Eccentric lamellar keratolimbal grafts harvested with a manually guided microkeratome

Background: To perform lamellar keratolimbal allograft transplantation in a one- step procedure with a single graft, we investigated the feasibility of harvesting eccentric lamellar keratolimbal grafts from conventionally processed corneoscleral buttons using a manually guided microkeratome in conjunction with an artificial anterior chamber system. Methods: We used the Moria LSK- One microkeratome and the automated lamellar therapeutic keratoplasty ( ALTK) system ( Antony, France). Ten human donor eyes were used to obtain single- piece lamellar keratolimbal grafts. Specimens were processed for light and electron microscopy. Results: Eccentric keratolimbal grafts could be obtained from all human donor buttons. Grafts include a crescent- shaped limbal and a large corneal portion. No visible damage to the limbal region was discernible. Conclusion: Our data show that the LSK- One microkeratome in conjunction with the ALTK system allows harvesting eccentric keratolimbal grafts from donor corneoscleral buttons. Copyright (c) 2007 S. Karger AG, Basel

Lens stem cells may reside outside the lens capsule: an hypothesis

In this paper, we consider the ocular lens in the context of contemporary developments in biological ideas. We attempt to reconcile lens biology with stem cell concepts and a dearth of lens tumors

Comparison of Conjunctival Autografts, Amniotic Membrane Grafts, and Primary Closure for Pterygium Excision

Objectives: The purpose of the study is to determine whether amniotic membrane can be used as an alternative to conjunctival autograft after pterygium excision.Design: A prospective study of amniotic membrane grafts (group A) and primary closure (group B) was compared retrospectively with conjunctival autografts (group C) in patients with pterygia.Participants: Group A included 46 eyes with primary pterygia and 8 eyes with recurrent pterygia, group B had 20 eyes with primary pterygia, and group C consisted of 78 eyes with primary and 44 eyes with recurrent pterygia.Intervention: For the above three different surgeries, the amount of tissue removed was estimated from histopathologic analysis, and the result was evaluated by clinical examination.Main Outcome Measures: Recurrence, survival analysis, and final appearance were compared.Results: In group A, the recurrence rate was 10.9%, 37.5%, and 14.8% for primary, recurrent, and all pterygia, respectively (mean follow-up, II months), These three rates were significantly higher than 2.6%, 9.1%, and 4.9% noted in group C (mean follow-up, 23 months) (P < 0.001, 0.018, and 0.01, respectively). However, the latter recurrence rate was significantly lower than 45% (mean follow-up, 5.2 months) in group B for primary pterygia (P < 0.001), The onset of recurrence was delayed significantly in group C as compared with that of groups A and B.Conclusions: The relatively low recurrence rate for primary pterygia allows one to use amniotic membrane transplantation as an alternative first choice, especially for advanced cases with bilateral heads or those who might need glaucoma surgery later