James Myerscough

Southend University Hospital NHS Foundation Trust · Department of Ophthalmology

Case A 58-year-old female was referred to our clinic for corneal scarring in the left eye. She previously underwent ipsilateral rotational autokeratoplasty (IRA) for herpetic keratitis in 2001. Day to day visual acuity was 0.74 logMAR and best corrected visual acuity was 0.40 logMAR. Slit lamp exam showed significant stromal scarring in the visual...

Pregnancy is a medical condition in which the physiological changes in the maternal body and the potential impact on the developing fetus require a cautious approach in terms of drug administration. Individual treatment, a thorough assessment of the extent of the disease, and a broad knowledge of the therapeutic options and different routes of admi...

Objectives: After penetrating keratoplasty (PK) for keratoconus, vision can be impaired by high-degree astigmatism, particularly in those patients with recurrent peripheral ectasia. Scleral contact lenses (CLs) have long been used in the management of keratoconus both in treatment-naive corneas and those postcorneal transplants. We report the use...

Unlabelled: *Correspondence, Ahmad Shakeel: drshakeel333@gmail.com PURPOSE: To evaluate the clinical results of postureless (no intraoperative or postoperative posturing) Descemet's membrane endothelial keratoplasty (DMEK) with the first postoperative review conducted at one week. Design: Retrospective, noncomparative, interventional case series...

Unlabelled: *Correspondence, Shakeel Ahmad: drshakeel333@gmail.com PURPOSE: To evaluate the feasibility of residual corneoscleral buttons after primary surgery for practising the donor tissue preparation for Descemet's membrane endothelial keratoplasty (DMEK) by trainees and fellows. Methods: Fellows with zero experience in DMEK used 5 residual...

Unlabelled: *Correspondence, Jesse Panhtagani: jesse.panthagani@nhs.net OBJECTIVE: To investigate the factors associated with the disparity between manifest refractive cylinder (MRC) and keratometric astigmatism (KA) in keratoconic eyes to refine the refractive outcomes of toric intraocular lenses in keratoconic cataract surgery. Methods: A retr...

Purpose: The aim of this study was to describe a new surgical technique to replace a conventional diameter (≤8 mm) deep anterior lamellar keratoplasty (DALK) graft with associated high astigmatism refractory to corneal-based astigmatic procedure/intolerance to contact lenses with a larger diameter (≥9 mm) DALK graft to improve best spectacle-corre...

Background/objectives: To determine the incidence of day one postoperative complications after Descemet Membrane Endothelial Keratoplasty (DMEK) performed with intraoperative inferior peripheral iridotomy (PI), and whether their early detection influences postoperative intervention. Subjects/methods: 70 eyes of 70 consecutive patients that under...

Background/objectives: To describe the visual and clinical outcomes of patients with post endothelial keratoplasty (EK) cystoid macular oedema (CMO) refractory to topical treatment with intravitreal sustained-release dexamethasone implant (Ozurdex). Subjects/methods: 131 eyes from 111 patients undergoing solitary or combined EK (52 DSAEK (40.0%)...

Background/Objectives To report the incidence, microbiological profile and in-vitro antimicrobial susceptibilities of microbial keratitis (MK) in the East of England (EoE) over a 6-year period. Subjects/Methods A retrospective study of patients diagnosed with MK who underwent corneal scraping at participating trusts, within the EoE, between 01/01/...

Purpose: The aim of the study was to present the rates of corneal transplant rejection from 2018 to 2022 at both Moorfields Eye Hospital UK, and Ospedali Privati Forli (OPF) "Villa Igea", Italy and evaluate the purported association between COVID-19 vaccination and rejection. Methods: We performed a retrospective review of rejection cases presen...

Purpose: To examine the safety and efficacy of selective laser trabeculoplasty (SLT) in patients responding to topical steroids with elevated intraocular pressure following endothelial keratoplasty. Methods: Patients that underwent Descemet Membrane Endothelial Keratoplasty (DMEK) or Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) wer...

PURPOSE: The aim of the study was to present the rates of corneal transplant rejection from 2018 to 2022 at both Moorfields Eye Hospital UK, and Ospedali Privati Forli (OPF) “Villa Igea”, Italy and evaluate the purported association between COVID-19 vaccination and rejection. METHODS: We performed a retrospective review of rejection cases presenti...

Purpose: The purpose of this study was to describe a novel surgical technique using an ab interno stromal patch to treat corneal perforation and to present the histological findings of the patch after its removal during definitive mushroom keratoplasty. Methods: The endothelium had already been removed with the submerged cornea using backgrounds...

Purpose To report the outcomes of a new technique, pull-through sutureless ‘mini-DSAEK’, to manage corneal perforations secondary to different aetiologies including trauma, neurotrophic ulcer following penetrating keratoplasty (PK), herpes simplex keratitis and microbial keratitis. Methods In this retrospective case series, we report the clinical...

Learning Points • Retained lens fragment after routine cataract surgery is an uncommon but unfortunate complication and should be suspected in any patient with significant corneal oedema with no history of endothelial disease, especially when the eye is hypertensive. • Conventional examination including gonioscopy is insufficient to rule out retain...

PURPOSE : To report the outcomes of two-piece microkeratome-assisted MK for eyes with full-thickness traumatic corneal scars and otherwise functional endothelium following corneal penetrating injury. DESIGN : Interventional case series METHODS : In this single-center study, 41 consecutive eyes with traumatic corneal scars that underwent two-piece...

Aims To describe the incidence of postoperative cystoid macular oedema (CMO) after endothelial keratoplasty (EK) and to identify its contributory risk factors. Methods 2233 patients undergoing EK at Ospedali Privati Forlì ‘Villa Igea’, between January 2005 to October 2018 for Descemet stripping automated endothelial keratoplasty (DSAEK) and June 2...

Purpose To examine the ultrastructure of the natural plane of separation in grafted corneas and evaluate the outcomes of stromal peeling. Design Interventional case series Methods In this multicenter study, stromal peeling was attempted in 96 consecutive eyes with unsatisfactory vision following penetrating keratoplasty (PK) for keratoconus(n=79)...

Purpose: To describe a surgical technique for the diagnosis and treatment of post-Descemet stripping automated endothelial keratoplasty (DSAEK) infectious interface keratitis presenting as a cold abscess. Methods: This study included 2 eyes of 2 patients that developed delayed-onset interface infections after DSAEK. Through an anterior keratotom...

Purpose: The purpose of this study was to report a surgical technique for closure of a traumatic corneal perforation in a patient with healthy endothelium. Methods: A 69-year-old male patient presented to Southend University Hospital with a 2.5 mm round temporal corneal perforation caused by a metallic foreign body from an industrial accident. B...

Purpose: To evaluate the surgical and 3-year clinical outcomes of modified big-bubble 9-mm deep anterior lamellar keratoplasty (DALK) in eyes with previous ALK (ALK). Methods: In this interventional case series, 21 consecutive eyes with unsatisfactory vision after ALK (superficial ALK n = 9; laser-assisted ALK n = 7; and epikeratophakia n = 5) u...

Background/aims To evaluate the clinical outcomes of deep anterior lamellar keratoplasty performed by stromal peeling in eyes that have previously undergone penetrating keratoplasty (PK) for keratoconus. Methods Standardised stromal exchange included (1) 9 mm trephination of the recipient bed outside the old PK wound, (2) creation of a partial ant...

This case report describes a negative result for antigen testing for the SARS-CoV-2 virus in an aqueous sample taken during the management of suspected herpes simplex keratitis from a patient with confirmed SARS-CoV-2 based on antigen testing of high nasal swab. The implications of no viral load detectable in the aqueous sample are discussed in con...

Background/aims: To report the 10-year outcomes of modified microkeratome-assisted lamellar keratoplasty (LK) for keratoconus. Methods: In this single-centre interventional case series, 151 consecutive eyes with keratoconus underwent modified microkeratome-assisted LK. Eyes with scars extending beyond the posterior half of the corneal stroma and...

Purpose To report the 3-year outcomes of tri-folded, endothelium-in Descemet membrane endothelial keratoplasty (DMEK) using bimanual pull-through delivery technique. Design Interventional case series Methods In this single center study, 153 consecutive eyes undergoing DMEK for various indications (Fuchs endothelial corneal dystrophy (FECD) n=111;...

Purpose To compare the 5-year outcomes of 9mm deep anterior lamellar keratoplasty (DALK) for keratoconus against those converted to mushroom keratoplasty (MK). Design Retrospective cohort study Methods . Setting Ospedali Privati “Villa Igea”, Department of Ophthalmology, Forlì, Italy Patient or Study Population The medical records of all attemp...

Purpose To report the outcomes of initial high-dose and extended taper of antiviral and steroid prophylaxis for the treatment of eyes with high-risk vascularized herpetic corneal scars that underwent two-piece mushroom keratoplasty (MK). Design Prospective interventional case series. Methods In this single-center study, 52 consecutive eyes with v...

Donor‐to‐host transmission of infection is a rare complication of corneal transplantation. Recent evidence reported an increasing trend in the incidence of fungal infection after endothelial keratoplasty compared to penetrating keratoplasty (PK), although neither observation reached statistical significance. The main reason is the creation in lamel...

Purpose: To identify predictors of bubble formation and type during big-bubble deep anterior lamellar keratoplasty (BB-DALK) performed in keratoconus at different stages of severity. Design: Retrospective Cohort Study. Methods: Setting: University Magna Græcia (Catanzaro, Italy); Study Population: Consecutive keratoconus patients undergoing BB...

Purpose: To report the outcomes of Descemet membrane endothelial keratoplasty (DMEK) with intensive antiviral therapy for corneal edema secondary to herpes simplex virus type 1 (HSV-1)-mediated endotheliitis. Methods: All eyes with polymerase chain reaction positive for HSV-1 undergoing DMEK for endothelial decompensation between January 2014 an...

To describe a new surgical technique to correct a high astigmatism following modified deep anterior lamellar keratoplasty (DALK) and to evaluate the associated clinical outcomes. Retrospective interventional case series included eyes with high astigmatism following modified DALK performed between July 2012 and June 2016. The prevalence of keratomet...

Purpose: To evaluate the orientation of keratometric astigmatism (KA) after deep anterior lamellar keratoplasty (DALK) for keratoconus and its correlation with preoperative peripheral KA. Methods: This is a retrospective, single-center observational study including keratoconic patients undergoing DALK between January 2016 and January 2017 with r...

Purpose: To determine whether autologous Descemet stripping endothelial keratoplasty is technically feasible and whether it eliminates the risk of endothelial rejection in "only eyes" at high risk of immunological rejection. Methods: This is a prospective observational interventional study from 2016 to 2018 with a 24-month follow-up in a tertiar...

Background/aims To identify and evaluate risk factors associated with the need to convert intended deep anterior lamellar keratoplasty (DALK) to penetrating keratoplasty (PK). Methods Retrospective institutional cohort study including all consecutive eyes undergoing intended DALK between May 2015 and October 2018 at ‘Villa Igea’ Hospital (Forli, I...

AIMS: To evaluate deep corneal densitometry and visual outcomes after big-bubble (BB-DALK) and visco-bubble (VB-DALK) deep anterior lamellar keratoplasty performed in patients with keratoconus. METHODS: Prospective comparative study of 50 advanced keratoconic patients who underwent DALK surgery; 25 eyes (group I) were completed with BB-DALK an...

Background/Aims To evaluate the 5-year outcomes of sutureless superficial anterior lamellar keratoplasty (SALK) in the treatment of surface ablation-related corneal haze recurring after phototherapeutic keratectomy (PTK). Methods Prospective interventional study at a tertiary referral centre in Forli, Italy. Ten consecutive eyes with corneal haze...

Purpose: To evaluate the feasibility of regularizing the peripheral corneal thickness before deep trephination in highly irregular corneas undergoing deep anterior lamellar keratoplasty (DALK) by means of intrastromal hydration with saline. Methods: This is an interventional case series including all eyes with irregular peripheral corneal thickn...

Purpose To evaluate the relationship between surgical experience and the success rate of pneumatic dissection for deep anterior lamellar keratoplasty (DALK) using deep trephination. Methods A noncomparative case series evaluating the first 10 consecutive keratoconic eyes without deep stromal scarring, operated by 8 surgeons of 3 different experien...

Purpose: To identify risk factors predictive of postoperative double anterior chamber formation after deep anterior lamellar keratoplasty (DALK). Design: Retrospective institutional cohort study. Methods: The study group included all consecutive eyes undergoing primary DALK between May 2015 and October 2018 at Villa Igea private hospital (Forl...

Purpose: To report the outcomes of a modified deep anterior lamellar keratoplasty (DALK) procedure for the treatment of scarred corneas in otherwise healthy pediatric eyes. Methods: All pediatric eyes undergoing DALK by the same surgeon (M.B.) between July 2013 and June 2017 were enrolled. The standard DALK procedure was modified by including a...

Aim To provide a quantitative assessment of cataract theatre lists focusing on productivity and staffing levels/tasks using time and motion studies. Methods National Health Service (NHS) cataract theatre lists were prospectively observed in five different institutions (four NHS hospitals and one private hospital). Individual tasks and their timing...

To examine the effect of rounding of visual acuity data on estimates of surgical performance. In this observational study, the distribution of 1-year Snellen visual acuity data from 606 endothelial keratoplasties from the NHSBT UK transplant database was analysed. A curve was fitted to the data and used to estimate the frequencies of partly read Sn...