Lixia Lin

Intrastromal corneal ring segments (ICRS) are small, crescent shaped plastic rings placed in the deep, peripheral corneal stroma to flatten the cornea. Corneal melting is a rare complication of ICRS implantation, with no long term effects reported. Although ocular toxicities are associated with paclitaxel (PTX), corneal melting from PTX therapy remains rare. Here we report a case of corneal melting in a patient who had ICRS implanted 20 years ago following recent PTX therapy for breast cancer. A 35 year old female patient presented with eye pain, photophobia, and blurry vision in her left eye, following a history of ICRS implantation 20 years ago. She was diagnosed with breast cancer 6 months ago and was undergoing PTX chemotherapy therapy. Ocular examination revealed bilateral meibomian gland dysfunction (MGD) and corneal melting in the left eye at the site of the corneal ring. Treatment initially included only eye drops mainly to promote epithelial repair and control inflammation. After 2 weeks, the corneal melting showed signs of healing; however, the patient continued complaining about eye pain and discomfort. Subsequently, amniotic membrane transplantation (AMT) and corneal contact lenses were initiated, leading to significant improvement after 2 months of treatment.

Background: Chronic ocular graft-versus-host disease (oGVHD) is a common ocular complication following allogeneic hematopoietic stem cell transplantation (allo-HSCT), characterized by progressive inflammation of the ocular surface and refractory dry eye. In severe cases, sterile corneal perforation can occur, which poses a significant challenge, due to the low survival rate of grafts after corneal transplantation. Case Presentation: A 47-year-old female presented to our hospital with persistent dryness, foreign body sensation, and blurred vision in her left eye. Diagnosis of graft-versus-host disease with corneal descemetocele in the left eye was made after detailed history review and thorough examination. Multi-layer amniotic membrane transplantation was performed in the affected eye, resulting in amelioration of the patient’s symptoms. This amelioration of symptoms provided the patient with a level of comfort that permitted additional time while awaiting corneal transplantation. Conclusions: We report a successful case of multi-layer amniotic membrane transplantation for the management of corneal descemetocele following allo-HSCT.

Inflammation is the main cause of corneal and retinal damage in an ocular alkali burn (OAB). The aim of this study was to investigate the effect of tauroursodeoxycholic acid (TUDCA) on ocular inflammation in a mouse model of an OAB. An OAB was induced in C57BL/6j mouse corneas by using 1 M NaOH. TUDCA (400 mg/kg) or PBS was injected intraperitoneally (IP) once a day for 3 days prior to establishing the OAB model. A single injection of Infliximab (6.25 mg/kg) was administered IP immediately after the OAB. The TUDCA suppressed the infiltration of the CD45-positive cells and decreased the mRNA and protein levels of the upregulated TNF-α and IL-1β in the cornea and retina of the OAB. Furthermore, the TUDCA treatment inhibited the retinal glial activation after an OAB. The TUDCA treatment not only ameliorated CNV and promoted corneal re-epithelization but also attenuated the RGC apoptosis and preserved the retinal structure after the OAB. Finally, the TUDCA reduced the expression of the endoplasmic reticulum (ER) stress molecules, IRE1, GRP78 and CHOP, in the retinal tissues of the OAB mice. The present study demonstrated that the TUDCA inhibits ocular inflammation and protects the cornea and retina from injury in an OAB mouse model. These results provide a potential therapeutic intervention for the treatment of an OAB.