The Experts below are selected from a list of 9297 Experts worldwide ranked by ideXlab platform
Victor L. Perez - One of the best experts on this subject based on the ideXlab platform.
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Amniotic membrane use for management of corneal limbal stem Cell Deficiency
Current Opinion in Ophthalmology, 2017Co-Authors: Alfonso L. Sabater, Victor L. PerezAbstract:Purpose of reviewThe current article reviews the most recent surgical techniques for management of corneal limbal stem Cell Deficiency (LSCD) using amniotic membrane tissue.Recent findingsEarly successes with amniotic membrane transplantation (AMT) for the treatment of ocular surface disorders have
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modified simple limbal epithelial transplantation using cryopreserved amniotic membrane for unilateral limbal stem Cell Deficiency
American Journal of Ophthalmology, 2014Co-Authors: Guillermo Amescua, Marwan Atallah, Neda Nikpoor, Anat Galor, Victor L. PerezAbstract:Purpose To report the results of simple limbal epithelial transplantation using a double-layered cryopreserved amniotic membrane graft for the management of unilateral limbal stem Cell Deficiency. Design Retrospective case series. Methods Four consecutive patients with unilateral partial (2 eyes) and total (2 eyes) limbal stem Cell Deficiency secondary to ocular surface burns (2 eyes), trauma (1 eye) and conjunctival melanoma treatment (1 eye) underwent modified simple limbal epithelial transplantation at Bascom Palmer Eye Institute. Preoperative and postoperative visual acuity and quality of corneal epithelium were evaluated. Results The patients were followed up for a mean ± standard deviation of 7.5 ± 1.3 months. The donor eye returned to a healthy state in all patients. All patients had significant improvement in visual acuity and resolution of ocular pain in the affected eye. Regular corneal epithelium and a quiet ocular surface were obtained in all patients by a median of 4 weeks. Conclusions Compared with the currently used surgical techniques for management of limbal stem Cell Deficiency, simple limbal epithelial transplantation seems to be a safe, reproducible, and effective alternative. The use of a double layer allows more protection for the explant without impacting outcomes. Also, the use of cryopreserved amniotic membrane allows surgeons to perform this procedure in the Unites States. More cases with longer follow-up will be needed to assess the outcomes further.
José Álvaro Pereira Gomes - One of the best experts on this subject based on the ideXlab platform.
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global consensus on definition classification diagnosis and staging of limbal stem Cell Deficiency
Cornea, 2019Co-Authors: Sophie X. Deng, Clara C. Chan, José Álvaro Pereira Gomes, Shigeto Shimmura, V Borderie, Reza Dana, Francisco C Figueiredo, Graziella Pellegrini, Friedrich E KruseAbstract:Purpose:Despite extensive knowledge gained over the last 3 decades regarding limbal stem Cell Deficiency (LSCD), the disease is not clearly defined, and there is lack of agreement on the diagnostic criteria, staging, and classification system among treating physicians and research scientists working
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Impression cytology and in vivo confocal microscopy in corneas with total limbal stem Cell Deficiency
Arquivos Brasileiros De Oftalmologia, 2013Co-Authors: Aline Lütz De Araujo, José Reinaldo Da Silva Ricardo, Vivian Naomi Sakai, Jeison Nadai De Barros, José Álvaro Pereira GomesAbstract:PURPOSES: To describe corneal changes seen on in vivo confocal microscopy in patients with total limbal stem Cell Deficiency and to correlate them with cytological findings. METHODS: A prospective case series including 13 eyes (8 patients) with total limbal Deficiency was carried out. Stem Cell Deficiency was diagnosed clinically and by corneal impression cytology. Confocal images of the central cornea were taken with the Heidelberg Retina Tomograph II, Rostock Corneal Module (Heidelberg Engineering, Heidelberg, Germany). RESULTS: Impression cytology of the cornea revealed conjunctival epithelial Cells and goblet Cells in all cases. In vivo confocal microscopy showed disruption of normal layers of the corneal epithelium in all eyes. Confocal images showed Cells with characteristics of conjunctival epithelium at the cornea in 76.9% of the total. These findings on confocal microscopy were compatible to limbal stem Cell Deficiency. Additionally, goblet Cells, squamous metaplasia, inflammatory Cells and dendritic Cells were observed. The sub-basal nerve plexus was not identified in any of the corneas. Corneal neovessels were observed at the epithelium and stroma. All cases showed diffuse hyper-reflective images of the stroma corresponding to opacity of the tissue. CONCLUSIONS: Limbal stem Cell Deficiency had been confirmed by impression cytology in all cases, and 76.9% of the cases could also be diagnosed by in vivo confocal microscopy through the conjunctival epithelial Cell visualization on the corneal surface. Frequent confocal microscopy findings were abnormal Cells at the cornea (conjunctival epithelial, goblet and inflammatory Cells), corneal neovessels and diffuse hyper-reflection of the stroma.
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Amniotic membrane transplantation for partial and total limbal stem Cell Deficiency secondary to chemical burn
Ophthalmology, 2003Co-Authors: José Álvaro Pereira Gomes, Myrna Serapião Dos Santos, Marcelo Cunha, Vera L.úcia Degaspare Mascaro, Jeison De Nadai Barros, Luciene Barbosa De SousaAbstract:Abstract Purpose To evaluate the surgical outcome of preserved amniotic membrane transplantation (AMT) for ocular surface reconstruction in chemical burn with limbal stem Cell Deficiency. Design Prospective, noncomparative, interventional case series. Participants Twenty eyes of 20 consecutive patients with limbal stem Cell Deficiency secondary to ocular chemical injury. Intervention AMT with or without adjunctive limbal transplantation using limbal tissue from either the healthy contralateral eye (CLAU) or a living related donor (lr-CLAL). Main outcome measures Reconstruction of corneal epithelium (clear appearance without epithelial defect, normal fluorescein permeability and the absence of conjunctiva-derived goblet Cells on impression cytology), decrease in corneal vascularization and improvement in visual acuity. Results With a mean follow-up time of 19 months (range, 8–27 months), satisfactory ocular surface reconstruction was obtained in 15 eyes (75%), with reduced inflammation and vascularization of the ocular surface and a mean epithelialization time of 3.3 weeks. Success was observed in all cases of partial limbal stem Cell Deficiency (PLD) and in 68.75% (11 eyes) of cases of total limbal stem Cell Deficiency (TLD). Surgical failure was observed in five severe cases (31.25%). A significant visual improvement was observed in all cases after surgery, except for 2 eyes that maintained preoperative visual acuity. Conclusions AMT seems to be an efficient adjunct for ocular surface reconstruction in chemical burns with PLD. When performed in conjunction with limbal stem Cell transplantation, it is also effective in most cases of TLD.
Guillermo Amescua - One of the best experts on this subject based on the ideXlab platform.
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modified simple limbal epithelial transplantation using cryopreserved amniotic membrane for unilateral limbal stem Cell Deficiency
American Journal of Ophthalmology, 2014Co-Authors: Guillermo Amescua, Marwan Atallah, Neda Nikpoor, Anat Galor, Victor L. PerezAbstract:Purpose To report the results of simple limbal epithelial transplantation using a double-layered cryopreserved amniotic membrane graft for the management of unilateral limbal stem Cell Deficiency. Design Retrospective case series. Methods Four consecutive patients with unilateral partial (2 eyes) and total (2 eyes) limbal stem Cell Deficiency secondary to ocular surface burns (2 eyes), trauma (1 eye) and conjunctival melanoma treatment (1 eye) underwent modified simple limbal epithelial transplantation at Bascom Palmer Eye Institute. Preoperative and postoperative visual acuity and quality of corneal epithelium were evaluated. Results The patients were followed up for a mean ± standard deviation of 7.5 ± 1.3 months. The donor eye returned to a healthy state in all patients. All patients had significant improvement in visual acuity and resolution of ocular pain in the affected eye. Regular corneal epithelium and a quiet ocular surface were obtained in all patients by a median of 4 weeks. Conclusions Compared with the currently used surgical techniques for management of limbal stem Cell Deficiency, simple limbal epithelial transplantation seems to be a safe, reproducible, and effective alternative. The use of a double layer allows more protection for the explant without impacting outcomes. Also, the use of cryopreserved amniotic membrane allows surgeons to perform this procedure in the Unites States. More cases with longer follow-up will be needed to assess the outcomes further.
Sophie X. Deng - One of the best experts on this subject based on the ideXlab platform.
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Presentation, diagnosis and management of limbal stem Cell Deficiency.
Middle East African Journal of Ophthalmology, 2020Co-Authors: Kunjal D. Sejpal, Pejman Bakhtiari, Sophie X. DengAbstract:The human corneal surface epithelium is continuously repopulated by the limbal stem Cells (LSCs). Limbal Stem Cell Deficiency (LSCD) can lead to corneal opacity and vascularization, with consequent visual impairment or blindness. Many acquired and congenital diseases can lead to LCSD by direct injury to the LSCs, destruction of LSC niche, or both. Based on the severity of the disease, LSCD can present with various symptoms and signs. Although LSCD can be detected clinically, laboratory tests are necessary to confirm the diagnosis and monitor the disease progression. This article concisely reviews the clinical presentation, techniques for diagnosis and management of LSCD.
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Classification of Limbal Stem Cell Deficiency Using Clinical and Confocal Grading.
Cornea, 2019Co-Authors: Carolina Aravena, Kansu Bozkurt, Pichaya Chuephanich, Chantaka Supiyaphun, Fei Yu, Sophie X. DengAbstract:Purpose:To grade the severity of limbal stem Cell Deficiency (LSCD) based on the extent of clinical presentation and central corneal basal epithelial Cell density (BCD).Methods:This is a retrospective observational comparative study of 48 eyes of 35 patients with LSCD and 9 eyes of 7 normal subjects
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global consensus on definition classification diagnosis and staging of limbal stem Cell Deficiency
Cornea, 2019Co-Authors: Sophie X. Deng, Clara C. Chan, José Álvaro Pereira Gomes, Shigeto Shimmura, V Borderie, Reza Dana, Francisco C Figueiredo, Graziella Pellegrini, Friedrich E KruseAbstract:Purpose:Despite extensive knowledge gained over the last 3 decades regarding limbal stem Cell Deficiency (LSCD), the disease is not clearly defined, and there is lack of agreement on the diagnostic criteria, staging, and classification system among treating physicians and research scientists working
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The Diagnosis of Limbal Stem Cell Deficiency
Ocular Surface, 2017Co-Authors: Qihua Le, Jianjiang Xu, Sophie X. DengAbstract:Abstract Limbal stem Cells (LSCs) maintain the normal homeostasis and wound healing of corneal epithelium. Limbal stem Cell Deficiency (LSCD) is a pathologic condition that results from the dysfunction and/or an insufficient quantity of LSCs. The diagnosis of LSCD has been made mainly based on medical history and clinical signs, which often are not specific to LSCD. Methods to stage the severity of LSCD have been lacking. With the application of newly developed ocular imaging modalities and molecular methods as diagnostic tools, standardized quantitative criteria for the staging of LSCD can be established. Because of these recent advancements, effective patient-specific therapy for different stages of LSCD may be feasible.
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Existence of Normal Limbal Epithelium in Eyes With Clinical Signs of Total Limbal Stem Cell Deficiency.
Cornea, 2016Co-Authors: Eric H. Chan, Qihua Le, Andres Codriansky, Jiaxu Hong, Jianjian Xu, Sophie X. DengAbstract:Purpose:To report the presence of normal limbal epithelium detected by in vivo confocal laser scanning microscopy (IVCM) in 3 cases of clinically diagnosed total limbal stem Cell Deficiency (LSCD).Methods:This is a retrospective case report consisting of 3 patients who were diagnosed with total LSCD
Marwan Atallah - One of the best experts on this subject based on the ideXlab platform.
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modified simple limbal epithelial transplantation using cryopreserved amniotic membrane for unilateral limbal stem Cell Deficiency
American Journal of Ophthalmology, 2014Co-Authors: Guillermo Amescua, Marwan Atallah, Neda Nikpoor, Anat Galor, Victor L. PerezAbstract:Purpose To report the results of simple limbal epithelial transplantation using a double-layered cryopreserved amniotic membrane graft for the management of unilateral limbal stem Cell Deficiency. Design Retrospective case series. Methods Four consecutive patients with unilateral partial (2 eyes) and total (2 eyes) limbal stem Cell Deficiency secondary to ocular surface burns (2 eyes), trauma (1 eye) and conjunctival melanoma treatment (1 eye) underwent modified simple limbal epithelial transplantation at Bascom Palmer Eye Institute. Preoperative and postoperative visual acuity and quality of corneal epithelium were evaluated. Results The patients were followed up for a mean ± standard deviation of 7.5 ± 1.3 months. The donor eye returned to a healthy state in all patients. All patients had significant improvement in visual acuity and resolution of ocular pain in the affected eye. Regular corneal epithelium and a quiet ocular surface were obtained in all patients by a median of 4 weeks. Conclusions Compared with the currently used surgical techniques for management of limbal stem Cell Deficiency, simple limbal epithelial transplantation seems to be a safe, reproducible, and effective alternative. The use of a double layer allows more protection for the explant without impacting outcomes. Also, the use of cryopreserved amniotic membrane allows surgeons to perform this procedure in the Unites States. More cases with longer follow-up will be needed to assess the outcomes further.