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Corneal Diseases: Diagnosis, Management and Treatment
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Corneal Diseases: Diagnosis, Management and Treatment

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Ophthalmology".

Deadline for manuscript submissions: closed (15 January 2024) | Viewed by 11365

Special Issue Editors

Dr. Cristina Bovone

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Guest Editor
1. Department of Environmental Sciences and Prevention, University of Ferrara, Ferrara, Italy
2. Department of Ophthalmology, Ospedali Privati Forlì "Villa Igea", Forlì, Italy
Interests: cornea; ophthalmology; keratoplasty; anterior segment surgery
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Giuseppe Giannaccare

E-Mail Website
Guest Editor
Department of Ophthalmology, University Magna Gaecia of Catanzaro, Catanzaro, Italy
Interests: cornea; ocular surface disease; clinical ophthalmology; glaucoma; dry eye
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Massimo Busin

E-Mail Website
Guest Editor
1. Department of Ophthalmology, Ospedali Privati Forlì “Villa Igea”, Forlì, Italy
2. Department of Translational Medicine, University of Ferrara, Ferrara, Italy
Interests: corneal topography; cornea; hydroxyapatites; keratoconus; cataract surgery; glaucoma; phacoemulsification; cataract; anterior eye segment; pediatric ophthalmology

Special Issue Information

Dear Colleagues,

This Special Issue represents an opportunity for ophthalmologists to publish their innovative works focused on the diagnosis and management of corneal diseases, including corneal infection, corneal dystrophy, dry eye, ocular surface diseases, corneal ulcer, corneal transplantations, keratoconus, among others. Potential areas of interest include, but are not limited to, the following: high-tech diagnosis, disease biomarkers, machine learning and artificial intelligence, novel drugs/devices, surgical interventions. We invite you to submit your work for consideration in this Special Issue entitled “Corneal Diseases: Diagnosis, Management and Treatment". Original research articles (clinical or basic science research), reviews, short communications and interesting images are welcome. All papers will be fully open access upon publication after peer review.

Dr. Cristina Bovone
Prof. Dr. Giuseppe Giannaccare
Prof. Dr. Massimo Busin
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • keratoplasty
  • dry eye
  • keratoconus
  • ocular surface disease
  • corneal ulcer

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Published Papers (5 papers)

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Research

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9 pages, 933 KiB  
Article
Ex Vivo Histological Analysis of Corneas with Manually Implanted Intracorneal Stromal Ring Segments
by Noa Kapelushnik, Liliana Werner, Nadav Levinger, Samuel Levinger and Irina S. Barequet
J. Clin. Med. 2024, 13(11), 3350; https://doi.org/10.3390/jcm13113350 - 6 Jun 2024
Viewed by 649
Abstract
Backgrond: Intracorneal ring segments (ICRSs) are utilized to correct refractive changes impacting visual acuity, commonly implanted via femtosecond laser but can also inserted manually. Corneal deposits alongside the ICRS channels are seen commonly. Methods: This study explores the histological characteristics of corneal deposits [...] Read more.
Backgrond: Intracorneal ring segments (ICRSs) are utilized to correct refractive changes impacting visual acuity, commonly implanted via femtosecond laser but can also inserted manually. Corneal deposits alongside the ICRS channels are seen commonly. Methods: This study explores the histological characteristics of corneal deposits following manual ICRS implantation, comparing them to previously published articles describing femtosecond laser-assisted cases. Results: This is a retrospective analysis of three cases involving manual ICRS implantation, accumulation of whitish deposits and later explanation of the corneas due to penetrating keratoplasty (PKP). Patient demographics, ocular history, and surgical details were collected. Histological analysis employed Hematoxylin and Eosin (H&E) and Masson’s trichrome staining. Whitish deposits along ICRS tracts were observed in all cases, with minimal fibroblastic transformation of keratocytes adjacent to the segments. Comparing these cases of manual to femtosecond laser-assisted ICRS implantation, in most cases, similar deposits were identified, indicating the deposits’ association with the stromal tissue reaction to the ring segment and not to the surgical technique. Conclusions: This study contributes insights into the histopathology of manually implanted ICRS, emphasizing the shared nature of deposits in both insertion methods. The findings highlight the link between deposits and the stromal tissue reaction to the ring segment, irrespective of the insertion technique. Full article
(This article belongs to the Special Issue Corneal Diseases: Diagnosis, Management and Treatment)
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9 pages, 1176 KiB  
Article
Intraoperative Assessment of the Stromal Ablation in Photorefractive Keratectomy
by Dana Barequet, Eliya Levinger, Nadav Levinger, Samuel Levinger and Irina S. Barequet
J. Clin. Med. 2024, 13(7), 1901; https://doi.org/10.3390/jcm13071901 - 25 Mar 2024
Viewed by 746
Abstract
Purpose: To evaluate the difference between planned and measured central ablation depth (CAD) and compare the first and second operated eye in simultaneous bilateral myopic alcohol-assisted PRK. Methods: A retrospective review of patients was performed. Demographic and preoperative data was abstracted. Intraoperative assessment [...] Read more.
Purpose: To evaluate the difference between planned and measured central ablation depth (CAD) and compare the first and second operated eye in simultaneous bilateral myopic alcohol-assisted PRK. Methods: A retrospective review of patients was performed. Demographic and preoperative data was abstracted. Intraoperative assessment included environmental data, laser-planned algorithm of ablation (L-CAD), and optical coherence pachymetry (OCP) measurements. The true stromal ablation depth (O-CAD) was calculated by subtracting the immediate post-ablation OCP measurement from the OCP measurement before laser ablation. Deviation in pachymetry (DP) between O-CAD and L-CAD was also assessed. Results: The study comprised 140 eyes from 70 consecutive patients. The mean age was 26.91 ± 6.52 years, and 57.1% were females. O-CAD was significantly correlated to preoperative refractive errors and intraoperative laser settings. DP was not correlated to any of the pre- or intraoperative parameters. L-CAD showed a significant underestimation as compared to O-CAD (67.87 ± 25.42 µm and 77.05 ± 30.79 µm, respectively, p < 0.001), which was shown in 74.3% of the cases. A moderate agreement between the two methods was noted, with a mean deviation of 17%. This difference was maintained for each eye individually (p < 0.001). In addition, DP was significantly higher in the first operated eye as compared to the second operated eye (11.97 ± 16.3 µm and 6.38 ± 19.3 µm respectively, p = 0.04). Conclusion: The intraoperative assessment of stromal ablation showed significantly higher central ablation depth values compared to the laser-planned ablation algorithm. The deviation in pachymetry was higher in the first, compared to the second, operated eye. Awareness is warranted as to the discrepancy between preoperative planning and intraoperative assessment. Full article
(This article belongs to the Special Issue Corneal Diseases: Diagnosis, Management and Treatment)
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8 pages, 243 KiB  
Article
Dry Eye Disease following LASIK, PRK, and LASEK: An Observational Cross-Sectional Study
by Tal Yahalomi, Asaf Achiron, Roee Arnon, Nir Stanescu and Joseph Pikkel
J. Clin. Med. 2023, 12(11), 3761; https://doi.org/10.3390/jcm12113761 - 30 May 2023
Cited by 3 | Viewed by 2949
Abstract
Dry eye disease is the most frequent non-refractive postoperative complication following refractive surgery. This prospective study investigated the development of dry eye disease after three common refractive laser surgeries: laser in situ keratomileusis (LASIK), photorefractive keratectomy (PRK), and laser-assisted sub-epithelial keratectomy (LASEK). Patients [...] Read more.
Dry eye disease is the most frequent non-refractive postoperative complication following refractive surgery. This prospective study investigated the development of dry eye disease after three common refractive laser surgeries: laser in situ keratomileusis (LASIK), photorefractive keratectomy (PRK), and laser-assisted sub-epithelial keratectomy (LASEK). Patients who underwent uneventful refractive surgery in a single private medical center between May 2017 and September 2020 were included. Ocular surface disease was graded according to the Dry Eye Workshop severity (DEWS) classification. Patients were examined 6 months following refractive surgery. The analysis included 251 eyes of 137 patients: 64 eyes (36 patients) after LASEK, 90 eyes (48 patients) after PRK, and 97 eyes (53 patients) after LASIK. At 6 months post-surgery, the DEWS score was higher for the LASIK than the PRK and LASEK groups (p = 0.01). For the total cohort, severe DEWS score (grades 3 and 4) at 6 months post-surgery was correlated with female gender (p = 0.01) and to the amount of refractive correction (p < 0.001), but not to age (p = 0.87). In conclusion, LASIK surgery and female gender were associated with dry eye. Patients, particularly those with high myopia, should be counseled about the risk of developing dry eye after refractive surgeries. Full article
(This article belongs to the Special Issue Corneal Diseases: Diagnosis, Management and Treatment)

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17 pages, 628 KiB  
Systematic Review
Corneal Edema after Cataract Surgery
by Celeste Briceno-Lopez, Neus Burguera-Giménez, M. Carmen García-Domene, M. Amparo Díez-Ajenjo, Cristina Peris-Martínez and M. José Luque
J. Clin. Med. 2023, 12(21), 6751; https://doi.org/10.3390/jcm12216751 - 25 Oct 2023
Cited by 8 | Viewed by 4946
Abstract
This systematic review investigates the prevalence and underlying causes of corneal edema following cataract surgery employing manual phacoemulsification. A comprehensive search encompassing databases such as PubMed, Embase, ProQuest, Cochrane Library, and Scopus was conducted, focusing on variables encompassing cataract surgery and corneal edema. [...] Read more.
This systematic review investigates the prevalence and underlying causes of corneal edema following cataract surgery employing manual phacoemulsification. A comprehensive search encompassing databases such as PubMed, Embase, ProQuest, Cochrane Library, and Scopus was conducted, focusing on variables encompassing cataract surgery and corneal edema. Two independent reviewers systematically extracted pertinent data from 103 articles, consisting of 62 theoretical studies and 41 clinical trials. These studies delved into various aspects related to corneal edema after cataract surgery, including endothelial cell loss, pachymetry measurements, visual performance, surgical techniques, supplies, medications, and assessments of endothelial and epithelial barriers. This review, encompassing an extensive analysis of 3060 records, revealed significant correlations between corneal edema and endothelial cell loss during phacoemulsification surgery. Factors such as patient age, cataract grade, and mechanical stress were identified as contributors to endothelial cell loss. Furthermore, pachymetry and optical coherence tomography emerged as valuable diagnostic tools for assessing corneal edema. In conclusion, this systematic review underscores the link between corneal edema and endothelial cell loss in manual phacoemulsification cataract surgery. It highlights the relevance of factors like patient demographics and diagnostic modalities. However, further research is essential to unravel the complexities of refractive changes and the underlying mechanisms. Full article
(This article belongs to the Special Issue Corneal Diseases: Diagnosis, Management and Treatment)
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6 pages, 1026 KiB  
Case Report
Microsporidial Stromal Keratitis in Post-Keratoplasty Eyes
by Rossella Spena, Cristina Bovone, Nicolò Ciarmatori, Marco Pellegrini, Angeli Christy Yu, Giorgio Zauli and Massimo Busin
J. Clin. Med. 2023, 12(11), 3706; https://doi.org/10.3390/jcm12113706 - 27 May 2023
Viewed by 1518
Abstract
Purpose: The purpose of this paper is to report the clinical manifestations, diagnostic evaluation, management and outcomes of microsporidial keratitis in post-keratoplasty eyes. Methods: This is a retrospective review of three patients diagnosed with microsporidial stromal keratitis in post-keratoplasty eyes between January 2012 [...] Read more.
Purpose: The purpose of this paper is to report the clinical manifestations, diagnostic evaluation, management and outcomes of microsporidial keratitis in post-keratoplasty eyes. Methods: This is a retrospective review of three patients diagnosed with microsporidial stromal keratitis in post-keratoplasty eyes between January 2012 and December 2021 at a tertiary referral center (Ospedali Privati Forlì “Villa Igea”, Forlì, Italy). Results: All patients presented with fine multifocal granular infiltrates following keratoplasty for a presumed herpetic keratitis. No microorganisms were isolated from the corneal scrapings and no clinical response was observed with broad-spectrum antimicrobial therapy. In all cases, confocal microscopy demonstrated spore-like structures. The histopathologic examination of the excised corneal buttons confirmed the diagnosis of microsporidial stromal keratitis. Following therapeutic keratoplasty and treatment with an initial high dose and extended taper of topical fumagillin, clinical resolution was achieved in all eyes. The Snellen visual acuities at the final follow-up were 20/50, 20/63 and 20/32. Conclusions: Prior to definitive surgery, confocal microscopy can be employed for the in vivo detection of pathogenic microorganisms such as Microsporidium. In post-keratoplasty eyes, therapeutic keratoplasty and an initial high dose of topical fumagillin with extended taper can allow the resolution of microsporidial stromal keratitis with a satisfactory visual prognosis. Full article
(This article belongs to the Special Issue Corneal Diseases: Diagnosis, Management and Treatment)
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