By John V Forrester MD, Lucia Kuffova
This booklet offers a precis of a number of the elements of corneal transplantation — the medical, experimental (including multimedia demonstrate of the surgical techniques), immunological, healing and prosthetic elements — in a single quantity. The expert in a single box can hence have entry to details from the opposite fields and improve a huge inspiration of the demanding situations to be confronted in attaining the final word target, i.e. an optically transparent, visually passable, functioning corneal graft that is tolerated within the long-term with out the necessity for systemic immunosuppression. A moment function of the e-book is to supply information about present immunological suggestions of the method of corneal graft rejection. particularly, contemporary paintings within the fields of innate as opposed to adaptive immunity, novel therapeutics and corneal xenografts is gifted.
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Additional info for Corneal Transplantation: An Immunological Guide to the Clinical Problem
Jain S and Azar DT. N e w lamellar keratoplasty techniques: posterior keratoplasty and deep lamellar keratoplasty. Curr Opin Ophthalmol 2001; 12(4): 262. 11. Trimarchi F, Poppi E and Klersy C. Deep lamellar keratoplasty. J Fr Ophthalmol 2002; 25(7): 718. 12. Sugita J and Kondo J. Deep lamellar keratoplasty with complete removal of pathological stroma for vision improvement. Br J Ophthalmol 1997; 81(3): 184. 13. Krumeich J H and Daniel J. Live epikeratophakia and deep lamellar keratoplasty for I—III stage-specific surgical treatment of keratokonus.
As with experimental corneal grafts, there is a tendency to fibrin formation in the anterior chamber, sometimes of sufficient severity to require treatment with tPA. Fibrin deposition is the main inducer of anterior synechiae, which are also a major negative factor for graft survival, clinically and experimentally . Late spontaneous dehiscence may occur in about 7% of cases after removal of a continuous suture . 3 Suture-related complications. (A) Loose corneal sutures in a case of advanced corneal tissue melting associated with alkali burn.
The appearance of ciliary flush may precede infiltration of cells in the anterior chamber. 4A, B). 4 Acute rejection episode and chronic rejection-graft failure. (A, B) Acute corneal graft rejection associated with ciliary injection, keratic precipitates on donor endothelium and slightly oedematous corneal graft. (C) Opaque, failed corneal graft with 180° extent of neovascularization representing "high risk" recipient for a subsequent corneal grafting; note meiboinitis on upper eyelid. (D) Dense corneal leucoma after failed corneal transplantation with the impression of lOL beneath the failed graft.