Publications by authors named "Steven B Koenig"
Purpose: To report the clinical and refractive outcomes of a modified Yamane technique for scleral fixation of the CT Lucia 602 lens.
Design: Retrospective case series.
Patients: One hundred twenty-one eyes with dislocated posterior chamber lens implants, surgical aphakia, subluxed crystalline lenses, capsular tear, anterior chamber, or iris sutured posterior chamber lens intolerance were included.
To describe the successful treatment of epithelial ingrowth using combined surgical excision with intracameral adjuvant 5-fluorouracil (5-FU) followed by Descemet-stripping automated endothelial keratoplasty (DSAEK). A 71-year-old man presented with epithelial ingrowth after clear corneal phacoemulsification. He underwent surgical excision of the membrane together with pars plana vitrectomy, air fluid exchange, and intracameral 5-FU.
View Article and Find Full Text PDFPurpose: Treatment of calcific band keratopathy (CBK) is commonly performed with ethylenediaminetetraacetic acid (EDTA), but EDTA has become more difficult to obtain. This paper describes a technique for treating CBK using a diamond-dusted burr without EDTA in eyes with limited visual potential.
Patients And Methods: In this paper, we provide detailed instructions on how to perform the surgical technique for treating CBK, along with a surgical video.
Flanged intrascleral intraocular lens fixation with a single needle.
J Cataract Refract Surg
December 2018
Purpose: The purpose of this study was to describe the results of a simple 6-mm central descemetorhexis in eyes with Fuchs corneal endothelial dystrophy.
Methods: This prospective nonrandomized IRB approved pilot study was performed on 2 patients with coexisting Fuchs dystrophy and cataract who underwent combined phacoemulsification and descemetorhexis without endothelial transplantation.
Results: In each patient, residual disciform stromal edema corresponded to the diameter of the descemetorhexis and led to an associated loss of visual acuity.
Purpose: To describe a case of acute corneal hydrops in a patient with corneal ectasia after laser in situ keratomileusis (LASIK).
Methods: An observational study presenting clinical, slit-lamp, and optical coherence tomographic findings.
Results: A 66-year-old man with a history of moderate myopic astigmatism presented with a sudden loss of vision in his left eye 11 years after undergoing LASIK.
Purpose: To report a case of long-term corneal clarity after spontaneous resolution of corneal edema associated with iatrogenic endothelial trauma in a patient with Fuchs dystrophy.
Methods: Retrospective case report.
Results: An 84-year-old woman with Fuchs dystrophy experienced an iatrogenic descemetorhexis during complicated phacoemulsification.
Ocular iris metastasis from lung cancer is uncommon. We report a patient with metastatic non-small cell lung cancer who was found to have a metastatic lesion to the iris. Local therapy for pain control and vision loss was administered with intracameral bevacizumab.
View Article and Find Full Text PDFPurpose: To report the development of a delayed massive suprachoroidal hemorrhage after Descemet stripping automated endothelial keratoplasty (DSAEK).
Design: Retrospective case report.
Results: A 70-year-old woman with a failed graft for keratoconus underwent DSAEK in the setting of continued systemic anticoagulation.
A simple technique to improve centration during trephination of the donor lenticula in DSAEK.
Ophthalmic Surg Lasers Imaging
July 2011
The author describes a technique to improve centration of the trephination of the donor corneal lenticula during Descemet's stripping and automated endothelial keratoplasty. Following resection of the anterior corneal lamella with the microkeratome, a 10-mm trephine stained with gentian-violet dye is used to mark the perimeter of the resection bed. The remaining donor cornea is centered on the Barron-Hessburg punching block endothelial side up using the easily seen annular mark as a guide.
View Article and Find Full Text PDFPurpose: To evaluate the visual acuity, graft clarity, refractive outcome, and crystalline lens clarity in phakic patients undergoing Descemet stripping automated endothelial keratoplasty (DSAEK).
Methods: Six eyes of 4 consecutive patients with clear crystalline lenses and corneal edema because of either Fuchs dystrophy (4 eyes) or amantadine-induced corneal endothelial toxicity (2 eyes) were included in this study. All patients underwent simple DSAEK using a 4.
Purpose: To measure corneal sensation after Descemet stripping and automated endothelial keratoplasty (DSAEK).
Methods: Prospective comparative case series involving 52 eyes of 29 patients in the early postoperative period (<6 months) after small-incision DSAEK. Patients' contralateral eye served as a control.
Purpose: To determine if the 1-month postoperative error of predicted refraction of the first eye can be used to alter intraocular lens (IOL) power selection and improve refractive results for the second eye in patients undergoing bilateral, sequential phacoemulsification with IOL implantation (phaco/IOL).
Design: Retrospective, consecutive, case series.
Participants: Three hundred consecutive patients who underwent uncomplicated bilateral, sequential phaco/IOL between January 1, 2006, and December 31, 2007, by a single surgeon using a single IOL platform.
Context: With one exception, a case report of amantadine-induced corneal toxicity has described reversible corneal edema.
Objective: To report a patient with unrecognized amantadine-induced corneal edema.
Design: Patient with schizophrenia and tardive dyskinesia developed bilateral corneal edema while receiving chronic amantadine hydrochloride.
Purpose: To report the donor-to-host transmission of Candida albicans after Descemet stripping and automated endothelial keratoplasty (DSAEK).
Methods: An 80-year-old woman with pseudophakic bullous keratopathy developed an infiltrate in the donor corneal lenticule after DSAEK.
Results: Donor corneoscleral rim cultures grew C.
The authors describe a technique to facilitate the centration of the donor lenticule during Descemet's stripping and automated endothelial keratoplasty. The donor corneal lenticule is unfolded and grossly centered in the anterior chamber using a barbed 30-gauge needle on a 3-cc air syringe or a reverse Sinsky hook. Fine adjustments to center the lenticule can be achieved by applying external pressure to the cornea with a laser in-situ keratomileusis flap roller.
View Article and Find Full Text PDFThe observational case describes bilateral recurrent keratoconus in corneal transplants performed in a patient with self-induced keratoconus secondary to compulsive eye rubbing. Slitlamp findings demonstrated corneal stromal thinning and scarring in the patient's right eye and temporal corneal hydrops in his left eye. Videokeratography of the right eye confirmed the presence of corneal steepening and irregular astigmatism, consistent with the diagnosis of keratoconus involving each transplant.
View Article and Find Full Text PDFPurpose: To report the diagnosis and treatment of a patient who developed epithelial ingrowth after Descemet-stripping automated endothelial keratoplasty (DSAEK).
Methods: We describe the case of an 80-year-old woman who underwent DSAEK for pseudophakic bullous keratopathy. After surgery, the patient underwent 2 additional rebubbling procedures for recurrent donor lenticule dislocation.
Purpose: To report our results of using Descemet stripping and automated endothelial keratoplasty (DSAEK) in eyes with failed penetrating keratoplasty (PK).
Methods: An institutional review board-approved, prospective, surgical case series of 7 eyes of 7 consecutive patients undergoing DSAEK for graft failure after 1 or more PKs at 1 academic eye center.
Results: The mean follow-up period was 13.
Purpose: To evaluate visual acuity, refractive outcomes, and endothelial cell density 6 months after Descemet stripping and automated endothelial keratoplasty (DSAEK).
Methods: We performed an institutional review board-approved prospective study of a surgical case series of 34 patients at 2 institutions undergoing DSAEK for Fuchs endothelial dystrophy, pseudophakic bullous keratopathy, or aphakic bullous keratopathy with or without simultaneous phacoemulsification and intraocular lens implantation. Clinical outcomes, including best spectacle-corrected visual acuity (BSCVA), spherical equivalent refraction, and refractive astigmatism and topographic or keratometric astigmatism, were assessed at the 6-month postoperative examination and compared with preoperative values with paired Student t tests.
Dislocation of the graft is a well-recognized complication of Descemet's stripping automated endothelial keratoplasty (DSAEK). We describe a technique to promote adhesion of the graft during DSAEK using an anterior chamber air-fluid infusion and exchange for direct control of the pressure and medium used to tamponade the graft against the host stroma.
View Article and Find Full Text PDFPurpose: To evaluate visual acuity (VA), graft clarity, and refractive outcome of Descemet's stripping and automated endothelial keratoplasty (DSAEK) combined with phacoemulsification and intraocular lens (IOL) implantation in patients with coexisting Fuchs' endothelial dystrophy and immature senile cataracts.
Design: Pilot, prospective, noncomparative, surgical case series.
Participants: Twenty-one eyes of 21 consecutive patients with coexisting visually significant immature senile cataracts and Fuchs' corneal dystrophy with guttata of Descemet's membrane and either microcystic epithelial edema or stromal edema presenting to a single academic eye institute.
We describe a technique to facilitate unfolding and prevent inversion of the donor corneal lenticule during Descemet's stripping and automated endothelial keratoplasty (DSAEK). The donor corneal lenticule is unfolded in the anterior chamber using a bent 30-gauge needle on a 3 cc air syringe. The needle tip is used to pinion the edge of the lenticule while an air bubble is simultaneously injected between the folded edges of the donor graft.
View Article and Find Full Text PDFPurpose: To describe our technique and early results of Descemet's stripping and automated endothelial keratoplasty (DSAEK), identify perioperative complications, and discuss their management.
Design: Prospective, noncomparative, surgical case series.
Participants: Twenty-six eyes of 26 patients who had corneal edema from Fuchs' endothelial dystrophy, pseudophakic bullous keratopathy, or aphakic bullous keratopathy.