JUL 2013

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

Issue link: https://digital.eyeworld.org/i/146899

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14 EW NEWS & OPINION July 2013 2013 continued from page 13 by the algorithm for building the discriminating rule that best discriminates between these two populations of eyes. Forty-seven subclinical KC eyes, defined as the topographically normal contralateral eye of a KC, were identified and differentiated from 177 normal corneas with a high discriminant power: 93.6% sensitivity and 97.2% specificity. In addition, parameters related to posterior surface asymmetry and thickness spatial distribution were automatically selected by the algorithm with their cutoff values as the two most discriminant variables. Clinical risk factors for failure of autologous limbal stem cell transplantation Anupam B. Bagdi, MBBS, Sayan Basu, MBBS, MS, Md Hasnat Ali, MSc, Virender Sangwan, MBBS, MS Literature shows that 20-50% of all limbal transplants fail. Customizing the prognosis of limbal transplantation for a patient is difficult because the risk factors predisposing to failure of surgery are multifactorial. This retrospective study included 526 eyes of patients with unilateral LSCD following ocular surface burns who were treated with ex-vivo autologous cultivated limbal epithelial We're Changing The Game with our new Model M4 valve. Model M4 Porous Plate www.ahmedvalve.com 800.832.5327 transplantation between 2001 and 2011. A multivariate analysis was performed using multiple logistic regression to elucidate the strength of association between the various preoperative, intraoperative, and postoperative clinical factors and recurrence of LSCD. Successful restoration of the ocular surface was seen in 292 (55.5%) of the 526 eyes at a mean follow-up of 1.4 years. Among all the pre-, intra- and postoperative clinical factors that were assessed, pediatric age group (OR=1.4, P=0.04), previous ocular surgeries (OR=1.3, P=0.02), presence of symblepharon (OR=1.2, P<0.001), and simultaneous keratoplasty (OR=3.2, P=0.02) were found to be associated with greater chances of failure of autologous cultivated limbal epithelial transplantation. Endothelial cell density after Descemet's membrane endothelial keratoplasty with and without air re-injection: Multi-year follow-up Matthew T. Feng, MD, Zachary Burkhart, MD, Marianne O. Price, PhD, Francis W. Price Jr., MD The key difference between DMEK and DSAEK is the inclusion of supporting stroma. Its presence in DSAEK donors confers ease of handling for surgeons at the expense of increased incision size, higher order aberrations, and rejection for patients—relative to DMEK. However, DMEK donors can be technically challenging to prepare, unfold, and attach, raising concerns about endothelial cell loss. This prospective study found cell loss to be 25-26% from one month to two years after DMEK. Cell loss was 36-38% at three to four years. When compared to the best DSAEK data in the current peer-reviewed literature, this was higher initially but equivalent by one year postoperatively. Air re-injection showed a significant dose-dependent association with increased loss. In conclusion, most DMEK cell loss occurs perioperatively, consistent with graft manipulation. Fortunately, this is offset by a slower rate of cell loss versus DSAEK, presumably due to lower rejection rates. EW

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