Effect of Descemet Membrane Endothelial Keratoplasty Graft Storage Time on Graft Elasticity

imagePurpose:

The purpose of this study was to evaluate the effect of Descemet membrane endothelial keratoplasty (DMEK) graft storage time on its elastic properties, measured using atomic force microscopy (AFM).

Methods:

Twenty human corneas (from 10 donors), unsuitable for transplantation, were obtained from the eye bank (S. Fyodorov Eye Microsurgery State Institution, Moscow). Ten DMEK grafts were prepared and stored in the corneal storage medium, Optisol-GS at 4°C after preparation, and AFM analysis was performed within 12 hours after preparation (group A). Ten paired corneas from the respective donors were stored in Optisol-GS at 4°C for 1 week after preparation before AFM analysis (group B). Data were analyzed using the Hertz model for the evaluation of the Young modulus of elasticity.

Results:

Force–distance curve analysis showed an increase in the Young modulus of elasticity in group B in comparison with that in group A, and the mean values were 10.4 ± 1.8 kPa and 6.77 ± 2.25 kPa, respectively (P

Opioid Prescribing Patterns for Ulcerative Keratitis

imagePurpose:

The purpose of this study was to characterize rates of opioid prescription for different ulcerative keratitis types.

Methods:

This cohort study included patients diagnosed with ulcerative keratitis according to the University of Michigan electronic health record data between September 1, 2014 and December 22, 2020. Ulcerative keratitis was categorized by etiologic type (bacterial, fungal, viral, acanthamoeba, inflammatory, polymicrobial, or unspecified) using rule-based data classification that accounted for billing diagnosis code, antimicrobial or antiinflammatory medications prescribed, laboratory results, and manual chart review. Opioid prescriptions were converted to morphine milligram equivalent and summed over 90 days from diagnosis. Opioid prescription rate and amount were compared between ulcerative keratitis types.

Results:

Of 3322 patients with ulcerative keratitis, 173 (5.2%) were prescribed at least 1 opioid for pain management within 90 days of diagnosis. More patients with acanthamoeba (32.4%), fungal (21.1%), and polymicrobial (25.0%) keratitis were treated with opioids compared with bacterial (6.7%), unspecified (2.9%), or viral (1.8%) keratitis (all Bonferroni adjusted P