letter to the Editor — Fri, 23 Mar 2012 09:44:30 +0000

I have Fuchs’ dystrophy and have had a cataract surgery 6 months ago. So far stable. Here are my questions.

1) What is the expected survival time of DSEK or DMEK grafts? Can DSEK or DMEK be repeated on a patient if the first graft wears away?

2) If everything else fails, can we turn to artificial cornea? How long do they survive?

3) Can full PK be performed if DSEK/DMEK fails?

New Limbal Transplantation Technique Used To Treat Blindness Caused by Burns

Dr. Ari Weitzner — Thu, 08 Mar 2012 09:10:55 +0000

Ocular burns cause blindness by permanently damaging the limbal stem cells found in the eye, which causes loss in corneal transparency. In such cases, stem cells are harvested from the healthy eye and transplanted to the damaged eye. There are currently two techniques.

One is to directly transplant the stem cells to the damaged eye. This technique, known as CLAU (conjunctival limbal autografting), involves removing almost 50 per cent of the limbus (6 mm to 8 mm length of the limbus) from the healthy eye (which may permanently damage it).

The alternative technique — cultivated limbal epithelial transplantation (CLET) — is to remove a smaller portion (2 mm by 2 mm) of the limbus containing the stem cells and increase (expand) the cells in the laboratory and then transplant them to the damaged eye.

The January 2012 issue of the British Journal of Ophthalmology reported on the results of a new novel surgical technique of limbal transplantation, which combines the benefits of existing techniques while avoiding their difficulties. Called SLET (simplified technique of limbal transplantation), the technique involves removing only a small portion of the limbus tissue from the healthy eye (as in the case of CLET), but the stem cell expansion takes place not in the lab but in the damaged eye itself. The procedure is cheaper and there is less risk of contamination (since the expansion does not take place in a lab).

Click here to read the abstract.

Click here to read a more detailed discussion of the new SLET technique in The Hindu

KeraSoft IC Lenses for Keratoconus Patient in Pennsylvania

Patient Letter to the Editor — Tue, 28 Feb 2012 09:41:47 +0000

I was diagnosed with Keratoconus a couple of year ago and i cant stand the hard contact lenses.

I am looking for an eye doctor in Pensylvania that can fit me with the new KeraSoft IC lenses.

Thank you for you help. I have called several places and no one is working with them.

Options for Patient With Damaged Corneas From Radial Keratotomy in 1982

Patient Letter to the Editor — Mon, 27 Feb 2012 09:32:30 +0000

I had 16 cut Radial Keratotomy (RK) surgery in 1982, and now have issues with my sight. My ophthalmologist has recommended refractive lens exchange (RLE), saying I am a +4 and a +6. I have the beginning of a cataract in my left eye, but it is not bad enough to be covered by insurance yet.

Wouldn’t a solution to the corneal defects be to replace the cornea? Having had 4 surgeries (all for esotropia) and the 2 for RK, I think RLE is risky. My doctor is not especially good at explaining everything, and I am a bit unnerved by more surgery of that type which would enter from the periphery of my cornea.

I am not sure what to ask, but hope that the technology is getting to the point where I could just replace my surgically damaged corneas with rebuilt ones from my own adult stem cells. I believe just by fixing my corneas a lot of the halos, starbursts and night blindness could be diminished.

Is this a possibility yet? I am trying to research all my options.

Transplanting Limbal Tissue No Better Than Plain Conjunctiva In Pterygium Surgery

Dr. Ari Weitzner — Fri, 17 Feb 2012 09:42:10 +0000

Feb. Ophthalmology: Researchers compared autografting conjunctiva to conjunctiva plus limbal tissue, combined with mitomycin application, and found excellent results for both with no difference. Allow me to remind everyone that conjunctiva autografting with fibrin glue is superior to amniotic membrane and should be standard of care, if you ask me, in the clinic where we treat Black and Hispanic populations.

Corneas Clear Up After Endothelium Removed!

Dr. Ari Weitzner — Wed, 15 Feb 2012 09:29:51 +0000

Feb. Ophthalmololgy: Unbelievable. After a second failed DSEK in one eye, the surgeon noted that the cornea cleared up where the graft had detached. So for the fellow eye, he simply stripped the Descemet’s and endothelium, and lo and behold, after two months, the cornea was completely clear, and specular microscopy found that the endothelium (supposedly unable to regenerate) had completely covered the cornea. The patient had both Fuch’s and posterior polymorphous (confirmed by histology), and he wonders if this combination made the corneas special in some way. This case actually not so strange- earlier articles had found some endothelium migration after graft displacement, with no need to re-position the graft.