Cases Of Corneal Blindness Research Articles

Need for new corneal restoration technologies in a post‐COVID world

In most countries, the supply of corneal material do not meet the demands for corneal transplantation. This has been exacerbated by COVID‐19. Patients have not been seen during lockdown. Many are presenting late. There has been fewer operations done during the pandemic resulting in a backlog. Even in normal times, there are cases of corneal blindness not amenable to cadaveric corneal transplantation. The clinical and research community have two tasks. One is to develop artificial corneae or contructs through biotechnology to replace cadaveric transplantation. The other is to improve keratoprostheses which are used for vascularised corneae and multiple previous failed grafts (Boston KPro1 and similar) and for dry keratinised ocular surface (the OOKP and alternatives).

Microbiological profile of infective keratitis in a tertiary care hospital in north Karnataka

Corneal blindness is seen worldwide with 1.5 to 2 million new cases reported every year and approximately there are 6.8 million cases of corneal blindness in India. The study constituted 109 clinically diagnosed infective keratitis cases. Aseptically collected corneal scrapings are subjected to Gram stain, KOH wet mount & Culture. Further identification done by study of Colony morphology, staining & biochemical tests. Antibiotic sensitivity was found using Kirby buer’s disc diffusion method following CLSI guidelines. Males affected more common than females. Common age group being 21-40 yrs. Infective keratitis is usually Bacterial(61.4%) in origin than fungal(22%). Trauma found to be the most common predisposing factor followed by diabetes, other ocular diseases, surgery & corticosteroid therapy. Trauma with vegetative material is most common. Streptococcus pneumonia & pseudomonas are most common bacterial cause while Fusarium & Aspergillus cause most fungal cases. Infective keratitis both bacterial & fungal are more common in working males, mainly agriculturists who are exposed to vegetative trauma. Early detection and treatment with proper antibacterial & antifungals is important to prevent ocular problems and scarring of cornea.

A new vision through combined osteo-odonto-keratoplasty: A review

This is an extensive review of osteo-odonto-keratoplasty (OOKP) where the vision is restored by using tooth as an implant in the environment of the eye. The window of the soul is our eye and the window of the eye is cornea. This review article aims at discussing the remarkable operation to regain the sight of patients with corneal blindness. In this procedure where a multidisciplinary approach from both oral and maxillofacial surgeon and ophthalmologist contributes to restore vision in the most severe cases of corneal blindness. This involves removing a canine tooth from the patient, shaping and drilling to allow implantation of an artificial plastic corneal device and finally implanting back into the eye few months later. The OOKP, is the keratoprosthesis of choice for end-stage corneal blindness not amenable to penetrating keratoplasty. This transplantation procedure has an autologous dental root-bone lamina complex and buccal mucosal graft to secure the optical cylinder which acts as a ray of vision for corneal blindness. This review comprises the indications, contraindications, and patient assessment and the surgical procedure, complications ,surgical inter professionalism and future scope of OOKP. The source of data for the review has been Pubmed, Medline and all the research studies and published reports on osteo-odonto-keratoplasty. In this complex procedure good results can be obtained with modern technology and expertise.

Boston type I keratoprosthesis: Review

Regardless of significant progress in the field of corneal transplantation to treat corneal opacification, some cases of corneal blindness still present a poor prognosis for conventional penetrating keratoplasty. In patients with repeated graft failure and/or with severe ocular surface disease, the Boston type I keratoprosthesis (type I BKPro) has become a viable option. Modifications in its design and postoperative management have improved the long-term outcomes of visual acuity, retention, and postoperative infection rates. These advances made the type I BKPro be considered a safe alternative for visual rehabilitation in many patients with corneal pathologies. However, postoperative handle of chronic comorbidities, such as glaucoma, is still critical for preserving the visual gains achieved with BKPro.

The role of the limbal cornea in vision.

The eagle retina is bifoveal. The temporal fovea, which can resolve targets subtending half a minute or less must depend upon its peripheral cornea for such sharp resolution. Our studies showed the eagle cornea to be thinner, scatter less light and be more spherical than the human cornea. Further experimental studies determined the resolving power of the human peripheral cornea. Using, normal subjects, pinholes placed at the edge 8 mm dilated pupils yielded 20/30 visual acuity and normal contrast sensitivity measurements. Thus it is recommended that optical iridectomy be considered, in appropriate cases of corneal blindness with patches of clear peripheral cornea when no donor corneal material is available.