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Medicina
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Advances in Corneal Management
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Advances in Corneal Management

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Ophthalmology".

Deadline for manuscript submissions: 30 September 2025 | Viewed by 1292

Special Issue Editors

Dr. Sanja Masnec

E-Mail Website
Guest Editor
Department of Ophthalmology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
Interests: cornea; crosslinking; corneal transplantations; anterior segment diseases; cataract surgeries; dry eye disease; ophthalmic plastic and reconstructive surgeries
Prof. Dr. Rafael I. Barraquer

E-Mail Website
Guest Editor
Institut Universitari Barraquer, Autonomous University of Barcelona, Barcelona, Spain
Interests: keratoconus; corneal topography; cataract surgery; refractive surgery; laser corneal surgery; corneal diseases; astigmatism; refractive eye surgery; intraocular lens; presbyopia

Special Issue Information

Dear Colleagues,

Corneal disease and transplantation have represented prominent topics of interest since ancient times, with the first methods for corneal transplantation dating back to the ancient Greek physician Galen. The first successful human corneal transplantation was performed in 1905 by Eduard Zinn, and, since then, progress in this field has been remarkable. However, in some cases, the management and treatment of numerous corneal conditions/illnesses, such as keratoconus, Fuchs’ dystrophy, corneal ulcers, infections, and various traumas, remains a challenge. As these disorders affect millions of people globally and frequently result in severe visual impairment, novel therapeutic strategies are required.

In addition to the above, this Special Issue will also focus on novelties in the field of refractive surgery, which has revolutionized vision correction. While advancements in corneal remodeling techniques continue to evolve, together with new possibilities, they also bring with them many challenges.

Our aim in launching this Special Issue is to present novel and original research, reviews, and clinical studies in the field of corneal diseases/conditions, corneal transplantation, and refractive surgery in order to provide an overview of current knowledge, therapeutic options, and future research directions in this field. We are eager to publish not only clinical work but also pre-clinical and laboratory research that can help us understand the mechanisms responsible for corneal pathology and its treatment. Studies exploring novel diagnostic tools and therapeutic approaches are particularly welcome.

We look forward to advancing and developing research on corneal illness and transplantation, in addition to refractive surgery, by bringing together innovative studies and a range of viewpoints.

Dr. Sanja Masnec
Prof. Dr. Rafael I. Barraquer
Guest Editors

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. Medicina is an international peer-reviewed open access monthly 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 2200 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

  • cornea
  • corneal disease
  • corneal transplantation
  • keratoconus
  • keratoplasty
  • penetrating keratoplasty
  • descemet stripping automated endothelial keratoplasty
  • deep anterior lamellar keratoplasty
  • descemet membrane endothelial keratoplasty
  • cross-linking
  • corneal infections
  • refractive surgery
  • photorefractive keratectomy
  • laser-assisted in situ keratomileusis
  • kerato–lenticule extraction
  • corneal imaging

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

Published Papers (2 papers)

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12 pages, 896 KiB  
Article
Comparative Analysis of Corneal Morphological and Optical Parameters in Predicting DSAEK Surgery Outcome
by Antonela Geber, Sanja Masnec, Miro Kalauz, Iva Bešlić, Ivan Škegro, Dina Lešin Gaćina, Sonja Jandroković, Ana Meter and Tomislav Kuzman
Medicina 2025, 61(6), 1022; https://doi.org/10.3390/medicina61061022 - 31 May 2025
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Abstract
Background and Objectives: Descemet stripping automated endothelial keratoplasty (DSAEK) is a widely used surgical technique for treating corneal endothelial dysfunctions such as Fuchs endothelial corneal dystrophy (FECD) and pseudophakic bullous keratopathy (PBK). This study aimed to investigate the association between postoperative visual [...] Read more.
Background and Objectives: Descemet stripping automated endothelial keratoplasty (DSAEK) is a widely used surgical technique for treating corneal endothelial dysfunctions such as Fuchs endothelial corneal dystrophy (FECD) and pseudophakic bullous keratopathy (PBK). This study aimed to investigate the association between postoperative visual acuity and various corneal morphological and optical parameters, including corneal densitometry (CD) and higher-order aberrations (HOAs), measured using the Pentacam (OCULUS Optikgeräte GmbH, Wetzlar, Germany), as well as graft thickness, which was assessed by anterior segment optic coherence tomography (AS-OCT), (Optovue Inc., Fremont, CA, USA), and corneal thickness, assessed by both AS-OCT and Pentacam. Materials and Methods: This prospective, observational cohort study included 17 eyes from 13 patients who underwent DSAEK. Data on preoperative visual acuity were collected, while postoperative parameters were assessed during follow-up visits. Corneal measurements included the total corneal and corneal graft thickness, corneal densitometry in 20 defined subregions, and corneal higher-order aberrations. Associations between these parameters and postoperative visual acuity were evaluated using nonparametric statistical tests. Results: The postoperative visual acuity improved significantly (p < 0.001). Strong correlations were found between poorer visual acuity and higher CD values. The strongest correlations with visual acuity were found for CD 2–6 mm total (Rho = 0.795; p < 0.001), CD central 2–6 mm (Rho = 0.791; p < 0.001), and CD central 0–2 mm (Rho = 0.730; p < 0.001). Significant associations were also observed with anterior and posterior HOAs (Rho = 0.624, p = 0.01; and Rho = 0.556, p = 0.02, respectively). No correlation was found between visual outcomes and graft thickness measured by AS-OCT (Rho = 0.051; p = 0.85), nor with total corneal thickness measured by AS-OCT (Rho = −0.227; p = 0.38) or Pentacam (Rho = −0.369; p = 0.14). Conclusions: This study demonstrates that CD and HOAs are more strongly associated with postoperative visual acuity after DSAEK than traditionally monitored parameters such as graft or corneal thickness. The results highlight the value of detailed corneal imaging and support the use of advanced optical diagnostics in postoperative evaluation. Full article
(This article belongs to the Special Issue Advances in Corneal Management)
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Review

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9 pages, 731 KiB  
Review
Rho-Kinase Inhibitors in the Management of Fuchs Endothelial Corneal Dystrophy: A Review
by Anđela Jukić, Ana Pupić Bakrač, Biljana Đapic Ivančić, Andrijana Kopić, Ana Meter, Rajka Kasalica Žužul, Josip Pavan and Tomislav Jukić
Medicina 2025, 61(5), 772; https://doi.org/10.3390/medicina61050772 - 22 Apr 2025
Viewed by 785
Abstract
Fuchs endothelial corneal dystrophy (FECD) is the most common corneal endothelial dystrophy. It is characterized by the progressive loss of corneal endothelial cells (CECs), guttae formation on the Descemet membrane, and corneal edema, leading to visual impairment. Corneal transplantation remains the standard treatment, [...] Read more.
Fuchs endothelial corneal dystrophy (FECD) is the most common corneal endothelial dystrophy. It is characterized by the progressive loss of corneal endothelial cells (CECs), guttae formation on the Descemet membrane, and corneal edema, leading to visual impairment. Corneal transplantation remains the standard treatment, but it has limitations such as donor shortages, infection risk, and graft rejection. Rho-kinase (ROCK) inhibitors have emerged as a promising pharmacological alternative. These agents promote CEC proliferation, migration, and adhesion while inhibiting apoptosis and enhancing corneal endothelial wound healing. Several studies have demonstrated the efficacy of ROCK inhibitors in improving corneal clarity and endothelial function, particularly when used as an adjunct to Descemet Stripping Only (DSO) surgery. Additionally, they show potential in preventing corneal edema in FECD patients undergoing cataract surgery. The methodology involved a literature search through the PubMed and Medline databases using relevant keywords. Only peer-reviewed articles in English were included, with additional references from selected articles reviewed to ensure comprehensive coverage. ROCK inhibitors offer a novel pharmacological approach to managing FECD. They have shown potential in promoting endothelial cell regeneration and improving corneal functIion. Despite promising results, further research is required to determine ROCK inhibitors’ long-term safety, optimal dosing, and efficacy in surgical and non-surgical FECD patients. Their potential to delay or prevent corneal transplantation represents a significant advancement in FECD management. Full article
(This article belongs to the Special Issue Advances in Corneal Management)
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