A 47-year-old woman with a history of pellucid marginal degeneration was referred for management of hydrops and peripheral perforation of the right cornea. The initial management with cyanoacrylate tissue adhesive and...A 47-year-old woman with a history of pellucid marginal degeneration was referred for management of hydrops and peripheral perforation of the right cornea. The initial management with cyanoacrylate tissue adhesive and bandage contact lens did not preclude aqueous leakage the next day. Amniotic membrane grafting using both a surgical graft and a bandage patch was thus performed in the operating room the following day. There was no aqueous leakage on the first post-operative day. The corneal integrity was restored with resolution of the corneal edema;and the visual acuity improved from 20/400 before surgery to 20/40 three months later. This case illustrates the clinical efficacy of amniotic membrane grafting as an effective alternative in the management of spontaneous corneal perforation resulted from pellucid marginal degeneration.展开更多
Dear Sir, I am Dr Yan-Long Bi, from the Department of Ophthalmology, Tongji University Affiliated to Tongji University School of Medicine, Shanghai, China. I write to present a case report of total limbal stem cells d...Dear Sir, I am Dr Yan-Long Bi, from the Department of Ophthalmology, Tongji University Affiliated to Tongji University School of Medicine, Shanghai, China. I write to present a case report of total limbal stem cells deficiency after treatment with ring-shaped lamellar keratoplasty secondary to Terrien marginal degeneration. During 3 years展开更多
Purpose: To treat the Terrien marginal degeneration using lamellar keratoplasty with dried corneosclera and evaluate the clinical effect of this operation.Methods: The study included 78 cases with Terrien marginal deg...Purpose: To treat the Terrien marginal degeneration using lamellar keratoplasty with dried corneosclera and evaluate the clinical effect of this operation.Methods: The study included 78 cases with Terrien marginal degeneration who underwent the lamellar keratoplasty with dried corneosclera. Among them, 48 cases in experiment Ⅰ group and 30 cases in experiment Ⅱ group underwent lamellar keratoplasty with glycerin-preserved corneosclera and anhydrous calcium chloride-storeded corneosclera respectively. All the patients were followed-up from 6 months to 10 years. The control group consisted of 38 cases with Terrien marginal degeneration electively undergoing lamellar keratoplasty with fresh corneosclera simultaneously.Results: The area of the corneal thinning was mended and the eyeball was saved. The corneal astigmatism of the patients was corrected obviously.The patient’s vision was improved significantly. No recurrence and rejection were observed after the operation.There is no significant difference between the experiment group (experiment Ⅰ group or experiment Ⅱ group) and control group. (P > 0.05), despite longer duration of postoperative corneal edema in experiment group.Conclusions: The lamellar keratoplasty with dried corneosclera for treatment of Terrien marginal degeneration is a safe and effective operation. It is an alternative to lamellar keratoplasty with fresh corneosclera for treatment of Terrien marginal degeneration. It is suitable to be popularized in the local hospital of our country.展开更多
Objective： To evaluate the clinical efficacy of peripheral deep anterior lamellar keratoplasty （DALK） using a cryopreserved donor cornea for Terrien＇s marginal degeneration （TMD）. Methods： Thirty-one eyes of 27...Objective： To evaluate the clinical efficacy of peripheral deep anterior lamellar keratoplasty （DALK） using a cryopreserved donor cornea for Terrien＇s marginal degeneration （TMD）. Methods： Thirty-one eyes of 27 patients with TMD underwent peripheral DALK using cryopreserved donor corneas, According to the distance between the inner edge of the lesion and the limbus, a ring-shaped or D-shaped DALK was performed. All grafts were stored at -20 ℃. Cryopreserved comeoscleral rims were prepared for ring-shaped grafts and cryopreserved whole eyeballs were prepared for D-shaped grafts. The general conditions, intraoperative performance, postoperative corneal reconstruc- tion, astigmatism, best corrected visual acuity （BCVA）, and various complications were analyzed. Results： Ring-shaped DALK was performed in 28 eyes and D-shaped DALK was performed in 3 eyes. Postoperative follow-up time was （28.4±24.8） months. There was evidence of inflammation before surgery in 12 eyes （38.7%） and intraoper- ative perforation occurred in 13 eyes （41.9%）. The corneal structures of all eyes were reconstructed. Postoperative astigmatism and BCVA showed improvement （both P=0.00） except for cases that underwent D-shaped DALK. Ten eyes （32.2%） developed transient ocular hypertension and one eye （3.2%） developed secondary glaucoma. No pri- mary disease recurrence or corneal allograft rejection was observed. Conclusions： Peripheral DALK for TMD using cryopreserved donor tissue is an effective technique that eliminates rejection and extends the use of donor eyes. Inflammatory history or intraoperative perforation has no adverse effect on graft recovery. However, D-shaped DALK did not achieve good visual outcomes.展开更多
<strong>Purpose:</strong> To determine the diagnostic value of the anterior segment optical coherence tomography (AS-OCT) indices in differentiating normal from ectatic corneas. <strong>Material and ...<strong>Purpose:</strong> To determine the diagnostic value of the anterior segment optical coherence tomography (AS-OCT) indices in differentiating normal from ectatic corneas. <strong>Material and Methods:</strong> Two groups of patients—with corneal ectasia and normal controls were compared. Each group consists of 80 eyes of 43 age and sex-matched patients. All of them underwent corneal topography with OCULUS Keratograph 5M and corneal pachymetry with AS-OCT with RTVue-100. The indices generated by the AS-OCT pachymetric scans were analyzed. <strong>Results:</strong> There was a statistically significant difference for all the examined indices between the two groups with p values <0.001 and a confidence interval of 95%. The minimal corneal thickness (Min) was the best performing index according to the ROC analysis with an area under the curve of 0.976 and a combination of sensitivity and specificity of 0.925 and 0.911 respectively, and a “cut-off” value of 484 microns, followed by the indices of focal thinning—Min-Med and Min-Max with an area under the curve of 0.973 and 0.971 and sensitivity/specificity of 0.938/0.962 and 0.938/0.937 respectively. The rest of the examined parameters had an area under the curve in the range between 0.950 for the central corneal thickness and 0.814 for the outer superior segment. <strong>Conclusion:</strong> The anterior segment OCT indices showed excellent capability in differentiating ectatic from normal corneas.展开更多
We describe all degenerations of the variety ■3 of Jordan algebras of dimension three over C.In particular,we describe all irreducible components in ■3.For every n we define an n-dimensional rigid“marginal”Jordan ...We describe all degenerations of the variety ■3 of Jordan algebras of dimension three over C.In particular,we describe all irreducible components in ■3.For every n we define an n-dimensional rigid“marginal”Jordan algebra of level one.Moreover,we discuss marginal algebras in associative,alternative,left alternative,non-commutative Jordan,Leibniz and anticommutative cases.展开更多
文摘A 47-year-old woman with a history of pellucid marginal degeneration was referred for management of hydrops and peripheral perforation of the right cornea. The initial management with cyanoacrylate tissue adhesive and bandage contact lens did not preclude aqueous leakage the next day. Amniotic membrane grafting using both a surgical graft and a bandage patch was thus performed in the operating room the following day. There was no aqueous leakage on the first post-operative day. The corneal integrity was restored with resolution of the corneal edema;and the visual acuity improved from 20/400 before surgery to 20/40 three months later. This case illustrates the clinical efficacy of amniotic membrane grafting as an effective alternative in the management of spontaneous corneal perforation resulted from pellucid marginal degeneration.
基金National Natural Science Foundation of China (No. 30973247)Shanghai Excellent University Teacher Foundation, China (No. 1500144019)
文摘Dear Sir, I am Dr Yan-Long Bi, from the Department of Ophthalmology, Tongji University Affiliated to Tongji University School of Medicine, Shanghai, China. I write to present a case report of total limbal stem cells deficiency after treatment with ring-shaped lamellar keratoplasty secondary to Terrien marginal degeneration. During 3 years
文摘Purpose: To treat the Terrien marginal degeneration using lamellar keratoplasty with dried corneosclera and evaluate the clinical effect of this operation.Methods: The study included 78 cases with Terrien marginal degeneration who underwent the lamellar keratoplasty with dried corneosclera. Among them, 48 cases in experiment Ⅰ group and 30 cases in experiment Ⅱ group underwent lamellar keratoplasty with glycerin-preserved corneosclera and anhydrous calcium chloride-storeded corneosclera respectively. All the patients were followed-up from 6 months to 10 years. The control group consisted of 38 cases with Terrien marginal degeneration electively undergoing lamellar keratoplasty with fresh corneosclera simultaneously.Results: The area of the corneal thinning was mended and the eyeball was saved. The corneal astigmatism of the patients was corrected obviously.The patient’s vision was improved significantly. No recurrence and rejection were observed after the operation.There is no significant difference between the experiment group (experiment Ⅰ group or experiment Ⅱ group) and control group. (P > 0.05), despite longer duration of postoperative corneal edema in experiment group.Conclusions: The lamellar keratoplasty with dried corneosclera for treatment of Terrien marginal degeneration is a safe and effective operation. It is an alternative to lamellar keratoplasty with fresh corneosclera for treatment of Terrien marginal degeneration. It is suitable to be popularized in the local hospital of our country.
基金Project supported by the Major Program for Science and Technology Research of Zhejiang Province(No.2011C13029-2)the Medical Scientific Research Foundation of Zhejiang Province(Nos2012ZDA026 and 2013ZDA012),China
文摘Objective： To evaluate the clinical efficacy of peripheral deep anterior lamellar keratoplasty （DALK） using a cryopreserved donor cornea for Terrien＇s marginal degeneration （TMD）. Methods： Thirty-one eyes of 27 patients with TMD underwent peripheral DALK using cryopreserved donor corneas, According to the distance between the inner edge of the lesion and the limbus, a ring-shaped or D-shaped DALK was performed. All grafts were stored at -20 ℃. Cryopreserved comeoscleral rims were prepared for ring-shaped grafts and cryopreserved whole eyeballs were prepared for D-shaped grafts. The general conditions, intraoperative performance, postoperative corneal reconstruc- tion, astigmatism, best corrected visual acuity （BCVA）, and various complications were analyzed. Results： Ring-shaped DALK was performed in 28 eyes and D-shaped DALK was performed in 3 eyes. Postoperative follow-up time was （28.4±24.8） months. There was evidence of inflammation before surgery in 12 eyes （38.7%） and intraoper- ative perforation occurred in 13 eyes （41.9%）. The corneal structures of all eyes were reconstructed. Postoperative astigmatism and BCVA showed improvement （both P=0.00） except for cases that underwent D-shaped DALK. Ten eyes （32.2%） developed transient ocular hypertension and one eye （3.2%） developed secondary glaucoma. No pri- mary disease recurrence or corneal allograft rejection was observed. Conclusions： Peripheral DALK for TMD using cryopreserved donor tissue is an effective technique that eliminates rejection and extends the use of donor eyes. Inflammatory history or intraoperative perforation has no adverse effect on graft recovery. However, D-shaped DALK did not achieve good visual outcomes.
文摘<strong>Purpose:</strong> To determine the diagnostic value of the anterior segment optical coherence tomography (AS-OCT) indices in differentiating normal from ectatic corneas. <strong>Material and Methods:</strong> Two groups of patients—with corneal ectasia and normal controls were compared. Each group consists of 80 eyes of 43 age and sex-matched patients. All of them underwent corneal topography with OCULUS Keratograph 5M and corneal pachymetry with AS-OCT with RTVue-100. The indices generated by the AS-OCT pachymetric scans were analyzed. <strong>Results:</strong> There was a statistically significant difference for all the examined indices between the two groups with p values <0.001 and a confidence interval of 95%. The minimal corneal thickness (Min) was the best performing index according to the ROC analysis with an area under the curve of 0.976 and a combination of sensitivity and specificity of 0.925 and 0.911 respectively, and a “cut-off” value of 484 microns, followed by the indices of focal thinning—Min-Med and Min-Max with an area under the curve of 0.973 and 0.971 and sensitivity/specificity of 0.938/0.962 and 0.938/0.937 respectively. The rest of the examined parameters had an area under the curve in the range between 0.950 for the central corneal thickness and 0.814 for the outer superior segment. <strong>Conclusion:</strong> The anterior segment OCT indices showed excellent capability in differentiating ectatic from normal corneas.
基金supported by FAPESP(16/16445-0,18/15712-0),RFBR(18-31-00001)the President's Program Support of Young Russian Scientists(grant MK-2262.2019.1).
文摘We describe all degenerations of the variety ■3 of Jordan algebras of dimension three over C.In particular,we describe all irreducible components in ■3.For every n we define an n-dimensional rigid“marginal”Jordan algebra of level one.Moreover,we discuss marginal algebras in associative,alternative,left alternative,non-commutative Jordan,Leibniz and anticommutative cases.
