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Weiss JS, Rapuano CJ, Seitz B, Busin M, Kivelä TT, Bouheraoua N, Bredrup C, Nischal KK, Chawla H, Borderie V, Kenyon KR, Kim EK, Møller HU, Munier FL, Berger T, Lisch W. IC3D Classification of Corneal Dystrophies-Edition 3. Cornea 2024; 43:466-527. [PMID: 38359414 PMCID: PMC10906208 DOI: 10.1097/ico.0000000000003420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/08/2023] [Accepted: 09/24/2023] [Indexed: 02/17/2024]
Abstract
PURPOSE The International Committee for the Classification of Corneal Dystrophies (IC3D) was created in 2005 to develop a new classification system integrating current information on phenotype, histopathology, and genetic analysis. This update is the third edition of the IC3D nomenclature. METHODS Peer-reviewed publications from 2014 to 2023 were evaluated. The new information was used to update the anatomic classification and each of the 22 standardized templates including the level of evidence for being a corneal dystrophy [from category 1 (most evidence) to category 4 (least evidence)]. RESULTS Epithelial recurrent erosion dystrophies now include epithelial recurrent erosion dystrophy, category 1 ( COL17A1 mutations, chromosome 10). Signs and symptoms are similar to Franceschetti corneal dystrophy, dystrophia Smolandiensis, and dystrophia Helsinglandica, category 4. Lisch epithelial corneal dystrophy, previously reported as X-linked, has been discovered to be autosomal dominant ( MCOLN1 mutations, chromosome 19). Classic lattice corneal dystrophy (LCD) results from TGFBI R124C mutation. The LCD variant group has over 80 dystrophies with non-R124C TGFBI mutations, amyloid deposition, and often similar phenotypes to classic LCD. We propose a new nomenclature for specific LCD pathogenic variants by appending the mutation using 1-letter amino acid abbreviations to LCD. Pre-Descemet corneal dystrophies include category 1, autosomal dominant, punctiform and polychromatic pre-Descemet corneal dystrophy (PPPCD) ( PRDX3 mutations, chromosome 10). Typically asymptomatic, it can be distinguished phenotypically from pre-Descemet corneal dystrophy, category 4. We include a corneal dystrophy management table. CONCLUSIONS The IC3D third edition provides a current summary of corneal dystrophy information. The article is available online at https://corneasociety.org/publications/ic3d .
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Affiliation(s)
- Jayne S Weiss
- Departments of Ophthalmology, Pathology and Pharmacology, Louisiana State University Eye Center of Excellence, Louisiana State University Health Sciences Center, New Orleans, LA
| | - Christopher J Rapuano
- Cornea Service, Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA
| | - Berthold Seitz
- Department of Ophthalmology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Massimo Busin
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
- Istituto Internazionale per la Ricerca e Formazione in Oftalmologia, Forlì, Italy
| | - Tero T Kivelä
- Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Nacim Bouheraoua
- Department of Ophthalmology, Quinze-Vingts National Ophthalmology Hospital and Sorbonne Université, Paris, France
| | - Cecilie Bredrup
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Ken K Nischal
- Division of Pediatric Ophthalmology, Strabismus and Adult Motility, University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, Pittsburgh, PA
| | - Harshvardhan Chawla
- Department of Ophthalmology, Louisiana State University Health Sciences Center, New Orleans, LA
| | - Vincent Borderie
- Department of Ophthalmology, Quinze-Vingts National Ophthalmology Hospital and Sorbonne Université, Paris, France
| | - Kenneth R Kenyon
- Department of Ophthalmology, Tufts University School of Medicine and Harvard Medical School, Schepens Eye Research Institute and New England Eye Center, Boston, MA
| | - Eung Kweon Kim
- Corneal Dystrophy Research Institute, Yonsei University College of Medicine, Seoul, Korea
- Saevit Eye Hospital, Goyang, Korea
| | - Hans Ulrik Møller
- Department of Pediatric Ophthalmology, Aarhus University Hospital, Aarhus, Denmark
| | - Francis L Munier
- Retinoblastoma and Oculogenetic Units, Jules-Gonin Eye Hospital and Fondation Asile des Aveugle, University of Lausanne, Lausanne, Switzerland; and
| | - Tim Berger
- Department of Ophthalmology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Walter Lisch
- Department of Ophthalmology, Johannes Gutenberg University Mainz, Mainz, Germany
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Knoeri J, Mhenni R, Friquet C, Hage A, Cuyaubère R, Borderie M, Leveziel L, Bouheraoua N, Borderie V. Comparison of optical aberrations in keratoconus with scleral versus rigid gas permeable lenses. Eur J Ophthalmol 2024; 34:394-398. [PMID: 38128913 DOI: 10.1177/11206721231221588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
PURPOSE to assess optical aberrations under scleral (SL) versus rigid gas permeable (RGP) lenses in patients with keratoconus. METHODS A prospective study including 25 eyes of 14 patients. The best-corrected visual acuity (BCVA) with corrective glasses, RGP and SL, stage of keratoconus (Amsler-Krumeich classification), minimum pachymetry, maximum keratometry, and corneal higher-order aberrations (i.e, total HOAs, coma, and trefoil) with RGP and with SL were collected. Aberrometry was performed using iTrace® aberrometer (Tracey Technologies, USA). RESULTS 80% of the included keratoconus patients were stage 4, with a mean age of 34.3 years (±8.8). There were no significant differences in mean BCVA (logMAR) between SL and RGP. The mean BCVAs were significantly better both with SL (p < 0.0001) and RGP (p < 0.0001) compared with corrective glasses. Total HOAs (p = 0.01), coma (p = 0.003) and trefoil (p = 0.008) were significantly lower with SL compared with RGP. The BCVA decreased with the stage of keratoconus in SL (p = 0.01) and RGP (p = 0.02). The BCVA decreased with decreasing minimum pachymetry in SL (p = 0.02) and RGP (p = 0.002), and with increasing maximum keratometry in SL (p = 0.02) and RGP (p = 0.01). Significant correlations were found between BCVA, total HOAs (p = 0.008), and coma (p = 0.02) in SL. CONCLUSION For the same keratoconus patients, total higher order, coma and trefoil optical aberrations were reduced with scleral lenses compared to rigid gas permeable lenses.
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Affiliation(s)
- Juliette Knoeri
- Sorbonne Université, GRC n°32, Transplantation et Thérapies Innovantes de la Cornée, AP-HP, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, 28 rue de Charenton, F-75012, Paris, France
| | - Rania Mhenni
- Sorbonne Université, GRC n°32, Transplantation et Thérapies Innovantes de la Cornée, AP-HP, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, 28 rue de Charenton, F-75012, Paris, France
| | - Chloé Friquet
- Sorbonne Université, GRC n°32, Transplantation et Thérapies Innovantes de la Cornée, AP-HP, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, 28 rue de Charenton, F-75012, Paris, France
| | - Alexandre Hage
- Sorbonne Université, GRC n°32, Transplantation et Thérapies Innovantes de la Cornée, AP-HP, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, 28 rue de Charenton, F-75012, Paris, France
| | - Roxane Cuyaubère
- Sorbonne Université, GRC n°32, Transplantation et Thérapies Innovantes de la Cornée, AP-HP, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, 28 rue de Charenton, F-75012, Paris, France
| | - Marie Borderie
- Sorbonne Université, GRC n°32, Transplantation et Thérapies Innovantes de la Cornée, AP-HP, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, 28 rue de Charenton, F-75012, Paris, France
| | - Loïc Leveziel
- Sorbonne Université, GRC n°32, Transplantation et Thérapies Innovantes de la Cornée, AP-HP, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, 28 rue de Charenton, F-75012, Paris, France
| | - Nacim Bouheraoua
- Sorbonne Université, GRC n°32, Transplantation et Thérapies Innovantes de la Cornée, AP-HP, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, 28 rue de Charenton, F-75012, Paris, France
| | - Vincent Borderie
- Sorbonne Université, GRC n°32, Transplantation et Thérapies Innovantes de la Cornée, AP-HP, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, 28 rue de Charenton, F-75012, Paris, France
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Sellam A, Tourabaly M, Borderie V, Bouheraoua N. Evaluation of the efficacy and safety of pars plana vitrectomy with irido-zonulo-hyaloidotomy for malignant glaucoma. J Fr Ophtalmol 2024; 47:103963. [PMID: 37777420 DOI: 10.1016/j.jfo.2023.03.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/26/2023] [Accepted: 03/04/2023] [Indexed: 10/02/2023]
Abstract
PURPOSE To assess the efficacy and safety of pars plana vitrectomy with irido-zonulo-hyaloidotomy (IZH) for fluid misdirection syndrome (FMS) in pseudophakic eyes. METHODS This was a retrospective case series study of patients treated with pars plana vitrectomy with IZH for FMS between February 2017 and March 2020. Complete success was defined as central anterior chamber (AC) deepening with an intraocular pressure (IOP) of 21mmHg or less (on 2 consecutive visits at least 1 week apart) without topical or systemic glaucoma medications. Qualified success was defined as central AC deepening with an IOP of 21mmHg or less (on 2 consecutive visits at least 1 week apart) with topical or systemic glaucoma medications. RESULTS Twelve eyes of 12 patients with a diagnosis of FMS were included. The mean age of the population was 73.6±15.4 years [39-90] with a majority of women (58.3%). Prior surgeries at the time of FMS diagnosis were trabeculectomy (4 eyes) and non-perforating deep sclerectomy (2 eyes). At presentation, mean IOP was 38.2±9.8mmHg, which decreased to 17.9±7.7mmHg (P<0.0001) at final follow-up (mean follow-up of 4.9±4.3 months). Complete success was achieved in 6 eyes (50%) and qualified success in 10 eyes (83%), with two eyes failing treatment. There was no statistical significant relationship between demographic data and clinical success (P > 0.05). CONCLUSION Pars plana vitrectomy combined with IZH appears to be a safe and effective technique for the treatment of FMS in pseudophakic patients.
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Affiliation(s)
- A Sellam
- Centre hospitalier national d'ophtalmologie des Quinze-Vingts, Inserm-DGOS CIC 1423, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France
| | - M Tourabaly
- Centre hospitalier national d'ophtalmologie des Quinze-Vingts, Inserm-DGOS CIC 1423, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France
| | - V Borderie
- Centre hospitalier national d'ophtalmologie des Quinze-Vingts, Inserm-DGOS CIC 1423, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France; Sorbonne université, Inserm, CNRS, institut de la vision, 17, rue Moreau, 75012 Paris, France
| | - N Bouheraoua
- Centre hospitalier national d'ophtalmologie des Quinze-Vingts, Inserm-DGOS CIC 1423, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France; Sorbonne université, Inserm, CNRS, institut de la vision, 17, rue Moreau, 75012 Paris, France.
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Sandali O, Tahiri Joutei Hassani R, Dulière C, El Sanharawi M, Borderie V, Williams GA. Use of the Three-dimensional Viewing System and Microscope Tilting to Extend the Peripheral Retinal View. Retina 2023; 43:2109-2112. [PMID: 37983377 DOI: 10.1097/iae.0000000000003442] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To describe and evaluate the effectiveness of the microscope and lens tilting technique associated with the three-dimensional viewing system for improving the peripheral retinal view in noncontact lens vitreoretinal surgeries. METHODS Prospective, single-center, single-surgeon, consecutive case series of 25 patients undergoing vitrectomy for macular surgeries with three-dimensional visualization system. At the end of each surgery, the microscope and the noncontact lens were rotated by 20° in a direction opposite to the rotation of the eye to extend the peripheral visual field. RESULTS Microscope and lens tilting technique extended the edge of the peripheral viewing field relative to its position with the microscope untilted, by 1.72 mm (±0.37) for the superior retina and 1.93 mm (±0.42) for the inferior retina (P < 0.0001). The ora serrata was visualized in 33% and 0% of cases for the superior retina and 91% and 36% of cases for the inferior retina, in tilted and nontilted microscope positions, respectively (P < 0.01). CONCLUSION Microscope and lens tilting could be useful to extend the peripheral visual field of view in retinal surgery. The three-dimensional system allowed to maintain surgeon comfort and posture during surgery.
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Affiliation(s)
- Otman Sandali
- Centre Hospitalier National d'Ophtalmologie des XV-XX, Unit 5, Pierre & Marie Curie University, Research Team 968, Institut de la Vision, Paris, France
- Hôpital Guillaume-de-Varye, service de chirurgie ambulatoire, Bourges, France
| | | | - Cedric Dulière
- Hôpital Guillaume-de-Varye, service de chirurgie ambulatoire, Bourges, France
| | | | - Vincent Borderie
- Centre Hospitalier National d'Ophtalmologie des XV-XX, Unit 5, Pierre & Marie Curie University, Research Team 968, Institut de la Vision, Paris, France
| | - George A Williams
- Centre Hospitalier National d'Ophtalmologie des XV-XX, Unit 5, Pierre & Marie Curie University, Research Team 968, Institut de la Vision, Paris, France
- Hôpital Guillaume-de-Varye, service de chirurgie ambulatoire, Bourges, France
- Centre Hospitalier de Granville, service de chirurgie ambulatoire, Granville, France; and
- Centre Hospitalier de Châteaudun, service d'ophtalmologie, Châteaudun, France
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Vilbert M, Bocheux R, Georgeon C, Borderie V, Pernot P, Irsch K, Plamann K. A new method for in vivo assessment of corneal transparency using spectral-domain OCT. PLoS One 2023; 18:e0291613. [PMID: 37796869 PMCID: PMC10553212 DOI: 10.1371/journal.pone.0291613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 09/02/2023] [Indexed: 10/07/2023] Open
Abstract
Corneal transparency is essential to provide a clear view into and out of the eye, yet clinical means to assess such transparency are extremely limited and usually involve a subjective grading of visible opacities by means of slit-lamp biomicroscopy. Here, we describe an automated algorithm allowing extraction of quantitative corneal transparency parameters with standard clinical spectral-domain optical coherence tomography (SD-OCT). Our algorithm employs a novel pre-processing procedure to standardize SD-OCT image analysis and to numerically correct common instrumental artifacts before extracting mean intensity stromal-depth (z) profiles over a 6-mm-wide corneal area. The z-profiles are analyzed using our previously developed objective method that derives quantitative transparency parameters directly related to the physics of light propagation in tissues. Tissular heterogeneity is quantified by the Birge ratio Br and the photon mean-free path (ls) is determined for homogeneous tissues (i.e., Br~1). SD-OCT images of 83 normal corneas (ages 22-50 years) from a standard SD-OCT device (RTVue-XR Avanti, Optovue Inc.) were processed to establish a normative dataset of transparency values. After confirming stromal homogeneity (Br <10), we measured a median ls of 570 μm (interdecile range: 270-2400 μm). By also considering corneal thicknesses, this may be translated into a median fraction of transmitted (coherent) light Tcoh(stroma) of 51% (interdecile range: 22-83%). Excluding images with central saturation artifact raised our median Tcoh(stroma) to 73% (interdecile range: 34-84%). These transparency values are slightly lower than those previously reported, which we attribute to the detection configuration of SD-OCT with a relatively small and selective acceptance angle. No statistically significant correlation between transparency and age or thickness was found. In conclusion, our algorithm provides robust and quantitative measurements of corneal transparency from standard SD-OCT images with sufficient quality (such as 'Line' and 'CrossLine' B-scan modes without central saturation artifact) and addresses the demand for such an objective means in the clinical setting.
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Affiliation(s)
- Maëlle Vilbert
- Laboratory for Optics and Biosciences (LOB)— École Polytechnique, CNRS, INSERM, IPP, Palaiseau, France
- Vision Institute—CNRS, INSERM, Sorbonne University, Paris, France
- GRC 32, Transplantation et Thérapies Innovantes de la Cornée, Sorbonne Université, Centre Hospitalier National d’Ophtalmologie des Quinze-Vingts, Paris, France
| | - Romain Bocheux
- Laboratory for Optics and Biosciences (LOB)— École Polytechnique, CNRS, INSERM, IPP, Palaiseau, France
- GRC 32, Transplantation et Thérapies Innovantes de la Cornée, Sorbonne Université, Centre Hospitalier National d’Ophtalmologie des Quinze-Vingts, Paris, France
- Physical Chemistry Institute (ICP)—CNRS, University of Paris-Saclay, Orsay, France
| | - Cristina Georgeon
- GRC 32, Transplantation et Thérapies Innovantes de la Cornée, Sorbonne Université, Centre Hospitalier National d’Ophtalmologie des Quinze-Vingts, Paris, France
| | - Vincent Borderie
- GRC 32, Transplantation et Thérapies Innovantes de la Cornée, Sorbonne Université, Centre Hospitalier National d’Ophtalmologie des Quinze-Vingts, Paris, France
| | - Pascal Pernot
- Physical Chemistry Institute (ICP)—CNRS, University of Paris-Saclay, Orsay, France
| | - Kristina Irsch
- Vision Institute—CNRS, INSERM, Sorbonne University, Paris, France
- GRC 32, Transplantation et Thérapies Innovantes de la Cornée, Sorbonne Université, Centre Hospitalier National d’Ophtalmologie des Quinze-Vingts, Paris, France
| | - Karsten Plamann
- Laboratory for Optics and Biosciences (LOB)— École Polytechnique, CNRS, INSERM, IPP, Palaiseau, France
- LOA—ENSTA Paris, École polytechnique, CNRS, IPP, Palaiseau, France
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Bertret C, Leveziel L, Knoeri J, Georgeon C, Jamart C, Bouheraoua N, Borderie V. Freeze-dried amniotic membrane graft with a spongy layer in bilateral peripheral ulcerative keratitis: a case report. BMC Ophthalmol 2023; 23:387. [PMID: 37735358 PMCID: PMC10515264 DOI: 10.1186/s12886-023-03129-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 09/08/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Peripheral ulcerative keratitis (PUK) is a group of inflammatory corneal ulcers with stromal thinning and peripheral localization. Amniotic membranes (AM) are used for their anti-inflammatory and healing properties. A freeze-drying process now allows maintaining the AM viable for a long time at room temperature without altering its physical, biological, and morphologic characteristics. The effectiveness of spongy freeze-dried amniotic membrane (FD-AM) graft with multimodal imaging in the management of severe corneal thinning PUK has not been reported. CASE PRESENTATION A 67-year-old Caribbean man histologically diagnosed with ulcerative colitis, was referred to our tertiary eye care center for a deep nasal juxtalimbal ulcer of the left eye. He was treated with topical steroids and antibiotics, methylprednisolone pulses, and oral prednisone. Due to continuous stromal thinning with 100 μm of residual corneal thickness, the decision was made to perform surgery. Conjunctival resection, inlay and overlay spongy FD-AM (Visio Amtrix® S, Tissue Bank of France, FR) were performed to preserve globe integrity. Despite tapering off oral steroids, PUK developed in the fellow eye on the 2 months follow-up. Treatment with human monoclonal antibody against tumor necrosis factor-alpha was initiated to control the active underlying inflammation. Six months following surgery, the ulcer was healed and corneal thickness in front of the former ulceration was measured at 525 μm on anterior segment-optical coherence tomography. Confocal microscopy confirmed the integration of the amniotic membrane between the corneal epithelium and the anterior stroma. CONCLUSION Transplantation of FD-AM with a spongy layer was associated with restoration of normal corneal thickness in the PUK area. It seems to be a safe, effective, and easily accessible solution for the surgical management of PUK with impending perforation.
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Affiliation(s)
- Clara Bertret
- Sorbonne Université, GRC n°32, Transplantation et Thérapies Innovantes de la Cornée, AP- HP, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, 28 rue de Charenton, Paris, F-75012, France
| | - Loïc Leveziel
- Sorbonne Université, GRC n°32, Transplantation et Thérapies Innovantes de la Cornée, AP- HP, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, 28 rue de Charenton, Paris, F-75012, France
| | - Juliette Knoeri
- Sorbonne Université, GRC n°32, Transplantation et Thérapies Innovantes de la Cornée, AP- HP, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, 28 rue de Charenton, Paris, F-75012, France.
| | - Cristina Georgeon
- Sorbonne Université, GRC n°32, Transplantation et Thérapies Innovantes de la Cornée, AP- HP, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, 28 rue de Charenton, Paris, F-75012, France
| | - Céline Jamart
- Internal Medicine Department, AP-HP, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, 28 rue de Charenton, Paris, F-75012, France
| | - Nacim Bouheraoua
- Sorbonne Université, GRC n°32, Transplantation et Thérapies Innovantes de la Cornée, AP- HP, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, 28 rue de Charenton, Paris, F-75012, France
| | - Vincent Borderie
- Sorbonne Université, GRC n°32, Transplantation et Thérapies Innovantes de la Cornée, AP- HP, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, 28 rue de Charenton, Paris, F-75012, France
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Fournié P, Acquadro M, Touboul D, Cochener B, Chiambaretta F, Muraine M, Borderie V, Bourges JL, Benmedjahed K, Tugaut B, Bernheim D, Bourcier T, Burillon C, David T, Delbosc B, Gain P, Hoffart L, Labetoulle M, Laroche L, Malet F, Orignac I, Robert PY, Thuret G, Vabres B, Malecaze F, Arnould B. Keratoconus and the Impact of Treatment on Patients' Quality of Life: A Qualitative Study. Ophthalmol Ther 2023; 12:1939-1956. [PMID: 37157013 PMCID: PMC10287584 DOI: 10.1007/s40123-023-00717-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 04/11/2023] [Indexed: 05/10/2023] Open
Abstract
INTRODUCTION Keratoconus has a significant impact on patients' quality of life (QoL), from diagnosis to the advanced stages of the disease. The aim of this research was to identify domains of QoL affected by this disease and its treatment. METHODS Phone interviews were conducted using a semi-structured interview guide, with patients with keratoconus stratified according to their current treatment. A board of keratoconus experts helped identify the guide's main themes. RESULTS Thirty-five patients (rigid contact lenses, n = 9; cross-linking, n = 9; corneal ring implants, n = 8; and corneal transplantation, n = 9) were interviewed by qualitative researchers. Phone interviews revealed several QoL domains affected by the disease and its treatments: "psychological", "social life", "professional life", "financial costs" and "student life". All domains were impacted, independently of the treatment history. Few differences were found between treatment regimens and keratoconus stages. Qualitative analysis enabled the development of a conceptual framework based on Wilson and Cleary's model for patient outcomes common to all patients. This conceptual model describes the relationship between patients' characteristics, their symptoms, their environment, their functional visual impairment and the impact on their QoL. CONCLUSIONS These qualitative findings supported the generation of a questionnaire to evaluate the impact of keratoconus and its treatment on patients' QoL. Cognitive debriefings confirmed its content validity. The questionnaire is applicable for all stages of keratoconus and treatments and may help tracking change over time in regular clinical settings. Psychometric validation is yet to be performed before its use in research and clinical practices.
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Affiliation(s)
- Pierre Fournié
- CHU Toulouse, Université Paul Sabatier, Toulouse, France
| | | | - David Touboul
- CHU Bordeaux, Université de Bordeaux, Bordeaux, France
| | | | | | | | | | | | | | | | - Diane Bernheim
- CHU Grenoble, Université Grenoble-Alpes, Grenoble, France
| | - Tristan Bourcier
- Hôpitaux Universitaires de Strasbourg (NHC), Université de Strasbourg, Strasbourg, France
| | | | - Thierry David
- CHU Marseille, Université Aix-Marseille, Marseille, France
| | | | - Philippe Gain
- CHU Saint-Etienne, Université Jean Monnet, Saint-Etienne, France
| | | | - Marc Labetoulle
- CHU Bicêtre, APHP, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Laurent Laroche
- Faculté de Médecine Sorbonne Université, Institut de La Vision-Paris, Paris, France
| | | | | | | | - Gilles Thuret
- CHU Saint-Etienne, Université Jean Monnet, Saint-Etienne, France
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Lemaitre D, Tourabaly M, Borderie V, Dechartres A. Long-term Outcomes After Lamellar Endothelial Keratoplasty Compared With Penetrating Keratoplasty for Corneal Endothelial Dysfunction: A Systematic Review. Cornea 2023:00003226-990000000-00271. [PMID: 37185592 DOI: 10.1097/ico.0000000000003240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
PURPOSE The purpose of this study is to evaluate long-term outcomes of endothelial keratoplasty (EK) compared with penetrating keratoplasty (PK) for corneal endothelial dysfunction [Fuchs endothelial corneal dystrophy (FECD) and bullous keratopathy (BK)]. METHODS In this systematic review, we searched PubMed, the Cochrane Library, and Embase up to May 2022 and considered all types of studies addressing our objective. Graft survival at 5, 10, and 15 years was the main outcome. RESULTS Fifty cohort studies were included. At 5 years, in FECD and BK, graft survival seemed higher after EK than PK. Two comparative studies showed either a higher 5-year graft survival after EK than PK or no significant differences. Including noncomparative studies, in FECD, the 5-year graft survival ranged from 0.69 to 0.98 for PK, from 0.93 to 1.00 for DSEK, and from 0.93 to 0.99 for Descemet membrane endothelial keratoplasty (DMEK). In BK, the 5-year graft survival ranged from 0.39 to 0.91 for PK, from 0.65 to 0.89 for DSEK, and from 0.84 to 0.95 for DMEK. The 10-year graft survival ranged from 0.20 to 0.90 for PK and from 0.62 to 0.92 for EK. The mean 5-year best spectacle-corrected visual acuity ranged from 0.73 to 0.43 LogMAR for PK, from 0.61 to 0.09 for DSEK, and from 0.31 to 0.05 for DMEK. The 5-year rejection rate ranged from 11.0% to 28.7% for PK, from 5.0% to 7.9% for DSEK, and from 1.7% to 2.6% for DMEK. CONCLUSIONS These results suggest a higher 5-year graft survival and better secondary outcomes after EK. Nevertheless, the level of evidence was low. PROSPERO REGISTRATION CRD42021260614.
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Affiliation(s)
- Daniel Lemaitre
- GRC 32, Transplantation et Thérapies Innovantes de la Cornée, Sorbonne Université, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France; and
| | - Moise Tourabaly
- GRC 32, Transplantation et Thérapies Innovantes de la Cornée, Sorbonne Université, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France; and
| | - Vincent Borderie
- GRC 32, Transplantation et Thérapies Innovantes de la Cornée, Sorbonne Université, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France; and
| | - Agnes Dechartres
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, UMR-S 1136, AP-HP, Hôpital Pitié-Salpêtrière, Département de Santé Publique, Paris, France
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Saad S, Saad R, Goemaere I, Cuyaubere R, Borderie M, Borderie V, Bouheraoua N. Efficacy, Safety, and Outcomes following Accelerated and Iontophoresis Corneal Crosslinking in Progressive Keratoconus. J Clin Med 2023; 12:jcm12082931. [PMID: 37109267 PMCID: PMC10141117 DOI: 10.3390/jcm12082931] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/05/2023] [Accepted: 04/15/2023] [Indexed: 04/29/2023] Open
Abstract
PURPOSE To investigate the outcomes of accelerated (A-CXL) and iontophoresis (I-CXL) corneal crosslinking in a large retrospective cohort with progressive keratoconus. METHODS This retrospective observational cohort study included consecutive patients treated by A-CXL (9 mW/5.4 J/cm2) or I-CXL with a minimal follow-up of 12 months. Visual acuity, manifest refraction, topography, specular microscopy, and corneal optical coherence tomography (OCT) were evaluated at baseline and at the last visit. Progression was defined as an increase in the maximum topographic keratometry (Kmax) of 1D. RESULTS 302 eyes of 241 patients with a mean age of 25.2 ± 7.5 years were included from 2012 to 2019: 231 and 71 eyes in the A-CXL and I-CXL groups, respectively. The mean follow-up was 27.2 ± 13.2 months (maximum: 85.7 months). Preoperatively, the mean Kmax was 51.8 ± 4.0D, with no differences between groups. Mean topographic measurements and spherical equivalent remained stable during the follow-up. At the last visit, CXL failure was reported in 60 eyes (19.9%): 40 (14.7%) versus 20 (28.2%) in A-CXL versus I-CXL, respectively, p = 0.005. The likelihood of progression after CXL was significantly higher following I-CXL: RR = 1.62, CI95 = [1.02 to 2.59], p = 0.04. Demarcation line presence at 1 month was positively correlated with higher efficacy of CXL, p = 0.03. No endothelial damage was reported, especially in 51 thin corneas (range = 342-399 µm). CONCLUSIONS A-CXL seems more effective than I-CXL in stabilizing keratoconus; this is to be taken into account when a therapeutic indication is posed according to the aggressiveness of the keratoconus.
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Affiliation(s)
- Sami Saad
- CHNO Des Quinze-Vingts, IHU ForeSight, INSERM-DGOS CIC 1423, 28 Rue de Charenton, F-75012 Paris, France
| | - Rana Saad
- CHNO Des Quinze-Vingts, IHU ForeSight, INSERM-DGOS CIC 1423, 28 Rue de Charenton, F-75012 Paris, France
| | - Isabelle Goemaere
- CHNO Des Quinze-Vingts, IHU ForeSight, INSERM-DGOS CIC 1423, 28 Rue de Charenton, F-75012 Paris, France
| | - Roxane Cuyaubere
- CHNO Des Quinze-Vingts, IHU ForeSight, INSERM-DGOS CIC 1423, 28 Rue de Charenton, F-75012 Paris, France
| | - Marie Borderie
- CHNO Des Quinze-Vingts, IHU ForeSight, INSERM-DGOS CIC 1423, 28 Rue de Charenton, F-75012 Paris, France
| | - Vincent Borderie
- CHNO Des Quinze-Vingts, IHU ForeSight, INSERM-DGOS CIC 1423, 28 Rue de Charenton, F-75012 Paris, France
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012 Paris, France
| | - Nacim Bouheraoua
- CHNO Des Quinze-Vingts, IHU ForeSight, INSERM-DGOS CIC 1423, 28 Rue de Charenton, F-75012 Paris, France
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012 Paris, France
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10
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Sandali O, El Sanharawi M, Tahiri Joutei Hassani R, Armia Balamoun A, Duliere C, Ezzouhairi SM, Sallam AB, Borderie V. Use of Digital Methods to Optimize Visualization during Surgical Gonioscopy. J Clin Med 2023; 12:jcm12082794. [PMID: 37109131 PMCID: PMC10146903 DOI: 10.3390/jcm12082794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 03/17/2023] [Accepted: 03/31/2023] [Indexed: 04/29/2023] Open
Abstract
Purpose: The aim of this study was to evaluate the efficacy of digital visualization for enhancing the visualization of iridocorneal structures during surgical gonioscopy. Methods: This was a prospective, single-center study on a series of 26 cases of trabecular stent implantation performed by the same surgeon. Images were recorded during surgical gonioscopy, and before stent implantation, with standard colors and with the optimization of various settings, principally color saturation and temperature and the use of the cyan color filter. Subjective analyses were performed by two glaucoma surgeons, and objective contrast measurements were made on iridocorneal structure images. Results: The surgeons evaluating the images considered the optimized digital settings to produce enhanced tissue visibility for both trabecular meshwork pigmentation and Schlemm's canal in more than 65% of cases. The mean difference in the standard deviation of the pixel intensity values was 37.87 (±4.61) for the optimized filter images and 32.37 (±3.51) for the standard-color images (p < 0.001). The use of a cyan filter provided a good level of contrast for the visualization of trabecular meshwork pigmentation. Increasing the color temperature highlighted the red appearance of Schlemm's canal. Conclusions: We report here the utility of optimized digital settings including the cyan filter and a warmer color for enhancing the visualization of iridocorneal structures during surgical gonioscopy. These settings could be used in surgical practice to enhance the visualization of the trabecular meshwork and Schlemm's canal during minimally invasive glaucoma surgery.
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Affiliation(s)
- Otman Sandali
- Centre Hospitalier National d'Ophtalmologie des XV-XX, 28 Rue de Charenton, 75571 Paris, France
- Service de Chirurgie Ambulatoire, Hôpital Guillaume-de-Varye, 18230 Bourges, France
| | - Mohamed El Sanharawi
- Service d'Ophtalmologie, Centre Hospitalier de Châteaudun, 28200 Châteaudun, France
| | | | - Ashraf Armia Balamoun
- Watany Eye Hospital, Cairo 11775, Egypt
- Watany Research and Development Centre, Cairo 11775, Egypt
- Ashraf Armia Eye Clinic, Giza 12655, Egypt
| | | | | | - Ahmed B Sallam
- Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | - Vincent Borderie
- Centre Hospitalier National d'Ophtalmologie des XV-XX, 28 Rue de Charenton, 75571 Paris, France
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11
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Sandali O, Tahiri Joutei Hassani R, Armia Balamoun A, Franklin A, Sallam AB, Borderie V. Operative Digital Enhancement of Macular Pigment during Macular Surgery. J Clin Med 2023; 12:jcm12062300. [PMID: 36983301 PMCID: PMC10051350 DOI: 10.3390/jcm12062300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 03/09/2023] [Accepted: 03/10/2023] [Indexed: 03/18/2023] Open
Abstract
Purpose: To describe the feasibility of intraoperative digital visualization and its contribution to the enhancement of macular pigmentation visualization in a prospective series of macular surgery interventions. Materials and Methods: A prospective, single-center, single-surgeon study was performed on a series of 21 consecutive cases of vitrectomy for various types of macular surgery using a 3D visualization system. Two optimized filters were applied to enhance the visualization of the macular pigment (MP). For filter 1, cyan, yellow, and magenta color saturations were increased. Filter 2 differed from filter 1 only in having a lower level of magenta saturation for the green-magenta color channel. Results: Optimized digital filters enhanced the visualization of the MP and the pigmented epiretinal tissue associated with the lamellar and macular holes. In vitreomacular traction surgery, the filters facilitated the assessment of MP integrity at the end of surgery. Filter 1 enhanced MP visualization most strongly, with the MP appearing green and slightly fluorescent. Filter 2 enhanced MP visualization less effectively but gave a clearer image of the retinal surface, facilitating safe macular peeling. Conclusion: Optimized digital filters could be used to enhance MP and pigmented epiretinal tissue visualization during macular surgery. These filters open new horizons for future research and should be evaluated in larger series and correlated with intraoperative OCT.
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Affiliation(s)
- Otman Sandali
- Centre Hospitalier National d’Ophtalmologie des XV-XX 28, Rue de Charenton, 75012 Paris, France
- Service de Chirurgie Ambulatoire, Hôpital Guillaume-de-Varye, 18230 Bourges, France
- Correspondence: ; Tel.: +33-1-4002-1508
| | | | - Ashraf Armia Balamoun
- Watany Eye Hospital, Cairo 11775, Egypt
- Watany Research and Development Centre, Cairo 11775, Egypt
- Ashraf Armia Eye Clinic, Giza 12655, Egypt
| | - Alan Franklin
- Diagnostic and Medical Clinic, 1720 SpringHill Ave Suite 300, Mobile, AL 36604, USA
| | - Ahmed B. Sallam
- Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, 4301 W Markham St, Little Rock, AR 72205, USA
| | - Vincent Borderie
- Centre Hospitalier National d’Ophtalmologie des XV-XX 28, Rue de Charenton, 75012 Paris, France
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12
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Memmi B, Knoeri J, Bouheraoua N, Borderie V. Intraocular Lens Calcification After Pseudophakic Endothelial Keratoplasty. Am J Ophthalmol 2023; 246:86-95. [PMID: 36457226 DOI: 10.1016/j.ajo.2022.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/29/2022] [Accepted: 10/18/2022] [Indexed: 01/24/2023]
Abstract
PURPOSE To determine the incidence and to document risk factors for intraocular lens (IOL) calcification after pseudophakic endothelial keratoplasty. METHODS We retrospectively studied 2700 consecutive penetrating, anterior lamellar and endothelial keratoplasties carried out between December 1992 and June 2022 at the National Eye Hospital, Paris, France. DESIGN Retrospective cohort study. RESULTS All IOL calcification cases were associated with endothelial keratoplasty. Out of 588 endothelial keratoplasty procedures, 576 eyes were pseudophakic at the end of surgery. Fourteen cases of IOL calcification were observed during follow-up. The cumulative incidence of IOL calcification after endothelial keratoplasty was 4.5%±1.3% at 60 months. Hydrophilic acrylic IOL material (P < .001) and use of SF6 for anterior chamber tamponade (P = .001) were significantly and independently associated with the cumulative incidence of IOL calcification. CONCLUSION The incidence of IOL calcifications seems to be around 5%. Ophthalmologists should avoid hydrophilic acrylic IOLs in patients with endothelial disorders. When the patient already has a hydrophilic IOL, SF6 should be avoided. The only effective treatment is IOL exchange.
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Affiliation(s)
- Benjamin Memmi
- From the GRC 32, Transplantation et Thérapies Innovantes de la Cornée, Sorbonne Université, Sorbonne Université, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France
| | - Juliette Knoeri
- From the GRC 32, Transplantation et Thérapies Innovantes de la Cornée, Sorbonne Université, Sorbonne Université, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France
| | - Nacim Bouheraoua
- From the GRC 32, Transplantation et Thérapies Innovantes de la Cornée, Sorbonne Université, Sorbonne Université, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France
| | - Vincent Borderie
- From the GRC 32, Transplantation et Thérapies Innovantes de la Cornée, Sorbonne Université, Sorbonne Université, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France.
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13
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Saad S, Labani S, Goemaere I, Cuyaubere R, Borderie M, Borderie V, Benkhatar H, Bouheraoua N. Corneal neurotization in the management of neurotrophic keratopathy: A review of the literature. J Fr Ophtalmol 2023; 46:83-96. [PMID: 36473789 DOI: 10.1016/j.jfo.2022.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 12/12/2022]
Abstract
Neurotrophic keratopathy (NK) is a rare degenerative disease in which damage to the corneal nerves leads to corneal hypoesthesia or anesthesia. Neurotrophic corneal ulcers are notoriously difficult to treat and can lead to blindness. Corneal neurotization (CN) is a recent surgical technique aimed at restoring corneal sensation and may offer a definitive treatment in the wake of NK. Herein, we review the surgical techniques utilized in direct and indirect CN. Technical considerations, outcomes, current limitations and future perspectives are also discussed. This article highlights the key points of this promising procedure and biological aspects that will help provide the best treatment options for patients with severe NK.
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Affiliation(s)
- S Saad
- CHNO des Quinze-Vingts, IHU FOReSIGHT, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France
| | - S Labani
- CHNO des Quinze-Vingts, IHU FOReSIGHT, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France
| | - I Goemaere
- CHNO des Quinze-Vingts, IHU FOReSIGHT, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France
| | - R Cuyaubere
- CHNO des Quinze-Vingts, IHU FOReSIGHT, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France
| | - M Borderie
- CHNO des Quinze-Vingts, IHU FOReSIGHT, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France
| | - V Borderie
- CHNO des Quinze-Vingts, IHU FOReSIGHT, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France; Sorbonne université, Inserm, CNRS, institut de la vision, 17, rue Moreau, 75012 Paris, France
| | - H Benkhatar
- CHNO des Quinze-Vingts, IHU FOReSIGHT, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France; Versailles Hospital Center, Department of Otorhinolaryngology-Head and Neck Surgery, Le Chesnay, France
| | - N Bouheraoua
- CHNO des Quinze-Vingts, IHU FOReSIGHT, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France; Sorbonne université, Inserm, CNRS, institut de la vision, 17, rue Moreau, 75012 Paris, France.
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Irsch K, Grieve K, Borderie M, Vilbert M, Plamann K, Ghoubay D, Georgeon C, Borderie V. Full-field Optical Coherence Microscopy for Histology-like Analysis of Stromal Features in Corneal Grafts. J Vis Exp 2022. [DOI: 10.3791/57104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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15
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Sandali O, Tahiri JHR, Armia Balamoun A, Duliere C, El Sanharawi M, Borderie V. Use of Black-and-White Digital Filters to Optimize Visualization in Cataract Surgery. J Clin Med 2022; 11:jcm11144056. [PMID: 35887820 PMCID: PMC9316540 DOI: 10.3390/jcm11144056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 07/06/2022] [Accepted: 07/11/2022] [Indexed: 02/05/2023] Open
Abstract
Purpose: To evaluate the effect of a black-and-white (BW) filter on the optimization of visualization at each stage of cataract surgery. Methods: Prospective, single-center, single-surgeon, consecutive case series of 40 patients undergoing cataract surgery with BW filter. Surgical images and videos were recorded with and without the BW filter at each stage of cataract surgery. Contrast measurements of surgical images and subjective analysis of video sequences were performed. Results: The surgeons assessed the BW filter to optimize the tissue visibility of capsulorhexis contours, hydrodissection fluid wave perception, the contrast of instruments through a nucleus during phaco-chop, and subincisional cortex contrast through the corneal edema. Despite the higher contrasts’ value obtained with BW filter images during nucleus removal, posterior capsular polishing and viscous removal, the surgeons subjectively reported no significant advantage of using a BW filter. Standard color images were found to be better for localizing the limbal area during incision and for nucleus sculpture to assess groove depth. Conclusions: In conclusion, we describe here the potential indications for BW filter use at particular stages in cataract surgery. A BW filter could be used, with caution, in cases of poor visualization.
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Affiliation(s)
- Otman Sandali
- Centre Hospitalier National d’Ophtalmologie des XV-XX, Research Team 968, Institut de la Vision, Pierre & Marie Curie University Paris 06, 75012 Paris, France;
- Service de Chirurgie Ambulatoire, Hôpital Guillaume-de-Varye, 18230 Bourges, France
- Correspondence: ; Tel.: +33-1-40-021-508
| | | | - Ashraf Armia Balamoun
- Watany Eye Hospital (WEH), Cairo 11775, Egypt;
- Watany Research and Development Centre, Cairo 11775, Egypt
- Ashraf Armia Eye Clinic, Giza 12655, Egypt
| | | | - Mohamed El Sanharawi
- Service d’Ophtalmologie, Centre Hospitalier de Châteaudun, 28200 Châteaudun, France;
| | - Vincent Borderie
- Centre Hospitalier National d’Ophtalmologie des XV-XX, Research Team 968, Institut de la Vision, Pierre & Marie Curie University Paris 06, 75012 Paris, France;
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Bremond-Gignac D, Robert M, Daruich A, Borderie V, Chiambaretta F, Valleix S. [National protocol for diagnosis and care of congenital aniridia: Summary for the attending physician]. J Fr Ophtalmol 2022; 45:647-652. [PMID: 35667788 DOI: 10.1016/j.jfo.2022.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 01/10/2022] [Indexed: 11/29/2022]
Abstract
Congenital aniridia is a rare panocular disease defined by a national diagnostic and care protocol (PNDS) validated by the HAS. In most cases, it is due to an abnormality in the PAX6 gene, located at 11p13. Aniridia is a potentially blinding autosomal dominant disease with high penetrance. The prevalence varies from 1/40,000 births to 1/96,000 births. Approximately one third of cases are sporadic. Ocular involvement includes complete or partial absence of iris tissue, corneal opacification with neovascularization, glaucoma, cataract, foveal hypoplasia, optic disc hypoplasia and ptosis. These ocular disorders coexist to varying degrees and progress with age. Congenital aniridia manifests in the first months of life as nystagmus, visual impairment and photophobia. A syndromic form such as WAGR syndrome, WAGRO syndrome (due to the risk of renal Wilms tumor) or Gillespie syndrome (cerebellar ataxia) must be ruled out. Systemic associations may include diabetes, due to expression of the PAX6 gene in the pancreas, as well as other extraocular manifestations. Initial assessment is best carried out in a referral center specialized in rare ophthalmologic diseases, with annual follow-up. The management of progressive ocular involvement must be both proactive and responsive, with medical and surgical management. Visual impairment and photophobia result in disability, leading to difficulties in mobility, movement, communication, learning, fine motor skills, and autonomy, with consequences in personal, school, professional, socio-cultural and athletic life. Medico-socio-educational care involves a multidisciplinary team. Disability rehabilitation must be implemented to prevent and limit situations of handicap in activities of daily living, relying on the Commission for the Rights and Autonomy of People with Disabilities (CDAPH) within the Departmental House of People with Disabilities (MDPH). The general practitioner coordinates multidisciplinary medical and paramedical care.
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Affiliation(s)
- D Bremond-Gignac
- Service d'ophtalmologie, centre hospitalier universitaire Necker-Enfants Malades, AP-HP, université de Paris, 149, rue de Sèvres, 75015 Paris, France; Inserm 1138, T17, université de Paris, Paris, France; OPHTARA, Coordonnateur centre de maladies rares en ophtalmologie (CRMR), Filière Sensgene, centre hospitalier universitaire Necker-Enfants Malades, Paris, France.
| | - M Robert
- Service d'ophtalmologie, centre hospitalier universitaire Necker-Enfants Malades, AP-HP, université de Paris, 149, rue de Sèvres, 75015 Paris, France; OPHTARA, Coordonnateur centre de maladies rares en ophtalmologie (CRMR), Filière Sensgene, centre hospitalier universitaire Necker-Enfants Malades, Paris, France
| | - A Daruich
- Service d'ophtalmologie, centre hospitalier universitaire Necker-Enfants Malades, AP-HP, université de Paris, 149, rue de Sèvres, 75015 Paris, France; Inserm 1138, T17, université de Paris, Paris, France; OPHTARA, Coordonnateur centre de maladies rares en ophtalmologie (CRMR), Filière Sensgene, centre hospitalier universitaire Necker-Enfants Malades, Paris, France
| | - V Borderie
- Ophtalmologie, CHNO des XV-XX, Paris, France
| | - F Chiambaretta
- Ophtalmologie, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - S Valleix
- Inserm 1138, T17, université de Paris, Paris, France; Laboratoire de génétique moléculaire, centre hospitalier universitaire Necker-Enfants Malades, AP-HP, université de Paris, Paris, France
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Olivier R, Knoeri J, Leveziel L, Negrier P, Georgeon C, Kobal A, Bouheraoua N, Baudouin C, Nordmann J, Brignole‐Baudouin F, Merabet L, Borderie V. Update on fungal keratitis in France: a case-control study. Acta Ophthalmol 2022; 100:159-163. [PMID: 34031997 DOI: 10.1111/aos.14910] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 05/01/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE To report an epidemiological update of documented fungal keratitis (FK) in a French tertiary ophthalmological centre from 2014 to 2018 in comparison with a previous period from 1993 to 2008. METHODS Sixty-two consecutive FK documented by microbiological corneal scrapings were compared with the 64 FK of the previous study. Amphotericin B and voriconazole eye drops were administered hourly. Population characteristics, clinical findings, aetiological organisms and treatments were analysed. RESULTS The most frequently identified fungi were Fusarium (61%), Aspergillus (6.5%) and Candida (5%). Thirty out of 44 cases examined with in vivo confocal microscopy (IVCM) presented filaments. Ten required conventional cross-linking, 9 therapeutic penetrating keratoplasty, and 2 enucleation. Risk factors significantly associated with the absence of response to medical treatment were patient age (p = 0.01), presence of a deep stromal infiltrate at presentation (p = 0.04) and high numbers of filaments in IVCM images (p = 0.01). The two populations were comparable in age, but not in sex ratio males/females (18/44 versus 37/26 in the previous study; p = 0.001). The frequency of contact lens-associated infection increased from 35.5% to 71% (p = 0.0001) between the two periods. Since then, filamentous FK increased from 69% (44/64) to 95% (59/62) (p = 0.0001). A history of keratoplasty was less frequently reported during the last period (3.2% (2/62) versus 17% (11/64) of cases (p = 0.01)). A clear decrease in the frequency of therapeutic keratoplasty was noted from 39% (25/64) to 14% (9/62) (p = 0.02). CONCLUSION The frequency of filamentous keratomycosis is currently increasing. Elderly patients and the presence of numerous filaments in IVCM are associated with poor clinical outcomes.
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Affiliation(s)
- Roxane Olivier
- GRC32 Sorbonne Université Centre Hospitalier National d'Ophtalmologie des Quinze‐Vingts Paris France
- Faculté de médecine Hyacinthe Bastaraud Pointe‐à‐Pitre France
| | - Juliette Knoeri
- GRC32 Sorbonne Université Centre Hospitalier National d'Ophtalmologie des Quinze‐Vingts Paris France
| | - Loïc Leveziel
- GRC32 Sorbonne Université Centre Hospitalier National d'Ophtalmologie des Quinze‐Vingts Paris France
| | - Pierre Negrier
- GRC32 Sorbonne Université Centre Hospitalier National d'Ophtalmologie des Quinze‐Vingts Paris France
| | - Cristina Georgeon
- GRC32 Sorbonne Université Centre Hospitalier National d'Ophtalmologie des Quinze‐Vingts Paris France
| | - Alfred Kobal
- GRC32 Sorbonne Université Centre Hospitalier National d'Ophtalmologie des Quinze‐Vingts Paris France
| | - Nacim Bouheraoua
- GRC32 Sorbonne Université Centre Hospitalier National d'Ophtalmologie des Quinze‐Vingts Paris France
- Sorbonne Université UM80 INSERM UMR 968 CNRS UMR 7210 Institut de la Vision IHU ForeSight Paris France
| | - Christophe Baudouin
- GRC32 Sorbonne Université Centre Hospitalier National d'Ophtalmologie des Quinze‐Vingts Paris France
- Sorbonne Université UM80 INSERM UMR 968 CNRS UMR 7210 Institut de la Vision IHU ForeSight Paris France
| | - Jean‐Philippe Nordmann
- GRC32 Sorbonne Université Centre Hospitalier National d'Ophtalmologie des Quinze‐Vingts Paris France
| | - Françoise Brignole‐Baudouin
- GRC32 Sorbonne Université Centre Hospitalier National d'Ophtalmologie des Quinze‐Vingts Paris France
- Sorbonne Université UM80 INSERM UMR 968 CNRS UMR 7210 Institut de la Vision IHU ForeSight Paris France
| | - Lilia Merabet
- GRC32 Sorbonne Université Centre Hospitalier National d'Ophtalmologie des Quinze‐Vingts Paris France
| | - Vincent Borderie
- GRC32 Sorbonne Université Centre Hospitalier National d'Ophtalmologie des Quinze‐Vingts Paris France
- Sorbonne Université UM80 INSERM UMR 968 CNRS UMR 7210 Institut de la Vision IHU ForeSight Paris France
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Sandali O, El Sanharawi M, Tahiri Joutei Hassani R, Roux H, Bouheraoua N, Borderie V. Early corneal pachymetry maps after cataract surgery and influence of 3D digital visualization system in minimizing corneal oedema. Acta Ophthalmol 2021; 100:e1088-e1094. [PMID: 34750943 DOI: 10.1111/aos.15060] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 10/25/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE To describe the early topography of corneal swelling occurring after cataract surgery and to evaluate the impact of the three-dimensional (3D) digital visualization system in minimizing corneal oedema. METHODS Prospective observational, single-centre, consecutive case series of 134 patients undergoing cataract surgery performed by the same surgeon, with either 3D or conventional visualization systems. Eyes were assigned to two groups based on their anterior chamber depth (group ACD ≤3 mm and group ACD >3 mm). Optical coherence tomography was performed to evaluate postoperative corneal swelling. RESULTS Three corneal swelling profiles were identified on the first postoperative day type 1, limited corneal oedema near peripheral corneal incisions; type 2, dome-shaped corneal swelling spreading from the principal corneal incision and reaching the paracentral cornea; type 3, continuous oedema spreading from the principal incision to central cornea, with a generalized oedema predominating in the upper part of the cornea. On the first day after surgery, in group ACD ≤3 mm, visual acuity was significantly better in patients undergoing surgery with 3D visualization (0.023 vs 0.072 logMar, p = 0.014) with reduced central corneal thickening 17.3 µm (±3.2) in comparison with conventional visualization 44.0 µm (±9.3) (p = 0.0082). In group ACD >3 mm, no significant association was found between the use of the 3D system and pachymetry changes and early visual rehabilitation. On day 21 after surgery, no significant differences in corneal pachymetry values were observed between the two surgical approaches in both groups. CONCLUSIONS We describe early postoperative corneal map profiles providing insight into the pathogenesis of postoperative corneal swelling and possible prevention strategies. By improving visualization of the narrow surgical space in patients with shallow anterior chambers, the 3D system could help to minimize postoperative corneal oedema.
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Affiliation(s)
- Otman Sandali
- Quinze‐Vingts National Ophthalmology Hospital Paris France
- Ambulatory Department Guillaume‐de‐Varye Hospital Bourges France
| | | | | | - Hillary Roux
- Ambulatory Department Guillaume‐de‐Varye Hospital Bourges France
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Barugel R, David C, Kallel S, Borderie M, Cuyaubère R, Goemaere I, Borderie V, Bouheraoua N. Comparative Study of Asymmetric Versus Non-asymmetric Intrastromal Corneal Ring Segments for the Management of Keratoconus. J Refract Surg 2021; 37:552-561. [PMID: 34388067 DOI: 10.3928/1081597x-20210526-01] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare the outcomes obtained with models of asymmetric and non-asymmetric intracorneal ring segments (ICRS) in keratoconic eyes with asymmetric topo-graphic patterns. METHODS In this prospective observational study, ICRS were implanted alternately in patients with the same tomographic patterns of keratoconus assigned to four groups. Patients with the "duck" phenotype received one asymmetric or non-asymmetric ICRS and patients with the "snowman" pheno-type received two asymmetric or non-asymmetric ICRS. Visual, refractive, astigmatism, keratometric, and corneal aberrometry changes were evaluated over a 6-month follow-up period. RESULTS Sixty-eight eyes were analyzed. No significant difference was observed between the use of one asymmetric and one non-asymmetric ICRS in duck phenotypes. In snowman keratoconus, the inferior-superior index decreased significantly (P = .03) with asymmetric but not with non-asymmetric ICRS implantation. Total corneal higher order aberrations and coma rates were lower, but not significantly so, after the implantation of two asymmetric ICRS in snowman phenotypes (2.85 ± 0.89 to 2.60 ± 0.91 µm, P = .20 and 2.64 ± 0.93 to 2.39 ± 0.98 µm, P = .21), and significantly higher after the implantation of two non-asymmetric ICRS (2.56 ± 1.28 to 3.08 ± 1.62 µm, P = .02 and 2.34 ± 1.27 to 2.84 ± 1.62 µm, P = .02). CONCLUSIONS Asymmetric ICRS did not improve the outcomes of ICRS implantation in duck keratoconus. However, the implantation of two asymmetric ICRS was more effective than that of two non-asymmetric ICRS for decreasing vertical asymmetry and preventing increases in corneal aberration in the snowman phenotype of keratoconus. [J Refract Surg. 2021;37(8):552-561.].
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20
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Saad S, Sellam A, Borderie V, Bouheraoua N. [OCT-guided aspiration of subfoveal perfluorocarbon liquid using a 27-gauge cannula]. J Fr Ophtalmol 2021; 44:1076-1078. [PMID: 34243999 DOI: 10.1016/j.jfo.2021.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 01/10/2021] [Indexed: 11/15/2022]
Affiliation(s)
- S Saad
- CHNO des Quinze-Vingts, Inserm-DGOS CIC 1423, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France
| | - A Sellam
- CHNO des Quinze-Vingts, Inserm-DGOS CIC 1423, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France.
| | - V Borderie
- CHNO des Quinze-Vingts, Inserm-DGOS CIC 1423, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France; Sorbonne Université, Inserm, CNRS, Institut de la Vision, 17, rue Moreau, 75012 Paris, France
| | - N Bouheraoua
- CHNO des Quinze-Vingts, Inserm-DGOS CIC 1423, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France; Sorbonne Université, Inserm, CNRS, Institut de la Vision, 17, rue Moreau, 75012 Paris, France
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21
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Puyo L, David C, Saad R, Saad S, Gautier J, Sahel JA, Borderie V, Paques M, Atlan M. Laser Doppler holography of the anterior segment for blood flow imaging, eye tracking, and transparency assessment. Biomed Opt Express 2021; 12:4478-4495. [PMID: 34457427 PMCID: PMC8367265 DOI: 10.1364/boe.425272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/28/2021] [Accepted: 05/30/2021] [Indexed: 05/04/2023]
Abstract
Laser Doppler holography (LDH) is a full-field blood flow imaging technique able to reveal human retinal and choroidal blood flow with high temporal resolution. We here report on using LDH in the anterior segment of the eye without making changes to the instrument. Blood flow in the bulbar conjunctiva and episclera as well as in corneal neovascularization can be effectively imaged. We additionally demonstrate simultaneous holographic imaging of the anterior and posterior segments by simply adapting the numerical propagation distance to the plane of interest. We used this feature to track the movements of the retina and pupil with high temporal resolution. Finally, we show that the light backscattered by the retina can be used for retro-illumination of the anterior segment. Hence digital holography can reveal opacities caused by absorption or diffusion in the cornea and eye lens.
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Affiliation(s)
- Léo Puyo
- Centre Hospitalier National d’Ophtalmologie des Quinze-Vingts, INSERM-DHOS CIC 1423, 28 rue de Charenton, 75012 Paris, France
- Paris Eye Imaging, France
- Institute of Biomedical Optics, University of Lübeck. Peter-Monnik-Weg 4, 23562 Lübeck, Germany
| | - Clémentine David
- Centre Hospitalier National d’Ophtalmologie des Quinze-Vingts, INSERM-DHOS CIC 1423, 28 rue de Charenton, 75012 Paris, France
| | - Rana Saad
- Centre Hospitalier National d’Ophtalmologie des Quinze-Vingts, INSERM-DHOS CIC 1423, 28 rue de Charenton, 75012 Paris, France
- Paris Eye Imaging, France
| | - Sami Saad
- Centre Hospitalier National d’Ophtalmologie des Quinze-Vingts, INSERM-DHOS CIC 1423, 28 rue de Charenton, 75012 Paris, France
| | - Josselin Gautier
- Centre Hospitalier National d’Ophtalmologie des Quinze-Vingts, INSERM-DHOS CIC 1423, 28 rue de Charenton, 75012 Paris, France
- Paris Eye Imaging, France
| | - José Alain Sahel
- Centre Hospitalier National d’Ophtalmologie des Quinze-Vingts, INSERM-DHOS CIC 1423, 28 rue de Charenton, 75012 Paris, France
- Paris Eye Imaging, France
- Department of Ophthalmology, The University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
- Institut de la Vision, Sorbonne Université, INSERM, CNRS, 17 Rue Moreau, 75012 Paris, France
| | - Vincent Borderie
- Centre Hospitalier National d’Ophtalmologie des Quinze-Vingts, INSERM-DHOS CIC 1423, 28 rue de Charenton, 75012 Paris, France
| | - Michel Paques
- Centre Hospitalier National d’Ophtalmologie des Quinze-Vingts, INSERM-DHOS CIC 1423, 28 rue de Charenton, 75012 Paris, France
- Paris Eye Imaging, France
- Institut de la Vision, Sorbonne Université, INSERM, CNRS, 17 Rue Moreau, 75012 Paris, France
| | - Michael Atlan
- Paris Eye Imaging, France
- Institut Langevin, CNRS, PSL University, ESPCI Paris, 1 rue Jussieu, 75005 Paris, France
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Hoarau G, Merabet L, Knoeri J, Georgeon C, Poirier P, Borderie V, Brignole-Baudouin F, Bouheraoua N. Microsporidial keratoconjunctivitis: Report of two imported cases. J Fr Ophtalmol 2021; 44:e551-e554. [PMID: 34148704 DOI: 10.1016/j.jfo.2020.12.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 12/08/2020] [Indexed: 11/20/2022]
Affiliation(s)
- G Hoarau
- CHNO des Quinze-Vingts, Inserm-DGOS CIC 1423, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France
| | - L Merabet
- CHNO des Quinze-Vingts, Inserm-DGOS CIC 1423, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France
| | - J Knoeri
- CHNO des Quinze-Vingts, Inserm-DGOS CIC 1423, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France
| | - C Georgeon
- CHNO des Quinze-Vingts, Inserm-DGOS CIC 1423, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France
| | - P Poirier
- Laboratoire de parasitologie-mycologie, 3IHP, centre hospitalier universitaire Gabriel-Montpied, 58, rue Montalembert, 63000 Clermont-Ferrand, France; Université Clermont-Auvergne, CNRS UMR 6023, laboratoire Micro-organismes: génome et environnement, Clermont-Ferrand, France
| | - V Borderie
- CHNO des Quinze-Vingts, Inserm-DGOS CIC 1423, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France; Sorbonne université, Inserm, CNRS, Institut de la Vision, 17, rue Moreau, 75012 Paris, France
| | - F Brignole-Baudouin
- CHNO des Quinze-Vingts, Inserm-DGOS CIC 1423, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France
| | - N Bouheraoua
- CHNO des Quinze-Vingts, Inserm-DGOS CIC 1423, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France; Sorbonne université, Inserm, CNRS, Institut de la Vision, 17, rue Moreau, 75012 Paris, France.
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David C, Reinstein DZ, Archer TJ, Kallel S, Vida RS, Goemaere I, Cuyaubère R, Borderie M, Laroche L, Borderie V, Bouheraoua N. Postoperative Corneal Epithelial Remodeling After Intracorneal Ring Segment Procedures for Keratoconus: An Optical Coherence Tomography Study. J Refract Surg 2021; 37:404-413. [PMID: 34170769 DOI: 10.3928/1081597x-20210225-02] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To assess epithelial corneal remodeling by anterior segment optical coherence tomography (AS-OCT) after intracorneal ring segments (ICRS) implantation in keratoconic eyes. METHODS This prospective observational study included patients with keratoconus receiving ICRS of different arc lengths according to their tomographic pattern. AS-OCT and corneal topography (Scheimpflug camera) were performed before and 1, 3, and 6 months after surgery. Corneal pachymetry mapping was performed and total corneal and epithelial thicknesses (3-mm central and 16 points on 6-mm zone) were measured over the pupil center using AS-OCT. Topographic parameters were also assessed. RESULTS A total of 68 keratoconic eyes were analyzed (Amsler-Krumeich stages 1 to 4) in four groups of 17 eyes: 210° ICRS, 320° ICRS, double 160° ICRS, and single 160° ICRS. Corneal pachymetry mapping revealed that epithelial thickness increased significantly in the internal zones juxtaposed to the ICRS without smoothing during the postoperative period (P < .05). Mean maximum epithelial thickness increased from 67 ± 6 to 79 ± 7 µm for 210° ICRS, 66 ± 9 to 82 ± 4 µm for 320° ICRS, 63 ± 6 to 78 ± 7 µm for double 160° ICRS, and 62 ± 5 to 77 ± 5 µm for single 160° ICRS (P < .0001). Significant epithelial thickening at the apex of the cone was observed in all groups (P < .05). CONCLUSIONS Significant epithelial thickening occurs after ICRS implantation adjacent to the ICRS to compensate for the ridge created with a thickening of epithelium over the cone due to regularization of the stromal surface. [J Refract Surg. 2021;37(6):404-413.].
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Levy A, Knoeri J, Borderie M, Leveziel L, Borderie V. Therapeutic management of post-traumatic epithelial ingrowth in a 10-year-old boy. J Fr Ophtalmol 2021; 44:e471-e473. [PMID: 33934904 DOI: 10.1016/j.jfo.2020.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 11/18/2020] [Indexed: 11/26/2022]
Affiliation(s)
- A Levy
- Centre hospitalier national d'ophtalmologie des Quinze-Vingts, GRC32 Sorbonne Université, 28, rue de Charenton, 75012 Paris, France.
| | - J Knoeri
- Centre hospitalier national d'ophtalmologie des Quinze-Vingts, GRC32 Sorbonne Université, 28, rue de Charenton, 75012 Paris, France
| | - M Borderie
- Centre hospitalier national d'ophtalmologie des Quinze-Vingts, GRC32 Sorbonne Université, 28, rue de Charenton, 75012 Paris, France
| | - L Leveziel
- Centre hospitalier national d'ophtalmologie des Quinze-Vingts, GRC32 Sorbonne Université, 28, rue de Charenton, 75012 Paris, France
| | - V Borderie
- Centre hospitalier national d'ophtalmologie des Quinze-Vingts, GRC32 Sorbonne Université, 28, rue de Charenton, 75012 Paris, France; Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17, rue Moreau, 75012 Paris, France
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David C, Kallel S, Trinh L, Goemaere I, Borderie V, Bouheraoua N. [Intracorneal ring segments in keratoconus management]. J Fr Ophtalmol 2021; 44:882-898. [PMID: 33895029 DOI: 10.1016/j.jfo.2020.10.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 09/30/2020] [Accepted: 10/02/2020] [Indexed: 11/25/2022]
Abstract
Intracorneal ring segments (ICRS), used in the management of keratoconus since the 2000s, have enjoyed significant technological development. Various types of ICRS exist, whose arc length, thickness, and diameter can be chosen according to the desired effect on the spherical equivalent, keratometry and asphericity. Individualized implantation strategies, based on each patient's topographic and tomographic pattern, are constantly evolving. The surgical procedure is standardized, and complications remain very rare. Combined procedures (corneal collagen cross-linking and refractive photokeratectomy±topo-guided, phakic and pseudophakic intraocular lenses) are increasingly used and require a good knowledge of the effect of ICRS alone on the keratoconic cornea. The objective of this review is to summarize clinical practices used in the visual rehabilitation of keratoconic patients using the ICRS+- combined procedures.
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Affiliation(s)
- C David
- INSERM-DGOS CIC 1423, CHNO des Quinze-Vingts, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France
| | - S Kallel
- INSERM-DGOS CIC 1423, CHNO des Quinze-Vingts, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France
| | - L Trinh
- INSERM-DGOS CIC 1423, CHNO des Quinze-Vingts, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France
| | - I Goemaere
- INSERM-DGOS CIC 1423, CHNO des Quinze-Vingts, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France
| | - V Borderie
- INSERM-DGOS CIC 1423, CHNO des Quinze-Vingts, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France; Inserm, CNRS, Sorbonne université, institut de la Vision, 17, rue Moreau, 75012 Paris, France
| | - N Bouheraoua
- INSERM-DGOS CIC 1423, CHNO des Quinze-Vingts, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France; Inserm, CNRS, Sorbonne université, institut de la Vision, 17, rue Moreau, 75012 Paris, France.
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Leveziel L, Knoeri J, Errera MH, Kobal A, Fardeau C, Bouheraoua N, Sahel JA, Baudouin C, Nordmann JP, Baudouin F, Merabet L, Borderie V. Anterior chamber tap cytology in acute postoperative endophthalmitis: a case-control study. Br J Ophthalmol 2021; 106:807-814. [PMID: 33574032 DOI: 10.1136/bjophthalmol-2020-317438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 09/24/2020] [Accepted: 01/04/2021] [Indexed: 11/03/2022]
Abstract
AIMS To determine anterior chamber tap cytology characteristics in acute postoperative bacterial endophthalmitis. METHODS 488 eyes of 488 patients were included in this retrospective case-control study. The study group included 93 eyes with bacteriologically documented endophthalmitis and 85 eyes with clinical endophthalmitis. The control group included 33 eyes with non-infectious postoperative inflammation, 116 eyes with acute uveitis and 161 cataract surgery eyes with no ocular inflammation. Cytological analysis, direct examination and microbiological cultures were performed in aqueous humour (AqH) samples. Inclusion criteria for the study group were the following: suspected endophthalmitis within 30 days following cataract surgery by phacoemulsification, secondary lens implantation, pars plana vitrectomy or intravitreal injection; best-corrected visual acuity (BCVA) <20/400; hypopyon or cyclitic membrane; absence of visibility of the retina; vitritis at a slit-lamp examination or in ultrasound B-scan. RESULTS Cell line counts (mainly polymorphonuclear neutrophils) were significantly higher in the two endophthalmitis study subgroups than in the three control subgroups. The study group showed a predominance of polymorphonuclear neutrophils as opposed to the three control subgroups including uveitis (p<0.00001). The best sensitivity/specificity was obtained using a polymorphonuclear neutrophil threshold of 10 per field (sensitivity, 0.90; specificity, 0.75). The sensitivity of the bacterial culture was 32% in the AqH. High neutrophil count was associated with poorer initial BCVA (rs=0.62; p<0.00001) and higher risk of retinal detachment during (p=0.04) and after (p<0.001) hospitalisation. CONCLUSION Anterior chamber tap cytology is a quick and accessible tool complementary to culture and PCR for the management of acute postoperative endophthalmitis.
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Affiliation(s)
- Loic Leveziel
- Ophthalmology, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, Île-de-France, France
| | - Juliette Knoeri
- Ophthalmology, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, Île-de-France, France
| | - Marie-Helene Errera
- Ophthalmology, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, Île-de-France, France.,Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Alfred Kobal
- Laboratory of Biology, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, Ile-de-France, France
| | - Christine Fardeau
- Ophthalmology, Hôpital Universitaire Pitié Salpêtrière, Paris, Île-de-France, France
| | - Nacim Bouheraoua
- Ophthalmology, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, Île-de-France, France
| | - José Alain Sahel
- Ophthalmology, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, Île-de-France, France.,Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Christophe Baudouin
- Ophthalmology, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, Île-de-France, France
| | - Jean-Philippe Nordmann
- Ophthalmology, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, Île-de-France, France
| | - Françoise Baudouin
- Laboratory of Biology, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, Ile-de-France, France
| | - Lilia Merabet
- Laboratory of Biology, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, Ile-de-France, France
| | - Vincent Borderie
- Ophthalmology, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, Île-de-France, France
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Tourabaly M, Knoeri J, Leveziel L, Bouheraoua N, Ameline B, Borderie V. Prevention of infection after corneal refractive surgery: a French survey. J Cataract Refract Surg 2021; 47:27-32. [PMID: 32826703 DOI: 10.1097/j.jcrs.0000000000000396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 07/30/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE To report the French refractive surgeons' real-life practices for preventing infection after corneal refractive surgery (photorefractive keratotomy [PRK], laser in situ keratomileusis [LASIK], and small-incision lenticule extraction). SETTING France. DESIGN Anonymous practice survey. METHODS The questionnaire was sent in a single email invitation to 400 declared refractive surgeons. The following information was recorded between December 2019 and April 2020, before the coronavirus pandemic: demographics data, preoperative evaluation and preparation of the patient, surgical management, immediate and postoperative protocol, and infections reported after corneal refractive surgery. RESULTS Eighty-three of 400 surgeons (20.75%) responded to the questionnaire; 55 (66.0%) performed more than 50 corneal refractive surgeries a year, and 25 (30.1%) performed more than 200 procedures a year. Thirty-six (43.4%) surgeons wore 3 protective items, 37 (44.6%) 2, 5 (6.0%) 1, and 5 (6.0%) zero. Seventy-seven (92.8%) surgeons used povidone-iodine for skin area disinfection and 54 (65%) for conjunctival fornix disinfection. The contact time of povidone-iodine was less than 3 minutes for 71 (85.0%) surgeons. Twenty surgeons (24.1%) reported at least 1 postrefractive surgery infection. Twenty percent of surgeons who wore sterile gloves for PRK reported postoperative infections compared with 62.5% for those who did not (P = .008). These figures were, respectively, 8.7% and 66.7% for the use of sterile gloves during LASIK (P = .002); 8.9% of surgeons who wore surgical masks for LASIK reported postoperative infections compared with 50.0% for those who did not (P = .01). CONCLUSIONS Practices are variable among French refractive surgeons. Wearing a surgical mask and sterile gloves during corneal refractive surgery appears to be advisable.
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Affiliation(s)
- Moïse Tourabaly
- From the Quinze-Vingts National Ophthalmology Hospital, Sorbonne University (Tourabaly, Knoeri, Leveziel, Bouheraoua, Ameline, Borderie), and the Vision Institute, Sorbonne University (Bouheraoua, Borderie), Paris, France
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Levy A, Knoeri J, Borderie V. [Ciprofloxacin deposits under an amniotic membrane graft]. J Fr Ophtalmol 2020; 44:454-455. [PMID: 33308838 DOI: 10.1016/j.jfo.2020.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 05/01/2020] [Accepted: 05/05/2020] [Indexed: 11/15/2022]
Affiliation(s)
- A Levy
- Service d'ophtalmologie V, CHNO des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France.
| | - J Knoeri
- Service d'ophtalmologie V, CHNO des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France
| | - V Borderie
- Service d'ophtalmologie V, CHNO des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France
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Saad S, Saad R, Jouve L, Kallel S, Trinh L, Goemaere I, Borderie V, Bouheraoua N. Corneal crosslinking in keratoconus management. J Fr Ophtalmol 2020; 43:1078-1095. [DOI: 10.1016/j.jfo.2020.07.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 07/09/2020] [Accepted: 07/30/2020] [Indexed: 01/04/2023]
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Tourabaly M, Jabrane F, Banayan N, Borderie V, Bouheraoua N. [Mycotic aneurysm secondary to bacterial endocarditis in a 24-year-old man]. J Fr Ophtalmol 2020; 44:263-264. [PMID: 33190962 DOI: 10.1016/j.jfo.2020.03.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 03/25/2020] [Indexed: 11/25/2022]
Affiliation(s)
- M Tourabaly
- Inserm-DGOS CIC 1423, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France
| | - F Jabrane
- Inserm-DGOS CIC 1423, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France
| | - N Banayan
- Inserm-DGOS CIC 1423, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France
| | - V Borderie
- Inserm-DGOS CIC 1423, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France; Inserm, CNRS, Institut de la vision, Sorbonne université, 17, rue Moreau, 75012 Paris, France
| | - N Bouheraoua
- Inserm-DGOS CIC 1423, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France; Inserm, CNRS, Institut de la vision, Sorbonne université, 17, rue Moreau, 75012 Paris, France.
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Cuyaubère R, Jouve L, Borderie V, Bouheraoua N. [Bilateral prominent corneal nerves associated with primary amyloidosis]. J Fr Ophtalmol 2020; 44:472-474. [PMID: 33172716 DOI: 10.1016/j.jfo.2020.04.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 04/15/2020] [Indexed: 10/23/2022]
Affiliation(s)
- R Cuyaubère
- Inserm-DGOS CIC 1423, IHU ForeSight, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France
| | - L Jouve
- Inserm-DGOS CIC 1423, IHU ForeSight, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France
| | - V Borderie
- Inserm-DGOS CIC 1423, IHU ForeSight, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France; Inserm, CNRS, institut de la vision, Sorbonne université, 17, rue Moreau, 75012 Paris, France
| | - N Bouheraoua
- Inserm-DGOS CIC 1423, IHU ForeSight, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France; Inserm, CNRS, institut de la vision, Sorbonne université, 17, rue Moreau, 75012 Paris, France.
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Alafaleq M, Knoeri J, Boutboul S, Borderie V. Contact lens induced bacterial keratitis in LCD II: Management and multimodal imaging: a case report and review of literature. Eur J Ophthalmol 2020; 31:2313-2318. [PMID: 33124478 DOI: 10.1177/1120672120968724] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To describe the management and multimodal imaging of lattice corneal dystrophy type II (LCD-II) complicated by an infectious keratitis due to a bandage contact lens and to review current literature. OBSERVATION A 50-year-old female was diagnosed with Meretoja's Syndrome by the triad of facial palsy, loose skin (cutix laxa), and stromal corneal dystrophy. At slit lamp, bilateral lattice corneal dystrophy (LCD) was characterized by multiple linear refractile lines and subepithelial fibrosis along with Neurotrophic keratitis Mackie grade I. Findings of anterior segment optical coherence tomography (AS-OCT) were epithelial irregularity, subepithelial fibrosis, hyperreflectivity on anterior stromal layer, lobulated stromal surface. In vivo confocal microscopy (IVCM) showed hyperreflected deposits on the basal and Bowman layers, visible keratocytes; fine lines and streaks between corneal lamella. The sub-basal nerve plexus and the stromal nerves were no longer visible. She presented in emergency with a left red eye. A severe bacterial keratitis was diagnosed as a complication of a bandage contact lens used to treat recurrent epithelial erosion. Corneal anesthesia was complete. Corneal neovascularization was evident 10 weeks later and topical bevacizumab (5 mg/ml) was introduced twice daily. Partial regression of deep stromal vessels was noticed at 3 months. CONCLUSION In Meretoja's syndrome, neurotrophic keratopathy secondary to polyneuropathy due to systemic amyloid deposits is present in the advanced stages, promotes recurrent corneal erosions. Corneal sensitivity test, AS-OCT and IVCM are crucial in the diagnosis behind any recurrent corneal erosion. The use of bandage contact lens should be avoided in Meretoja's syndrome to prevent a possible infectious keratitis.
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Affiliation(s)
- Munirah Alafaleq
- Centre hospitalier national d'ophtalmologie des Quinze-Vingts, GRC32 Sorbonne Université, Paris, France
| | - Juliette Knoeri
- Centre hospitalier national d'ophtalmologie des Quinze-Vingts, GRC32 Sorbonne Université, Paris, France
| | - Sandrine Boutboul
- Centre hospitalier national d'ophtalmologie des Quinze-Vingts, GRC32 Sorbonne Université, Paris, France
| | - Vincent Borderie
- Centre hospitalier national d'ophtalmologie des Quinze-Vingts, GRC32 Sorbonne Université, Paris, France.,Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
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Bennedjaï A, Bouheraoua N, Gatfossé M, Dupasquier-Fediaevsky L, Errera MH, Tazartes M, Borderie V, Hennocq Q, Dellal A, Riviere S, Heron E, Fain O, Mekinian A. Tocilizumab versus Rituximab in Patients with Moderate to Severe Steroid-resistant Graves' Orbitopathy. Ocul Immunol Inflamm 2020; 30:500-505. [PMID: 32965148 DOI: 10.1080/09273948.2020.1808688] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Introduction: To describe the efficacy of tocilizumab in patients with Graves' orbitopathy resistant or dependent to steroids and compare to rituximab treated patients.Patients and Methods: Graves's orbitopathy response was considered as decrease of at least 2 points of the CAS.Results: Twenty-one patients were included, 7 patients were treated with tocilizumab and 14 with rituximab. The primary was achieved in all 7 patients (100%) on tocilizumab and 9 out of 14 patients on (64%) rituximab (p = .17). Mean change in CAS was consistent with a decrease of 3.3 ± 0.5 points in patients on tocilizumab versus 2.5 ± 1.9 in patients on rituximab (p = .07). One patient on tocilizumab (14%) and 4 patients (29%) on rituximab experienced significant relapse during the follow-up. The difference in relapse-free survival was not significant in patients on tocilizumab (10.8 ± 4 months) compared with rituximab (17.88 ± 3.66).Conclusion: We showed a significant improvement in the CAS, visual acuity, diplopia, and proptosis with both tocilizumab and rituximab.
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Affiliation(s)
- Amin Bennedjaï
- Centre Hospitalier National d'Ophtalmologie Des 15-20, Sorbonne Universités, Paris, France
| | - Nacim Bouheraoua
- Centre Hospitalier National d'Ophtalmologie Des 15-20, Sorbonne Universités, Paris, France
| | - Marc Gatfossé
- AP-HP, Hôpital Saint Antoine, Service De Médecine Interne Et Inflammation-Immunopathology-Biotherapy Department (DMU i3), Sorbonne Universités, Paris, France.,UPMC Université Paris 06, UMR 7211, Département Hospitalo-UniversitaireInflammation-Immunopathologie-Biotherapie(DMU i3), Sorbonne Universités, Paris, France
| | | | - Marie-Hélène Errera
- Centre Hospitalier National d'Ophtalmologie Des 15-20, Sorbonne Universités, Paris, France.,Department of Ophthalmology, University of Pittsburgh Medical School, Pittsburgh, Pennsylvania, USA
| | - Michel Tazartes
- Centre Hospitalier National d'Ophtalmologie Des 15-20, Sorbonne Universités, Paris, France
| | - Vincent Borderie
- Centre Hospitalier National d'Ophtalmologie Des 15-20, Sorbonne Universités, Paris, France
| | - Quentin Hennocq
- AP-HP, Hôpital Pitié Salpêtrière, Service De Chirurgie Maxillo-faciale, Paris, France
| | | | - Sebastien Riviere
- AP-HP, Hôpital Saint Antoine, Service De Médecine Interne Et Inflammation-Immunopathology-Biotherapy Department (DMU i3), Sorbonne Universités, Paris, France.,UPMC Université Paris 06, UMR 7211, Département Hospitalo-UniversitaireInflammation-Immunopathologie-Biotherapie(DMU i3), Sorbonne Universités, Paris, France
| | - Emmanuel Heron
- Centre Hospitalier National d'Ophtalmologie Des 15-20, Sorbonne Universités, Paris, France
| | - Olivier Fain
- AP-HP, Hôpital Saint Antoine, Service De Médecine Interne Et Inflammation-Immunopathology-Biotherapy Department (DMU i3), Sorbonne Universités, Paris, France.,UPMC Université Paris 06, UMR 7211, Département Hospitalo-UniversitaireInflammation-Immunopathologie-Biotherapie(DMU i3), Sorbonne Universités, Paris, France
| | - Arsène Mekinian
- AP-HP, Hôpital Saint Antoine, Service De Médecine Interne Et Inflammation-Immunopathology-Biotherapy Department (DMU i3), Sorbonne Universités, Paris, France.,UPMC Université Paris 06, UMR 7211, Département Hospitalo-UniversitaireInflammation-Immunopathologie-Biotherapie(DMU i3), Sorbonne Universités, Paris, France
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Georgeon C, Bouheraoua N, Borderie V. [In vivo histologic diagnosis of keratoconus by multimodal imaging]. J Fr Ophtalmol 2020; 44:132-134. [PMID: 32950289 DOI: 10.1016/j.jfo.2020.01.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 01/23/2020] [Accepted: 01/27/2020] [Indexed: 11/26/2022]
Affiliation(s)
- C Georgeon
- Centre hospitalier national d'ophtalmologie des XV-XX, 28, rue de Charenton, 75571 Paris cedex 12, France
| | - N Bouheraoua
- Centre hospitalier national d'ophtalmologie des XV-XX, 28, rue de Charenton, 75571 Paris cedex 12, France
| | - V Borderie
- Centre hospitalier national d'ophtalmologie des XV-XX, 28, rue de Charenton, 75571 Paris cedex 12, France.
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Romito N, Trinh L, Goemaere I, Borderie V, Laroche L, Bouheraoua N. Corneal Remodeling After Myopic SMILE: An Optical Coherence Tomography and In Vivo Confocal Microscopy Study. J Refract Surg 2020; 36:597-605. [DOI: 10.3928/1081597x-20200713-01] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 06/12/2020] [Indexed: 11/20/2022]
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36
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Labani S, Basli E, Goemaere I, Borderie V, Laroche L, Bouheraoua N. Atypical severe diffuse lamellar keratitis presenting as concentric rings after femtosecond laser-assisted small-incision lenticule extraction (SMILE). J Fr Ophtalmol 2020; 43:e95-e99. [PMID: 32035631 DOI: 10.1016/j.jfo.2019.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 08/21/2019] [Accepted: 08/26/2019] [Indexed: 10/25/2022]
Affiliation(s)
- S Labani
- CHNO des Quinze-Vingts, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France
| | - E Basli
- CHNO des Quinze-Vingts, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France
| | - I Goemaere
- CHNO des Quinze-Vingts, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France
| | - V Borderie
- CHNO des Quinze-Vingts, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France; Sorbonne université, Inserm, CNRS, institut de la Vision, 17, rue Moreau, 75012 Paris, France
| | - L Laroche
- CHNO des Quinze-Vingts, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France; Sorbonne université, Inserm, CNRS, institut de la Vision, 17, rue Moreau, 75012 Paris, France
| | - N Bouheraoua
- CHNO des Quinze-Vingts, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France; Sorbonne université, Inserm, CNRS, institut de la Vision, 17, rue Moreau, 75012 Paris, France.
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Tourabaly M, Chetrit Y, Provost J, Georgeon C, Kallel S, Temstet C, Bouheraoua N, Borderie V. Influence of graft thickness and regularity on vision recovery after endothelial keratoplasty. Br J Ophthalmol 2019; 104:1317-1323. [PMID: 31848210 DOI: 10.1136/bjophthalmol-2019-315180] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 11/25/2019] [Accepted: 11/29/2019] [Indexed: 11/04/2022]
Abstract
AIM To assess the influence of graft thickness and regularity on visual recovery and postoperative wavefront aberrations after endothelial keratoplasty (EK). METHODS 150 EKs performed in eyes with corneal endothelial disorders and no other ocular comorbidities, preoperative and postoperative assessment with spectral domain optical coherence tomography and postoperative assessment with whole eye wavefront aberrometry were retrospectively analysed. Eyes were classified into five groups: Descemet Membrane Endothelial Keratoplasty (DMEK), nanothin Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) (15-49 µm), ultrathin DSAEK (50-99 µm), thin DSAEK (100-149 µm) and conventional DSAEK (150-250 µm). RESULTS The preoperative diagnosis was Fuchs dystrophy in 139 eyes (92.7%). The graft thickness measured after graft deswelling was in average 74 µm with a mean coefficient of variation of 17%. The average follow-up time was 32 months. The mean spectacle-corrected logarithm of minimum angle of resolution visual acuity improved from 0.76 (20/116) before surgery to 0.14 (20/27) at last follow-up visit. No significant differences in final visual acuity were found between the five groups. The time to reach 20/40 vision was significantly shorter in the DMEK and nanothin DSAEK groups compared with the remaining three DSAEK groups. No significant differences in postoperative aberrometry measurements were found between the five groups. Shorter time to reach 20/40 visual acuity was associated with better preoperative visual acuity and thinner graft. Higher final vision improvement was associated with poorer preoperative visual acuity. Higher postoperative high-order aberrations were associated with poorer preoperative visual acuity. CONCLUSION The main advantage of DMEK and nanothin DSAEK over thicker DSAEKs was the rapidity of visual recovery. Final quality of vision was not influenced by graft thickness and regularity.
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Affiliation(s)
- Moïse Tourabaly
- Department of Ophthalmology, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, Île-de-France, France
| | - Yaïr Chetrit
- Department of Ophthalmology, Assistance Publique - Hôpitaux de Paris, Pitié Salpêtrière University Hospital, Pierre et Marie Curie University Paris VI, Paris, France
| | - Julien Provost
- Department of Ophthalmology, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, Île-de-France, France
| | - Cristina Georgeon
- Department of Ophthalmology, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, Île-de-France, France
| | - Sofiène Kallel
- Department of Ophthalmology, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, Île-de-France, France
| | - Cyril Temstet
- Department of Ophthalmology, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, Île-de-France, France
| | - Nacim Bouheraoua
- Department of Ophthalmology, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, Île-de-France, France
| | - Vincent Borderie
- Department of Ophthalmology, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, Île-de-France, France
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Goemaere I, Banayan N, Borderie V, Bouheraoua N. [In vivo confocal microscopy and optical coherence tomography in punctiform and polychromatic pre-Descemet's corneal dystrophy]. J Fr Ophtalmol 2019; 42:1131-1133. [PMID: 31732267 DOI: 10.1016/j.jfo.2019.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Accepted: 06/18/2019] [Indexed: 11/30/2022]
Affiliation(s)
- I Goemaere
- CHNO des Quinze-Vingts, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France
| | - N Banayan
- CHNO des Quinze-Vingts, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France
| | - V Borderie
- CHNO des Quinze-Vingts, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France; Sorbonne université, CNRS, Institut de la Vision, Inserm, 17, rue Moreau, 75012 Paris, France
| | - N Bouheraoua
- CHNO des Quinze-Vingts, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France; Sorbonne université, CNRS, Institut de la Vision, Inserm, 17, rue Moreau, 75012 Paris, France.
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Deng SX, Borderie V, Chan CC, Dana R, Figueiredo FC, Gomes JAP, Pellegrini G, Shimmura S, Kruse FE. Reply. Cornea 2019; 38:e56-e57. [PMID: 31517726 DOI: 10.1097/ico.0000000000002145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Sophie X Deng
- Stein Eye Institute, David Geffen School of Medicine, University of California, LA
| | - Vincent Borderie
- Quinze-Vingts National Eye Hospital, Faculté de Médecine Sorbonne Université, Paris, France
| | - Clara C Chan
- Department of Ophthalmology & Vision Sciences, University of Toronto, Toronto, Canada
| | - Reza Dana
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA
| | - Francisco C Figueiredo
- Department of Ophthalmology, Royal Victoria Infirmary and Institute of Genetic Medicine, Newcastle University, Newcastle Upon Tyne, UK
| | - José A P Gomes
- Department of Ophthalmology and Visual Sciences, Escola Paulista de Medicina/Universidade Federal de São Paulo (EPM/UNIFESP), Brazil
| | | | - Shigeto Shimmura
- Department of Ophthalmology, Keio University School of Medicine, Japan
| | - Friedrich E Kruse
- Department of Ophthalmology, University Hospital Erlangen and Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Germany
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Bocheux R, Pernot P, Borderie V, Plamann K, Irsch K. Quantitative measures of corneal transparency, derived from objective analysis of depth-resolved corneal images, demonstrated with full-field optical coherence tomographic microscopy. PLoS One 2019; 14:e0221707. [PMID: 31461476 PMCID: PMC6713351 DOI: 10.1371/journal.pone.0221707] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 08/13/2019] [Indexed: 11/18/2022] Open
Abstract
Loss of corneal transparency, as occurs with various pathologies, infections, immune reactions, trauma, aging, and surgery, is a major cause of visual handicap worldwide. However, current means to assess corneal transparency are extremely limited and clinical and eye-bank practice usually involve a subjective and qualitative observation of opacities, sometimes with comparison against an arbitrary grading scale, by means of slit-lamp biomicroscopy. Here, we describe a novel objective optical data analysis-based method that enables quantifiable and standardized characterization of corneal transparency from depth-resolved corneal images, addressing the demand for such a means in both the laboratory and clinical ophthalmology setting. Our approach is based on a mathematical analysis of the acquired optical data with respect to the light attenuation from scattering processes in the corneal stroma. Applicable to any depth-resolved corneal imaging modality, it has been validated by means of full-field optical coherence tomographic microscopy (FF-OCT or FF-OCM). Specifically, our results on ex-vivo corneal specimens illustrate that 1) in homogeneous tissues, characterized by an exponential light attenuation with stromal depth (z), the computation of the scattering mean-free path (ls) from the rate of exponential decay allows quantification of the degree of transparency; 2) in heterogeneous tissues, identified by significant deviations from the normal exponential z -profile, a measure of exponential-decay model inadequacy (e.g., by computation of the Birge ratio) allows the estimation of severity of stromal heterogeneity, and the associated depth-dependent variations around the average ls enables precise localization of the pathology.
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Affiliation(s)
- Romain Bocheux
- Laboratoire d'Optique et Biosciences (LOB)–École polytechnique, CNRS UMR 7645, INSERM U 1182, Institut polytechnique de Paris, and LOA–ENSTA ParisTech, École polytechnique, CNRS UMR 7639, Institut polytechnique de Paris, Palaiseau, France
- Vision Institute / Quinze-Vingts National Eye Hospital / GRC32 / CIC1423 –Sorbonne University, CNRS UMR 7210, INSERM U 968, Paris, France
| | - Pascal Pernot
- Laboratoire de Chimie Physique–Université Paris-Sud, CNRS UMR 8000, Orsay, France
| | - Vincent Borderie
- Vision Institute / Quinze-Vingts National Eye Hospital / GRC32 / CIC1423 –Sorbonne University, CNRS UMR 7210, INSERM U 968, Paris, France
| | - Karsten Plamann
- Laboratoire d'Optique et Biosciences (LOB)–École polytechnique, CNRS UMR 7645, INSERM U 1182, Institut polytechnique de Paris, and LOA–ENSTA ParisTech, École polytechnique, CNRS UMR 7639, Institut polytechnique de Paris, Palaiseau, France
| | - Kristina Irsch
- Vision Institute / Quinze-Vingts National Eye Hospital / GRC32 / CIC1423 –Sorbonne University, CNRS UMR 7210, INSERM U 968, Paris, France
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Schmeltz M, Teulon C, Latour G, Ghoubay D, Borderie V, Aimé C, Schanne-Klein MC. Implementation of artifact-free circular dichroism SHG imaging of collagen. Opt Express 2019; 27:22685-22699. [PMID: 31510554 DOI: 10.1364/oe.27.022685] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Second harmonic generation (SHG) enables in situ imaging of fibrillar collagen architecture in connective tissues. Recently, Circular Dichroism SHG (CD-SHG) microscopy has been implemented to take advantage of collagen chirality to improve 3D visualization. It measures the normalized difference in the SHG signal obtained upon excitation by left versus right circular polarizations. However, CD-SHG signal is not well characterized yet, and quite different CD-SHG values are reported in the literature. Here, we identify two major artifacts that may occur in CD-SHG experiments and we demonstrate that thorough optimization and calibration of the experimental setup are required for CD-SHG imaging. Notably it requires a careful calibration of the incident circular polarizations and a perfect mechanical stabilization of the microscope stage. Finally, we successfully record CD-SHG images in human cornea sections and confirm that this technique efficiently reveals collagen fibrils oriented out of the focal plane.
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Rouimi F, Ouanezar S, Goemaere I, Bayle AC, Borderie V, Laroche L, Bouheraoua N. Presbyopia management with Q-factor modulation without additive monovision: One-year visual and refractive results. J Cataract Refract Surg 2019; 45:1074-1083. [PMID: 31126780 DOI: 10.1016/j.jcrs.2019.02.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 02/20/2019] [Accepted: 02/23/2019] [Indexed: 01/19/2023]
Abstract
PURPOSE To analyze refractive results after hyperopic presbyopia surgery by Q-factor modulation without additive monovision. SETTING Quinze-Vingts National Ophthalmology Hospital, Paris, France. DESIGN Prospective nonrandomized study. METHODS Forty-five hyperopic presbyopic patients not tolerating monovision were included. The target for the dominant eye was emmetropia, whereas that for the nondominant eye was emmetropia associated with a target Q factor of -0.8. The postoperative follow-up included assessments of spherical equivalent (SE) refraction, monocular and binocular corrected and uncorrected (UDVA) distance visual acuities, and binocular corrected and uncorrected (UNVA) near visual acuities. Corneal pachymetry, topography, aberrometry and an analysis of patient satisfaction were performed at the 12-month examination. RESULTS The study comprised 90 eyes of 45 consecutive patients. The mean age at surgery was 53.8 years ± 4.99 (SD). The mean preoperative SE was +2.33 ± 1.16 diopters (D) in the dominant eyes and +2.26 ± 1.17 D in the nondominant eyes. At 12 months postoperatively, 42 patients (93%) had a binocular UDVA of Snellen 20/20 and 37 patients (82%) had a binocular UNVA of Jaeger 2 (Parinaud 3). The mean SE at 12 months was -0.22 ± 0.35 D in the dominant eyes (P < .0001) and -0.83 ± 0.50 D in the nondominant eyes (P < .0001). Two eyes required retreatment. Overall, 39 patients (87%) said that they were satisfied and would recommend the intervention. CONCLUSION The Q-factor modulation without additive monovision aims to compensate for presbyopia by changing the Q factor of the nondominant eye to generate a greater depth of field in hyperopic presbyopic patients who are unable to tolerate monovision. The visual outcomes and quality of vision were satisfactory, and only a few patients required additional correction.
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Affiliation(s)
- Fabien Rouimi
- Quinze-Vingts National Ophthalmology Hospital, UPMC - Sorbonne Université, Paris, France
| | - Sofiane Ouanezar
- Quinze-Vingts National Ophthalmology Hospital, UPMC - Sorbonne Université, Paris, France
| | - Isabelle Goemaere
- Quinze-Vingts National Ophthalmology Hospital, UPMC - Sorbonne Université, Paris, France
| | - Anne Charlotte Bayle
- Quinze-Vingts National Ophthalmology Hospital, UPMC - Sorbonne Université, Paris, France
| | - Vincent Borderie
- Quinze-Vingts National Ophthalmology Hospital, UPMC - Sorbonne Université, Paris, France; Institut de la Vision, INSERM UMR S 968, UPMC - Sorbonne Université, Paris, France
| | - Laurent Laroche
- Quinze-Vingts National Ophthalmology Hospital, UPMC - Sorbonne Université, Paris, France; Institut de la Vision, INSERM UMR S 968, UPMC - Sorbonne Université, Paris, France
| | - Nacim Bouheraoua
- Quinze-Vingts National Ophthalmology Hospital, UPMC - Sorbonne Université, Paris, France; Institut de la Vision, INSERM UMR S 968, UPMC - Sorbonne Université, Paris, France.
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Drouglazet-Moalic G, Levy O, Goemaere I, Borderie V, Laroche L, Bouheraoua N. Deep Intrastromal Arcuate Keratotomy With In Situ Keratomileusis (DIAKIK) for the Treatment of High Astigmatism After Keratoplasty: 2-Year Follow-up. J Refract Surg 2019; 35:239-246. [PMID: 30984981 DOI: 10.3928/1081597x-20190227-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 02/27/2019] [Indexed: 11/20/2022]
Abstract
PURPOSE To describe 2-year results of deep intrastromal arcuate keratotomy with in situ keratomileusis (DIAKIK) for the treatment of high astigmatism after keratoplasty. METHODS This prospective study included 20 eyes from 20 patients presenting with high astigmatism after keratoplasty. All were treated by two-step femtosecond laser surgery, with two intrastromal arcuate keratotomies and a corneal flap, followed a few months later by excimer photoablation after reopening of the flap. RESULTS At 24 months, both uncorrected (UDVA) and corrected (CDVA) distance visual acuity had improved from 1.12 ± 0.42 logMAR (20/200 Snellen) before surgery to 0.58 ± 0.23 logMAR (20/80 Snellen) (P < .001) and from 0.31 ± 0.26 logMAR (20/40 Snellen) to 0.20 ± 0.20 logMAR (20/32 Snellen) (P = .04), respectively. The mean spherical equivalent improved from -5.01 ± 4.35 to -1.54 ± 2.42 diopters. The mean efficacy index was 0.63. The mean correction index was 0.93 ± 0.32. The mean flattening index was 1.09 ± 0.75 and the mean safety index was 1.39. No graft rejection or epithelial ingrowth was observed. CONCLUSIONS This two-step procedure was an effective treatment for high astigmatism after keratoplasty. The use of both femtosecond and excimer lasers helped to avoid some complications that would have jeopardized the grafts. Refractive and topographic stability was good 2 years after surgery. [J Refract Surg. 2019;35(4):239-246.].
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Deng SX, Borderie V, Chan CC, Dana R, Figueiredo FC, Gomes JAP, Pellegrini G, Shimmura S, Kruse FE. Global Consensus on Definition, Classification, Diagnosis, and Staging of Limbal Stem Cell Deficiency. Cornea 2019; 38:364-375. [PMID: 30614902 PMCID: PMC6363877 DOI: 10.1097/ico.0000000000001820] [Citation(s) in RCA: 173] [Impact Index Per Article: 34.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE Despite extensive knowledge gained over the last 3 decades regarding limbal stem cell deficiency (LSCD), the disease is not clearly defined, and there is lack of agreement on the diagnostic criteria, staging, and classification system among treating physicians and research scientists working on this field. There is therefore an unmet need to obtain global consensus on the definition, classification, diagnosis, and staging of LSCD. METHODS A Limbal Stem Cell Working Group was first established by The Cornea Society in 2012. The Working Group was divided into subcommittees. Four face-to-face meetings, frequent email discussions, and teleconferences were conducted since then to obtain agreement on a strategic plan and methodology from all participants after a comprehensive literature search, and final agreement was reached on the definition, classification, diagnosis, and staging of LSCD. A writing group was formed to draft the current manuscript, which has been extensively revised to reflect the consensus of the Working Group. RESULTS A consensus was reached on the definition, classification, diagnosis, and staging of LSCD. The clinical presentation and diagnostic criteria of LSCD were clarified, and a staging system of LSCD based on clinical presentation was established. CONCLUSIONS This global consensus provides a comprehensive framework for the definition, classification, diagnosis, and staging of LSCD. The newly established criteria will aid in the correct diagnosis and formulation of an appropriate treatment for different stages of LSCD, which will facilitate a better understanding of the condition and help with clinical management, research, and clinical trials in this area.
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Affiliation(s)
- Sophie X. Deng
- Stein Eye Institute, David Geffen School of Medicine, University of California, Los Angeles
| | - Vincent Borderie
- Quinze-Vingts National Eye Hospital, Faculté de Médecine Sorbonne Université, Paris, France
| | - Clara C. Chan
- University of Toronto Department of Ophthalmology & Vision Sciences Toronto, Ontario
| | - Reza Dana
- Massachusetts Eye and Ear Infirmary, Harvard Medical School
| | - Francisco C. Figueiredo
- Department of Ophthalmology, Royal Victoria Infirmary and Institute of Genetic Medicine, Newcastle University, Newcastle Upon Tyne, UK
| | - José A. P. Gomes
- Department of Ophthalmology and Visual Sciences, Escola Paulista de Medicina/Universidade Federal de São Paulo (EPM/UNIFESP), Brazil
| | - Graziella Pellegrini
- Centre for Regenerative Medicine, University of Modena and Reggio Emilia; Holostem Terapie Avanzate, Modena, Italy
| | - Shigeto Shimmura
- Department of Ophthalmology, Keio University School of Medicine, Japan
| | - Friedrich E. Kruse
- Department of Ophthalmology, University Hospital Erlangen and Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Germany
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Atia R, Jouve L, Georgon C, Laroche L, Borderie V, Bouheraoua N. [In vivo confocal microscopy and optical coherence tomography in stromal corneal dystrophies]. J Fr Ophtalmol 2019; 42:200-205. [PMID: 30679118 DOI: 10.1016/j.jfo.2018.04.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 04/15/2018] [Accepted: 04/16/2018] [Indexed: 10/27/2022]
Affiliation(s)
- R Atia
- Centre hospitalier national d'ophtalmologie des Quinze-Vingts, 75012 Paris, France
| | - L Jouve
- Centre hospitalier national d'ophtalmologie des Quinze-Vingts, 75012 Paris, France
| | - C Georgon
- Centre hospitalier national d'ophtalmologie des Quinze-Vingts, 75012 Paris, France
| | - L Laroche
- Centre hospitalier national d'ophtalmologie des Quinze-Vingts, 75012 Paris, France; Institut de la vision, Sorbonne université, UPMC univ Paris 06, UMR S 968, 75012 Paris, France
| | - V Borderie
- Centre hospitalier national d'ophtalmologie des Quinze-Vingts, 75012 Paris, France; Institut de la vision, Sorbonne université, UPMC univ Paris 06, UMR S 968, 75012 Paris, France
| | - N Bouheraoua
- Centre hospitalier national d'ophtalmologie des Quinze-Vingts, 75012 Paris, France; Institut de la vision, Sorbonne université, UPMC univ Paris 06, UMR S 968, 75012 Paris, France.
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Romito N, Basli E, Goemaere I, Borderie V, Laroche L, Bouheraoua N. Persistent corneal fibrosis after explantation of a small-aperture corneal inlay. J Cataract Refract Surg 2018; 45:367-371. [PMID: 30584010 DOI: 10.1016/j.jcrs.2018.11.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 10/30/2018] [Accepted: 11/04/2018] [Indexed: 11/26/2022]
Abstract
The KAMRA small-aperture corneal inlay can compensate for presbyopia. A small number of complications have been reported, including glare, halos, decentration, iron deposition, compromised distance and night vision, infectious keratitis and reversal corneal haze. We describe a case of corneal fibrosis after small-aperture corneal inlay implantation and its persistence after late explantation. The postoperative period was uneventful, with good uncorrected near and distance visual acuities. Six years after implantation, the patient reported vision loss in the left eye. A slitlamp evaluation and optical coherence tomography showed stromal opacity and a stromal hyperreflective signal at the level of the small-aperture corneal inlay. The corneal inlay was removed, but persistent decreased visual acuity and fibrosis were observed even 8 months after explantation and did not respond to steroids. Long-term monitoring with multimodal imaging methods is important to detect late adverse events after small-aperture corneal inlay implantation.
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Affiliation(s)
- Norman Romito
- Quinze-Vingts National Ophthalmology Hospital, UPMC-Sorbonne Université, Paris, France
| | - Elena Basli
- Quinze-Vingts National Ophthalmology Hospital, UPMC-Sorbonne Université, Paris, France
| | - Isabelle Goemaere
- Quinze-Vingts National Ophthalmology Hospital, UPMC-Sorbonne Université, Paris, France
| | - Vincent Borderie
- Quinze-Vingts National Ophthalmology Hospital, UPMC-Sorbonne Université, Paris, France; Institut de la Vision, UPMC-Sorbonne Université, INSERM, CNRS UMR 7210, Paris, France
| | - Laurent Laroche
- Quinze-Vingts National Ophthalmology Hospital, UPMC-Sorbonne Université, Paris, France; Institut de la Vision, UPMC-Sorbonne Université, INSERM, CNRS UMR 7210, Paris, France
| | - Nacim Bouheraoua
- Quinze-Vingts National Ophthalmology Hospital, UPMC-Sorbonne Université, Paris, France; Institut de la Vision, UPMC-Sorbonne Université, INSERM, CNRS UMR 7210, Paris, France.
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Banayan N, Georgeon C, Grieve K, Ghoubay D, Baudouin F, Borderie V. [In vivo confocal microscopy and optical coherence tomography as innovative tools for the diagnosis of limbal stem cell deficiency (French translation of the article)]. J Fr Ophtalmol 2018; 41:968-980. [PMID: 30473234 DOI: 10.1016/j.jfo.2018.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 07/10/2018] [Accepted: 07/13/2018] [Indexed: 01/22/2023]
Abstract
The limbus is the anatomical and functional barrier between corneal and conjunctival epithelia. It is characterized by presence of the limbal stem cell niche which allows corneal homeostasis to be maintained. Limbal stem cell deficiency is characterized by a dual process: insufficient regeneration of corneal epithelium, which cannot therefore assure its function of physiological support, associated with corneal invasion by conjunctival proliferation. Diagnosis is currently made via routine clinical examination, corneal impression cytology and in vivo confocal microscopy (IVCM). Slit lamp examination shows abnormal limbal anatomy, thin and irregular epithelium with late fluorescein staining, and superficial vascularization. With its high resolution, IVCM allows identification of limbal and corneal epithelial changes at a cellular level in en face views, parallel to the corneal surface, but with a restricted viewing field of the corneal surface. It shows a poor transition between the corneal and conjunctival epithelia, associated with a loss of the normal corneal epithelial stratification, low basal cell and sub-basal nerve plexus densities, even with sub-epithelial fibrosis. Optical coherence tomography in central cornea and at the limbus, with scans in different orientations, allows a quick, global and non-invasive analysis of normal eyes and those with limbal stem cell deficiency. It shows a thin limbal epithelium, lacking normal thickening, featuring absence of stromal undulations and limbal crypts in cross-sections and sections parallel to the limbus, lack of visible limbal crypts in en face sections, loss of clear transition between the hyporeflective corneal epithelium and the hyperreflective conjunctival epithelium, and hyperreflective sub-epithelial fibrosis.
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Affiliation(s)
- N Banayan
- Service d'ophtalmologie 5, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France
| | - C Georgeon
- Service d'ophtalmologie 5, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France
| | - K Grieve
- Inserm UMR S 968, institut de la vision, Sorbonne université, CHNO des 15-20, 75012 Paris, France
| | - D Ghoubay
- Service d'ophtalmologie 5, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France; Inserm UMR S 968, institut de la vision, Sorbonne université, CHNO des 15-20, 75012 Paris, France
| | - F Baudouin
- Inserm UMR S 968, institut de la vision, Sorbonne université, CHNO des 15-20, 75012 Paris, France
| | - V Borderie
- Service d'ophtalmologie 5, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France; Inserm UMR S 968, institut de la vision, Sorbonne université, CHNO des 15-20, 75012 Paris, France.
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Banayan N, Georgeon C, Grieve K, Ghoubay D, Baudouin F, Borderie V. In vivo confocal microscopy and optical coherence tomography as innovative tools for the diagnosis of limbal stem cell deficiency. J Fr Ophtalmol 2018; 41:e395-e406. [DOI: 10.1016/j.jfo.2018.09.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 09/10/2018] [Accepted: 09/12/2018] [Indexed: 12/13/2022]
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Ouanezar S, Sandali O, Atia R, Temstet C, Georgeon C, Laroche L, Borderie V, Bouheraoua N. Contribution of Fourier-domain optical coherence tomography to the diagnosis of keratoconus progression. J Cataract Refract Surg 2018; 45:159-166. [PMID: 30367937 DOI: 10.1016/j.jcrs.2018.09.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 08/30/2018] [Accepted: 09/07/2018] [Indexed: 12/31/2022]
Abstract
PURPOSE To determine the anatomic criteria for diagnosing keratoconus progression by corneal optical coherence tomography (OCT). SETTING Quinze-Vingts National Ophthalmology Hospital, Paris, France. DESIGN Prospective case series. METHODS Scanning-slit corneal topography (Orbscan II) and Fourier-domain corneal OCT (RTVue) were performed in eyes with mild to moderate keratoconus (progressive or nonprogressive [stable] ectasia) at each examination to assess the keratoconus. Disease progression was defined as an increase of at least 1.0 diopter (D) in the steepest keratometry (K) measurement over 6 months. RESULTS Of the 134 eyes of 134 patients with mild to moderate keratoconus, 98 had had progressive ectasia and 36 nonprogressive ectasia. The mean maximum K increased significantly in the progressive group (2.1 D ± 1.2 [SD], P < .0001) and remained constant in the stable group (-0.03 ± 0.39 D, P = .31). The mean thinnest corneal thickness increased significantly in the progressive group (-7.98 ± 9.3 μm, P < .0001) and remained constant in the stable group (-0.52 ± 4.21 μm, P = .22). The change in maximum K was significantly correlated with changes in the thinnest corneal thickness (r = -0.61, P < .0001). A cutoff value of -5 μm for the change in thinnest corneal thickness was identified on receiver operating characteristic curves as a threshold separating cases of progressive and stable keratoconus (area under the curve, 0.79; sensitivity, 68%; specificity, 89%). CONCLUSIONS Topographic data partly reflected the structural changes occurring during the progression of corneal ectasia. Based on the pachymetric parameters provided by OCT, corneal and epithelial thinning was correlated with corneal deformation. The use of corneal OCT might therefore improve the diagnostic sensitivity for keratoconus progression.
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Affiliation(s)
- Sofiane Ouanezar
- Quinze-Vingts National Ophthalmology Hospital, UPMC-Sorbonne Université, Paris, France
| | - Otman Sandali
- Quinze-Vingts National Ophthalmology Hospital, UPMC-Sorbonne Université, Paris, France
| | - Raphael Atia
- Quinze-Vingts National Ophthalmology Hospital, UPMC-Sorbonne Université, Paris, France
| | - Cyrille Temstet
- Quinze-Vingts National Ophthalmology Hospital, UPMC-Sorbonne Université, Paris, France
| | - Cristina Georgeon
- Quinze-Vingts National Ophthalmology Hospital, UPMC-Sorbonne Université, Paris, France
| | - Laurent Laroche
- Quinze-Vingts National Ophthalmology Hospital, UPMC-Sorbonne Université, Paris, France; Institut de la Vision, Institut National de la Santé et de la Recherche Médicale UMR S968, UPMC-Sorbonne Université, Paris, France
| | - Vincent Borderie
- Quinze-Vingts National Ophthalmology Hospital, UPMC-Sorbonne Université, Paris, France; Institut de la Vision, Institut National de la Santé et de la Recherche Médicale UMR S968, UPMC-Sorbonne Université, Paris, France
| | - Nacim Bouheraoua
- Quinze-Vingts National Ophthalmology Hospital, UPMC-Sorbonne Université, Paris, France; Institut de la Vision, Institut National de la Santé et de la Recherche Médicale UMR S968, UPMC-Sorbonne Université, Paris, France.
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Atia R, Lejoyeux R, Georgon C, Andreiuolo F, Laroche L, Borderie V, Bouheraoua N. [Corneal intraepithelial neoplasia: Dysplasia and carcinoma in situ]. J Fr Ophtalmol 2018; 41:881-883. [PMID: 30340878 DOI: 10.1016/j.jfo.2018.01.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Accepted: 01/26/2018] [Indexed: 11/30/2022]
Affiliation(s)
- R Atia
- Service d'ophtalmologie 5, Centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France
| | - R Lejoyeux
- Service d'ophtalmologie 5, Centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France
| | - C Georgon
- Service d'ophtalmologie 5, Centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France
| | - F Andreiuolo
- Service de neuropathology, hôpital Sainte-Anne, 1, rue Cabanis, 75014 Paris, France
| | - L Laroche
- Service d'ophtalmologie 5, Centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France; Sorbonne Université, Paris VI, Inserm UMR S 968, Institut de la Vision, 75012 Paris, France
| | - V Borderie
- Service d'ophtalmologie 5, Centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France; Sorbonne Université, Paris VI, Inserm UMR S 968, Institut de la Vision, 75012 Paris, France
| | - N Bouheraoua
- Service d'ophtalmologie 5, Centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France; Sorbonne Université, Paris VI, Inserm UMR S 968, Institut de la Vision, 75012 Paris, France.
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