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Maimaitiming R.,Urumqi City Ophthalmology and Otolaryngology Hospital | Yang X.,Urumqi City Ophthalmology and Otolaryngology Hospital | Wupuer K.,Urumqi City Ophthalmology and Otolaryngology Hospital | Ye N.,Urumqi City Ophthalmology and Otolaryngology Hospital | And 5 more authors.
International Journal of Clinical and Experimental Medicine | Year: 2015

Background: To explore the causes of corneal allograft rejection in Xinjiang Uygur patients and the factors that affect rejection through a retrospective clinical analysis. Methods: A retrospective analysis of 126 Uygur cases from January 2010 to November 2014 in which corneal transplantation had been performed at the Xinjiang Urumqi ENT hospital. Of the treated patients, 85 eyes belonged to male patients and 41 eyes belonged to female patients. Patients were aged 10-77 years (mean age 46.14 ± 8.20 years). Surgical methods included penetrating keratoplasty (75 eyes) and lamellar keratoplasty (38 eyes). Follow-up time ranged from 0.5 to 3 years and a total of seven pre-operative keratopathies were observed: walleye, corneal ulcer, bullous keratopathy, corneal degeneration. Eye changes included 72 cases of limbal vascularization and 15 cases of high intraocular pressure. Allograft rejection was observed in 25 eyes. Results: The pre-operative keratopathies associated with the highest incidences of allograft rejection were: viral corneal ulcer, bullous keratopathy, adhesive walleye, and fungal corneal ulcers. The rate of allograft rejection using avascular corneal tissue was 10%, while the rate was 36% with severly-vascularized cornea. The earliest time of rejection was 20 days after surgery, while the latest was 16.4 months after surgery. Heavy corneal vascularization is associated with more rapid post-operative rejection. The rate of allograft rejection was higher after combined surgery when compared to penetrating keratoplasty or lamellar keratoplasty alone, while the rate was higher with penetrating keratoplasty than with lamellar keratoplasty. With increasing graft diameter, there was an increase in post-operative allograft rejection. Allograft rejection was significantly increased when graft diameter was above 7.75 mm. Conclusion: The major cause of corneal allograft rejection is viral corneal ulcers. High corneal vascularization, combined surgical methods, large diameter graft transplantation are all risk factors for allograft rejection. © 2015, Int J Clin Exp Med. All rights reserved. Source


Maimaitiming R.,Urumqi City Ophthalmology and Otolaryngology Hospital | Yang X.,Urumqi City Ophthalmology and Otolaryngology Hospital | Wupuer K.,Urumqi City Ophthalmology and Otolaryngology Hospital | Ye N.,Urumqi City Ophthalmology and Otolaryngology Hospital | Pan Z.,Capital Medical University
International Journal of Clinical and Experimental Medicine | Year: 2015

Background: Using a rat penetrating keratoplasty model, this study aims to explore the inhibitory effect of hachimycin on corneal graft rejection, to provide new basis for its clinical application. Materials and methods: Female adult Sprague-Dawley (SD) rats weighing between 220-250 g were used as acceptors and male or female Wistar rats weighing between 220-250 g were used as donors. The rats with a successful keratoplasty were randomly divided into 3 groups with 10 rats in each group. Group A: penetrating keratoplasty group; Group B: penetrating keratoplasty followed by the application of control eye drops containing eye drops matrix dissolved in 20 g/L DMSO and 900 mL/L artificial tear; Group C: penetrating keratoplasty followed by the application of 0.5 g/L hachimycin eye drops. Hachimycin was dissolved in vitamin E to obtain an eye solution with a pH value of 6~7, and stored at 4°C. The local application of hachimycin eye drops started 5 days after the keratoplasty surgery, 5 times per day until the onset of rejection response. At 4 days after the keratoplasty surgery, slit-lamp microscope was used to observe the transplanted cornea once every two days, and a rejection index (RI) of 0-12 was obtained according to the three graft components represented by corneal transparency, edema, and corneal neovascularization. Results: Penetrating keratoplasty was successfully performed on all the 3 groups of rats. Five days after the keratoplasty, both the transparency and the implant edema showed a score of 1-2 degrees in group A and B. Two weeks later, both these two grafts components increased to a score of 2-3 degrees in group A and B, with an active neovascularization. The group C also showed a transparency and implant edema of 1-2 degrees five days after the keratoplasty surgery. However, a transparent implant without edema was observed in group C two weeks after the keratoplasty surgery. In addition, the newly formed blood vessels disappeared and the retina appeared in a good status and in the correct position. The corneal transparency, edema, corneal neovascularization, and total RI scores of the 3 groups clearly indicated that the group B showed an improvement compared to the group A (P < 0.05), since in group B the new vessels were only distributed in the corneal limbus at five days after the surgery. However, at two weeks after the surgery no statistically significant difference in neovascularization degree was observed in group B when compared with group A, while a statistically significant decrease of neovascularization was observed in group C (P < 0.05). Conclusions: Hachimycin may inhibit the rejection responses after penetrating keratoplasty by the reduction of corneal edema, transparency and neovascularization. © 2015, E-Century Publishing Corporation. All rights reserved. Source

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