Publications by authors named "Mario Matthaei"
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.
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.
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.
View Article and Find Full Text PDFArticle 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.
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.
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.
Purpose: The aim of this study was to assess the long-term outcome of excimer laser phototherapeutic keratectomy (PTK) for treating remaining anterior corneal opacities after Descemet membrane endothelial keratoplasty (DMEK).
Methods: This cohort study analyzed 67 eyes of 66 patients undergoing PTK in addition to and after DMEK between 2012 and 2021 at the Department of Ophthalmology, University of Cologne. Patients who were treated by PTK after previous DMEK on the same eye were included.
Article Synopsis
- - Patients undergoing Descemet membrane endothelial keratoplasty (DMEK) with corneal abrasion experience significant burning pain post-surgery, which traditional systemic pain relief struggles to alleviate.
- - A study analyzed 28 patients retrospectively, comparing standard pain management (cohort S) to an additional topical lidocaine gel treatment (cohort L), finding that those with lidocaine experienced significantly less burning pain postoperatively.
- - The use of topical lidocaine gel effectively reduced early postoperative pain without impacting the overall surgical outcomes, indicating it could be a valuable addition to pain management for these patients.
The processing of the retrospective data pool for ophthalmology holds huge potential, especially for the research sector. "Big Data" enables medical science to draw conclusions for the future from historical data. Based on the evaluation of such data, algorithms could be trained, for instance, that are capable of making decisions with the help of artificial intelligence.
View Article and Find Full Text PDFBackground: The blood-aqueous barrier (BAB) separates immunoprivileged tissue of the eye from the blood circulation. Disruption of the BAB is therefore a risk factor for rejection after keratoplasty.
Purpose: The present work provides a review of the work of our group and others on BAB disruption in penetrating and posterior lamellar keratoplasty and its implications for clinical outcome.
Acute hydrops refers to sudden corneal edema caused by rupture of Descemet's membrane (DM) - often in progressive keratectasia. It leads to a sudden decrease in visual acuity, pain, and foreign body sensation as well as an increased glare sensation. Acute hydrops usually heals with scarring within months, but complications such as corneal perforation, infectious keratitis, and corneal vascularization may occur.
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- Recent research shows that lymphatic vessels, once thought absent in the eye, play a significant role in various eye diseases.
- The review explores how these vessels contribute to conditions like dry eye, corneal graft rejection, and tumors, as well as the underlying molecular mechanisms involved.
- It also highlights new therapeutic approaches based on targeting lymphangiogenesis, with promising initial results from clinical trials aimed at improving transplant survival and managing glaucoma.
Purpose: Corneal biomechanical failure is the hallmark of keratoconus (KC); however, the cause of this failure remains elusive. Collagen type XII (), which localises to Bowman's layer (BL), is thought to function in stress-bearing areas, such as BL. Given the putative protective role of in biomechanical stability, this study aims to characterise expression in all corneal layers involved in KC.
View Article and Find Full Text PDFPurpose: The aim of this study was to quantify preparation difficulties and complications during DMEK graft preparation and their influence on clinical outcome.
Methods: A retrospective evaluation of 214 consecutive DMEK surgeries from the prospective Cologne DMEK database was performed between July 2018 and December 2019. Preparation conditions (such as central and peripheral adherences, tissue fragility, and Descemet membrane splitting) were quantified and divided into 3 groups: easy, difficult, and very difficult preparation.
Analysis of internet search queries (ISQ) could be useful to study public interest and medical need for corneal, cataract, and refractive surgery. To date, there are preliminary data on seasonal trends in ophthalmic conditions, but only few studies correlate these data with real data from healthcare systems. The aim of this study is to analyze ISQ and correlate it with real healthcare system data.
View Article and Find Full Text PDFPurpose: The purpose of the study was to evaluate the feasibility of mini-descemet membrane endothelial keratoplasty ("Mini-DMEK," graft diameter <5 mm) for the treatment of chronic focal corneal endothelial decompensation for reasons other than acute hydrops in patients with keratoconus.
Methods: Of the 3010 patients registered in the prospective Cologne DMEK database, 16 patients with focal corneal endothelial decompensation treated with Mini-DMEK were identified. After exclusion of patients with acute hydrops in keratoconus (n = 9), indications for focal corneal endothelial decompensation were either defects in Descemet membrane after intraocular surgeries (n = 5) or corneal edema in the area of Haab striae in buphthalmus (n = 2).
Central subendothelial geographic deposits are formed as a fibrillar layer (FL) in advanced Fuchs endothelial corneal dystrophy (FECD). Previous studies demonstrated a significant decrease in corneal endothelial cell (CEC) density and an increase in focal corneal backscatter in the FL area. The present study investigated the association of the FL with edema formation and its localization.
View Article and Find Full Text PDFPurpose: To develop an artificial intelligence (AI) algorithm enabling corneal surgeons to predict the probability of rebubbling after Descemet membrane endothelial keratoplasty (DMEK) from images obtained using optical coherence tomography (OCT).
Methods: Anterior segment OCT data of patients undergoing DMEK by 2 different DMEK surgeons (C.C.
Purpose: The study aims to compare outcomes after deep anterior lamellar keratoplasty (DALK) and penetrating keratoplasty (PK) in keratoconic eyes with or without previous hydrops.
Methods: Retrospective analysis of 211 eyes who received PK (group 1, n = 74 [history of hydrops: n = 33]) or DALK (group 2, n = 137 [history of hydrops: n = 9]) from 2012 to 2019 at the Department of Ophthalmology, University of Cologne, Germany. Analysis included best spectacle-corrected visual acuity (BSCVA), complications, immune reactions, graft survival and keratometry, and subgroup analyses for subjects with or without previous hydrops.
Background: Due to the risk of amblyopia congenital and infantile corneal opacities have a narrow therapeutic window, frequently with a complex surgical treatment.
Objective: The present study gives an overview of the current treatment options for congenital and infantile corneal opacities.
Methods: The results of a literature search are presented and own clinical data and examples are shown.
Background: Posterior lamellar keratoplasty and especially Descemet membrane endothelial keratoplasty (DMEK) are gaining interest worldwide. Little is known about the influence of donor factors on DMEK outcome. Here we provide an overview of the existing peer-reviewed literature on this topic and present the design of the upcoming cooperation study COMEDOS (Cologne-Mecklenburg-Vorpommern DMEK Donor Study).
View Article and Find Full Text PDFPurpose: The purpose of this study was to analyze the influence of patient positioning on intraocular pressure (IOP) after Descemet membrane endothelial keratoplasty (DMEK) in pseudophakic patients treated for Fuchs endothelial corneal dystrophy.
Methods: Forty patients were included in this prospective, single-blinded, randomized controlled clinical trial. Patients received a YAG iridotomy 1 day before surgery and an 80% anterior chamber tamponade [20% concentration of sulfur hexafluoride (SF6)].
Unlabelled: A central collagen-rich subendothelial fibrillar layer (FL) correlates with areas of accentuated loss of corneal endothelial cells in advanced Fuchs endothelial corneal dystrophy (FECD). The present study sought to investigate whether the FL may be visualized by en face Scheimpflug backscatter imaging in vivo.
Design: Retrospective analysis of a prospective observational case series.
Purpose: 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).
Purpose: To identify global gene expression changes in the corneal epithelium of keratoconus (KC) patients compared to non-KC myopic controls.
Methods: RNA-sequencing was performed on corneal epithelium samples of five progressive KC and five myopic control patients. Selected results were validated using TaqMan quantitative PCR (qPCR) on 31 additional independent samples, and protein level validation was conducted using western blot analysis on a subset.