Notes

Enzymatic purification involving microplastics throughout soil.
To identify the recurrence rate, complication rate, cosmetic results, and patient satisfaction after P.E.R.F.E.C.T. for PTERYGIUM more than 10 years after surgery.

This is a prospective cohort study with 312 patients (351 surgeries). All patients underwent pterygium removal using P.E.R.F.E.C.T. for PTERYGIUM in 1 eye or both eyes by the author. The main parameters studied were recurrence rate, complication rate, esthetic outcomes, and patient satisfaction.

Two hundred twenty-nine patients (77% of surviving cohort group) were able to be followed up with 16 patients deceased. The basic biographical data of the group followed up and those lost to follow-up were not different. The follow-up period was 153 ± 20 months. Selpercatinib in vivo Twenty-five percent of the surgeries were for recurrent pterygia. The recurrence rate was zero, and there were no serious complications. Ninety-four percent of patients were graded as having normal or excellent cosmetic appearance by the surgeon, and 95% of the patients graded the appearance os than recurrence rate alone.
To analyze the effect of anticoagulant therapy (ACT) for systemic diseases on the outcome of Descemet membrane endothelial keratoplasty (DMEK).

Consecutive eyes with Fuchs endothelial dystrophy that underwent DMEK between August 4, 2011, and July 15, 2016, were retrospectively analyzed. Data were obtained from the Cologne DMEK database at the University of Cologne, Germany. Best spectacle-corrected visual acuity (logMAR), endothelial cell density (at baseline and postoperatively up to 12 months), and rebubbling rates were compared between patients receiving ACT (ACT group) and those with no anticoagulant treatment (NCT group).

In this study, 329 eyes of 329 patients were included (ACT group n = 97, NCT group n = 232; mean age 69.9 ± 9.1 years). Bleeding was more common in the ACT group (P < 0.001). Preoperative best spectacle-corrected visual acuity was 0.59 ± 0.44 and 0.48 ± 0.35 logMAR for the ACT and NCT groups, respectively, which improved to 0.13 ± 0.08 and 0.08 ± 0.16 logMAR, respectively, at 12 months postoperatively. No significant difference in endothelial cell density loss at 12 months was found between the groups (ACT group 36.2% ± 14.7%, NCT group 38.5% ± 15.1%; P = 0.467). Rebubbling rate was 19.6% in the ACT group and 28.9% in the NCT group (P = 0.08).

Although ACT increases the risk for preoperative and intraoperative bleeding in DMEK, there seems to be no negative effect on DMEK outcome. Thus, it is not advisable to stop ACT for DMEK surgery.
Although ACT increases the risk for preoperative and intraoperative bleeding in DMEK, there seems to be no negative effect on DMEK outcome. Thus, it is not advisable to stop ACT for DMEK surgery.
To describe the demographic features and clinical characteristics of patients with herpes keratitis (HK) and limbal stem cell deficiency (LSCD) and identify possible factors associated with development of LSCD after HK.

In this retrospective case-series study, records of patients with a clinical diagnosis of HK seen at Massachusetts Eye and Ear over a 5-year period were reviewed for evidence of LSCD. Patient demographics, medical history, treatment, and best-corrected visual acuities (BCVAs) were recorded.

We identified 626 patients with HK. Fifty-seven had been diagnosed with LSCD (9.3%). Thirteen percent of patients with herpes zoster keratitis (N= 25) and 7% of patients with herpes simplex keratitis (N= 32) had LSCD (P = 0.01). Keratitis caused by herpes zoster virus [odds ratios (OR), 1.77; 95% confidence interval (CI), 0.97-3.19; P = 0.01], stromal involvement (OR, 2.28; 95% CI, 1.27-4.18; P = 0.02), and the use of topical antihypertensives (OR, 2.28; 95% CI, 1.27-4.18; P = 0.02) were found to be associated with a higher likelihood of developing LSCD. The final logarithm of the minimum angle of resolution (LogMAR) BCVA was significantly lower in patients with LSCD compared with those without LSCD with a mean BCVA of 1.34 ± 1.52 LogMar (∼20/200) as compared to 0.18 ± 0.54 LogMar (∼20/30 ± 20/60) in those patients without LSCD (P = 0.005).

Our data suggest that HK may be a risk factor for development of LSCD. Patients with HK should be monitored for the development of LSCD to reduce the risk of chronic ocular surface morbidity.
Our data suggest that HK may be a risk factor for development of LSCD. Patients with HK should be monitored for the development of LSCD to reduce the risk of chronic ocular surface morbidity.
To evaluate the outcomes of Descemet membrane endothelial keratoplasty (DMEK) in patients with toxic anterior segment syndrome (TASS).

Thirteen eyes of 13 patients who underwent DMEK for endothelial decompensation secondary to TASS were retrospectively reviewed. A comprehensive ocular examination including best-corrected visual acuity (BCVA), slitlamp biomicroscopy, intraocular pressure measurement, fundus evaluation, and measurement of central corneal thickness were performed in all patients at preoperatively and postoperatively.

There were 8 men and 5 women, with an average age of 56 ± 19 years. The mean follow-up was 8.7 ± 3.5 months. The time interval between the onset of TASS and DMEK was 4.9.±6.6 months (range, 1.5-26 months). Twelve of 13 grafts were clear at last visit. The mean preoperative BCVA was 20/666 (range, hand motion to 20/200), and the mean BCVA was 20/36 (range, hand motion to 20/20) at the postoperative last visit (P = 0.003). The decrease in mean pachymetry from preoperative (768 ± 69 μm) to postoperative last visit (523 ± 71 μm) was statistically significant (P < 0.001).

DMEK seems to be a safe and an effective treatment option in eyes with TASS-related endothelial decompensation.
DMEK seems to be a safe and an effective treatment option in eyes with TASS-related endothelial decompensation.Studies conducted in the United States suggest that 1% to 2% of corneal donor rims culture positive for fungus; the fungal agent is usually Candida, and the risk of an endothelial keratoplasty recipient developing an intraocular fungal infection is approximately 7% (1 in 15) if the donor rim was culture-positive. Routine culturing of corneal donor rims is useful because a positive fungal culture alerts the surgeon to carefully monitor the keratoplasty recipient for any signs of fungal infection. However, routine implementation of antifungal prophylaxis on receipt of a positive culture is problematic because there is a lack of definitive data regarding the optimal route of administration, necessary duration of prophylaxis, and relative efficacy of different antifungal agents. The use of topical prophylaxis alone has not been proven to be effective, and the systemic agents that are effective against Candida typically involve an azole, which has many side effects, including liver toxicity and potential interactions with other drugs.
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