To study corneal lymphangiogenesis after corneal transplantation, corneal allogenic transplantation models were established in rats. 8 female Wister rats were used as donors, and 16 Sprague Dawley (SD) rats were used as recipients and 2 SD served as controls. Corneal lymphangiogenesis and hemangiogenesis was examined by electron microscopy 1 and 2 weeks after corneal penetrating transplantation, and the expression of lymphatic vessel endothelial receptor (LYVE-1) was examined 1, 3, 7, 14 days after the transplantation respectively. In addition, 19 allograft failed human corneas were examined by 5'-nase-alkaline phosphatase (5'-NA-ALP) double-enzyme-histochemistry staining to detect corneal lymphangiogenesis and hemangiogenesis. By immunohistochemistry for LYVE-1, it was found that blown lymphatics were localized in the stroma 3 days after the corneal transplantation. With electron microscopy, new lymphatic vessels and blood vessels were found 1 and 2 weeks after the corneal transplantation. By 5'-NA-ALP enzyme-histochemistry, corneal hemangiogenesis was found in all allograft failed human corneas and 5 of 19 (26.3 %) cases had developed corneal lymphangiogenesis. It is concluded that corneal lymphangiogenesis is present after corneal transplantation, which may play an important role in allograft rejection.
Cornea/*blood supply ; Cornea/chemistry ; Cornea/ultrastructure ; Corneal Neovascularization/etiology ; Corneal Neovascularization/metabolism ; Corneal Transplantation/adverse effects ; Corneal Transplantation/*methods ; Immunohistochemistry ; Lymphangiogenesis ; Microscopy, Electron ; Rats, Sprague-Dawley ; Rats, Wistar ; Vesicular Transport Proteins/biosynthesis

BACKGROUNDSmall incision refractive lenticule extraction (SMILE) is an effective laser procedure that treats myopia. This research was to describe a novel approach to treat corneal ulcer or perforation using the corneal lenticules obtained from SMILE and to evaluate the safety and effectiveness of tectonic keratoplasty with femtosecond laser intrastromal lenticule (TEKIL).

METHODSA total of twenty patients (22 eyes) were monitored for at least 6 months and were assessed using slit lamp microscopy, optical coherence tomography, and best-corrected visual acuity (BCVA). Postoperative complications throughout the study period were recorded.

RESULTSCorneal ulcer in 14 patients (16 eyes) and corneal perforation in six patients (6 eyes) were treated with TEKIL. The patients were ten females and ten males, with a mean age of 58.5 ± 16.3 years (range: 16-81 years). In this study, the most causes of corneal ulcer or perforation were immunologic causes (54.5%). After TEKIL procedure, global integrity was achieved in all cases. No immune rejection or perforation was detected. The mean BCVA improved from 0.17 ± 0.20 preoperatively to 0.27 ± 0.25 postoperatively at the final follow-up (t = 2.095, P = 0.052). The postoperative BCVA improved in 12 eyes (54.5%) and maintained in nine eyes (40.9%). Vision function successfully maintained in all eyes (100%). In three cases, corneal ulcers were treated by reoperation of TEKIL at 3 months after the initial surgery for the reason that the residual corneal thickness was <250 μm.

CONCLUSIONSTEKIL seems to be an effective treatment for corneal ulcer and perforation in the condition of emergency and donor shortage.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cornea ; surgery ; Corneal Perforation ; physiopathology ; surgery ; Corneal Transplantation ; adverse effects ; methods ; Corneal Ulcer ; physiopathology ; surgery ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications ; Retrospective Studies ; Tomography, Optical Coherence ; Visual Acuity ; physiology ; Young Adult

OBJECTIVETo study the inhibitory effect of Juhua Jueming powder (JJP) on high-risk corneal transplantation immune rejection in rats.

METHODSThe high-risk corneal transplantation immune rejection rat model was established by inducing corneal neoangiogenesis by suture method and the penetrating transplantation. Model rats were divided into two groups, the treated group and the control group, they were administered with JJP 0.1 g (dissolved in 2 mL water) and normal saline respectively via gastric infusion every day after transplantation. The survival status of the allograft, histopathology, local and systemic immune status in the recipients were observed using immunofluorescence histochemistry and flow cytometry.

RESULTSThe survival time of the allograft in the treated group (14.50 +/- 3.55 days) was significantly longer than that in the control group (8.25 +/- 0.71 days, P < 0.01). Levels of Fas, FasL expressions in iris were stronger, and the percentage of CD4 CD FOXP3 positive cells in peripheral blood was less (5.11 +/- 3. 92% vs. 14.81 +/- 2.58%) in the control group than those in the treated group respectively. The concentration of IL-2 was lower while that of IL-10 was higher in aqueous humor of the treated group than those of the control group, respectively.

CONCLUSIONJJP has certain effect for preventing high-risk corneal transplantation immune rejection in rat model.

Animals ; Corneal Transplantation ; adverse effects ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Graft Rejection ; prevention & control ; Phytotherapy ; Rats ; Rats, Inbred F344 ; Rats, Inbred Lew

We report four cases in which a pericardium (Tutoplast(R)) plug was used to repair a corneoscleral fistula after Ahmed Glaucoma Valve (AGV) explantation. In four cases in which the AGV tube had been exposed, AGV explantation was performed using a pericardium (Tutoplast(R)) plug to seal the defect previously occupied by the tube. After debridement of the fistula, a piece of processed pericardium (Tutoplast(R)), measured 1 mm in width, was plugged into the fistula and secured with two interrupted 10-0 nylon sutures. To control intraocular pressure, a new AGV was implanted elsewhere in case 1, phaco-trabeculectomy was performed concurrently in case 2, cyclophotocoagulation was performed postoperatively in case 3 and anti-glaucomatous medication was added in case 4. No complication related to the fistula developed at the latest follow-up (range: 12~26 months). The pericardium (Tutoplast(R)) plug seems to be an effective method in the repair of corneoscleral fistulas resulting from explantation of glaucoma drainage implants.
Adolescent ; Corneal Diseases/etiology/*surgery ; Device Removal/adverse effects ; Fistula/etiology/*surgery ; *Glaucoma Drainage Implants ; Glaucoma, Neovascular/*surgery ; Humans ; Intraocular Pressure ; Male ; Middle Aged ; Pericardium/*transplantation ; *Postoperative Complications ; Reoperation ; Scleral Diseases/etiology/*surgery ; Suture Techniques

OBJECTIVETo study the immunosuppressive effect of the interleukin-2-pseudomonas exotoxin 66(IL-2-PE66) on murine corneal allograft rejection.

METHODSThirty-six recipient female BALB/c mice received corneal allografts from C57BL/6 mice and were divided randomly into treatment and control groups. The condition of the grafts was observed twice a week. On days 10, 15, 25 and 35 after the transplantation, the operated eyes were removed for pathological examinations. Peripheral blood samples were also collected for analysis of T cell subsets and T lymphocyte colony forming unit (T-CFU) assay.

RESULTSThe survival time of corneal allograft averaged 15.8-/+2.1 days in the control group and 31.2-/+2.9 days in the treatment group. The CD(4)(+)/ CD(8)(+)/ of the T cell subsets 15 days after the operation was 1.26-/+0.23 in the treatment group and 2.01-/+0.23 in the control group, with T-CFU of 201-/+18.2 and 286-/+16.8, respectively.

CONCLUSIONIL-2-PE66 can delay the development of corneal graft rejection, significantly reduce the percentage of T helper cells, and weaken the aggregation of the peripheral T cells.

Animals ; Bacterial Proteins ; therapeutic use ; Corneal Transplantation ; adverse effects ; Cytotoxins ; therapeutic use ; Exotoxins ; therapeutic use ; Female ; Graft Rejection ; drug therapy ; Graft Survival ; drug effects ; Immunosuppressive Agents ; therapeutic use ; Interleukin-2 ; therapeutic use ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C57BL ; Random Allocation ; Recombinant Fusion Proteins ; therapeutic use