Cataract surgery in patients with Fuchs' endothelial corneal dystrophy: when to consider a triple procedure.

Purpose: To ascertain preoperative and intraoperative factors that predict the need for endothelial keratoplasty (EK) in patients with Fuchs' endothelial corneal dystrophy (FECD) undergoing cataract surgery.

Design: Prospective, observational cohort study.

Participants: Eighty-nine patients (89 eyes) with FECD who require cataract surgery.

Economic evaluation of endothelial keratoplasty techniques and penetrating keratoplasty in the Netherlands.

Purpose: To evaluate cost-effectiveness of penetrating keratoplasty (PK), femtosecond laser-assisted Descemet stripping endothelial keratoplasty (FS-DSEK), and Descemet stripping automated endothelial keratoplasty (DSAEK).

Design: Cost-effectiveness analysis based on data from a randomized multicenter clinical trial and a noncomparative prospective study.

Methods: Data of 118 patients with corneal endothelial dysfunction were analyzed in the economic evaluation.

Monitoring the inflammatory process in herpetic stromal keratitis: the role of in vivo confocal microscopy.

Purpose: To investigate the role of in vivo confocal microscopy (IVCM) in the detection of inflammatory activity and follow-up of herpetic stromal keratitis (HSK).

Design: Prospective observational cohort study.

Participants: Thirty-eight patients with active HSK.

How normal is the transparent cornea? Effects of aging on corneal morphology.

Purpose: To ascertain the effects of aging on corneal morphology and to illustrate the morphologic diversity of the different layers in the normal cornea as seen by in vivo confocal microscopy (IVCM).

Design: Observational cross-sectional study.

Participants: A total of 150 healthy subjects, evenly distributed over 5 age categories, comprising 75 men and 75 women.

Descemet stripping automated endothelial keratoplasty: effect of intraoperative lenticule thickness on visual outcome and endothelial cell density.

Purpose: To determine the correlation between the intraoperative donor lenticule thickness in Descemet stripping automated endothelial keratoplasty (DSAEK) and both the best-corrected visual acuity (BCVA) and endothelial cell density (ECD) at 6 months. To describe relevant surgical considerations with regard to the choice of microkeratome head.

Design: Prospective case series.

Normative database for corneal backscatter analysis by in vivo confocal microscopy.

Purpose: To ascertain the sex and age relatedness, diurnal variation, and repeatability of backscatter measurement in the normal human cornea.

Methods: Seven corneal backscatter variants were measured by in vivo confocal microscopy (IVCM) in both normal eyes (n = 314) of 157 healthy subjects. These subjects were assigned to one or more of three groups.

Quality of vision after femtosecond laser-assisted descemet stripping endothelial keratoplasty and penetrating keratoplasty: a randomized, multicenter clinical trial.

Purpose: To compare the quality of vision (straylight and contrast sensitivity) after femtosecond laser-assisted Descemet stripping endothelial keratoplasty (FS DSEK) and penetrating keratoplasty (PK).

Design: Prospective, randomized clinical trial.

Methods: setting: Multicenter (5 ophthalmic centers in The Netherlands).

Economic evaluation of deep anterior lamellar keratoplasty versus penetrating keratoplasty in The Netherlands.

Purpose: To evaluate the cost effectiveness of deep anterior lamellar keratoplasty (DALK) versus penetrating keratoplasty (PK) in The Netherlands.

Design: Cost-effectiveness analysis alongside a randomized, multicenter clinical trial.

Methods: Fifty-three patients with corneal stromal pathologic features not affecting the endothelium were included with 28 patients in the DALK group and 25 in the PK group.

Endothelial cell loss and visual outcome of deep anterior lamellar keratoplasty versus penetrating keratoplasty: a randomized multicenter clinical trial.

Objective: To compare endothelial cell (EC) loss, visual and refractive outcomes, and complications after deep anterior lamellar keratoplasty (DALK) and penetrating keratoplasty (PK).

Design: Randomized, multicenter clinical trial.

Participants: Fifty-six eyes of 56 patients with a corneal stromal pathology not affecting the endothelium were randomized to DALK or PK.

Corneal graft dehiscence during swinging eyelid orbital decompression.

A 68-year-old man with Graves orbitopathy underwent a bilateral swinging eyelid orbital decompression for disfiguring proptosis. A penetrating keratoplasty for keratoconus of the left eye had been performed 13 years earlier. Prior to orbital decompression, biomicroscopy of the left eye showed a partially decompensated sutureless corneal graft with good wound apposition.

Efficacy and safety of femtosecond laser-assisted corneal endothelial keratoplasty: a randomized multicenter clinical trial.

Background: To evaluate the efficacy and safety of femtosecond laser-assisted endothelial keratoplasty (FLEK) versus penetrating keratoplasty (PK) in patients with corneal endothelial disease.

Methods: A randomized multicenter clinical trial of 80 eyes of 80 patients with corneal endothelial disease were randomized to FLEK or PK. Clinical outcomes (astigmatism and visual acuity) and incidence of postoperative complications were compared between the two groups.

Preliminary results of femtosecond laser-assisted descemet stripping endothelial keratoplasty.

Objective: To evaluate the preliminary visual results of femtosecond laser-assisted Descemet stripping endothelial keratoplasty (FS-DSEK).

Methods: We prospectively analyzed results of 20 consecutive patients with Fuchs endothelial dystrophy or aphakic/pseudophakic bullous keratopathy who underwent FS-DSEK. Best spectacle-corrected visual acuity (BSCVA), refraction, corneal topography, and endothelial cell density were measured preoperatively and 3 and 6 months after FS-DSEK.

Femtosecond laser-assisted inverted mushroom keratoplasty.

Purpose: To evaluate best-corrected visual acuity (BCVA), refractive outcome, corneal topography, optical coherence tomography, and endothelial cell density 12 months after femtosecond laser-assisted inverted mushroom keratoplasty.

Methods: We performed a prospective study of a surgical case series of 5 patients undergoing femtosecond laser-assisted inverted mushroom keratoplasty for pseudophakic bullous keratopathy or pre-Descemet X-linked ichthyosis. The femtosecond laser was used to create a top-hat configuration in the donor cornea and recipient cornea.

Graft insertion during Descemet-stripping automated endothelial keratoplasty: pulling the graft inward.

We describe a technique to facilitate insertion of the folded donor graft during Descemet-stripping automated endothelial keratoplasty (DSAEK). Surgery is performed using a standard technique, and the graft is pulled into the anterior chamber using a double-armed 10-0 polypropylene suture with straight 16 mm needles. The technique of pulling the graft inside the anterior chamber is easy and ensures that the graft is inserted and unfolded in the right direction.

Late postoperative complications of backward implantation of a Vivarte phakic intraocular lens.

A 34-year-old man had bilateral implantation of a Vivarte phakic intraocular lens (pIOL) (Ciba Vision) to correct high myopia. Postoperatively, both pIOLs appeared to have been implanted backward. After a few weeks, the position of the pIOL in the right eye was corrected in a second procedure.

Predicting cataract surgery results using a macular function test.

Purpose: To assess the predictive value of a macular function test in the preoperative evaluation of cataract patients.

Setting: Clinique Generale St-Jean, Brussels, Belgium.

Methods: This prospective study comprised 396 uneventful consecutive cataract procedures performed by 1 surgeon from September 2000 to February 2001.