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At least 19 recordsLinked to original sources

Corneal asphericity in eye bank eyes implanted with the intrastromal corneal ring.

OBJECTIVE: To evaluate the effects of the intrastromal corneal ring, a device developed to reduce myopia, on corneal asphericity in a large set of eye bank eyes. METHODS: Forty-one deturgesced eye bank eyes were implanted with intrastromal corneal rings of five different thicknesses, ranging from 0.25 mm to 0.45 mm. Corneal asphericity, before and after implantation, was examined using two different metrologies. Corneal asphericity profiles were produced from dioptric power data collected from videokeratography. To statistically assess the corneal asphericity differences between exam times for each intrastromal corneal ring thickness, dependent sample confidence intervals (95%) were calculated for the mean differences between preoperative and postoperative measures for each topographic diameter zone. Laser holographic interferometry was used to inspect corneal asphericity in one eye bank eye case study for four intrastromal corneal ring sizes. Wave unit map and geometric zonal spot ray tracing analyses derived from laser holographic interferometry topography were surveyed. RESULTS: Videokeratographic analysis suggested that preoperative corneal shape was prolate, i.e., flattened from central to paracentral cornea. Corneal shape became more prolate with intrastromal corneal ring implantation for all intrastromal corneal ring thicknesses. Laser holographic interferometry demonstrated that prolate asphericity was preserved with the intrastromal corneal ring sizes tested and that optical collection efficiency of the cornea was not diminished. CONCLUSION: Using two different measurement techniques, this eye bank eye study demonstrated that intrastromal corneal rings maintain prolate corneal asphericity.

Cornea↗

The Minnesota Grading System of eye bank eyes for age-related macular degeneration.

PURPOSE: The Minnesota Grading System (MGS) is a method to evaluate human eye bank eyes and determine the level of age-related macular degeneration (AMD), by using criteria and definitions from the Age-Related Eye Disease Study (AREDS). METHODS: Donor eyes (108 pairs) from the Minnesota Lions Eye Bank were cut circumferentially at the pars plana to remove the anterior segment. A 1000 +/- 2.5-microm ruby sphere was placed on the optic nerve as a size reference. A digital, high-resolution, color macular photograph was taken through a dissecting microscope. The neurosensory retina was removed from one globe of the pair. The underlying retinal pigment epithelium was rephotographed, localizing the fovea with a proportional triangle. A grid was superimposed in the macular photographs and images were graded according to AREDS criteria. Twenty pairs were dissected bilaterally and graded for symmetry. RESULTS: Eighty-eight globes were graded into one of four MGS categories. Nineteen (95%) of 20 globes had symmetric grades. CONCLUSIONS: The MGS provides a methodology to grade donor tissue from eye bank eyes to correspond to the AREDS classification system. Donor tissue may be used for subsequent molecular analysis, including genomics and proteomics.

Aged↗

Flattening of central corneal curvature with intrastromal corneal rings of increasing thickness: an eye-bank eye study.

Intrastromal Corneal Rings (ICRs) have been demonstrated to flatten human corneas when implanted into peripheral intrastromal corneal channels. To study the flattening effect, ICRs of increasing thickness, 0.26, 0.31, 0.36, 0.41, and 0.46 mm, were placed into oversized (approximately 70% depth) intrastromal channels in 38 eye-bank eyes. Each of 33 eyes received one ICR; the mean change in dioptric data was obtained for four meridians using an intraoperative photokeratoscope. Intrastromal corneal rings of increasing thickness resulted in corneal flattening of 3.8 +/- 1.1, 4.9 +/- 0.6, 5.2 +/- 1.1, 5.3 +/- 1.9, and 7.3 +/- 1.6 diopters, respectively, for keratoscope mire 2. One of each size ICR was placed into one of five additional eye-bank eyes; the degree of flattening measured by laser holographic interferometry was 1.8, 2.9, 5.5, 4.7, and 10.1 diopters, respectively, for the central 6 mm corneal zone. These results indicate that the ICR provides a fairly linear flattening relationship over the range of thicknesses tested. Additionally, laser holographic interferometry wave unit maps of preoperative and postoperative corneas demonstrated that the ICR tends to preserve positive corneal asphericity if present preoperatively.

Anthropometry↗

Tensile strength of lens capsules in eye-bank eyes.

PURPOSE: To measure the tensile strength of the anterior and posterior lens capsules in eye-bank eyes and study the tensile strength of capsules dehydrated with hypertonic glucose solution. SETTING: Tongren Hospital, Beijing, China. METHODS: The in situ anterior and posterior capsules of 35 eye-bank eyes (Group 1) donated by healthy men aged 20 to 40 years (mean 27.1 years) were measured with a biomembrane strength device. Sixteen eyes (Group 2), from donors aged 20 to 37 years (mean 27.0 years) and similar to those in Group 1, were measured in the same way after the anterior and posterior capsules were exposed to glucose 50% solution for 15 minutes. RESULTS: In Group 1, anterior and posterior capsule strength was 6.269 +/- 1.118 and 3.755 +/- 0.835 g, respectively (P < .01), and the correlation between the tensile strength of the anterior and posterior capsules was statistically significant (r = .94; P < .001). In Group 2, the strength of the capsules increased to 9.024 +/- 0.586 and 4.424 +/- 0.761 g, respectively, a finding that was statistically significantly different from that in Group 1 (P < .01 and .05, respectively. CONCLUSION: The tensile strength of the anterior capsule was stronger than that of the posterior capsule under the experimental conditions. Glucose 50% solution has the potential to increase the tensile strength of anterior and posterior capsules.

Adult↗

Corneal flattening by shallow circular trephination in human eye bank eyes.

Recent reports documenting central keratometric changes after removal of failed epikeratoplasty lenticules, compared to preoperative keratometry measurements, suggest that the annular corneal wound alters corneal curvature. Central corneal steepening has also been reported following circular and hexagonal keratotomy. We performed standard epikeratoplasty trephination with a Hessburg-Barron suction trephine followed by a peripheral lamellar spreading keratotomy on seven human eye bank eyes to determine the effect of these incisions on corneal topography. In seven human eye bank eyes, the mean acute central keratometric flattening from the shallow trephine incision was 2.81 D (SD 2.28, P = .017), with no significant change in keratometry due to peripheral lamellar spreading (P = .916). Computerized numeric and three-dimensional graphic analysis of the keratographs demonstrated this central topographic flattening. Further studies are needed to investigate the reversibility of host corneal changes induced by epikeratoplasty procedures.

Cornea↗

Analysis of IL-6 levels in human vitreous fluid obtained from uveitis patients, patients with proliferative intraocular disorders and eye bank eyes.

Several studies suggest a role for IL-6 in the pathogenesis of uveitis. Earlier we have shown that aqueous humour obtained from patients with uveitis contained raised levels of IL-6. In the study described here we investigated the IL-6 levels in vitreous fluid samples obtained from 75 uveitis patients with different uveitis entities. Vitreous samples from 14 patients with proliferative intraocular disorders (PID) and 29 eye bank eyes were used as controls. All the samples were tested in the IL-6 B9 bioassay as well as in a sensitive ELISA for IL-6. Raised IL-6 levels were detected in the vitreous fluid of uveitis patients as well as patients with PID, implicating IL-6 as a common inflammatory mediator. The highest mean level of IL-6 was found in the vitreous fluid of patients with acute retinal necrosis. The mean IL-6 levels measured by the ELISA were higher compared to the levels measured by the B9 bioassay. This may be caused by the presence of B9 bioassay inhibitory factors in the vitreous fluid of these patients.

Biological Assay↗

Corneal preparation of eye bank eyes for experimental surgery.

PURPOSE: To evaluate the efficacy of dextran in balanced salt solution (BSS) as a preparation of eye bank corneas for experimental surgeries. METHODS: We used 12 eye bank eyes that were unsuitable for transplant. The corneas were removed from the globe and affixed to a Hanna artificial anterior chamber. Four concentrations of dextran-BSS (10%, 15%, 20%, and 30% [+/-0.56%]) were used to dehydrate the corneas, and corneal thickness was assessed with an ultrasonic pachymeter (+/-5 microm) at varying time-intervals over 3 hours. RESULTS: The corneas were thinned to an average thickness of 477+/-54 microm, 430+/-54 microm, 406+/-61 microm, and 391+/-52 microm at average times of 75+/-0 minutes, 85+/-23 minutes, 60+/-12 minutes, and 45+/-0 minutes for the 10%, 15%, 20%, and 30% concentrations, respectively. Corneal thickness was stabilized in both a 15% and a 20% solution. The data was fit to exponential curves until a minimum value was reached, after which linear regression analysis was used to determine the slopes of the data. The slopes for the 15% and 20% concentrations were not significantly different from 0 (p = 0.5 and p = 0.4, respectively). The slopes for each set of data from the 10% and 30% concentrations were significantly different from each other (p = 0.010 and p = 0.001, respectively). CONCLUSIONS: A solution of 20% dextran in BSS is effective for dehydrating eye bank corneas to a quasi-normal physiologic thickness and for maintaining the thickness for a sufficient amount of time. Both the posterior and anterior sides of the cornea should be exposed to the solution for 60 minutes.

Acetates↗

Objective measurement of postocclusion surge during phacoemulsification in human eye-bank eyes.

PURPOSE: To objectively compare the postocclusion vacuum surge among different phacoemulsification machines and devices. DESIGN: Experimental study. METHODS: Infiniti, Legacy, Millennium, and Sovereign were tested in an eye-bank eye. All the machines were tested with 20-gauge non-ABS tips, 430 mm Hg vacuum pressure, 24 ml/minute aspiration rate, peristaltic pump, and 75 cm bottle height. In addition, Infiniti and Legacy were also tested with 20-gauge bypass tips (ABS), 125 cm bottle height, and 40 ml/minute flow rate. We also tested 19-gauge tips with Infiniti and Sovereign and the venturi pump for Millennium. RESULTS: Significant differences were found between all the machines tested with Millennium peristaltic generating the least and Millennium Venturi the most surge. ABS tips significantly decreased the surge for Legacy but not for Infiniti. Cruise Control (CC) had a significant effect on Sovereign but not on Millennium. Increasing the bottle height decreased surge while increasing the flow increased surge for both Infiniti and Legacy. The 19-gauge tips increased surge for both Infiniti and Sovereign. CONCLUSIONS: Surge varied over a range of 40 microm to more than 2 mm. ABS and CC decrease surge, especially when the machine is not functioning near the limits of surge prevention. Certain parameters, such as a 19-gauge tip and high flow, dramatically increased surge, whereas elevating the bottle ameliorates it. Understanding the impact of all these features will help in minimizing the problem.

Eye↗

Use of microbubble ultrasound contrast agent to demonstrate the iris valve effect in human eye bank eyes.

PURPOSE: To demonstrate that the interface between the normal iris and the lens surface functions as a flap valve. METHOD: Microbubble ultrasound contrast agent was injected into the anterior and posterior chambers of human eye bank eyes and the distribution of contrast imaged with high-frequency ultrasound. RESULTS: Contrast agent did not enter the posterior chamber when injected into the anterior chamber, but contrast agent injected into the posterior chamber easily flowed into the anterior chamber. CONCLUSIONS: The iris-lens interface normally functions as a flap valve, preventing retrograde flow from the anterior to the posterior chamber. A temporary increase in anterior chamber pressure thus results in iris concavity in pigmentary dispersion syndrome.

Adult↗

Comparison of the morphologic changes after selective laser trabeculoplasty and argon laser trabeculoplasty in human eye bank eyes.

OBJECTIVE: To compare the histopathologic changes in the human trabecular meshwork (TM) after argon laser trabeculoplasty (ALT) and selective laser trabeculoplasty (SLT) with a Q-switched, frequency-doubled, neodymium:yttrium-aluminum-garnet laser. DESIGN: Human "in vitro" experimental study. TISSUE AND CONTROLS: Eight human autopsy eyes were obtained within 18 hours of death from persons aged 71 to 78 years. METHODS: The anterior segment of autopsy eyes was isolated, and one half of each trabecular meshwork underwent SLT and the other half ALT. Specimens were evaluated with scanning and transmission electron microscopy. MAIN OUTCOME MEASURES: Structural changes in the TM were detected by scanning electron microscopy, and cellular or intracellular changes were seen with transmission electron microscopy. RESULTS: Evaluation of the TM after ALT revealed crater formation in the uveal meshwork at the junction of the pigmented and nonpigmented TM. Coagulative damage was evident at the base and along the edge of craters, with disruption of the collagen beams, fibrinous exudate, lysis of endothelial cells, and nuclear and cytoplasmic debris. Evaluation of the TM after SLT revealed no evidence of coagulative damage or disruption of the corneoscleral or uveal trabecular beam structure. Minimal evidence of mechanical damage was present after SLT, and the only ultrastructural evidence of laser tissue interaction was cracking of intracytoplasmic pigment granules and disruption of trabecular endothelial cells. CONCLUSIONS: SLT applied "in vitro" to the TM of human eye bank eyes seemed to cause no coagulative damage and less structural damage to the human TM when compared with ALT and, therefore, may be a safer and more repeatable procedure.

Aged↗

Air bubble endothelial damage during phacoemulsification in human eye bank eyes: the protective effects of Healon and Viscoat.

Following insertion of either Healon (sodium hyaluronate) or Viscoat (sodium chondroitin sulfate-sodium hyaluronate) into the anterior chamber of human eye bank eyes, a controlled amount of small air bubbles was introduced into the anterior chamber during phacoemulsification. After vital staining, damage to endothelial cells in the central cornea was quantified. Endothelial damage averaged 4.5% in eyes in which no viscoelastic was used (positive control), whereas damage was only 0.4% (P less than .001) in eyes in which a viscoelastic was inserted but no air bubbles were introduced (negative control). Endothelial damage in test specimens using air plus Healon averaged 4.9%. Damage in test specimens using air plus Viscoat averaged 0.3% (P less than .02). As demonstrated by scanning electron microscopy, many areas in the positive controls and in the Healon test specimens were damaged too extensively to quantitate accurately by the method we used. Thus, Viscoat may prevent or lessen damage to the corneal endothelium by small air bubbles during phacoemulsification.

Air↗

New screening methods for donor eye-bank eyes.

PURPOSE: Current methods of screening donor eyes for corneal transplantation are not always effective in excluding corneas with abnormal topography. We used the Orbscan to determine whether corneal-thickness maps could be used as a technique for donor tissue screening. METHODS: Forty eye-bank eyes were measured with the Orbscan, and a corneal-thickness map was generated. Average central pachymetry measurements from each map were compared with the thinnest midperipheral thickness reading. Two eyes from a donor who had photorefractive keratectomy (PRK) and two eyes from a donor with keratoconus were then compared with the normal donor eye results. RESULTS: The average difference between the thinnest midperipheral pachymetry and the central pachymetry in the control group was 0.040 +/- 0.026 mm. The eyes from the donor with PRK showed larger disparities between the central and midperipheral thicknesses because of the thinned central cornea, with differences of 0.154 mm in the right eye and 0.106 mm in the left eye. The eyes from the donor with keratoconus had midperipheral corneas that were thinner than the center, indicating eccentric, ectatic cones. The differences in thickness between the center and midperiphery in the eyes from the donor with PRK and the donor with keratoconus differed from the control group by >2 SD. CONCLUSIONS: Diseases or surgery that affect the relationship between the central and midperipheral corneal thickness may be screened through Orbscan pachymetry mapping with comparison with a normal range.

Aged↗

Corneal steepening in human eye bank eyes by combined hexagonal and transverse keratotomy.

An interrupted 5 mm diameter hexagonal keratotomy was modified to include six paracentral transverse incisions to augment the central corneal steepening. This combined modified-hexagonal and transverse (or hexagonal-transverse) keratotomy was performed on human eye bank eyes to an estimated 85% corneal depth yielding a mean of 7.50 +/- 1.69 diopter increase in central keratometric power (P less than .001); this finding was confirmed by keratography. These results encourage further studies of this procedure and its potential to surgically correct mild amounts of hyperopia.

Analog-Digital Conversion↗

Comparative tonometric measurements of eye bank eyes.

A comparison was made of the accuracy of the Tono-Pen, Pneumatonometer, and Perkins hand-held tonometers by measuring the hydrostatically controlled intracular pressure from 10 to 50 mm Hg in human eye bank eyes. The open stopcock method was used in which the cannulated eye, the hydrostatic pressure controlling column, and a manometer were continuously open to each other. The Pneumatonometer gave accurate results at 50 mm Hg but overestimated the lower intraocular pressures; whereas, the Perkins gave satifactory results at 10 and 20 mm Hg but underestimated higher intraocular pressures. The Tono-Pen displayed the least deviation from the controlled pressure over the entire range studied. Another aspect of this study involved determining that a therapeutic soft contact lens did not have any noticeably adverse effect on the accuracy of the Pneumatonometer and Tono-Pen tonometers.

Contact Lenses, Hydrophilic↗

Screening of myopic photorefractive keratectomy in eye bank eyes by computerized videokeratography.

BACKGROUND: In contrast to incisional keratotomy, corneas that have undergone photorefractive keratectomy may be difficult to detect by inspection with slitlamp biomicroscopy alone. Eye bank corneas that have undergone high myopic refractive surgical correction could potentially result in substantial postoperative hyperopic correction if used as donor tissue for corneal transplantation. Surface irregularities or displacement of the treated optical zone within the graft in relation to the entrance pupil of the recipient could result in significant induced astigmatism and distortion. This study examines computerized videokeratographic screening of eye bank globes as a strategy for detecting myopic photorefractive keratectomy. METHODS: Preoperative and postoperative corneal topographic maps of freshly enucleated human and rabbit eyes that have undergone myopic photorefractive keratectomy with an excimer laser were placed in a globe-fixating device and analyzed using a vertically oriented videokeratoscope. The same system was applied in an actual eye bank setting, and potentially transplantable globes from donors without a history of corneal surgery were analyzed. RESULTS: Computerized videokeratography using a vertically mounted system reliably detected photorefractive keratectomy in 12 of 12 human eye bank corneas treated by excimer photorefractive keratectomy in a range between -1.5 to -6.0 diopters. This method also detected similar changes on lased rabbit corneas enucleated 6 weeks after excimer surgery. Data processed with the tangential mode yielded a "bull's-eye" topography pattern reflecting central corneal flattening that was more sensitive in detecting myopic corrections than the conventional axial formula-based color maps. False-positive results were not detected in 96 cadaver globes sequentially screened in the eye bank. CONCLUSIONS: Computerized videokeratography represents a feasible method to screen donor globes for myopic photorefractive keratectomy as shown by the in vitro and rabbit models. However, only whole globes and not corneoscleral sections are amenable to processing with this technique. Tangential maps provided greater sensitivity in detecting low myopic corrections than the axial formula-based color maps.

Animals↗

Femtosecond laser-assisted posterior lamellar keratoplasty: initial studies of surgical technique in eye bank eyes.

OBJECTIVE: To perfect the technique of femtosecond laser-assisted cutting of the lamellar corneal disc in posterior lamellar keratoplasty. DESIGN: Experimental study. METHODS: The femtosecond laser was used to make the posterior corneal lamellar interface and trephine (side) cut in 20 eye bank globes and 9 eye bank corneoscleral buttons. Laser parameters were energy 7.4+/-0.1 microJ (lamellar cut) and 8.7+/-0.1 microJ (trephination cut), spot size 2.4 microm, firing rate 15 kHz, and trephination diameter 6.0 to 8.0 mm. The thicknesses of the excised corneal discs were measured with a digital micrometer and compared with values calculated from the laser treatment parameters and the preoperative ultrasound pachymetric readings. The cut surfaces were examined by light microscopy and scanning electron microscopy. In globes, the corneal disc was removed from the eye after laser treatment through a blade incision in the peripheral cornea. In corneoscleral buttons, the posterior disc was peeled off the cornea with forceps after laser treatment on an artificial anterior chamber device. In simulated transplantation, the excised corneal disc was placed into the posterior stromal bed in 7 globes. RESULTS: The femtosecond laser was successful in making posterior lamellar and trephination cuts in cornea. The cut surfaces were of very good quality with straight, orthogonal edges, albeit with a mild stucco texture of the lamellar stromal surfaces. In 3 globes, the lamellar surface showed shallow concentric ridges. The measured thickness of the excised discs was 55+/-61 microm thicker than the preoperatively predicted values. CONCLUSIONS: These preliminary studies show that the femtosecond laser can make nonmechanical cuts for posterior lamellar keratoplasty with relative ease and reliability, thus facilitating the most technically difficult step in this surgery.

Cornea↗

Introduction of corneal astigmatism through placement of a scleral fixation ring in eye bank eyes.

PURPOSE: To determine the effect of scleral fixation ring placement in induction of astigmatism by topographic analysis. METHODS: Baseline measurements were used in human eyes from the Utah Lions Eye Bank. In two control eyes, the effect of placing and replacing the eye in the holder was determined. In nine eyes, the effect of placing a 14-mm ring 2.0-mm from the limbus and an 18-mm ring 4.0-mm from the limbus, both in line with and between the rectus muscles, was determined. Induced astigmatism (IA) was determined by Alpins' vector analysis method. RESULTS: Control eyes had a mean variation of 0.26 +/- 0.18 diopters (D) (range, 0.07-0.65). The study eyes had a mean IA of 1.55 D with statistically significant differences noted when comparing 14-mm rings (0.92 +/- 2.00 D) versus 18-mm rings in line with the rectus (3.02 +/- 1.49 D; p = 0.02), with 18-mm rings in line with the rectus muscles (3.02 +/- 1.46 D) versus between the muscles (1.37 +/- 1.14 D; p = 0.03), and all measurements with the 14-mm ring (1.0 +/- 1.49 D) versus the 18-mm ring (2.14 +/- 1.51 D; p = 0.04.). CONCLUSIONS: Significant IA can occur with placement of fixation rings, especially when suture placement is near the insertions of the rectus muscles.

Astigmatism↗