Descemetorhexis Without Endothelial Keratoplasty in Fuchs Endothelial Corneal Dystrophy: A Systematic Review and Meta-Analysis

imagePurpose:

Descemetorhexis without endothelial keratoplasty (DWEK) is an innovative corneal intervention and potentially effective against Fuchs endothelial corneal dystrophy (FECD). We aimed to conduct a systematic review and meta-analysis on the outcomes of DWEK, associated or not with phacoemulsification (PKE) and rho-kinase inhibitor (RHOKI) in FECD.

Method:

PubMed, Cochrane Library, Embase, ClinicalTrials.gov, and Science Direct were searched for studies until November 29, 2020. We performed random-effects meta-analyses and meta-regressions, stratified by the type of intervention and descemetorhexis size (PROSPERO CRD42020167566).

Results:

We included 11 articles (mainly case series, both prospective and retrospective), representing 127 eyes of 118 patients. DWEK globally improved visual acuity (effect size = −1.11, 95% confidence interval, −1.70 to −0.52, P 4 mm did not. Overall, DWEK failure (ie, the prevalence of EK after DWEK) was 17% (7%–27%, P

Trends in Corneal Transplantation in a Tertiary Hospital in Brazil

imagePurpose:

The purpose of this study was to analyze the evolving trends of surgical techniques and indications of corneal transplantation (CT) at a tertiary hospital in Brazil.

Methods:

The medical records of all patients who underwent CT at the Hospital Oftalmológico de Sorocaba (Sorocaba Eye Hospital) from the Banco de Olhos de Sorocaba (Sorocaba Eye Bank) group in Sorocaba, Brazil, from January 1, 2012, to December 31, 2019, were analyzed. Data regarding age, sex, transplant indication, and surgical technique were collected.

Results:

A total of 16,250 CTs were performed. There was a statistically significant decreasing trend of keratoconus-related CT (P

Ultrasound-Enhanced Transcorneal Drug Delivery for Treatment of Fungal Keratitis

imagePurpose:

Transcorneal drug delivery is hindered by ocular physical and biochemical properties, such as tear production, the epithelial layer of the cornea, and blinking. The aim of this study was to determine whether ultrasound can be applied to increase the transcorneal drug delivery of natamycin used in the treatment of fungal keratitis without dangerously overheating the surrounding ocular tissues.

Methods:

To verify the safety of various sets of ultrasound parameters, modeling studies were conducted using OnScale, an ultrasonic wave modeling software. Ultrasound parameters determined optimal for ocular tissue safety were used in a laboratory setting in a jacketed Franz diffusion cell setup. Histological images of the cross-section of the corneas used in experiments were examined for cell damage under a microscope.

Results:

Increases in transcorneal drug delivery were seen in every treatment parameter combination when compared with the sham treatment. The highest increase was 4.0 times for 5 minutes of pulsed ultrasound at a 25% duty cycle and a frequency of 400 kHz and an intensity of 0.5 W/cm2 with statistical significance (P