Purpose: To evaluate the outcome of excimer laser-assisted deep anterior lamellar keratoplasty (Exc-DALK) and penetrating keratoplasty (Exc-PKP) for keratoconus (KC).
Methods: We included 123 eyes and compared the outcome of 30 eyes undergoing big-bubble Exc-DALK after stromal debulking (G1) against a matched group of 83 eyes undergoing Exc-PKP ( G2 ) in our department. G2 was created after performing a pseudorandom stratified bootstrapping of our PKP database starting with 2802 surgeries with removal of any bias.
Corneal stromal opacities can severely impact visual acuity if they are located in the visual axis. Homologous penetrating keratoplasty (HPK) is usually the preferred surgical option in such clinical circumstances. However, autologous penetrating keratoplasty (APK) could be an immunologically safer alternative.
View Article and Find Full Text PDFBacterial infections are by far the most frequent cause of infectious keratitis in high-income countries. The clinical appearance can vary widely depending on the type and species of bacteria, ranging from small superficial infiltrates to necrotizing forms. The numerous classes of available antibiotics render the treatment scope diverse and complex, especially before the pathogen has been specified and the sensitivity to antibiotics has been tested.
View Article and Find Full Text PDFObjectives: To investigate the correlation between postoperative endothelial cell loss (ECL) and donor, host, and surgical parameters, and to assess the clinical impact of maintaining a high endothelial cell density (ECD) of ≥ 1500 cells/mm 5 years after penetrating keratoplasty (PKP).
Methods: This retrospective cohort study included 216 eyes with 5 years of follow-up, of which 94 had annual visits, and who underwent normal-risk elective PKP for noninfectious indications by one corneal microsurgeon (B. S.
Purpose: To report functional and refractive outcomes of manual arcuate keratotomy (AK) with compression sutures for high regular postkeratoplasty astigmatism.
Setting: Department of Ophthalmology, Saarland University Medical Center, Homburg/Saar, Germany.
Design: Retrospective analysis.
To evaluate the impact of excimer laser-assisted deep anterior lamellar keratoplasty (Exc-DALK) and excimer laser-assisted penetrating keratoplasty (Exc-PKP) on subfoveal choroidal thickness (SFCT) in eyes with advanced keratoconus. A retrospective comparative clinical study, which compares the outcomes of 24 eyes treated with Exc-DALK (G1) against matched group of 43 eyes treated with Exc-PKP (G2) at both 2 months (T1) and 2 years (T2) postoperatively. Main outcomes included best-corrected visual acuity (BCVA), central macular thickness (CMT), and SFCT.
View Article and Find Full Text PDF: To evaluate the outcomes of intravitreal faricimab (IVF) for refractory neovascular age-related macular degeneration (nAMD) and investigate the impact of baseline optical coherence tomography, biomarkers for total IVF injections are needed. : A retrospective analysis of 33 eyes of patients who completed one year (52 W) of treatment with IVF. The eyes received four IVF injections (6 mg/0.
View Article and Find Full Text PDFSince the establishment of the first eye bank in the 1940s, their role has evolved to face new challenges. With the recent development of lamellar keratoplasties, eye banks play an even bigger role in the selection and preparation of donor tissues. The increasing number of keratoplasty techniques and the high demand for "ready-to-use" tissues are challenging eye banks to improve and develop new preparation techniques.
View Article and Find Full Text PDFPurpose: This retrospective longitudinal study evaluated the biomechanical E-staging in KC corneas before and after intracorneal ring segment (ICRS) implantation (Intacs® SK, Addition Technology, Illinois, United States).
Methods: Biomechanical E-staging for ectatic corneal diseases was applied retrospectively on 49 KC corneas of 41 patients who underwent ICRS implantation. The main outcome parameters included the Corvis Biomechanical Factor (CBiF, the linearized Corvis Biomechanical Index and the biomechanical parameters included), the resulting biomechanical E-staging, the stress-strain index, thinnest corneal thickness (TCT), maximal anterior keratometry (Kmax), and the anterior radius of curvature (ARC).
Background: The aim of this study was to assess the impact of the ratio between the graft and host corneal size (RGH) on postoperative complications, such as immune reactions, re-bubbling rate and endothelial cell loss (ECL) after Descemet membrane endothelial keratoplasty (DMEK).
Patients And Methods: Retrospectively, 457 patient eyes were included which had undergone surgery between 2016 and 2019 in the Department of Ophthalmology, Saarland University Medical Center in Homburg/Saar using DMEK or triple DMEK, diagnosed as Fuchs' endothelial dystrophy (n = 431), pseudophakic bullous keratopathy (n = 9) and others (n = 17). The follow-up period extended until the end of 2020.
Purpose: To objectify the indication for re-bubbling by analyzing graft detachments (GDs) after Descemet membrane endothelial keratoplasty.
Methods: In this retrospective monocentric observational study, re-bubbling cases of 450 Descemet membrane endothelial keratoplasties and the percentage of the residual gas filling (RGF) in the anterior chamber on the first postoperative day were collected. The number/location/extent of GDs and the corneal thickness above GDs were analyzed using anterior segment optical coherence tomography.
To compare prevalence of positive PCR tests for herpesviruses between patients with and without a history of clinical corneal endothelial allograft rejection (AGR). Retrospective cross-sectional study with two-group comparison. A total of 307 aqueous humor (AH) samples from 235 Patients and 244 eyes who underwent penetrating keratoplasty or Descemet membrane endothelial keratoplasty or had a diagnostic AH aspiration due to clinical AGR between 2019 and 2023 were tested for DNA of herpes simplex virus (HSV), varicella-zoster virus (VZV), cytomegalovirus (CMV), and Epstein-Barr virus (EBV).
View Article and Find Full Text PDFPurpose: The purpose of this study was to highlight characteristic clinical and microscopic findings and report the long-term follow-up of pediatric excimer laser-assisted penetrating keratoplasty (excimer-PKP) for congenital stromal corneal dystrophy (CSCD).
Methods: A 2-year-old Greek child presented with CSCD at our department. Clinical examination showed bilateral flake-like whitish corneal opacities affecting the entire corneal stroma up to the limbus.
Purpose: The aim of this study was to describe 3 cases of recalcitrant Acanthamoeba keratitis (AK) that were successfully treated using in vivo corneal confocal microscopy (IVCM) to guide excimer laser ablation depth with adjunctive mitomycin C 0.02%.
Methods: Three patients diagnosed with AK did not respond to several weeks of intensive topical therapy with antiamoebic agents.
Background: This study aims to evaluate visual outcome, central corneal thickness, and re-bubbling rate in a cohort with undersized sequential Descemet Membrane Endothelial Keratoplasty (DMEK) due to endothelial graft decompensation following primary penetrating keratoplasty (PK).
Methods: All patients who received a sequential DMEK (n = 16) or triple DMEK (n = 2) after failed primary PK between November 2020 and June 2022 were retrospectively evaluated. Analyzed parameters were corrected distance visual acuity (CDVA), central corneal thickness (CCT), re-bubbling rate and graft survival.
Purpose: This study investigated the influence of cleanroom conditions on the discard rates of donor corneas in a German university eye bank.
Methods: Discard rates were analysed from 2017 to 2020 at the LIONS Cornea Bank at Saarland University Medical Center. 1941 corneas from 971 donors were included.
Purpose: To present the outcomes of a patient with anterior chamber intraocular lens (ACIOL) related endothelial decompensation who underwent Descemet membrane endothelial keratoplasty (DMEK) and cataract surgery with intraocular lens (IOL) implantation in the capsular bag (so-called DMEK) combined with ACIOL removal ( DMEK) in both eyes.
Methods: Case report.
Results: A 58-year-old female patient was referred due to decreased visual acuity within the last 18 months.
Purpose: The aim of this study was to analyze changes in corneal biomechanical properties after implantation of intracorneal ring segments (ICRSs) in keratectasia.
Methods: This retrospective single-center study included 112 patient eyes that underwent femtosecond laser-assisted ICRS implantation (Intacs SK; Addition Technology Inc, Des Plaines, IL) for keratectasia. Biomechanical analysis was performed using the Ocular Response Analyzer (ORA; Reichert Inc, Depew, NY), with determination of corneal resistance factor, corneal hysteresis, and Keratoconus Match Index, as well as by Corvis ST (OCULUS, Wetzlar, Germany), with determination of stiffness parameter A1, Ambrosio relational thickness to the horizontal profile (Arth), integrated radius, deformation amplitude ratio, and stress-strain index as well as Corvis Biomechanical Index and Tomographic Biomechanical Index.
Corneal diseases include a wide spectrum of different manifestations (inflammatory/noninflammatory) that need to be accurately classified for precise diagnosis and targeted treatment. In addition to the anamnesis and slit lamp biomicroscopy, further device-based examinations can be performed to narrow down the diagnosis. Nowadays, modern corneal imaging provides a variety of technologies, such as topography, tomography, in vivo confocal microscopy and analysis of biomechanics, which are able to reliably classify different pathologies.
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