Publications by authors named "Allan Slomovic"
Purpose: To identify areas of consensus among experts on the performance of endothelial keratoplasty by using a modified Delphi approach, to help create a framework for novice surgeons to adopt these procedures.
Methods: Thirty-one international experts in endothelial keratoplasty participated. Two rounds of electronic survey were followed by a hybrid, virtual meeting.
Purpose: Ocular surface disorders (OSDs) can severely affect vision and quality of life. Autologous blood products, such as plasma rich in growth factors (PRGF), are recently available to treat OSDs refractory to traditional therapies. This review aims to summarize the efficacy and safety of PRGF in OSDs.
View Article and Find Full Text PDFPurpose: To compare long-term outcomes of simultaneous accelerated corneal crosslinking (CXL) with intrastromal corneal ring segments (CXL-ICRS) with simultaneous accelerated CXL with topography-guided photorefractive keratectomy (CXL-TG-PRK) in progressive keratoconus (KC).
Setting: Kensington Eye Institute and Bochner Eye Institute, Toronto, Canada.
Design: Prospective nonrandomized interventional study.
Objective: To describe clinical features and management of toxic keratoconjunctivitis associated with punctal and (or) canaliculus stenosis (toxic soup syndrome).
Design: Retrospective observational case series.
Methods: Electronic medical record database search for the keywords "toxic soup syndrome" and retrospective chart review were performed.
Article Synopsis
- The study aimed to compare the effectiveness of femtosecond-enabled deep anterior lamellar keratoplasty (FE-DALK) with standard deep anterior lamellar keratoplasty (S-DALK) for patients with keratoconus or corneal scarring.
- A total of 100 eyes from 97 participants were randomly assigned to either FE-DALK or S-DALK, with key measurements focused on postoperative astigmatism and other visual outcomes taken at 15 months.
- The results indicated similar outcomes for both techniques, showing comparable levels of postoperative astigmatism and surgically induced corneal astigmatism, suggesting that both methods are equally effective.
Purpose: To report outcomes of keratolimbal allograft (KLAL) compatible for both human leukocyte (HLA) and/or blood type using oral prednisone, mycophenolate, and tacrolimus, with basiliximab if panel reactive antibodies (PRA) are present. Intravenous immunoglobulin (IVIG) was used post-operatively if donor-specific anti-HLA antibodies (DSA) were present.
Methods: Retrospective interventional series of consecutive patients with KLAL for limbal stem cell deficiency (LSCD) from HLA and/or blood type compatible deceased donors with a minimum follow-up time of 12 months.
Objectives: To assess outcomes of limbal stem cell deficiency (LSCD) in patients treated with Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE).
Methods: Retrospective case series. Patients with LSCD who received PROSE treatment were included.
Objectives: To assess outcomes of the Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE) treatment in patients with advanced Terrien marginal degeneration (TMD).
Methods: This is a retrospective case series of patients with advanced TMD who were assessed and fit with customized PROSE lenses. Data were collected on PROSE fitting details including visual acuity (VA) before and after PROSE, slit-lamp findings, and corneal tomography scans.
Purpose: The purpose of this study was to assess long-term stability and outcomes of femtosecond astigmatic keratotomy (FSAK) after treatment of high postkeratoplasty astigmatism.
Methods: This retrospective study included patients who underwent FSAK for high astigmatism (≥4 D) after penetrating keratoplasty or deep anterior lamellar keratoplasty. Main outcome measures were corneal astigmatism, uncorrected visual acuity, and best-corrected visual acuity (BCVA) at 1 month and 1, 5, and 10 years.
Purpose: This study aims to determine predictive factors for success of Descemet stripping only (DSO) in Fuchs corneal endothelial dystrophy and propose a DSO treatment algorithm.
Methods: Ovid MEDLINE, Embase, and Cochrane CENTRAL databases were searched to evaluate DSO case series, including combined phacoemulsification and DSO, and the use of Rho-kinase inhibitors (ROC-i). Our primary outcome was success of corneal clearance.
Purpose: The scrolling properties of the Descemet membrane endothelial keratoplasty (DMEK) graft are essential for surgical success. Currently, there is limited knowledge on what dictates the tightness of the DMEK scroll. The purpose of this study was to determine the impact of temperature and protein digestion on DMEK graft scroll tightness.
View Article and Find Full Text PDFUnlabelled: Fungal keratitis is a devastating and difficult-to-treat ocular infection with high morbidity. Understanding geographic microbiological and clinical trends helps to guide rapid and effective treatment. We therefore report the characteristics and outcomes of fungal keratitis in Toronto,ON Canada, over a 20-year period.
View Article and Find Full Text PDFPurpose: The purpose of this study was to report a case of "smoldering" keratolimbal allograft (KLAL) rejection in a patient with subtherapeutic levels of systemic immunosuppression in temporal association with BNT162b2 messenger RNA vaccination for severe acute respiratory syndrome coronavirus 2.
Methods: This was a case report.
Observations: A 72-year-old man presented with circumferential perilimbal engorgement, stagnation, and tortuosity of vessels with mild chemosis in his right eye KLAL segments 1 month after receiving the BNT162b2 messenger RNA vaccine while his tacrolimus trough blood levels were subtherapeutic measuring <2 ng/mL.
Purpose: The purpose of this study was to evaluate 5-year safety and efficacy outcomes of femtosecond-enabled Descemet membrane endothelial keratoplasty (F-DMEK) in patients with Fuchs' endothelial dystrophy (FED).
Methods: This was a retrospective study, including patients with FED and cataract who underwent either F-DMEK (16 eyes of 15 patients) or manual DMEK (M-DMEK) (42 eyes of 37 patients) combined with cataract extraction. Outcome measures included visual acuity, graft detachment, graft survival, and endothelial cell loss.
Objective: To compare outcomes of phototherapeutic keratectomy (PTK) versus epithelial debridement combined with anterior stromal puncture (ASP) or diamond burr for the treatment of recurrent corneal erosions (RCES) in a large tertiary centre.
Methods: Patients with a diagnosis of RCES secondary to trauma or epithelial basement membrane dystrophy who underwent a surgical procedure between 2009 and 2019 were included in the study. The following data were collected: demographics, ocular history, prior medical treatment, ocular surgeries, intervention, complete epithelialization at postoperative week 1, recurrences, and complications.
Objective: To compare subjective and objective outcomes of 4 different Descemet membrane endothelial keratoplasty (DMEK) peeling techniques performed by novice surgeons at different stages in their surgical career.
Design: An ex vivo prospective study.
Methods: In the first round, 2 DMEK peeling techniques were pitched against each other: the peripheral scoring and Sinskey dissection technique with the peripheral scoring and microhoe dissection and the peripheral blunt microhoe dissection against the scleral spurectomy and microhoe dissection.
Objective: To perform an economic appraisal of the Prosthetic Replacement of Ocular Surface Ecosystem (PROSE; BostonSight, Needham Heights, Mass.) lens in patients with a distorted corneal surface or ocular surface disease in Canada.
Design: Retrospective observational cohort study with cost, cost-utility, and benefit-cost analyses.
Purpose: To assess the fellow eye as a predictor for keratoconus progression following bilateral same-day accelerated corneal cross-linking (A-CXL).
Methods: This was a post-hoc analysis of data from a prospective study of bilateral A-CXL for progressive keratoconus between 2013 and 2015. The primary outcome measures were absolute change in maximum keratometry (Kmax) (diopters [D]), relative change in Kmax (%), and A-CXL progression (increase in Kmax > 2.
Purpose: The success of Descemet stripping only (DSO) is optimized by performing a well-centered, accurately sized diameter of descemetorhexis with a smooth curvilinear border. To achieve this success, we describe a repeatable and relatively straightforward technique to optimize this descemetorhexis for DSO.
Methods: The "two-flaps" technique uses the Gorovoy DSO forceps.
Article Synopsis
- The study evaluated the effectiveness of a sutureless dehydrated amniotic membrane treatment for persistent epithelial defects (PED) in patients who had not benefited from previous treatments.
- Nine eyes from eight patients, primarily suffering from limbal stem cell deficiency, were treated, resulting in an 89% success rate for PED resolution within approximately 18 days.
- Vision significantly improved for the participants, with further research suggested to determine the long-term safety and effectiveness of this treatment.
Objectives: To investigate underlying diagnoses and outcomes of patients undergoing Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE) treatment at the first Canadian PROSE center.
Methods: A retrospective chart review was conducted on patients referred for PROSE treatment and fitted with PROSE devices from 2018 to 2020. Data were collected on diagnoses, presenting symptoms, previous lens modalities attempted, best-corrected visual acuities (BCVAs) pre-PROSE and post-PROSE, daily wear time, and failure rates.
Purpose: Vitrectomized eyes pose a technical challenge when performing endothelial keratoplasty (EK). The aim of the study was to compare outcomes of Descemet membrane endothelial keratoplasty (DMEK) and Descemet stripping automated endothelial keratoplasty (DSAEK) in complex eyes undergoing pars plana vitrectomy (PPV) prior to or during surgery.
Methods: This retrospective study included consecutive eyes that underwent pars plana infusion-assisted DMEK or pull-through DSAEK which underwent PPV prior to or during the EK at a tertiary center.
Article Synopsis
- The study compares the 4-year survival rates of two eye surgery techniques, DMEK and DSAEK, in patients who had previous glaucoma surgery.
- Both techniques showed similar graft survival and rejection rates, indicating effectiveness in this context.
- However, patients who underwent DMEK experienced better visual acuity in the postoperative period compared to those who had DSAEK.