Peripheral ulcerative keratitis (PUK) is an inflammatory disease of the peripheral cornea, which may frequently be associated with several rare, but potentially life-threatening systemic diseases. The inflammatory pathogenesis of PUK results from humoral and cell-mediated inflammation. The diagnosis is usually based on the typical clinical findings and always requires detailed diagnostic testing to identify a potential systemic underlying disease.
View Article and Find Full Text PDFAtopic dermatitis (AD) is a chronic recurrent inflammatory skin disease with a bipolar age distribution in childhood, adolescence and middle adulthood. Up to 50% of AD patients show ocular involvement, which can be potentially sight threatening. Clinically, the majority of cases present with atopic blepharo(kerato)conjunctivitis or atopic keratoconjunctivitis (AKC); other clinical variants from this group of inflammatory ocular surface diseases are keratoconjunctivitis vernalis in childhood and adolescence and allergic conjunctivitis.
View Article and Find Full Text PDFEndothelial cell density (ECD) is a crucial parameter for the release of corneal grafts for transplantation. The Lions Eye Bank of Baden-Württemberg uses the "Rhine-Tec Endothelial Analysis System" for ECD quantification, which is based on a fixed counting frame method considering only a small sample of 15 to 40 endothelial cells. The measurement result therefore depends on the frame placement and manual correction of the cells counted within the frame.
View Article and Find Full Text PDFThe aim of global ophthalmology is to maximize vision, ocular health and functional ability, thereby contributing to overall health and well-being, social inclusion and quality of life of every individual worldwide. Currently, an estimated 1.1 billion people live with visual impairment, 90% of which can be prevented or cured through largely cost-effective interventions.
View Article and Find Full Text PDFPurpose: The Supine Positioning for Descemet Membrane Endothelial Keratoplasty Attachment (SUPER-DMEK) trial assessed the efficacy of prolonged supine head positioning on graft attachment.
Design: Randomized controlled trial.
Methods: Participants with Fuchs' dystrophy were randomized to 5 days of supine head positioning (intervention) or to 1 day (control).
Klin Monbl Augenheilkd
June 2024
The purpose of this study is to report the outcome of Descemet membrane endothelial keratoplasty (DMEK) in three eyes with a complex anterior segment and an artificial iris. A retrospective chart review of three cases was performed and clinically meaningful patient characteristics, clinical events, and therapeutic interventions were outlined. A literature search was performed and the clinical course of the three cases was discussed in the context of the published literature.
View Article and Find Full Text PDFThe Section on Tissue Transplantation and Biotechnology of the German Ophthalmologic Society presented its 11th annual report for the year 2021. The number of corneal samples has still risen in comparison to former years. Nevertheless, there is still a need for import of transplants from abroad.
View Article and Find Full Text PDFBackground: Keratoconus is associated with an impairment in corneal biomechanics. Using nanoindentation, spatially resolved measurement of biomechanical properties can be performed on corneal tissue. The aim of this study is to assess the biomechanical properties of corneas with keratoconus in comparison to healthy controls.
View Article and Find Full Text PDFPurpose: To evaluate the standard of care, in particular the use of topical or subconjunctival interferon-2b, in treating ocular surface squamous neoplasia or melanocytic tumours in tertiary eye centres in Germany.
Methods: A survey containing 14 questions was sent to 43 tertiary eye centres in Germany. The questions addressed the surgical and medical management of ocular surface squamous neoplasia and melanocytic tumours (primary acquired melanosis and malignant melanoma), as well as the clinical experiences and difficulties in prescribing off-label interferon-2b eye drops and subconjunctival injections.
Background: Ocular involvement in mucous membrane pemphigoid (MMP) is relatively rare, with a prevalence of 25 cases per million population, equating to approx. 2,100 patients throughout Germany. Diagnosis can be difficult - especially in cases of isolated ocular involvement - and treatment can be complex and lengthy.
View Article and Find Full Text PDFPatients with Fuchs endothelial dystrophy often develop visual symptoms between 50 - 60 years of age, which is the same time that the first symptoms of a developing cataract start to appear. On the other hand, in patients with a clinically significant cataract, corneal guttata may be detected by chance during a routine clinical workup. In both situations, the surgeon has to decide whether DMEK or cataract surgery should be performed alone or in combination.
View Article and Find Full Text PDFKlin Monbl Augenheilkd
November 2023
Two very rare cases of intrastromal keratolimbal epithelial cysts are reported. Firstly, an enlarging congenital cyst in a 9-year-old boy, and secondly, a recurrent postsurgical cyst in an 18-year-old female patient. Both cases presented with a limbal cyst, continuing into the corneal stroma as a whitish mass up to the optical axis.
View Article and Find Full Text PDFPurpose: The Eye Drops for Early Morning-Associated Swelling (EDEMAS) trial assessed the efficacy of hyperosmolar eye drops on corneal edema resolution.
Design: Double-masked, randomized controlled trial of hyperosmolar eye drops.
Participants: Participants with Fuchs' dystrophy scheduled for Descemet membrane endothelial keratoplasty.
Purpose: The posterior cornea is rotationally asymmetric, and Descemet membrane endothelial keratoplasty (DMEK) grafts preferentially scroll vertically. This prospective study assessed whether graft attachment after DMEK differed depending on the rotational alignment of the donor graft in the recipient eye.
Methods: Pseudo-randomization and blinding of the graft orientation in the recipient's eye were possible by procedural separation: (1) The eye bank recorded the position of an orientation marker in the donor cornea; (2) the surgeon preparing the DMEK graft recorded an upside-down marker relative to the eye bank marker; and (3) the surgeon assessed the position of the upside-down marker in the recipient after DMEK.
Background: Ever since the first successful keratoplasty in 1905, there has been a need to store corneas for transplantation. R. Townley Paton founded the first eye bank in New York in 1944.
View Article and Find Full Text PDFBackground: Penetrating keratoplasty (PK) gets more and more reserved to cases of increasing complexity. In such cases, ocular comorbidities may limit graft survival following PK. A major cause for graft failure is endothelial graft rejection.
View Article and Find Full Text PDFImportance: Predicting the extent of corneal edema resolution after Descemet membrane endothelial keratoplasty (DMEK) may help in preoperative decision-making by identifying patients who may benefit from restoring endothelial function.
Objective: To develop and validate a predictive model for edema resolution after DMEK using Scheimpflug tomographic imaging.
Design, Setting, And Participants: Two prospective studies recruited participants with advanced Fuchs dystrophy at a university-based tertiary referral center between July 1, 2017, and August 31, 2019.
Purpose: Heterogeneity in scrolling behavior of Descemet membrane endothelial keratoplasty (DMEK) grafts complicates DMEK surgery. This prospective observational study assessed scrolling axes of DMEK grafts relative to the donor's eye.
Methods: The eye bank randomly marked the rim of corneoscleral donor buttons during trephination and recorded the position relative to the donor's axis.
Background: After preparation of a graft for Descemet membrane endothelial keratoplasty (DMEK), the diameter of the graft's scroll varies significantly. In particular, narrow scrolls may complicate DMEK surgery. In this study we investigated how temperature, osmolarity, and deswelling of the donor tissue influence scrolling diameter.
View Article and Find Full Text PDF