Khodadoust line

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Khodadoust line
Differential diagnosis complication of corneal graft surgery

A Khodadoust Line or chronic focal transplant reaction is a medical sign that indicates a complication of corneal graft surgery on the eye. [1] This method is called Khodadoust Line because of many years research about this by Professor Ali Asghar Khodadoust. This medical condition is similar to organ rejection after an organ transplant, except that it involves immunological rejection of a transplanted cornea rather than an internal organ.

A Khodadoust line is made up of mononuclear cells (white blood cells). These cells appear at the vascularized edge of the recently transplanted cornea. If untreated, the line of white blood cells will move across and damage the endothelial cells of the cornea over the space of several days.

Prompt treatment by immunosuppression can prevent further damage. [2]

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Keratoconus (KC) is a disorder of the eye that results in progressive thinning of the cornea. This may result in blurry vision, double vision, nearsightedness, irregular astigmatism, and light sensitivity leading to poor quality-of-life. Usually both eyes are affected. In more severe cases a scarring or a circle may be seen within the cornea.

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Limbal stem cells, also known as corneal epithelial stem cells, are stem cells located in the basal epithelial layer of the corneal limbus. They form the border between the cornea and the sclera. Characteristics of limbal stem cells include a slow turnover rate, high proliferative potential, clonogenicity, expression of stem cell markers, as well as the ability to regenerate the entire corneal epithelium. Limbal stem cell proliferation has the role of maintaining the cornea; for example, by replacing cells that are lost via tears. Additionally, these cells also prevent the conjunctival epithelial cells from migrating onto the surface of the cornea.

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A corneal button is a replacement cornea to be transplanted in the place of a damaged or diseased cornea normally approximately 8.5–9.0mm in diameter. It is used in a corneal transplantation procedure whereby the whole, or part, of a cornea is replaced. The donor tissue can now be held for days to even weeks of the donor's death and is normally a small, rounded shape. The main use of the corneal button is during procedures where the entirety of the cornea needs to be replaced, also known as penetrating keratoplasty.

References

  1. Corneal Graft Rejection on eMedicine
  2. "Atlas of Ophthalmology". Atlasophthalmology.com. Archived from the original on 2011-07-07. Retrieved 2011-01-02.