Cornea and External Eye Disease: Corneal by Jerry Y. Niederkorn (auth.), Thomas Reinhard, Frank Larkin

By Jerry Y. Niederkorn (auth.), Thomas Reinhard, Frank Larkin (eds.)

The eight routine volumes of the "Essentials in Ophthalmology" sequence disguise the newest advancements in a single of 8 subspecialties in Ophthalmology. With 4 volumes released in line with yr, each one subspecialty is newly visited each 24 months, with a special specialise in fresh advancements. through bridging the space among unique study and clinical textbooks, the move of this constructing wisdom into day-by-day perform is drastically enhanced.

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Extra resources for Cornea and External Eye Disease: Corneal Allotransplantation, Allergic Disease and Trachoma

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23 Transgenes for Prolonging Corneal Graft Survival At this stage, gene therapy approaches for corneal transplantation have been restricted to laboratory studies using animal models. No clinical studies have been undertaken. Most of the work has been done in inbred rodents, and some in larger outbred animals such as sheep. Species differences have considerable influences on outcomes. 1) [41–52]. For the most part, gene therapy in rats and mice has produced rather modest prolongation of corneal graft survival, but the results are sufficiently encouraging to suggest that ex vivo transduction of corneas prior to transplantation is worthy of exploration in pre-clinical models.

The pathogenesis of chronic rejection is not clear. Chronic rejection is up to now only characterized by accelerated endothelial cell loss; however, this question is still not answered sufficiently [2, 3]. Chronic rejection cannot be prevented sufficiently with current immunosuppressive drugs (which mainly work through their interference with T cells), so the present strategy is to limit the number of acute rejection episodes. , the number and severity of acute rejection episodes and recurrence of herpetic ocular disease.

This might partially be explained by its relatively narrow safety margins. While CSA might be given in a body weight-adjusted dose (a sub-optimal therapeutic approach), Tacrolimus has to be closely monitored because there is a greater risk of over-immunosuppression . This is also the reason for the initial, rather unjustified, bad reputation of this drug: initially, blood levels of 20–30 ng/ml have been targeted (with corresponding adverse events), whereas today blood levels of 5–10 ng/ml are considered as the optimal range.

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