The cornea is the transparent front part of the eye covering the iris and the pupil, allowing light to enter and covering two thirds of the eye’s focusing tasks. This two volume set is a comprehensive guide to the latest research and techniques for the cornea. Beginning with basic science, examination techniques and epidemiology, the following chapters discuss the diagnosis and the medical and surgical treatment of numerous different conditions and diseases that may affect the cornea. Written by an extensive international editor and author team, this manual features more than 1300 full colour clinical and histopathological images, as well as a DVD demonstrating a multitude of surgical techniques described in the book. Key points Comprehensive two volume set describing diagnosis and treatment of numerous corneal disorders Features more than 1300 colour images and illustrations Includes a DVD demonstrating surgical techniques and procedures Extensive international author and editor team
Imagination is the key to any discovery, and its presence in the science to improve vision is no exception. Vision science is racing forward, spurred on by a host of exciting novel research discoveries and the efforts of scientists. This book, a collection of reviewed and relevant research chapters, intends to provide readers with a comprehensive overview of the latest and most advanced findings in several aspects of ophthalmology, ophthalmic pathology, ocular imaging, and certain treatments and surgical strategies. It is an excellent, well-integrated review of treatment options in eye disease that aims to provide a thorough overview of the recent developments written by international authors. "Frontiers in Ophthalmology and Ocular Imaging" can be used as an important reference for clinically oriented ophthalmologists and scientists.
Mastering Corneal Surgery: Recent Advances and Current Techniques comprehensively covers all the recent advances in the existing techniques for common and rare corneal conditions, as well as presents the potential intraoperative circumstances the surgeon can face with their patients. Mastering Corneal Surgery: Recent Advances and Current Techniques by Drs. Amar Agarwal and Thomas John, along with more than 50 contributors, cover the most recent innovations in corneal surgery, including corneal procedures in combination with IOL implantation in eyes with deficient capsules, and combining endothelial keratoplasty with IOL repositioning. Bonus! Extensive high-quality video demonstrations of the techniques discussed inside Mastering Corneal Surgery: Recent Advances and Current Techniques enhances the written text, creating a superior companion website resource. The 28 videos, combined with the written text, clinical photographs and pictures, furthers the learning process more than learning from text or video alone. Mastering Corneal Surgery: Recent Advances and Current Techniques covers all the recent advances in the existing techniques for common and rare corneal conditions and presents the potential intraoperative circumstances the surgeon can encounter with their patients. The general ophthalmologist and cornea specialist will welcome the novel surgical methods and their differences from the existing techniques highlighted inside this cutting-edge resource.
Core Concepts Perianesthesia Organization and Administration Preanesthesia Care and Preparation of the Patient and Family Phase I and Phase II Recovery Airway Issues Pain Management Postoperative and Postdischarge Nausea and Vomiting Thermoregulation Issues Fluid, Electrolyte, and Acid-Base Imbalance Integumentary Issue Infection Prevention Strategies Population Specific Principles of Anesthesia Bariatric Patients Patients with Chronic Diseases Critically Ill Patients Extended Care/Observation Care Patients Geriatric Patients Trauma Patients Patients with Mental Health Considerations Families of Perianesthesia Patients Pediatric Patients Pregnant Patients Surgery Specific Abdominal Cardiac Surgery Plastic and Reconstructive Surgery Dental and Oral Maxillofacial Surgery The Endocrine System ENT Surgery Genitourinary Surgery Gynecologic & Obstetric Neurosurgical Surgical Oncology Ophthalmic Orthopedic Surgery Thoracic Liver and Kidney Transplantation Vascular Surgery Cardiovascular Interventional Endoscopic/Laparoscopic/Minimally Invasive Procedures.
Pathologic angiogenesis is involved in cancer and several blinding conditions such as wet age-related macular degeneration, proliferative retinopathies and corneal neovascularization. In these dieseases, the angiogenic triggers are hypoxia and inflammation, and both involve the main angiogenic mediator, which is Vascular Endothelial Growth Factor (VEGF). Among available treatments, anti-VEGF often shows limited or temporary efficacy, while steroids are potentially responsible for many side-effects. This thesis presents a series of linked studies aimed at elucidating the early pathologic changes leading to inflammation and corneal neovascularization, and how various treatments affect this process. In this thesis, anti-inflammatory and anti-angiogenic treatments are applied in corneal neovascularization models, to identify VEGF-independent pathways and other novel factors as future therapy targets, as well as to investigate the endogenous modulation of angiogenesis. A model of experimental neovascularization in the rat cornea was used as main model, where the neovascular response is triggered by a surgical suture placed into the cornea. Investigational treatments (anti-Vegf, dexamethasone, IMD0354, Gap27, or control substances) were then given topically, with the exception of IMD0354, which was given systemically. The effects in the cornea were studied in vivo with slit lamp photography to assess and quantify macroscopic vessel growth and using in vivo confocal microscopy (IVCM) to study cell infiltration and limbal vessel dilation and detect microscopic vessel sprouts; these examinations were performed longitudinally. Genomic analysis with RNA microarray, selected gene expression with q-RT-PCR, and selected protein expression in tissue (immunohistochemistry, immunofluorescence, Western blot) were performed at different time-points. Moreover, other experiments on cell cultures (HUVEC and HCEC), organ cultures (human corneas), ex vivo models (aortic rings) and in vivo studies (zebrafish vasculogenesis) were performed. Dexamethasone suppressed limbal vasodilation and corneal neovascularization more than anti-Vegf, despite no difference in inflammatory cell infiltration into the cornea. Five-hundred eleven fewer genes were differentially expressed in dexamethasone-treated corneas relative to naïve corneas, compared to anti-Vegf. Among them, several major pro-angiogenic and pro-inflammatory factors and chemokines were suppressed only by dexamethasone and represent novel candidate factors to target in order to improve anti-VEGF treatment. On the other hand, selective inhibition of a single inflammatory pathway (NF-?B), despite showing similar early effects as dexamethasone in suppressing tissue inflammation, was not effective enough to suppress new vessel growth. The same factors suppressed by dexamethasone are also inhibited in endogenous modulation of angiogenesis. Surprisingly, dexamethasone activated several complement factors, which could possibly be beneficial in the anti-angiogenic response. In a different therapeutic approach, promoting cell migration to accelerate epithelial wound closure similarly was not sufficient to avoid inflammation and angiogenesis in the cornea. In conclusion, new and more effective treatments are needed for corneal inflammation and neovascularization with fewer side-effects. In this thesis, several novel factors and mechanisms related to inflammation are identified, factors that are not addressed by anti-Vegf therapy, and therefore represent interesting objects for further study, as they have the potential to be targets for adjuvant therapy. Specific anti-inflammatory treatment as well as therapeutic activation of endogenous regulatory pathways, and potentially complement modulation, might represent new strategies to improve anti-angiogenic therapy, but when used alone they do not seem to avoid corneal neovascularization.
Inflammation and angiogenesis, the growth of new blood vessels from pre-existing ones, are involved in tumor growth, ocular diseases and wound healing. In ocular angiogenesis, new pathological vessels grow into a specific eye tissue, leak fluid, and disrupt vision. The development of safe and effective therapies for ocular angiogenesis is of great importance for preventing blindness, given that current treatments have limited efficacy or are associated with undesirable side effects. The search for alternative treatment targets requires a deeper understanding of inflammation and how it can lead to angiogenesis in the eye in pathologic situations. This thesis provides new insights into the regulation of inflammation and angiogenesis, particularly at the gene expression and phenotypic levels, in different situations characterized by angiogenesis of the cornea, often called corneal neovascularization. For instance, specific genes and pathways are either endogenously activated or suppressed during active inflammation, wound healing, and during resolution of inflammation and angiogenesis, serving as potential targets to modulate the inflammatory and angiogenic response. In addition, as part of the healing response to restore corneal transparency, inflammation and angiogenesis subside with time in the cornea. In this context, LXR/RXR signaling was found to be activated in a time-dependent manner, to potentially regulate resolution of inflammation and angiogenesis. During regression of new angiogenic capillaries, ghost vessels and empty basement membrane sleeves are formed, which can persist in the cornea for a long time. Here, ghost vessels were found to facilitate subsequent revascularization of the cornea, while empty basement membrane sleeves did not revascularize. The revascularization response observed here was characterised by vasodilation, increased inflammatory cell infiltration and by sprouting at the front of the reperfused vessels. Importantly, reactive oxygen species and nitrous oxide signaling among other pro-inflammatory pathways were activated, and at the same time anti-inflammatory LXR/RXR signaling was inhibited. The interplay between activation and inhibition of these pathways highlights potential mechanisms that regulate corneal revascularization. When treating corneal neovascularization clinically, corticosteroids are in widespread use due to their effectiveness. To minimize the many undesirable side effects associated with corticosteroid use, however, identifying new and more selective agents is of great importance. Here, it was observed that corticosteroids not only suppressed pro-inflammatory chemokines and cytokines, but also activated the classical complement pathway. Classical complement may represent a candidate for further selective therapeutic manipulation to investigate its effect on treatment of corneal neovascularization. In summary, this thesis identifies genes, pathways, and phenotypic responses involved in sprouting and remodeling of corneal capillaries, highlights novel pathways and factors that may regulate inflammation and angiogenesis in the cornea, and provides insights into regulation of capillary regression and reactivation. Further investigation of these regulatory mechanisms may offer alternative and effective treatment targets for the treatment of corneal inflammation and angiogenesis.
This book provides a comprehensive, practical, and state-of-the art review addressing the major issues and challenges in cytopathology practice using a question and answer format. Making an accurate diagnosis, especially on a limited cytology sample obtained by minimally invasive procedures, is often challenging, yet crucial to patient care. Using the most current and evidence-based approaches, this book: 1) focuses on frequently asked questions in day-to-day practice of cytopathology as well as surgical pathology; 2) provides quick, accurate, and useful answers; 3) emphasizes the importance of clinical, radiological, and cytological correlation, as well as cyto-histological correlation; and 4) delineates how to judiciously use immunohistochemistry, molecular tests, flow cytometry, cytogenetics, and other established ancillary studies including next generation sequencing and computer-assisted diagnostics. Chapters are written by experts in their fields and provide the most up-to-date information in the field of cytopathology. Practical Cytopathology: Frequently Asked Questions serves as a practical resource and guide to relevant references for trainees, cytotechnologists, and cytopathologists at various skill levels.
Volume 1 of this edited book covers basics of endothelial keratoplasty and various surgical techniques currently in use. Chapters on DSAEK, DMEK, big bubble, air pump-assisted and endoilluminator assisted DMEK/PDEK, pre-Descemet’s endothelial keratoplasty (PDEK), and Descemet’s membrane endothelial transfer (DMET) complete the topics on various surgical procedures. Complex situations and complications have been covered in volume 2 of Mastering Endothelial Keratoplasty. Endothelial keratoplasty is a field of great interest to all corneal surgeons. It is an exciting and evolving field in corneal transplantation as the newer techniques of DSAEK, DMEK, E-DMEK and PDEK have inherent advantages that make them supersede the older techniques by far. Hence, in today's scenario with the clearly superior results that these techniques offer, it is imperative for all corneal surgeons to learn them and know everything about managing the patient from the pre-operative to the postoperative period. This two-volume book is a must-read for the beginner as well as the established ophthalmologist with interest in corneal transplantation. It is also a must-have for educational institutions, hospital- based libraries and for post-graduate students, fellows and residents who want to expand their knowledge.
This book, "Histopathology-An Update" is a comprehensive book that deals with the latest advances in the field of histopathology. This book will be of help to pathologists, clinicians and researchers in the latest update in histopathology of various organs.
Permanent surgical treatment for presbyopia remains the hereto unconquered “last frontier” in anterior segment surgery. Over the years, continuing innovations like Phaco, Radial Keratotomy, LASIK, and premium intraocular lenses have pushed toward this ultimate goal, but now anterior segment surgery is closer than ever with the advent of modern laser-assisted presbyopic lens implantation. Let Refractive Lens Exchange: A Surgical Treatment for Presbyopia, the first book of its kind, be your guide to this fifth wave of innovation in the surgical treatment of presbyopia. Dr. Ming X. Wang, MD, PhD, joined by Associate Editor Dr. Tracy S. Swartz, OD, MS, FAAO and more than 30 expert contributors, compiled this remarkable book. Never before has there been a book dedicated to all aspects of refractive lens exchange as a permanent treatment for presbyopia, both medically and surgically. Highlights of Refractive Lens Exchange include: Overview of all surgical treatments for presbyopia Dysfunctional lens syndrome and pathophysiology Patient education and preoperative assessment Marketing refractive lens exchange as a surgical treatment for presbyopia New technologies in assessing dysfunctional lens syndrome New technologies in mapping cornea and lens for refractive lens exchange Retinal issues related to refractive lens exchange Presbyopic lens types, indications, and contraindications for refractive lens exchange Lens- and cornea-based astigmatism correction Intraocular calculations for post refractive surgery eyes for refractive lens exchange Intraoperative wavefront technology 3D high-definition microsurgical visualization and positioning technology Femtosecond laser application in refractive lens exchange Postoperative care and complication management YAG capsulotomy after refractive lens exchange: indications and alternatives Postoperative care and complication management Keratorefractive enhancement Designed for newcomers as well as seasoned eyecare professionals, Refractive Lens Exchange: A Surgical Treatment for Presbyopia is the first book to guide ophthalmic surgeons, optometrists, and technicians through this exciting new field that is emerging as a safe and effective primary surgical treatment for presbyopia.
