ISSN:0277-3740    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:0277-3740    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:0277-3740    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:0277-3740    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:0277-3740    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Summary.The history of lamellar keratoplasty (LK) surgery spans over 100 years, and the advantages of lamellar surgery have long been known. The surgery is usually used for tectonic purposes; however, new techniques and technology over the past 25 years have expanded the applications of LK in optical rehabilitation. Instrumentation such as viscoelastics, diamond knives, ultrasonic pachymetry, artificial anterior chambers, advanced microkeratomes, and the excimer laser have enhanced our ability to work more safely in the tedious microsurgical environment of the lamellar procedure. Advances in surgical techniques such as deep lamellar anterior keratoplasty and deep lamellar endothelial keratoplasty have expanded the application of lamellar surgery to endothelial replacement and have achieved visual results approaching those of penetrating keratoplasty while reducing the rate of rejection and improving the long-term graft stability. As research continues, LK promises to be an increasingly important option for the corneal surgeon.

ISSN:0277-3740    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Over the past quarter century, advances in our understanding of corneal anatomy, physiology, and wound healing have all played an integral role in the management of corneal trauma. As the etiologies of corneal trauma have changed, so has our understanding of the impact of injury on corneal function as it relates to visual rehabilitation. Numerous new classes of antibiotics, antiinflammatory agents, and tissue adhesives have emerged. Occlusive therapy has advanced from simple pressure patching bandage soft contact lenses and collagen shields. Surgical instrumentation, operating microscopes, viscoelastic substances, and suture materials have all improved the outcomes of corneal trauma repair. Improved understanding of the refractive properties of the cornea through topography and alternative suture techniques has helped us restore the natural corneal curvature and visual outcomes. Consequently, in the last quarter of this century our therapeutic approaches to cornea trauma, both medical and surgical, have improved.

ISSN:0277-3740    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Purpose.To describe the most recent advances in our understanding of the cellular and molecular mechanisms involved in the immunopathogenesis of corneal immunoinflammatory disorders including microbial keratitis, peripheral ulcerative keratitis, and allograft rejection.Methods.Review of the published peer-reviewed literature that has contributed significantly to our modern understanding of corneal immunology. In addition, the authors have summarized the information in conceptual diagrams that highlight the critical cellular and molecular pathways that lead to corneal immune responses in the two most thoroughly studied corneal immune disorders, herpes simplex keratitis (HSK) and transplant rejection.Results.In spite of the wide array of molecular and cellular factors that mediate corneal immunity, critical mechanistic facets are shared by the various corneal immunoinflammatory disorders. These include activation and migration of local antigen-presenting cells (APCs), including Langerhans cells (LCs), upregulation in pleiotropic proinflammatory cytokines such as interleukin-1 (IL-1) and tumor necrosis factor-alfa (TNF-&agr;) that can mediate a wide array of immune functions in addition to upregulating protease expression, and chemokines that play a critical role on the one hand in attracting nonantigen-specific inflammatory cells such as neutrophils and on the other in attracting CD4+T helper type 1 (Th1) cells that mediate most of the destruction in the cornea.Conclusions.In the last 25 years, we have seen our field develop from a descriptive stage into a new phase where the fundamental processes that mediate and effect corneal immunity are being accurately deciphered. It is anticipated that this new knowledge will allow development of specific molecular and genetic therapeutic strategies that could target critical steps in the immunopathogenesis of disease without the untoward side-effects of nonspecific generalized immune suppression that still remains the standard of care today.

ISSN:0277-3740    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Purpose.To review the advances in the diagnosis, pathogenesis, and management of dry eye disease in the past 25 years.Methods.Literature review.Results.The preocular tear film is a hydrated mucus gel that contains soluble antimicrobial proteins and growth factors that protect and support the ocular surface. The final common pathway in dry eye is a perturbation of the integrated ocular surface/lacrimal gland reflex unit. Diagnostic tests evaluating tear composition and clearance appear to show stronger correlation with the severity of ocular irritation symptoms and keratoconjunctivitis sicca (KCS) than the conventional Schirmer tests. KCS is a condition of abnormal differentiation and mucus production by the ocular surface epithelium that results in a poorly lubricated, abnormally permeable ocular surface that has increased susceptibility to environmental insults. Chronic subclinical ocular surface inflammation appears to play a key role in the pathogenesis of KCS. New therapeutic strategies are aimed at reducing the ocular surface inflammation of dry eye disease.Conclusions.There has been a tremendous increase in knowledge regarding dry eye disease in the past 25 years that has resulted in improved diagnostic classification and new targeted therapies.

ISSN:0277-3740    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Purpose.Chronic blepharitis is one of the most common conditions seen in the ophthalmologist's office; but, it is difficult to treat effectively. Nevertheless, much progress has been made over the last quarter century, not only in diagnosis but also in treatment of blepharitis.Methods.Perhaps the most important progress has been made as the result of extensive and detailed clinical evaluations of patients, sometimes over extended periods of time with diverse patient populations.Results.The availability of sophisticated instrumentation and laboratory techniques, as well as an array of antibiotics, has enhanced the whole picture for effective blepharitis treatment.Conclusion.Although much progress has been made, it is important to build on the present understanding. Most important is the continued development of targeted treatment protocols that address specific signs, as is now possible with microbial abnormalities. Progress in the understanding and treatment of relevant inflammatory processes will benefit from continuing biomedical discoveries.

ISSN:0277-3740    

出版商:OVID    

年代:2000

数据来源: OVID