Publications by authors named "Christopher J Rapuano"
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.
Objectives: To evaluate demographic, socioeconomic, and clinical factors associated with nonadherence with initial follow-up after a diagnosis of infectious keratitis.
Methods: A retrospective chart review of patients aged 18 to 60 years who were diagnosed with infectious keratitis at the Wills Eye Hospital Emergency Room from March 2019 to September 2019 was conducted. The primary outcome was nonadherence with initial follow-up recommendation and included patients who did not follow-up in the time frame requested by the diagnosing physician and those who were lost to follow-up.
Article Synopsis
- * Chronic exposure to BAK can damage various parts of the eye and trigger inflammation, which complicates treatment and may diminish the success of surgeries for glaucoma patients.
- * To mitigate BAK's harmful effects, switching to preservative-free eye drops or less toxic alternatives is recommended, along with considering non-drug treatments to enhance patient comfort and prevent further complications.
Article Synopsis
- The study investigates the demographics and clinical features of patients who experienced graft failure after keratoplasty, focusing on both Penetrating Keratoplasty (PK) and Descemet's Stripping Endothelial Keratoplasty (DSEK) methods over a five-year period.
- A total of 186 eyes from 170 patients were analyzed, finding that DSEK failures mostly happened within the first year and were generally linked to surgical risks, while PK failures were more gradual and associated with patient-related factors.
- PK patients had a higher incidence of multiple graft failures compared to those who had DSEK, suggesting that DSEK may be less influenced by demographic and clinical characteristics of patients than PK.
Purpose Of Review: The field of corneal biomechanics has rapidly progressed in recent years, reflecting technological advances and an increased understanding of the clinical significance of measuring these properties. This review will evaluate in-vivo biomechanical properties obtained by current technologies and compare them regarding their relevance to established biomechanical properties obtained by gold-standard ex-vivo techniques normally conducted on elastic materials.
Recent Findings: Several new technologies have appeared in recent years, including vibrational optical coherence tomography (VOCT) and the corneal indentation device (CID).
Purpose: The International Committee for the Classification of Corneal Dystrophies (IC3D) was created in 2005 to develop a new classification system integrating current information on phenotype, histopathology, and genetic analysis. This update is the third edition of the IC3D nomenclature.
Methods: Peer-reviewed publications from 2014 to 2023 were evaluated.
Purpose: Investigate trends in keratoconus (KCN) treatment patterns and diagnosis age from 2015 to 2020 and evaluate sociodemographic associations with the treatment approach.
Design: Retrospective cohort study.
Participants: Patients with a new KCN diagnosis from 2015 to 2020 were identified in the Academy IRIS® Registry (Intelligent Research in Sight).
Purpose: The aim of this study was to describe variations in practice patterns for the management of zone 1 open globe injuries among corneal specialists worldwide.
Methods: This cross-sectional study was performed using an online survey distributed to members of The Cornea Society. Responses were collected between September 9, 2021, and September 30, 2021.
Purpose: The aims of this study were to describe the clinical course of microbial infectious scleritis and identify factors associated with poor visual outcomes.
Methods: Data from 26 eyes of 26 patients with culture-proven bacterial or fungal scleritis presenting at a single tertiary center from January 1, 2007, to July 1, 2021, were reviewed. Thirty-six variables were analyzed for associations with poor vision [best-corrected visual acuity (BCVA) <20/200] or loss of vision (no light perception vision or requirement for enucleation or evisceration) at final visit.
Isolated from , mitomycin C (MMC) has various applications in the management of corneal and external disease due to its ability to modulate cellular proliferation. It has been employed in pterygium surgery, ocular surface neoplasia, and refractive surgery. Currently, there is no definite consensus on the treatment protocols for each of the aforementioned applications.
View Article and Find Full Text PDFArticle Synopsis
- Demodex blepharitis is a common eyelid disease affecting about 25 million Americans, caused by Demodex mites that can lead to mechanical damage, bacterial infection, and inflammation.
- Risk factors include older age, rosacea, and diabetes, with symptoms like redness, dryness, discomfort, and the presence of collarettes, which are indicative of the condition.
- Multiple management options exist, but none are FDA approved; however, a recent clinical trial suggests that lotilaner ophthalmic solution could effectively treat the disease by eradicating the Demodex mites and reducing symptoms.
Article Synopsis
- Alkali injuries to the eyes are urgent situations that can lead to serious, long-lasting damage to vision if not treated immediately.
- Treatment typically focuses on neutralizing the chemical damage, managing inflammation, and helping the eye heal effectively.
- A case study of a 35-year-old man exposed to sodium hydroxide illustrates successful recovery using an amniotic membrane and a special ring, resulting in improved vision four months later.
Conjunctival and Lingual mucosal neuromas without multiple endocrine neoplasia type 2B.
Am J Ophthalmol Case Rep
June 2023
Purpose: To report a patient with conjunctival and buccal neuromas and enlarged corneal nerves without Multiple Endocrine Neoplasia 2B (MEN2B).
Observations: A 28-year-old female presented with progressively enlarging bilateral limbal conjunctival growths. Slit lamp examination was notable for enlarged corneal nerves and well-circumscribed gelatinous subepithelial limbal nodules.
Purpose: Our team previously identified the presence of five corneal resonant frequency (RF) peaks in healthy volunteers using vibrational optical coherence tomography (VOCT). Prior studies have suggested that the ≤100 Hz RF peak represents the cellular element of tissue. The aim of this study was to confirm that this peak reflects the human corneal cellular component using VOCT and histological analysis.
View Article and Find Full Text PDFAmong the various indications for keratoplasty, failed graft is one of the commonest indications in many published series. It is well known that the major cause of graft failure is endothelial rejection. In the last two decades, there has been a major paradigm shift in the surgical management of corneal diseases, and component keratoplasty has emerged from the concept of replacing the layer that is actually diseased, rather than replacing the full-thickness cornea with the traditional penetrating keratoplasty.
View Article and Find Full Text PDFPurpose: Corneal pathology can obstruct the visualization required for surgical management of coexisting posterior segment diseases, and use of a temporary keratoprosthesis (TKP) permits combined penetrating keratoplasty (PK) and vitreoretinal surgery. We evaluated graft outcomes after TKP for combined PK and vitreoretinal surgery and analyzed risk factors for graft failure.
Methods: We reviewed the electronic medical records for patients who underwent TKP for PK combined with vitreoretinal surgery at Wills Eye Hospital between May 2007 and April 2021.
Purpose: The aim of this study was to determine possible associations between demographic and socioeconomic factors and graft survival after penetrating keratoplasty (PK).
Methods: This study was a retrospective chart review of patients undergoing PK at a tertiary-care corneal practice at Wills Eye Hospital between May 1, 2007, and September 1, 2018. The first PK of the first eye was included.
Late Descemet membrane detachment after uneventful cataract surgery.
Am J Ophthalmol Case Rep
March 2023
Purpose: To report 5 patients with late Descemet membrane (DM) detachment after uneventful cataract surgery.
Observations: After a retrospective chart analysis of consecutive patients that developed DM detachment after uneventful cataract surgery, six eyes of five patients were enrolled. In all cases, patients reported good vision initially after cataract surgery.
Descriptive analysis of cornea and anterior segment fellowship program directors in 2020.
J Cataract Refract Surg
December 2022
Purpose: To investigate demographic characteristics, educational backgrounds, and academic achievements among program directors (PDs) of cornea and external disease and anterior segment fellowships in the United States in 2020.
Setting: Database study of U.S.
Purpose: To determine the in vivo elastic modulus of the human cornea using vibrational optical coherence tomography (VOCT).
Methods: Vibrational analysis coupled with optical coherence tomography (OCT) was used to obtain the resonant frequency (RF) and elastic modulus of corneal structural components. VOCT corneal thickness values were measured using OCT images and correlated with corneal thickness determined with Pentacam (Oculus, Wetzlar, Germany).
Purpose Of Review: Despite affecting approximately 1.8 billion individuals worldwide, until recently, a pharmacologic treatment for presbyopia was not available. This special commentary reviews the treatment of presbyopia with a focus on the recently approved medication Vuity (pilocarpine 1.
View Article and Find Full Text PDFPurpose: Frequent activating mutations in the mitogen-activated protein kinase (MAPK) pathway genes have been identified in histiocytoses. MAPK signaling consistently upregulates cyclin D1. The goal of this study was to determine whether cyclin D1 expression by immunohistochemistry is a useful diagnostic marker for periocular histiocytoses and to further characterize their genetic basis.
View Article and Find Full Text PDFPurpose: To present a case of traumatic mydriasis (MD) and accommodative dysfunction (AD) secondary to a sweetgum ball ocular injury that resolved 8 years after the inciting trauma.
Observations: A 6-year-old female presented with left eye ocular trauma after being hit with a sweetgum ball. Sweetgum balls are the small, spiky fallen fruits of the American Sweetgum tree ().
Purpose: To evaluate the rates of ghost and honorary authorship in ophthalmology and to determine risk factors associated with ghost and honorary authorship.
Design: Cross-sectional survey.
Methods: Corresponding authors of articles published in Ophthalmology, JAMA Ophthalmology, and the American Journal of Ophthalmology from June 2019 to December 2020 were emailed an electronic survey.
Aims: To determine whether prior penetrating keratoplasty (PK) in the contralateral eye increases risk of second eye PK graft rejection.
Methods: Cohort study of 593 consecutive PKs in transplant-naïve eyes (500 unilateral cases, 93 second eyes). Outcomes were compared between PKs performed in eyes with versus without a history of prior contralateral eye PK.