Publications by authors named "Bjoern O Bachmann"
Corneal inflammatory hem- and lymphangiogenesis significantly increase the risk for immune rejection after subsequent allogeneic corneal transplantation. The purpose of this study was to analyze the impact of temporary selective inhibition of lymphangiogenesis after transplantation on graft survival. Allogeneic transplantation from C57BL/6 mice to BalbC mice was performed as "high-risk" keratoplasty in a prevascularized corneal host bed (suture-induced inflammatory corneal neovascularization).
View Article and Find Full Text PDFPurpose: The purpose of this study was to investigate the impact of transient elevations in postoperative intraocular pressure (IOP) on the clinical outcome of Descemet membrane endothelial keratoplasty (DMEK) surgery in non-glaucoma patients.
Methods: Retrospective analysis from a prospective database of eyes without preexisting glaucoma that underwent DMEK with 90% anterior chamber and 20% sulfur hexafluoride endotamponade. Group A included eyes without postoperative IOP increase (IOP <30 mm Hg and a relative increase from preoperative value <10 mm Hg).
In the past decade, novel lamellar keratoplasty techniques such as Deep Anterior Lamellar Keratoplasty (DALK) for anterior keratoplasty and Descemet stripping automated endothelial keratoplasty (DSAEK)/Descemet membrane endothelial keratoplasty (DMEK) for posterior keratoplasty have been developed. DALK eliminates the possibility of endothelial allograft rejection, which is the main reason for graft failure after penetrating keratoplasty (PK). Compared to PK, the risk of endothelial graft rejection is significantly reduced after DSAEK/DMEK.
View Article and Find Full Text PDFPurpose: To analyze the dynamics of telemetrically measured intraocular pressure (IOP) during the first year after implantation of a Boston keratoprosthesis type I (BI-KPro) cornea and to compare agreement of telemetric IOP measurements with finger palpations.
Design: Prospective, open-label, multicenter, single-arm clinical trial.
Methods: In the ARGOS (NCT02945176) study, 12 individuals underwent implantation of an Eyemate-IO intraocular system.
Purpose: To investigate the effect of intensified postoperative topical steroid therapy after Descemet membrane endothelial keratoplasty combined with cataract surgery (Triple-DMEK) on postoperative endothelial cell density (ECD).
Methods: This comparative clinical study with historical controls was conducted at a tertiary hospital, specialized in corneal surgery. Patients undergoing DMEK or Triple-DMEK are included prospectively in the Cologne DMEK Database.
Purpose: To analyze the effect of intensified topical steroid therapy after Descemet membrane endothelial keratoplasty combined with cataract surgery (triple-DMEK) on the incidence of postoperative cystoid macular edema (CME).
Design: Single-center comparative clinical study with historical controls.
Setting: Department of Ophthalmology, University of Cologne, Germany, tertiary hospital, performing 500 corneal transplant surgeries per year.
Purpose: To evaluate the incidence of peripheral corneal edema after Descemet membrane endothelial keratoplasty (DMEK) with respect to the size of the descemetorhexis.
Methods: A single-center retrospective review of data of 200 consecutive DMEK surgeries for Fuchs endothelial dystrophy was performed. Forty-eight eyes of 47 patients were enrolled in this study based on the presence of a peripheral zone of free denuded stroma between the margin of the graft and the host's Descemet membrane (DM) (group A) or a peripheral overlap between the graft and the host's DM (group B).
Purpose: To reinvestigate the ultrastructure of the posterior stroma of the human cornea and to correlate the findings with the stromal behavior after big-bubble creation.
Design: Observational consecutive 3-center case series.
Specimens: Fresh corneoscleral buttons from human donors (n = 19) and organ-cultured corneoscleral buttons (n = 10) obtained after Descemet's membrane endothelial keratoplasty.
Purpose: The aim of this study was to compare the efficacy and side effects of prednisolone acetate 1% versus fluorometholone 0.1% after Descemet membrane endothelial keratoplasty (DMEK).
Methods: DMEK recipients used prednisolone acetate 1% for 1 month, and they were randomized to either prednisolone or fluorometholone for months 2 through 12.
Purpose: To characterize the alterations of extracellular matrix proteins in Descemet's membranes (DM) of patients with late-onset Fuchs' corneal dystrophy (FCD) and to differentiate them from nonspecific alterations in pseudophakic bullous keratopathy (PBK).
Methods: Human DM-endothelial cell complexes were obtained from patients with late-onset FCD (n = 40), PBK (n = 6), and control eyes (n = 5). Gene expression profiles of endothelial cells were compared using a commercial real-time PCR array and quantitative real-time PCR assays for confirmation of differentially expressed genes.
Importance: It is essential to devise strategies that improve graft adhesion after Descemet membrane endothelial keratoplasty (DMEK) to reduce the rebubbling rate.
Objective: To evaluate the influence of the extent of descemetorhexis on graft adhesion properties after DMEK.
Design, Setting, And Participants: Single-surgeon, retrospective, observational case series conducted in the Department of Ophthalmology, University of Erlangen-Nuremberg, Germany, that reviewed the medical records of 200 consecutive patients undergoing DMEK.
Purpose: To describe the use of an accidentally torn Descemet membrane (DM) to successfully complete Descemet membrane endothelial keratoplasty (DMEK) surgery.
Methods: Retrospective, observational case series of 3 eyes of 3 patients undergoing DMEK with a DM accidentally torn into 2 pieces during graft preparation. The mean outcome measures included best-corrected visual acuity, endothelial cell density, and central corneal thickness, before and at 1, 3, and 6 months after the DMEK surgery was performed.
Purpose: To assess the reproducibility of manual graft preparation and evaluate the incidence rate and nature of structural anomalies of Descemet's membrane (DM) preventing successful graft preparation in DM endothelial keratoplasty (DMEK).
Design: Prospective, single-center, nonrandomized, consecutive case series.
Participants: We analyzed 350 corneoscleral buttons from donors aged 18-95 years stored in Optisol-GS or Dulbecco's modified Eagle's medium and used for DMEK surgery in 343 consecutive patients with Fuchs' endothelial dystrophy or pseudophakic bullous keratopathy.
Purpose: To evaluate the functional and morphologic outcome of Descemet membrane endothelial keratoplasty (DMEK) combined with phacoemulsification and intraocular lens implantation in patients suffering from endothelial dysfunction and cataract.
Design: Retrospective, single-center, consecutive case series.
Methods: Triple-DMEK (DMEK with simultaneous cataract surgery) was performed in 61 consecutive eyes of 56 patients using corneal donor tissue pre-stored in either short-term culture (Optisol-GS) at 4 C or organ culture (Dulbecco's modified Eagle's medium, CorneaMax medium) at 34 C.
Purpose: To evaluate visual outcome and endothelial cell survival after Descemet membrane endothelial keratoplasty (DMEK) in comparison with Descemet stripping automated endothelial keratoplasty (DSAEK).
Design: Single-center, retrospective, consecutive case series.
Methods: Thirty-eight eyes of 38 consecutive patients undergoing DMEK, who completed a 6-month follow-up, were compared with 35 eyes of 35 consecutive patients undergoing DSAEK for Fuchs endothelial dystrophy or pseudophakic bullous keratopathy.
Purpose: To describe the clinical results of Pentacam-based big bubble deep anterior lamellar keratoplasty (DALK) to achieve an intended 90% depth of initial lamellar trephination.
Methods: Fifty consecutive eyes of 50 patients with keratoconus, keratoglobus, and anterior stromal scars were included. DALK was performed with the big bubble technique using a 90% intended depth for initial lamellar trephination based on preoperative pachymetry by Pentacam.
Purpose: We compared corneal higher-order aberrations (HOAs) in eyes after Descemet's membrane endothelial keratoplasty (DMEK), Descemet's stripping automated endothelial keratoplasty (DSAEK), and penetrating keratoplasty (PK), and in a control group that had not undergone surgery.
Design: Retrospective analysis of clinical data.
Participants: Thirty eyes of 30 patients who had undergone standard DMEK, 20 eyes of 20 patients after DSAEK, 20 eyes of 20 patients after PK, and 20 eyes of 20 controls were analyzed.
Purpose: To evaluate the feasibility of split cornea transplantation for 2 recipients by combining deep anterior lamellar keratoplasty (DALK) and Descemet membrane endothelial keratoplasty (DMEK).
Design: Interventional case series.
Methods: Fifty consecutive eyes with anterior stromal disease suitable for DALK and 50 eyes with endothelial disease suitable for DMEK were scheduled for split cornea transplantation combining both procedures within 72 hours.
Purpose: To define the cleavage plane between Descemet's membrane (DM) and posterior corneal stroma in Descemet's membrane endothelial keratoplasty (DMEK) concerning its ultrastructural and immunohistochemical characteristics.
Design: Observational, consecutive case series.
Participants: Fifteen corneoscleral buttons from donors 71.
Purpose: To describe myofibroblastic metaplasia of corneal endothelial cells in 2 cases with impaired visual function despite complete graft adherence after Descemet membrane endothelial keratoplasty (DMEK).
Design: Interventional case series.
Methods: In 2 of 90 consecutive DMEK surgeries, the cornea failed to clear up to 6 months postoperatively despite complete graft attachment.
Purpose: To investigate the effect of culture conditions of donor tissue on functional outcome after Descemet membrane endothelial keratoplasty.
Design: Retrospective, single-center, consecutive case series.
Methods: Descemet membrane endothelial keratoplasty was performed routinely in 82 eyes of 82 consecutive patients using corneal donor tissue prestored in either short-term culture (Optisol-GS; Bausch & Lomb) at 4 C (group A; n = 37) or organ culture (Dulbecco Modified Eagle Medium [Biochrom]; CorneaMax Medium [Eurobio]) at 34 C (group B; n = 45) in a randomized fashion.
Purpose: To evaluate the feasibility of using a single donor cornea for 2 recipients by combining deep anterior lamellar keratoplasty (DALK) and Descemet's membrane endothelial keratoplasty (DMEK) surgeries on the same day.
Design: Single-center, nonrandomized, prospective, interventional case series.
Participants: Twelve consecutive donor corneas were scheduled for split cornea transplantation combining DALK for a keratoconus patient and DMEK for a Fuchs' endothelial dystrophy patient on the same surgery day.
Purpose: Descemet membrane endothelial keratoplasty is a new technique for the replacement of diseased corneal endothelium with healthy donor endothelium. During this procedure, manipulation of the donor endothelium-Descemet membrane layer within the recipient anterior chamber can be associated with loss of the correct anterior-posterior orientation. Herein, we describe a simple method to keep the correct donor orientation during transplantation by marking the edge of the endothelium-Descemet membrane layer.
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