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Clinical Advances and Management in Corneal Diseases
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Clinical Advances and Management in Corneal Diseases

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Ophthalmology".

Deadline for manuscript submissions: closed (25 March 2025) | Viewed by 2034

Special Issue Editor

Dr. Yukako Taketani

E-Mail Website
Guest Editor
Department of Ophthalmology, University of Tokyo Hospital, Tokyo, Japan
Interests: cornea; refractive surgery; corneal transplantation; corneal dystrophy

Special Issue Information

Dear Colleagues,

We are delighted to announce the launch of our upcoming Special Issue. Recently, many innovative technologies have been developed to advance the treatment of corneal diseases. However, some diseases are still hard to control. This Special Issue, entitled "Clinical Advances and Management in Corneal Diseases", aims to focus on the latest developments in the diagnosis, treatment, and management of corneal disorders. We aim to cover a range of topics, including innovative surgical techniques, such as advanced keratoplasty methods and the use of regenerative medicine in corneal transplantation. Additionally, we set out to explore authentic therapeutic approaches, including pharmacological treatments and surgery, aimed at improving patient outcomes. In this Special Issue, we welcome the submission of papers focused on the diagnosis, treatment, and management of corneal diseases.

Dr. Yukako Taketani
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • refractive surgery
  • corneal transplantation
  • regenerative medicine
  • AI diagnosis
  • infectious disease
  • corneal dystrophy

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  • e-Book format: Special Issues with more than 10 articles can be published as dedicated e-books, ensuring wide and rapid dissemination.

Further information on MDPI's Special Issue policies can be found here.

Published Papers (3 papers)

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Research

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18 pages, 1182 KiB  
Article
Outcomes of Post-Keratoplasty Microbial Keratitis: A 16-Year Analysis
by Joanna Przybek-Skrzypecka, Małgorzata Ryk-Adamska, Janusz Skrzypecki, Justyna Izdebska, Monika Udziela, Joanna Major and Jacek P. Szaflik
J. Clin. Med. 2025, 14(9), 3165; https://doi.org/10.3390/jcm14093165 (registering DOI) - 3 May 2025
Abstract
Purpose: To determine the incidence, risk factors (including systemic immunosuppression), and outcomes of microbial keratitis in corneal transplants over a 16-year observation period at a tertiary referral hospital in Poland. Methods: This retrospective cohort study included 125 episodes of infectious keratitis in 117 [...] Read more.
Purpose: To determine the incidence, risk factors (including systemic immunosuppression), and outcomes of microbial keratitis in corneal transplants over a 16-year observation period at a tertiary referral hospital in Poland. Methods: This retrospective cohort study included 125 episodes of infectious keratitis in 117 patients who underwent corneal transplantation between 2008 and 2023 at the Department of Ophthalmology, Medical University of Warsaw, Poland. The data collected included demographics, indications for transplantation, infection rates, risk factors, best-corrected visual acuity (BCVA) at presentation and discharge, changes in visual acuity, and treatments received prior to hospital admission. Clinical signs, symptoms, diagnostic tests, and management strategies were also reviewed. Additionally, the outcomes of surgical interventions, such as therapeutic corneal transplantation and evisceration, were examined. Results: Among the 2869 corneal transplants performed over the 16-year period, the incidence of post-keratoplasty microbial keratitis (PKMK) was 4.35%. The most common indication for transplantation in affected patients was an active infection unresponsive to medical therapy (n = 62, 52%). One-third of PKMK cases occurred in patients with repeat transplants. Median visual acuity prior to infection was 1.6 logMAR, worsening to 2.3 logMAR at presentation. Following treatment, visual acuity improved to a median of 1.9 logMAR at discharge, with no significant improvement by the one-year follow-up. At that time, 75.1% of patients remained legally blind (BCVA ≤ 20/200); 21% recovered to pre-infection visual levels, while 46% experienced additional visual loss due to PKMK. Multivariate regression identified corneal perforation and systemic immunosuppression as independent predictors of poorer visual outcomes (p < 0.001 and p = 0.03, respectively. Conclusions: Microbial keratitis in corneal grafts is associated with poor long-term visual outcomes. At one year post-infection, the median BCVA was 1.9 logMAR, with 75.1% of patients remaining legally blind. Nearly half of the cohort experienced additional visual loss compared to their pre-infection status, underscoring the severity of PKMK and the need for vigilant postoperative care. Full article
(This article belongs to the Special Issue Clinical Advances and Management in Corneal Diseases)
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10 pages, 3169 KiB  
Article
Experimental Study on Ocular Surface Protection by Soft Contact Lenses Due to Volcanic Ash Exposure
by Hiroshi Toshida, Yusuke Matsuzaki and Masahiro Miyazaki
J. Clin. Med. 2024, 13(17), 5281; https://doi.org/10.3390/jcm13175281 - 6 Sep 2024
Viewed by 991
Abstract
Background: Sudden volcanic eruptions can lead to volcanic ash entering the eyes, causing severe discomfort and complicating evacuation efforts. The specific effects of volcanic ash on ocular tissues, especially when wearing soft contact lenses (SCLs), are not well documented, prompting this experimental [...] Read more.
Background: Sudden volcanic eruptions can lead to volcanic ash entering the eyes, causing severe discomfort and complicating evacuation efforts. The specific effects of volcanic ash on ocular tissues, especially when wearing soft contact lenses (SCLs), are not well documented, prompting this experimental investigation. Methods: White rabbits with normal eyes were randomly divided into three groups: (1) a bare eye group: bare eye + volcanic ash exposure + eye washing, (2) an SCL group: SCL-wearing eye + volcanic ash exposure + eye washing, and (3) a control group: eye washing only. In groups 1 and 2, volcanic ash was applied to one eye under topical anesthesia, followed by immediate saline rinsing. Slit-lamp microscopy and histopathological analysis were conducted after euthanasia. Results: Slit-lamp and histopathological examinations revealed more significant corneal and conjunctival erosion in the bare eye group compared to the SCL group, which showed limited damage. The control group displayed no ocular damage. Conclusions: Guidelines from the “Volcanic Ash Health Effects: A Guide for the Public” by the National Research Institute for Earth Science and Disaster Resilience recommend removing SCLs during ashfall. Our findings suggest that the damage to the corneal and conjunctival epithelium is less severe in SCL-wearing eyes than in bare eyes, recommending that SCL wearers prioritize evacuation over lens removal during sudden ashfall. Full article
(This article belongs to the Special Issue Clinical Advances and Management in Corneal Diseases)
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Other

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52 pages, 823 KiB  
Systematic Review
Acanthamoeba Keratitis Management and Prognostic Factors: A Systematic Review
by Pedro Marques-Couto, Mariana Monteiro, Ana Margarida Ferreira, João Pinheiro-Costa and Rodrigo Vilares-Morgado
J. Clin. Med. 2025, 14(7), 2528; https://doi.org/10.3390/jcm14072528 - 7 Apr 2025
Viewed by 594
Abstract
Background/Objectives: The aim of this study was to review the therapeutic and prognostic factors influencing Acanthamoeba Keratitis (AK) management. Methods: A systematic search was performed across MEDLINE® (via PubMed), Web of Science®, and Scopus®, following the [...] Read more.
Background/Objectives: The aim of this study was to review the therapeutic and prognostic factors influencing Acanthamoeba Keratitis (AK) management. Methods: A systematic search was performed across MEDLINE® (via PubMed), Web of Science®, and Scopus®, following the PRISMA 2020 guidelines, and registered in PROSPERO (CRD420251010774). Studies reporting AK treatment regiments and prognostic factors were included. After extracting the data from the included articles, the relevant aspects of the treatment and the prognostic factors were compared and summarized. Results: Sixty-one articles were included: nine were prospective, including 3 randomized controlled trials (RCTs), and fifty-two were retrospective. The findings suggest that therapeutic epithelial debridement (TED), followed by an association with biguanides, diamidines, and an antibacterial agent, is a strong initial treatment option. An adjunctive medical treatment with topical voriconazole 1% or oral miltefosine may also be considered. Surgical approaches were also assessed when the pharmaceutical therapy failed, with Deep Anterior Lamellar Keratoplasty (DALK) playing an important role in the cases without a deep stroma involvement. Early Therapeutic Penetrating Keratoplasty (TPK) should be used as a salvage therapy and Optical Penetrating Keratoplasty (OPK) should be used for rehabilitation purposes. Key prognostic factors include older age, delayed diagnosis, corticosteroid use before prompt diagnosis, poor initial best corrected visual acuity (BCVA), and AK stage at presentation. Conclusions: The initial treatment with TED, biguanides, and diamidines remains the foundation of treatment. Surgical options can be considered in advanced cases. An early diagnosis, age, and initial BCVA are prognosis factors that should be considered. Future research may focus on improvement of protocols and searching for novel agents. Full article
(This article belongs to the Special Issue Clinical Advances and Management in Corneal Diseases)
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