Corneal cell response after flap creation using a mechanical microkeratome or a 200 kHz femtosecond laser.

Purpose: To compare the inflammatory cell response within the corneal flap interface created by a mechanical microkeratome and a femtosecond laser.

Setting: Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany.

Design: Experimental in vitro study.

Evaluation of interface quality in organ-cultured lamellar corneal transplants.

Background: With increasing numbers of lamellar keratoplasties, eye banks are challenged to deliver precut lamellar donor tissue. In Europe, the most common technique of corneal storage is organ culture which requires a deswelling process before surgical processing. The aim of this study was to investigate the influence of different deswelling times on the cutting plane quality after microkeratome-assisted lamellar dissection.

Application of 10% povidone iodine reduces conjunctival bacterial contamination rate in patients undergoing cataract surgery.

Purpose: To determine the efficacy of 10% povidone iodine (PVI) drops given before cataract extraction in addition to routine irrigation of the conjunctival sac with 1% PVI.

Methods: This prospective, randomized, single-center study at the Department of Ophthalmology, Ludwig-Maximilians-University, Munich, includes 263 eyes of 242 patients undergoing cataract surgery. Patients were randomized to receive 3 drops of 10% PVI into the conjunctival sac (study group) or no PVI drops (control group).

Propionibacterium acnes in capsular bag distension syndrome.

We report a case of capsular bag distension syndrome that developed 6 years after uneventful phacoemulsification with implantation of a foldable, single-piece acrylic intraocular lens (IOL) (AcrySof MA60BM). Slitlamp microscopy revealed a deep anterior chamber with no flare or cells. The posterior capsular bag was distended by a homogeneous milky substance between the back of the IOL and the capsular bag.

Real-time intraocular pressure measurement in standard and microcoaxial phacoemulsification.

Purpose: To evaluate intraocular pressure (IOP) in the vitreous cavity during various stages of cataract surgery.

Setting: University Eye Hospital, Ludwig-Maximilians University, Munich, Germany.

Methods: In consecutive eyes having combined phacoemulsification, intraocular lens implantation, and pars plana vitrectomy, IOP was monitored in real time through a 25-gauge pars plana cannula connected to an external pressure transducer.

Lamellar keratoplasty with a novel anterior chamber system and organ cultured donor corneas.

Purpose: To present a novel artificial anterior chamber system for anterior and posterior lamellar keratoplasty.

Methods: The artificial anterior chamber system MOZARTTM in conjunction with the AMADEUSTM II microkeratome was evaluated for its applicability in anterior and posterior lamellar keratoplasty using organ cultured donor corneas.

Results: Twelve patients underwent microkeratome-assisted lamellar keratoplasty for corneal opacifications due to either anterior stromal scaring or endothelial decompensation.

Amadeus II microkeratome: optimizing microkeratome settings for high flap accuracy using optical low coherence reflectometry.

Purpose: To investigate the impact of various experimental microkeratome settings and blade reuse on the accuracy of the flap thickness created with the new Amadeus II microkeratome (SIS, Ziemer Ophthalmic, Port, Switzerland).

Methods: In this prospective study, 120 porcine eyes were used to create corneal flaps with the Amadeus II using 2 different cutting heads (140 microm, 160 microm) with the Surepass blade. Using each blade twice, a head advance speed of 1.

Customizing the Amadeus II microkeratome: evaluation of cut quality with various settings using electron microscopy.

Purpose: To evaluate the cut quality of keratectomy specimens created with the new Amadeus II microkeratome (SIS, Ziemer Ophthalmic, Port, Switzerland) using scanning electron microscopy (SEM). Methods. Corneal cuts were performed in 24 freshly enucleated porcine eyes using the Amadeus II microkeratome with combinations of cutting-head depth, oscillation rate, head-advance speed, and reuse of the blade.

Optimizing the deswelling process of organ-cultured corneas.

Purpose: During deswelling of organ-cultured human corneas, endothelial cell loss occurs. Therefore, it is necessary to minimize the deswelling time and achieving an optimal central corneal thickness (CCT) of approximately 550 microm at the same time. We investigated the minimal deswelling time necessary and analyzed endothelial cell loss.

Posterior lamellar disc dislocation into the vitreous cavity during descemet stripping automated endothelial keratoplasty.

We present a case of a dislocated posterior lamellar lenticule into the vitreous cavity during Descemet stripping automated endothelial keratoplasty. After insertion of the donor disc in a partially vitrectomized eye with partial iris loss, the graft dislocated into the vitreous cavity. With a standard 3-port vitrectomy and the help of perflourocarbon fluid, the graft was lifted into the anterior segment of the eye and firmly attached to the recipient cornea using liquid-air exchange.

Performance of the Acri. Smart 46S intraocular lens in pediatric microincision cataract surgery.

Purpose: To evaluate the performance of the microincision Acri. Smart 46S intraocular lens (IOL) (Acri.Tec) in pediatric cataract surgery.

The challenge of dry eye diagnosis.

The currently available methods for the diagnosis of dry eye are still far from being perfect for a variety of reasons. This review attempts to highlight the advantages and disadvantages of both traditional tests (such as Schirmer's test, break-up time and ocular surface staining) and innovative noninvasive procedures, including tear meniscus height measurement, corneal topography, functional visual acuity, tear interferometry, tear evaporimetry and tear osmolarity assessment.

Eccentric lamellar keratolimbal grafts harvested with a manually guided microkeratome. Technical report.

Background: To perform lamellar keratolimbal allograft transplantation in a one-step procedure with a single graft, we investigated the feasibility of harvesting eccentric lamellar keratolimbal grafts from conventionally processed corneoscleral buttons using a manually guided microkeratome in conjunction with an artificial anterior chamber system.

Methods: We used the Moria LSK-One microkeratome and the automated lamellar therapeutic keratoplasty (ALTK) system (Antony, France). Ten human donor eyes were used to obtain single-piece lamellar keratolimbal grafts.

Pulsed electron avalanche knife: new technology for cataract surgery.

Background: The pulsed electron avalanche knife (PEAK-fc) is a new pulsed electrosurgical device that allows for precise, "cold" and traction-free tissue dissection.

Aim: To evaluate the surgical applicability, safety and potential complications of PEAK-fc in complicated cataract surgery.

Methods: The study included five children with congenital cataracts, two patients with advanced senile cataracts, six adults with mature cataracts, three of them with posterior iris synechia, three patients with post-traumatic cataracts with zonulolysis, one patient with intumescent traumatic cataract and three patients with massive anterior capsule opacification.

Persistent serous retinal detachment after radial optic neurotomy.

We report the case of a patient presenting with serous retinal detachment following radial optic neurotomy for central retinal vein occlusion. Initially, the retinal detachment was successfully treated by a second vitrectomy and laser coagulation. After reabsorption of the gas tamponade, a recurrence of the retinal detachment was seen with no detectable retinal break.

Pulsed electron avalanche knife for capsulotomy in congenital and mature cataract.

The pulsed electron avalanche knife (PEAK-fc, Carl Zeiss Meditec) is an electrosurgical cutting device that allows precise "cold" and traction-free tissue dissection. We describe its applicability and safety for anterior capsulotomy in a child with congenital cataract and an adult patient with mature cataract. The PEAK-fc was set at a voltage of 600 V and a pulse repetition rate of 80 Hz.

Pulsed electron avalanche knife in vitreoretinal surgery.

Purpose: To evaluate the advantages, disadvantages, safety, and surgical applicability of the pulsed electron avalanche knife (PEAK-fc), a new electrosurgical knife for "cold" and tractionless cutting, in vitreoretinal surgery. PEAK-fc is equipped with an integrated fiberoptic that makes bimanual procedures in intraocular surgery possible.

Methods: A prospective consecutive trial of 18 eyes in 18 patients who underwent vitreoretinal surgery for proliferative diabetic retinopathy, proliferative vitreoretinopathy, subretinal macular hemorrhage, or macular pucker was performed.

Amniotic membrane maintains the phenotype of rabbit retinal pigment epithelial cells in culture.

The success of surgical removal of choroidal neovascularisation followed by transplantation of autologous retinal pigment epithelial cells (RPE) for age-related macular degeneration (ARMD) may be limited by damage in Bruch's membrane. We investigated whether amniotic membrane (AM) might be used as an alternative basement membrane-containing matrix to support RPE growth and differentiation. Primary RPE plastic cultures were established from freshly enucleated Dutch belted rabbit eyes in DMEM/F12 containing 0.

Ex vivo expansion of limbal epithelial stem cells: amniotic membrane serving as a stem cell niche.

Identification, maintenance, and expansion of stem cells for subsequent transplantation has become a new strategy for treating many diseases in most medical subspecialties. The stem cells of the corneal epithelium are located in the limbal basal layer and are the ultimate source for constant corneal epithelial renewal. Like those in other tissues, limbal stem cells are supported by a unique stromal microenvironment called the stem cell niche, which consists of certain extracellular matrix components, cell membrane-associated molecules, and cytokine dialogues.

Modulation of keratin and connexin expression in limbal epithelium expanded on denuded amniotic membrane with and without a 3T3 fibroblast feeder layer.

Purpose: Based on the knowledge that limbal epithelial stem cells (SCs) do not express keratin-3 (K3), connexin (Cx)43, and Cx50, a study was conducted to investigate amniotic membrane (AM) culturing conditions that promote limbal SC expansion.

Methods: Human limbal epithelium was expanded on intact and epithelially denuded AM, with or without a 3T3 feeder layer, and subsequently transplanted to nude mice to induce epithelial stratification and differentiation. Immunostaining and Western blot analysis were used to determine protein expression of K3, Cx43, and Cx50.

Amniotic membrane transplantation with conjunctival limbal autograft for total limbal stem cell deficiency.

Purpose: To evaluate the outcomes of corneal surface reconstruction with conjunctival limbal autograft when combined with amniotic membrane transplantation on both the donor and recipient eyes.

Design: Retrospective, noncomparative, interventional small case series.

Participants: Five eyes of five patients with total limbal stem cell deficiency (LSCD) resulting from pseudopemphigoid (n = 1), chemical burns (n = 3), and extensive removal of conjunctival intraepithelial neoplasia (n = 1) were operated on by one surgeon (SCGT).

Cleavage of corneal basement membrane components by ethanol exposure in laser-assisted subepithelial keratectomy.

Purpose: To determine the anatomic cleavage plane after exposure to 20% ethanol for approximately 20 to 25 seconds to create an epithelial flap in laser-assisted subepithelial keratectomy (LASEK).

Setting: Ocular Surface Research & Education Foundation, Miami, Florida, and Hermann Eye Center Refractive Surgery Center, Houston, Texas, USA.

Methods: Immunofluorescence staining using monoclonal antibodies against laminin 5, collagen VII, and integrins beta(1) and beta(4) was performed to determine the anatomic location of the cleavage plane in an epithelial flap created by 20-second exposure to 20% ethanol in cadaver eyes and in epithelial flaps obtained from LASEK patients.

Amniotic membrane transplantation for bullous keratopathy in eyes with poor visual potential.

Purpose: To evaluate the long-term outcomes of epithelial debridement and amniotic membrane transplantation (AMT) for pain and discomfort relief in patients with symptomatic bullous keratopathy and poor visual potential.

Setting: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA.

Methods: This retrospective study included 18 eyes (18 patients) with bullous keratopathy presenting with intractable pain or discomfort and poor visual potential.

Phenotypic study of a case receiving a keratolimbal allograft and amniotic membrane for total limbal stem cell deficiency.

Purpose: To report the expression pattern of key molecules by the reconstructed corneal epithelium after a keratolimbal allograft (KLAL) and amniotic membrane transplantation (AMT) for total limbal stem cell deficiency.

Design: Interventional case report.

Method: A 50-year-old woman with severe chemical burns in both eyes received an AMT as a temporary patch at the acute stage, and a KLAL with AMT as a graft at the chronic stage for total limbal stem cell deficiency.