Publications by authors named "Claus Cursiefen"

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.

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Purpose: The novel endothelial keratoprosthesis EndoArt improves corneal edema by reducing the inflow of aqueous humor into the cornea. We assessed the early outcome after EndoArt implantation in patients at a high risk of graft failure after keratoplasty.

Methods: This retrospective study included 14 patients with high-risk eyes owing to at least one of the following risk factors for graft failure after keratoplasty: multiple previous surgeries (glaucoma surgery, keratoplasty) and recurrent intraocular inflammation because of uveitis, aniridia, or anterior synechia.

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Background: EndoArt® (Eye Yon Medical, Ness Ziona, Israel) is a novel artificial corneal inner layer transplant and an innovative treatment alternative for patients at high risk for graft failure after posterior lamellar corneal transplantation (EK).

Aim Of The Study: We present the initial results of the EndoArt® implantation in patients with glaucoma drainage devices (GDD).

Patients And Surgical Procedure: In this study 12 eyes with GDD were retrospectively evaluated.

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Article Synopsis
  • Fuchs endothelial corneal dystrophy (FECD) is a genetic and age-related disease leading to the loss of corneal endothelial cells, resulting in corneal swelling and vision issues.
  • Advanced FECD often shows a fibrillar layer (FL) on the corneal surface, especially in the inferotemporal quadrant, which can be measured using specialized imaging techniques.
  • Current treatments mainly involve corneal transplantation, particularly DMEK surgery, with new approaches like smaller grafts and advancements in imaging for better assessment and planning of surgeries.
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Objective Of Surgery: The aim of this surgical technique is the implantation of a glaucoma drainage device (GDD) in eyes with aphakic glaucoma following injector-assisted implantation of an artificial iris into the ciliary sulcus.

Indications: This atraumatic tube insertion technique can be performed during GDD implantation after implantation of an artificial iris into the ciliary sulcus.

Surgical Technique: Following injector-assisted implantation of an artificial iris into the ciliary sulcus of eyes, the iris can shift into the chamber angle.

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In May 2023, a 36-year-old carpenter complained of a sudden decrease in visual acuity in both eyes after his fourth COVID-19 vaccination. He underwent extensive evaluation by ophthalmological, neurological, and internal medicine specialists elsewhere, which was unremarkable, except for a computed tomography scan of his brain showing minor occipital calcifications. In 2021, he had been diagnosed with anterior basement membrane dystrophy and treated with phototherapeutic keratectomy (PTK) of the left eye, leading to significant postoperative haze.

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Article Synopsis
  • Corneal transparency and avascularity are crucial for clear vision, with a transition to vascularized conjunctiva at the limbus.
  • This study identifies a specific sub-population of limbal stromal cells expressing ABCB5, which exhibit mesenchymal stem cell traits and show potential for pluripotency and multi-lineage differentiation.
  • ABCB5+ cells demonstrate lower levels of pro-inflammatory and pro-angiogenic factors, suggesting they could help reduce inflammation and neovascularization in the cornea, with potential implications for therapeutic applications elsewhere in the body.
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Purpose: To present ocular clinical, histological, systemic, and genetic findings of a patient with familial lecithin-cholesterol acyltransferase (LCAT) deficiency caused by a novel genetic variant of the LCAT gene associated with secondary corneal amyloidosis.

Methods: Case report.

Results: A 74-year-old woman presented with decreased visual acuity (VA), sensitivity to light, and progressive whitening of both corneas for approximately 20 years.

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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).

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Article Synopsis
  • This project aimed to investigate the standards of genetic testing and counseling for patients with inherited retinal diseases (IRDs) in select European countries, focusing on expert opinions about current challenges and potential improvements in patient care.
  • A survey was distributed to professionals across ten European nations, gathering data on the prevalence of genetic testing and counseling practices.
  • Results showed that while genetic tests are common and largely funded by public health services, many IRD patients still lack adequate testing and counseling, highlighting the need for better education for healthcare providers, improved access to advanced testing, and more genetic counselors.
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Article Synopsis
  • A study was done to see how well Germany is doing in eye research, especially for diseases affecting vision.
  • An international group of experts said that overall, Germany's eye research is doing great, but there are a few areas that need improvement.
  • They suggested that Germany should focus on protecting new ideas, work together more with other research teams, and even create a special center just for eye research.
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Purpose: To evaluate the research performance in ophthalmology in Germany based on the findings of the recent research map of the German Ophthalmological Society ( DOG) and to suggest strategies for future improvements on a national level both to DOG as well as to politics. The focus is on preclinical and translational clinical research.

Methods: International expert panel evaluation and discussion organized by the Task Force Research of the German Ophthalmological Society (DOG).

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Purpose: To evaluate the rate of and risk factors for rhegmatogenous retinal detachment (RRD) after Descemet membrane endothelial keratoplasty (DMEK) either alone or in combination with cataract surgery.

Design: Retrospective analysis of prospective database.

Methods: Consecutive eyes with Fuchs endothelial corneal dystrophy (FECD) that received DMEK surgery with a minimum follow-up of 1 year between July 2011 and January 2021 at the Department of Ophthalmology at the University of Cologne were analyzed.

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Purpose: To compare safety and efficacy of isolated and combined UV-light corneal crosslinking (CXL) and fine-needle diathermy (FND) to regress pathological corneal vessels in vivo.

Methods: Mice with inflamed and pathologically vascularized corneas received CXL or FND as monotherapy or a combination of both treatments. Corneal pathological blood and lymphatic vessels, immune cells and the morphology of anterior segment structures were evaluated.

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There is a huge unmet need for new treatment modalities for ocular surface inflammatory disorders (OSIDs) such as dry eye disease and meibomian gland dysfunction. Mesenchymal stem cell therapies may hold the answer due to their potent immunomodulatory properties, low immunogenicity, and ability to modulate both the innate and adaptive immune response. MSC-like cells that can be isolated from the corneal stroma (C-MSCs) offer a potential new treatment strategy; however, an optimized culture medium needs to be developed to produce the ideal phenotype for use in a cell therapy to treat OSIDs.

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Purpose: To assess and compare the risk for development of cystoid macula edema (CME) after glaucoma drainage device (GDD) implantation versus conventional trabeculectomy with mitomycin (trab) for glaucoma.

Methods: Retrospective review of consecutive patients receiving trab or GDD implantation between 2016 and 2018. Inclusion criteria were availability of pre- and postoperative spectral domain optical coherence tomography (SD-OCT) of the macula.

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The training of artificial intelligence (AI) is becoming increasingly popular. More and more studies on lamellar keratoplasty are also being published. In particular, the possibility of non-invasive and high-resolution imaging technology of optical coherence tomography predestines lamellar keratoplasty for the application of AI.

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Article Synopsis
  • The study aims to identify donor characteristics, particularly previous medical conditions and surgeries, that affect the difficulty of preparing donor corneal tissue for DMEK surgery.
  • A total of 846 eyes were analyzed using data from a cornea bank and surgery records, categorizing preparation difficulty into three groups based on specific factors like adhesion and tissue fragility.
  • Key findings revealed that conditions like diabetes type 2, heart failure, and chronic kidney disease increase the likelihood of difficult tissue preparation, significantly impacting graft quality.
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Background: Good vision highly depends on the transparency of the cornea, which is the "windscreen" of the eye. In fact, corneal blindness due to transparency loss is the second most common cause of blindness worldwide, and corneal transplantation is the main cure. Importantly, the cornea is normally avascular but can secondarily be invaded by pathological (blood and lymphatic) vessels due to severe inflammation, and the survival prognosis of a corneal graft mainly depends on the preoperative vascular condition of the recipient's cornea.

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Purpose: To investigate the genetic cause, clinical characteristics, and potential therapeutic targets of infantile corneal myofibromatosis.

Design: Case series with genetic and functional analyses.

Participants: Four individuals from 2 unrelated families with clinical signs of corneal myofibromatosis were investigated.

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Purpose: To describe a novel corneal surgical technique combining Deep Anterior Lamellar Keratoplasty (DALK) with grafting of allogeneic limbus (Limbo-DALK) for the treatment of eyes with corneal stromal pathology and limbal stem cell deficiency (LSCD).

Methods: Clinical records of six Limbo-DALKs performed in five patients diagnosed with LSCD and corneal stromal pathology requiring keratoplasty were retrospectively reviewed. All patients were diagnosed with LSCD due to various pathologies including thermal and chemical burns, congenital aniridia or chronic inflammatory ocular surface disease.

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