Bhogal, Maninder Singh; (2020) Improving Outcomes in minimally invasive endothelial keratoplasty. Doctoral thesis (Ph.D), UCL (University College London).

Preview	Text M.Bhogal Thesis Corrected.pdf - Accepted Version Download (182MB) | Preview
	Video supplementary video 4.1 - endothelial damage associated with graft insetion .mov - Supplemental Material Download (123MB)
	Video suppplementary vide 6.2 EMT under DMT edge.mov - Supplemental Material Download (14MB)
	Video Supplementary video- EMT under DMEK 5.3.mov - Supplemental Material Download (28MB)
	Video Supplementary Video 7.1 rejection video .mp4 - Supplemental Material Download (36MB)
	Video supplementary video 6.1 DMT,Peel,scrape short.mp4 - Supplemental Material Download (6MB)
	Video supplemenatry video 5.2 rabbit dsaek.mp4 - Supplemental Material Download (8MB)
	Video supplementary video 5.1 rabbit dmek.mov - Supplemental Material Download (89MB)

Abstract

Corneal disease ranks second only to cataract as the leading cause of preventable blindness globally, and corneal transplantation is the commonest tissue transplant procedure performed worldwide. Whilst scarring and infection are overwhelmingly the major causes of corneal sight-loss in the developing world, in the USA, Europe and parts of Asia (e.g. Singapore and Australia) endothelial dysfunction is the primary indication for corneal transplantation. Over the past 20 years there has been a paradigm shift in the management of corneal endothelial dysfunction. Endothelial keratoplasty (EK), in which the patients’ diseased endothelium is selectively replaced with donor endothelial cells, has now surpassed penetrating keratoplasty in developed nations. This move from penetrating keratoplasty (PK) to EK – small-incision, lamellar transplantation – has hastened visual recovery, reduced post-operative refractive errors, reduced vulnerability to injury after surgery, and widened access to surgery under local anaesthetic. However, each iteration of EK has come with a new surgical learning curve, initial increases in donor tissue manipulation, and associated increases in primary graft failure rates. The goal in corneal transplantation for endothelial failure remains a minimally invasive, refractively neutral, and technically simple transplant that provides quick recovery and lasting restoration of endothelial function. Preservation of endothelial cell density during donor material preparation, implantation and storage are key to transplant survival. Low immunogenicity is desirable to reduce endothelial failure subsequent to rejection. Tools for assessing endothelial damage at each stage of the transplant process are pivotal to the development of new surgical strategies. In this thesis I describe the development of new image-based, viability assessment techniques that allow endothelial damage to be assessed at each stage of the transplant process.

Download activity - last month

Export as XMLCSVJSON

Download activity - last 12 months

Export as XMLJSONCSV

Downloads by country - last 12 months

Export as XMLJSONCSV

Archive Staff Only

View Item