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Maier AKB, Reichhart N, Gonnermann J, Kociok N, Riechardt AI, Gundlach E, Strauß O, Joussen AM. Effects of TNFα receptor TNF-Rp55- or TNF-Rp75- deficiency on corneal neovascularization and lymphangiogenesis in the mouse. PLoS One 2021; 16:e0245143. [PMID: 33835999 PMCID: PMC8034740 DOI: 10.1371/journal.pone.0245143] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 12/22/2020] [Indexed: 02/02/2023] Open
Abstract
Tumor necrosis factor (TNF)α is an inflammatory cytokine likely to be involved in the process of corneal inflammation and neovascularization. In the present study we evaluate the role of the two receptors, TNF-receptor (TNF-R)p55 and TNF-Rp75, in the mouse model of suture-induced corneal neovascularization and lymphangiogenesis. Corneal neovascularization and lymphangiogenesis were induced by three 11-0 intrastromal corneal sutures in wild-type (WT) C57BL/6J mice and TNF-Rp55-deficient (TNF-Rp55d) and TNF-Rp75-deficient (TNF-Rp75d) mice. The mRNA expression of VEGF-A, VEGF-C, Lyve-1 and TNFα and its receptors was quantified by qPCR. The area covered with blood- or lymphatic vessels, respectively, was analyzed by immunohistochemistry of corneal flatmounts. Expression and localization of TNFα and its receptors was assessed by immunohistochemistry of sagittal sections and Western Blot. Both receptors are expressed in the murine cornea and are not differentially regulated by the genetic alteration. Both TNF-Rp55d and TNF-Rp75d mice showed a decrease in vascularized area compared to wild-type mice 14 days after suture treatment. After 21 days there were no differences detectable between the groups. The number of VEGF-A-expressing macrophages did not differ when comparing WT to TNF-Rp55d and TNF-Rp75d. The mRNA expression of lymphangiogenic markers VEGF-C or LYVE-1 does not increase after suture in all 3 groups and lymphangiogenesis showed a delayed effect only for TNF-Rp75d. TNFα mRNA and protein expression increased after suture treatment but showed no difference between the three groups. In the suture-induced mouse model, TNFα and its ligands TNF-Rp55 and TNF-Rp75 do not play a significant role in the pathogenesis of neovascularisation and lymphangiogenesis.
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MESH Headings
- Animals
- Cornea/metabolism
- Cornea/pathology
- Corneal Neovascularization/genetics
- Corneal Neovascularization/pathology
- Gene Deletion
- Humans
- Lymphangiogenesis
- Mice, Inbred C57BL
- RNA, Messenger/genetics
- Receptors, Tumor Necrosis Factor, Type I/analysis
- Receptors, Tumor Necrosis Factor, Type I/genetics
- Receptors, Tumor Necrosis Factor, Type II/analysis
- Receptors, Tumor Necrosis Factor, Type II/genetics
- Mice
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Affiliation(s)
- Anna-Karina B. Maier
- Department of Ophthalmology, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt- Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Nadine Reichhart
- Department of Ophthalmology, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt- Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Johannes Gonnermann
- Department of Ophthalmology, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt- Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Norbert Kociok
- Department of Ophthalmology, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt- Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Aline I. Riechardt
- Department of Ophthalmology, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt- Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Enken Gundlach
- Department of Ophthalmology, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt- Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Olaf Strauß
- Department of Ophthalmology, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt- Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Antonia M. Joussen
- Department of Ophthalmology, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt- Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
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Lüdeke I, Gonnermann J, Jφrgensen J, Neuhann T, McKay K, Fleischer M, Galambos P, Lerche RC. Refractive outcomes of femtosecond laser–assisted secondary arcuate incisions in patients with residual refractive astigmatism after trifocal intraocular lens implantations. J Cataract Refract Surg 2019; 45:28-34. [DOI: 10.1016/j.jcrs.2018.08.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 08/06/2018] [Accepted: 08/09/2018] [Indexed: 11/24/2022]
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Davids AM, Pahlitzsch M, Boeker A, Torun N, Bertelmann E, Maier-Wenzel AK, Hager A, Gonnermann J, Klamann M. iStent inject as a reasonable alternative procedure following failed trabeculectomy? Eur J Ophthalmol 2018; 28:735-740. [PMID: 29592533 DOI: 10.1177/1120672117747010] [Citation(s) in RCA: 6] [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] [Indexed: 11/17/2022]
Abstract
PURPOSE: The aim of this study is to assess the intraocular pressure lowering effect and the performance of the glaucoma therapy of the iStent inject in glaucoma patients with uncontrolled intraocular pressure after failed trabeculectomy. METHODS: In this retrospective study, iStent inject implantation (Glaukos Corporation, Laguna Hills, CA, USA) was performed in 22 eyes of 21 subjects suffering from glaucoma (n = 18 primary open angle glaucoma, n = 3 pseudoexfoliation glaucoma, and n = 1 for secondary glaucoma) with an intraocular pressure above target pressure after failed trabeculectomy (mean = 9.6 ± 8.1 years; range: 1-35 years). The intraocular pressure and the number of antiglaucomatous medication were assessed preoperatively, 1 day, 6 weeks, 3 months, 6 months, and 1 year after surgery and compared to preoperative findings (SPSS v23.0; Shapiro-Wilk test, Wilcoxon test, Friedman test). RESULTS: The results showed a significant intraocular pressure decrease from 22.5 ± 4.6 to 15.5 ± 3.4 mmHg after 1 year follow-up (p = 0.012). The glaucoma therapy was 2.6 ± 1.2 preoperatively and reduced to 2.25 ± 1.5 number of medications after 1 year (p > 0.05). There was no significant difference in the number of medication during the whole follow-up period (1 year, p = 0.012). No significant intra- or postoperative complications were reported. CONCLUSION: Minimal invasive glaucoma surgery (iStent inject) can offer an effective intraocular pressure reduction in advanced adult primary and secondary open angle glaucoma after failed trabeculectomy in a follow-up period of 1 year. Glaucoma therapy, however, needs to be maintained to achieve an individual target pressure and to prevent glaucoma progression. In addition, a failure rate of 27.3% makes it necessary to select carefully patients for this treatment option.
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Affiliation(s)
- Anja-Maria Davids
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Milena Pahlitzsch
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Alexander Boeker
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Necip Torun
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Eckart Bertelmann
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | | | - Annette Hager
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Johannes Gonnermann
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Matthias Klamann
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Berlin, Germany
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Pahlitzsch M, Gonnermann J, Maier AKB, Bertelmann E, Klamann MKJ, Erb C. Modified goniotomy as an alternative to trabectome in primary open angle glaucoma and pseudoexfoliation glaucoma: 1 year results. Can J Ophthalmol 2016; 52:92-98. [PMID: 28237157 DOI: 10.1016/j.jcjo.2016.07.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 07/07/2016] [Accepted: 07/25/2016] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To assess the outcome of modified goniotomy and trabeculotomy ab interno (Trabectome) surgery in adult primary open-angle glaucoma (POAG) and pseudoexfoliation (PEX) glaucoma. DESIGN Retrospective cohort outcome study. PARTICIPANTS Two hundred and thirty-six eyes of 236 patients. METHODS This cohort outcome study included 68 POAG (mean age: 65.7 ± 16.0 years) and 22 PEX glaucoma patients (mean age: 78.3 ± 7.9 years) in the modified goniotomy cohort and 119 POAG (mean age: 73.9 ± 9.6 years) and 27 PEX glaucoma patients (mean age: 75.2 ± 8.0 years) in the Trabectome cohort. Modified goniotomy is defined as combined ab interno cyclodialysis and goniotomy. The patients were followed up for 12 months, and we analysed the data using SPSS v19.0. RESULTS In POAG, the intraocular pressure (IOP) was significantly reduced by 4.6 mm Hg in the Trabectome cohort (p < 0.001) and by 5.8 mm Hg (p < 0.001) in the goniotomy group at 1-year follow-up. In PEX glaucoma, the mean IOP was reduced by 9.7 mm Hg (p = 0.002) in the Trabectome surgery and by 6.7 mm Hg (p = 0.004) in the goniotomy cohort 1 year later. Comparing both surgery techniques in POAG, no significant correlation was found in terms of IOP at any of the follow-up visits (IOP at 1 year, p = 0.553). In PEX glaucoma, the IOP, visual acuity, and number of glaucoma medications did not differ significantly between the 2 surgery techniques 1 year later (IOP: p = 0.300; VA: p = 0.391; therapy: p = 0.908). CONCLUSION Modified goniotomy and Trabectome surgery are reliable and effective tools for the management of moderate POAG and PEX glaucoma. There was no significant difference in IOP between the 2 procedures over a follow-up period of 1 year.
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Affiliation(s)
- Milena Pahlitzsch
- University College London Institute of Ophthalmology, London, United Kingdom.
| | - Johannes Gonnermann
- Campus Virchow Clinic, Department of Ophthalmology, Charite University Medicine, Berlin, Germany
| | - Anna-Karina B Maier
- Campus Virchow Clinic, Department of Ophthalmology, Charite University Medicine, Berlin, Germany
| | - Eckart Bertelmann
- Campus Virchow Clinic, Department of Ophthalmology, Charite University Medicine, Berlin, Germany
| | - Matthias K J Klamann
- Campus Virchow Clinic, Department of Ophthalmology, Charite University Medicine, Berlin, Germany
| | - Carl Erb
- Eye Clinic Wittenbergplatz, Berlin, Germany
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Pahlitzsch M, Brünner J, Gonnermann J, Maier AKB, Torun N, Bertelmann E, Klamann MK. Comparison of ICare and IOPen vs Goldmann applanation tonometry according to international standards 8612 in glaucoma patients. Int J Ophthalmol 2016; 9:1624-1628. [PMID: 27990366 DOI: 10.18240/ijo.2016.11.14] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 10/24/2015] [Accepted: 05/16/2016] [Indexed: 11/23/2022] Open
Abstract
AIM To compare IOPen and ICare rebound tonometry to Goldmann applanation tonometry (GAT) according to International Standards Organization (ISO) 8612 criteria. METHODS Totally 191 eyes (n=107 individuals) were included. Criteria of ISO 8612 were fulfilled: 3 clusters of IOP, measured by GAT, were formed. The GAT results were given as mean±standard deviation. RESULTS GAT (19.7±0.5 mm Hg) showed a significant correlation to ICare (19.8±0.5 mm Hg) (r=0.547, P<0.001) and IOPen (19.5±0.5 mm Hg) (r=0.526, P<0.001). According to ISO 8612 criteria in all 3 IOP groups the number of outliers (of the 95% limits of agreement) exceeded 5% for ICare and IOPen vs GAT: No.1 (n=68) 29.4% and 22.1%, No.2 (n=62) 35.5% and 37.1%, No.3 (n=61) 26.2% and 42.6%, respectively. CONCLUSION The strict requirements of the ISO 8612 are not fulfilled in a glaucoma collective by ICare and IOPen at present. As long as the Goldmann tonometry is applicable it should be used first of all for reproducible IOP readings. ICare and IOPen tonometry should be considered as an alternative tool, if application of Goldmann tonometry is not possible.
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Affiliation(s)
- Milena Pahlitzsch
- Glaucoma and Retinal Degeneration Research Group, UCL, Institute of Ophthalmology, Bath Street, London, EC1V 9EL, United Kingdom
| | - Jeanette Brünner
- Department of Ophthalmology, Campus Virchow Clinic, Charite University Medicine, Augustenburger Platz 1, Berlin13353, Germany
| | - Johannes Gonnermann
- Department of Ophthalmology, Campus Virchow Clinic, Charite University Medicine, Augustenburger Platz 1, Berlin13353, Germany
| | - Anna-Karina B Maier
- Department of Ophthalmology, Campus Virchow Clinic, Charite University Medicine, Augustenburger Platz 1, Berlin13353, Germany
| | - Necip Torun
- Department of Ophthalmology, Campus Virchow Clinic, Charite University Medicine, Augustenburger Platz 1, Berlin13353, Germany
| | - Eckart Bertelmann
- Department of Ophthalmology, Campus Virchow Clinic, Charite University Medicine, Augustenburger Platz 1, Berlin13353, Germany
| | - Matthias Kj Klamann
- Department of Ophthalmology, Campus Virchow Clinic, Charite University Medicine, Augustenburger Platz 1, Berlin13353, Germany
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Gonnermann J, Bertelmann E, Pahlitzsch M, Maier-Wenzel AKB, Torun N, Klamann MKJ. Contralateral eye comparison study in MICS & MIGS: Trabectome® vs. iStent inject®. Graefes Arch Clin Exp Ophthalmol 2016; 255:359-365. [PMID: 27815624 DOI: 10.1007/s00417-016-3514-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [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: 06/22/2016] [Revised: 08/17/2016] [Accepted: 10/03/2016] [Indexed: 10/20/2022] Open
Abstract
PURPOSE To compare the safety and efficacy profile after combined micro-incision cataract surgery (MICS) and micro-invasive glaucoma surgery (MIGS) with the ab interno trabeculectomy (Trabectome®) in one eye versus two iStent® inject devices in the contralateral eye in patients with open-angle glaucoma (OAG) and cataract. METHODS This retrospective, intraindividual eye comparison study included 27 patients (54 eyes) who were treated with combined MICS and ab interno trabeculectomy (group I, Trabectome®) in one eye and two iStent® inject devices (group II, GTS 400) in the fellow eye. Primary outcome measures included intraocular pressure (IOP) and glaucoma medication after 6 weeks, 3, 6, and 12 months follow-up. Secondary outcome measures were number of postoperative interventions, complications, and best-corrected visual acuity (BCVA). RESULTS Mean preoperative IOP decreased from 22.3 ± 3.7 mmHg in group I and 21.3 ± 4.1 mmHg in group II to 15.6 ± 3.6 mmHg for Trabectome (p < 0.001) and 14.0 ± 2.3 mmHg for iStent inject (p < 0.001) at 12 months after surgery without a significant difference between the two groups (p > 0.05). No vision-threatening complications such as choroidal effusion, choroidal hemorrhage, or infection occurred. In each group trabeculectomy had to be performed in two eyes due to insufficient IOP lowering effect. CONCLUSIONS Ab interno trabeculectomy and iStent® inject were both effective in lowering IOP with a favourable and comparable safety profile in an intraindividual comparative study over a 12-months follow-up in OAG. However, longer follow-up of these patients will be necessary to determine long-term outcomes and to evaluate significant differences.
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Affiliation(s)
- Johannes Gonnermann
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
| | - Eckart Bertelmann
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Milena Pahlitzsch
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Anna-Karina B Maier-Wenzel
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Necip Torun
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Matthias K J Klamann
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
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Pahlitzsch M, Torun N, Pahlitzsch ML, Klamann MKJ, Gonnermann J, Bertelmann E, Pahlitzsch T. Correlation between anterior chamber characteristics and laser flare photometry immediately after femtosecond laser treatment before phacoemulsification. Eye (Lond) 2016; 30:1110-7. [PMID: 27229702 DOI: 10.1038/eye.2016.110] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 04/15/2016] [Indexed: 11/10/2022] Open
Abstract
PurposeTo assess the anterior chamber (AC) characteristics and its correlation to laser flare photometry immediately after femtosecond laser-assisted capsulotomy and photodisruption.Patients and methodsThe study included 97 cataract eyes (n=97, mean age 68.6 years) undergoing femtosecond laser-assisted cataract surgery (FLACS). Three cohorts were analysed relating to the flare photometry directly post femtosecond laser treatment (flare <100 n=28, 69.6±7 years; flare 100-249 n=47, 67.7±8 years; flare >249 photon counts per ms cohort n=22, 68.5±10 years). Flare photometry (KOWA FM-700), corneal topography (Oculus Pentacam, Germany: AC depth, volume, angle, pachymetry), axial length, pupil diameter, and endothelial cells were assessed before FLACS, immediately after femtosecond laser treatment and 1 day postoperative (LenSx Alcon, USA). Statistical data were analysed by SPSS v19.0, Inc.ResultsThe AC depth, AC volume, AC angle, central and thinnest corneal thickness showed a significant difference between flare <100 vs flare 100-249 10 min post femtosecond laser procedure (P=0.002, P=0.023, P=0.007, P=0.003, P=0.011, respectively). The AC depth, AC volume, and AC angle were significantly larger (P=0.001, P=0.007, P=0.003, respectively) in the flare <100 vs flare >249 cohort 10 min post femtosecond laser treatment.ConclusionsA flat AC, low AC volume, and a narrow AC angle were parameters associated with higher intraocular inflammation. These criteria could be used for patient selection in FLACS to reduce postoperative intraocular inflammation.
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Affiliation(s)
- M Pahlitzsch
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - N Torun
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - M L Pahlitzsch
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - M K J Klamann
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - J Gonnermann
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - E Bertelmann
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Berlin, Germany
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Pahlitzsch M, Torun N, Pahlitzsch ML, Klamann MKJ, Gonnermann J, Bertelmann E, Pahlitzsch T. Impact of the Femtosecond Laser in Line with the Femtosecond Laser-Assisted Cataract Surgery (FLACS) on the Anterior Chamber Characteristics in Comparison to the Manual Phacoemulsification. Semin Ophthalmol 2016; 32:456-461. [DOI: 10.3109/08820538.2015.1119859] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Milena Pahlitzsch
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Necip Torun
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | | | | | - Johannes Gonnermann
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Eckart Bertelmann
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Berlin, Germany
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Gonnermann J, Al-Mulsi S, Klamann M, Maier AKB, Pahlitzsch M, Torun N, Bertelmann E. [Long-term Outcomes and Complications after Surgical Posterior Capsule Polishing Due to Secondary Cataract]. Klin Monbl Augenheilkd 2016; 233:910-3. [PMID: 26854481 DOI: 10.1055/s-0042-100002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND To evaluate the long-term outcome and complication rate after surgical posterior capsule polishing as an alternative to Nd : YAG-Laser posterior capsulotomy in the treatment of posterior capsule opacity after cataract extraction in eyes with high risk of developing pseudophakic retinal detachment. PATIENTS AND METHODS This retrospective study comprised 265 eyes in 234 patients (134 women, 100 men, mean age: 61 years) with posterior capsule opacity who underwent surgical posterior capsule polishing between 1997 and 2010, with a follow-up of at least 12 months. RESULTS Surgical posterior capsule polishing was performed in 220 myopic eyes (axial length > 25 mm), in 28 eyes after retinal detachment surgery and in 17 eyes with traumatic cataract. The mean follow-up was 73 months (range: 12 to 202 months); in 206 eyes (77.8 %), follow-up was more than 3 years. The final best-corrected visual acuity (BCVA) in logMAR (mean 0.56 ± 0.63) improved significantly (p < 0.001) compared to the preoperative BCVA (mean 0.93 ± 0.72). Recurrent posterior capsule opacity occurred in 74 eyes (27.9 %) and was treated by one or more surgical posterior capsule polishing procedures. Nd : YAG-Laser posterior capsulotomy was performed in 28 eyes (10.6 %) and surgical capsulectomy in 8 eyes (3.0 %). Complications after surgical posterior capsule polishing included intraoperative capsule rupture in 9 eyes (3.5 %). No postoperative endophthalmitis was observed. However, retinal detachment occurred in 6 eyes (2.3 %) 62 months after surgical posterior capsule polishing. All eyes were myopic (axial length > 25 mm) and initially vitrectomised during first retinal detachment surgery. CONCLUSIONS Long-term outcome and complication rate indicate that surgical posterior capsule polishing is not only a more complex procedure but is also associated with a higher relapse risk than Nd : YAG-Laser posterior capsulotomy in the treatment of regenerative secondary cataract. Furthermore, conserving the posterior lens capsule does not always seem to minimise the cumulative risk of developing pseudophakic retinal detachment in high risk patients.
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Affiliation(s)
- J Gonnermann
- Klinik für Augenheilkunde, Campus Virchow Klinikum, Charité-Universitätsmedizin Berlin
| | - S Al-Mulsi
- Klinik für Augenheilkunde, Klinikum Barnim GmbH, Werner Forßmann Krankenhaus, Barnim
| | - M Klamann
- Klinik für Augenheilkunde, Campus Virchow Klinikum, Charité-Universitätsmedizin Berlin
| | - A-K B Maier
- Klinik für Augenheilkunde, Campus Virchow Klinikum, Charité-Universitätsmedizin Berlin
| | - M Pahlitzsch
- Klinik für Augenheilkunde, Campus Virchow Klinikum, Charité-Universitätsmedizin Berlin
| | - N Torun
- Klinik für Augenheilkunde, Campus Virchow Klinikum, Charité-Universitätsmedizin Berlin
| | - E Bertelmann
- Klinik für Augenheilkunde, Campus Virchow Klinikum, Charité-Universitätsmedizin Berlin
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Klamann MKJ, Gonnermann J, Pahlitzsch M, Maier AKJ, Torun N, Bertelmann E. iStent inject als stand-alone OP beim phaken Offenwinkelglaukom – Erste klinische Jahresdaten. Klin Monbl Augenheilkd 2015. [DOI: 10.1055/s-0035-1569181] [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: 10/22/2022]
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Brockmann T, Pham A, Sonnleithner CV, Gonnermann J, Klamann MKJ, Torun N, Bertelmann E. Binokulare Trifokalität: Vergleich klinischer Ergebnisse voll-diffraktiver und apodisiert-diffraktiver bifokaler Multifokallinsen. Klin Monbl Augenheilkd 2015. [DOI: 10.1055/s-0035-1569159] [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: 10/22/2022]
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Torun N, Steurer T, Maier AK, Gonnermann J, Klamann MKJ, Bertelmann E, Joussen AM. Therapieoptionen zur Behandlung der Limbusstammzellinsuffizienz. Klin Monbl Augenheilkd 2015. [DOI: 10.1055/s-0035-1569196] [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: 10/22/2022]
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Gonnermann J, Bertelmann E, Pahlitzsch M, Maier-Wenzel AKB, Torun N, Klamann MKJ. Intraindividuelle Vergleichsstudie in MIGS: Trabectome® vs. iStent inject®. Klin Monbl Augenheilkd 2015. [DOI: 10.1055/s-0035-1569179] [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: 10/22/2022]
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Pahlitzsch M, Torun N, Gonnermann J, Maier AK, Winterhalter S, Bertelmann E, Klamann MKJ. MIGS und Filtrationschirurgie: Einfluss auf die Quality of Life? Klin Monbl Augenheilkd 2015. [DOI: 10.1055/s-0035-1569177] [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: 10/22/2022]
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Tsangaridou MA, Gundlach E, Gonnermann J, Maier AK, Pilger D, Joussen AM, Torun N. Vergleich der Descemet Membrane Endothelial Keratoplasty (DMEK) mit und ohne Implantation einer irisfixierten retropupillären Linsenimplantation (IOL) bei fehlendem Linsenkapselapparat. Klin Monbl Augenheilkd 2015. [DOI: 10.1055/s-0035-1569195] [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: 10/22/2022]
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Pahlitzsch M, Torun N, Erb C, Bruenner J, Maier AKB, Gonnermann J, Bertelmann E, Klamann MKJ. Significance of the disc damage likelihood scale objectively measured by a non-mydriatic fundus camera in preperimetric glaucoma. Clin Ophthalmol 2015; 9:2147-58. [PMID: 26640365 PMCID: PMC4662372 DOI: 10.2147/opth.s93213] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose To assess the correlation between the disc damage likelihood scale (DDLS) objectively measured by a non-mydriatic fundus camera, Heidelberg Retina Tomograph 3, and optic coherence tomography in preperimetric glaucoma. Methods One-hundred-twenty-five patients with preperimetric primary open-angle glaucoma (POAG) and pseudoexfoliation glaucoma (n=30) were included (mean age 58.9±15.9 years). All three devices graded the optic disc topography: Diagnosis 1 was defined as “outside normal limits”, while Diagnosis 2 as “borderline or outside normal limits”. Results For Diagnosis 1, a significant correlation was shown between DDLS and Moorfields regression analysis (P=0.022), and for Diagnosis 2 with glaucoma probability score analysis (P=0.024), in POAG. In pseudoexfoliation glaucoma, DDLS did not correlate significantly with Heidelberg Retina Tomograph 3 and optic coherence tomography. Regarding the area under the curve the highest predictive power was demonstrated by the objective DDLS (0.513–0.824) compared to Burk (0.239–0.343) and Mikelberg (0.093–0.270) coefficients. Conclusions The DDLS showed a significant correlation to the Moorfields regression analysis in preperimetric POAG. The objective DDLS showed the highest predictive power and thus is an additive tool in diagnosing preperimetric glaucoma.
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Affiliation(s)
- Milena Pahlitzsch
- Department of Ophthalmology, University Medicine Charité, Campus Virchow Clinic, Berlin, Germany
| | - Necip Torun
- Department of Ophthalmology, University Medicine Charité, Campus Virchow Clinic, Berlin, Germany
| | - Carl Erb
- Augenklinik am Wittenbergplatz, Berlin, Germany
| | - Jeanette Bruenner
- Department of Ophthalmology, University Medicine Charité, Campus Virchow Clinic, Berlin, Germany
| | - Anna Karina B Maier
- Department of Ophthalmology, University Medicine Charité, Campus Virchow Clinic, Berlin, Germany
| | - Johannes Gonnermann
- Department of Ophthalmology, University Medicine Charité, Campus Virchow Clinic, Berlin, Germany
| | - Eckart Bertelmann
- Department of Ophthalmology, University Medicine Charité, Campus Virchow Clinic, Berlin, Germany
| | - Matthias K J Klamann
- Department of Ophthalmology, University Medicine Charité, Campus Virchow Clinic, Berlin, Germany
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Pahlitzsch M, Gonnermann J, Maier AKB, Torun N, Bertelmann E, Joussen AM, Klamann M. [Trabeculectomy Ab Interno in Primary Open Angle Glaucoma and Exfoliative Glaucoma]. Klin Monbl Augenheilkd 2015; 232:1198-207. [PMID: 26512851 DOI: 10.1055/s-0041-105941] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND To assess the outcome of routine trabectomy surgery in the treatment of primary (POAG) and secondary open angle glaucoma. PATIENTS/METHODS 296 eyes of 296 patients with diagnosed open angle glaucoma and exfoliative glaucoma were analysed from June 2012 until June 2014. IOP readings (intraocular pressure) and the number of antiglaucoma medications was evaluated at every follow-up visit. For statistical analysis, 4 study cohorts were built (cohort 1 = trabectomy in POAG, cohort 2 = trabectomy in exfoliative glaucoma (PEX), cohort 3 = trabectomy + IOL in POAG, cohort 4 = trabectomy + IOL in PEX glaucoma). RESULTS Mean IOP before trabectomy surgery was 19.8 ± 5.9 mmHg and 23.7 ± 9.5 mmHg in cohorts 1 and 2, respectively. At 1 year follow-up, IOP was reduced to normal level for cohorts 1 and 2 (14.8 ± 3.2 mmHg (p = 0.001) and 14.0 ± 3.3 mmHg (p = 0.046), respectively). The number of topical antiglaucoma medications changed to 2.1 ± 1.2 (p = 0.004) and 2.4 ± 1.2, respectively (p = 0.593) at one year follow-up, respectively, for POAG and exfoliative glaucoma. In study cohort 3 and 4, mean IOP before trabectomy surgery was 19.2 ± 4.0 mmHg and 23.2 ± 9.2 mmHg, respectively. At 1 year follow-up, IOP was reduced to normal levels in cohorts 3 and 4 (11.8 ± 3.1 mmHg (p < 0.01) and 12.6 ± 1.1 mmHg, respectively (p = 0.043)); the number of topical antiglaucoma medications changed to 2.3 ± 1.4 (p = 0.469) and 1.4 ± 0.8, respectively, (p = 0.102) at 1 year follow-up. A significant difference in IOP reduction could be demonstrated in POAG between the trabectomy + IOL group and the trabectomy cohort 1 year postoperative (p = 0.017); in the PEX trabectomy + IOL versus PEX trabectomy cohort no statistically significant difference (p = 0.678) could be demonstrated. No serious postoperative complications were recorded. CONCLUSION Trabectomy surgery seemed to be a reliable and effective tool for the management of mild and moderate primary and secondary open angle glaucoma with uncontrolled IOP in daily routine. One year follow-up showed a significant reduction in intraocular pressure in all cohorts.
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Affiliation(s)
- M Pahlitzsch
- Klinik für Augenheilkunde, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin
| | - J Gonnermann
- Klinik für Augenheilkunde, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin
| | - A-K B Maier
- Klinik für Augenheilkunde, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin
| | - N Torun
- Klinik für Augenheilkunde, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin
| | - E Bertelmann
- Klinik für Augenheilkunde, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin
| | - A M Joussen
- Klinik für Augenheilkunde, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin
| | - M Klamann
- Klinik für Augenheilkunde, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin
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Maier AKB, Gundlach E, Gonnermann J, Klamann MK, Joussen AM, Bertelmann E, Torun N. Superior versus temporal approach in descemet membrane endothelial keratoplasty. Am J Ophthalmol 2015; 159:111-7.e1. [PMID: 25284763 DOI: 10.1016/j.ajo.2014.09.042] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Revised: 09/24/2014] [Accepted: 09/25/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE To compare superior vs temporal approach in patients who underwent Descemet membrane endothelial keratoplasty (DMEK). DESIGN Monocentric, prospective nonmasked study. METHODS A prospective analysis of 53 DMEKs between January and September 2013 was performed at the Charité-Universitätsmedizin Berlin. Only DMEK cases with an incision size of 2.3 mm and with at least 1 month of follow-up were included. The surgically induced astigmatism (SIA), changes in corneal aberrations and in spherical equivalent, visual acuity, endothelial cell density, and complications were evaluated. RESULTS Visual acuity improved significantly (0.70 ± 0.39 logMAR vs 0.32 ± 0.31 logMAR after 1 month (n = 48), 0.19 ± 0.15 logMAR after 3 months (n = 46), and 0.16 ± 0.17 logMAR after 6 months (n = 47) (P < .001)) regardless of the approach. SIA was significantly lower after temporal than after superior approach (1.42 ± 0.91 diopters [D] [n = 13] vs 0.81 ± 0.68 D [n = 13], P = .038). Change in total root mean square of all aberrations (RMS) (P = .046) at 6 mm pupil diameter, and change in total RMS (P = .019), third-order aberrations (P = .007), and fourth-order aberrations (P = .041) at 4 mm pupil diameter, demonstrated significantly lower results after temporal compared to superior approach. A higher rate of eyes after temporal approach underwent at least 1 rebubbling (39.1% vs 26.7%, P = .252). The endothelial cell density (P = .053) and the change in spherical equivalent (P = .145) did not differ significantly. CONCLUSIONS The temporal approach induces significantly less SIA and corneal aberration. There are no significant differences between superior and temporal approach according to the change in spherical equivalent, visual acuity, and endothelial cell density. The need for rebubbling is higher using the temporal approach.
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Maier AKB, Gundlach E, Gonnermann J, Klamann MKJ, Eulufi C, Joussen AM, Bertelmann E, Rieck P, Torun N. Anterior segment analysis and intraocular pressure elevation after penetrating keratoplasty and posterior lamellar endothelial keratoplasty. Ophthalmic Res 2014; 53:36-47. [PMID: 25531077 DOI: 10.1159/000365252] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 05/28/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND Peripheral anterior synechiae (PAS) is a common problem after penetrating keratoplasty (PK) and leads to intraocular pressure (IOP) elevation. This study examines the risk factors for IOP elevation and post-keratoplasty glaucoma. METHODS A retrospective analysis was performed of 47 eyes following PK and of 65 eyes following Descemet's stripping endothelial keratoplasty (DSEK) between 2009 and 2011. The assessment included preoperative history of corneal disease and glaucoma, response to treatment, IOP, and visual acuity. Irido-trabecular contacts (ITC), the angle opening distance (AOD 500) and the anterior chamber angle (ACA 500) were calculated. RESULTS The incidences of IOP elevation and post-keratoplasty glaucoma were 27-36% and 10-29%, respectively. The incidence did not differ significantly between both procedures. Pre-existing glaucoma increased the risk for developing IOP elevation and post-DSEK glaucoma. Eyes with bullous keratopathy (BK) developed significantly more IOP elevation (p = 0.01, d.f. = 1, χ(2) = 6.11) and post-keratoplasty glaucoma (p = 0.01, d.f. = 1, χ(2) = 6.22) than eyes with Fuchs' endothelial dystrophy. Eyes with ITC developed post-keratoplasty glaucoma significantly more often than eyes without ITC (p = 0.01, d.f. = 1, χ(2) = 6.63). CONCLUSION IOP elevation and post-keratoplasty glaucoma showed a high incidence. Risk factors like pre-existing glaucoma, BK and PAS elevated the rate of IOP elevation and post-keratoplasty glaucoma for both procedures.
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Affiliation(s)
- Anna-Karina B Maier
- Department of Ophthalmology, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Steurer T, Gonnermann J, Bertelmann E. Kollagenmembranaufnähung als Alternative der Bindehautrekonstruktion. Klin Monbl Augenheilkd 2014. [DOI: 10.1055/s-0034-1396481] [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: 10/24/2022]
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Torun N, Schroeter J, Gonnermann J, Gundlach E, Bertelmann E, Joussen AM, Maier AKB. Möglichkeiten und Grenzen der DMEK: Daten von mehr als 500 durchgeführten DMEK-Transplantationen. Klin Monbl Augenheilkd 2014. [DOI: 10.1055/s-0034-1396485] [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: 10/24/2022]
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Brünner J, Pahlitzsch M, Gonnermann J, Maier AKB, Schwenteck T, Torun N, Bertelmann E, Klamann MKJ. Vergleich von zwei Impedanztonometern (ICare, IOPen) versus Goldmann Applanationstonometrie auf der Basis des internationalen Standards für Augentonometer ISO 8612 in einem Glaukomkollektiv. Klin Monbl Augenheilkd 2014. [DOI: 10.1055/s-0034-1396505] [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: 10/24/2022]
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Bertelmann E, Sonnleithner CV, Eulufi C, Gonnermann J. Große periokuläre Neoplasien: Grenzfälle des Bulbuserhalts. Klin Monbl Augenheilkd 2014. [DOI: 10.1055/s-0034-1396474] [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: 10/24/2022]
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Gonnermann J, Sonnleithner CV, Eulufi C, Bertelmann E. Freie autologe retroaurikuläre Knorpeltransplantation zur vertikalen Lidverlängerung. Klin Monbl Augenheilkd 2014. [DOI: 10.1055/s-0034-1396464] [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: 10/24/2022]
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Rübsam A, Tsangaridou MA, Maier AKB, Gonnermann J, Bertelmann E, Torun N, Klamann MKJ. Vergleich einer neuen dualen Scheimpflug-assistierten non-contact Tonometrie (Corvis ST) mit der Goldmann Applanationstonometrie (GAT) und der Dynamischen Contour Tonometrie (DCT). Klin Monbl Augenheilkd 2014. [DOI: 10.1055/s-0034-1396506] [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: 10/24/2022]
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von Sonnleithner C, Bergholz R, Gonnermann J, Klamann MK, Torun N, Bertelmann E. Clinical Results and Higher-Order Aberrations after 1.4-mm Biaxial Cataract Surgery and Implantation of a New Aspheric Intraocular Lens. Ophthalmic Res 2014; 53:8-14. [DOI: 10.1159/000364808] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Accepted: 05/16/2014] [Indexed: 11/19/2022]
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Gonnermann J, von Sonnleithner C, Bertelmann E. [Eyelid tumours and surgical reconstruction]. Klin Monbl Augenheilkd 2014; 231:1127-40; quiz 1141-2. [PMID: 25419670 DOI: 10.1055/s-0033-1358022] [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: 10/24/2022]
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Pahlitzsch M, Gonnermann J, Maier AKB, Schwenteck T, Torun N, Bertelmann E, Klamann MK. [Comparison of dynamic contour tonometry versus Goldmann applanation tonometry according to the International Ocular Tonometer Standards ISO 8612 in glaucoma patients]. Klin Monbl Augenheilkd 2014; 231:1107-13. [PMID: 25419668 DOI: 10.1055/s-0034-1383012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
INTRODUCTION The aim of this study was to compare the dynamic contour tonometry PASCAL® (DCT) versus the Goldmann applanation tonometry (GAT) in a glaucoma population and to analyse the correlation with the central corneal thickness (CCT). PATIENTS/METHODS 191 eyes of 107 Caucasian glaucoma patients (62 female, 45 male) were included: 3 repeated GAT and dynamic contour tonometry (DCT) measurements (quality factor 1-2) were analysed. CCT was measured by ultrasound pachymetry. Criteria of ISO 8612 were fulfilled: 3 groups of IOP measurements were formed: group 1: 7-16 mmHg, group 2: 16-23 mmHg and group 3: > 23 mmHg, each including at least 40 eyes. Only 5.0 % outliers per area of intraocular pressure were permitted in a tolerance of ± 5.0 mmHg. RESULTS Data of 191 eyes (mean CCT 553 µm) were analysed. GAT (19.68 mmHg ± 7.56 mmHg) showed good correlation to DCT (20.54 ± 8.21 mmHg) (r = 0.770, p < 0.001). Mean difference DCT-GAT was 0.86 ± 2.45 mmHg. In regard to the criteria of ISO 8612, the number of outliers were: group 1: (n = 68) 29.4 %, group 2: (n = 62) 41.9 %, and group 3: (n = 61) 31.2 %. No correlation was shown between CCT vs. GAT (r = 0.184, p = 0.057) and CCT vs. DCT (r = 0.177, p = 0.09), respectively. DISCUSSION In conclusion, despite good correlation to GAT measurements DCT does not fulfil the ISO 8612 reference criteria in glaucoma patients. DCT and GAT did not show correlation to CCT.
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Affiliation(s)
| | | | | | - T Schwenteck
- Physik, Physikalisch Technische Bundesanstalt Berlin
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Maier AKB, Gundlach E, Gonnermann J, Klamann MKJ, Bertelmann E, Rieck PW, Joussen AM, Torun N. Retrospective contralateral study comparing Descemet membrane endothelial keratoplasty with Descemet stripping automated endothelial keratoplasty. Eye (Lond) 2014; 29:327-32. [PMID: 25412715 DOI: 10.1038/eye.2014.280] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Accepted: 08/13/2014] [Indexed: 01/23/2023] Open
Abstract
PURPOSE In this retrospective study, the visual outcomes and postoperative complications after Descemet stripping automated endothelial keratoplasty (DSAEK) and Descemet membrane endothelial keratoplasty (DMEK) in the fellow eye were compared. The patient's satisfaction was evaluated. METHODS A retrospective analysis of 10 patients, who underwent DSAEK in one eye and DMEK surgery in their fellow eye, was performed. Intraoperative and postoperative complications were recorded. Visual and refractive outcomes were evaluated, including higher-order aberrations (HOA) and contrast thresholds. A subjective questionnaire was used to evaluate patient satisfaction. RESULTS Best-corrected visual acuity (BCVA) was significantly better in DMEK when compared with DSAEK (0.16±0.10 vs 0.45±0.58 logMAR, P=0.043). Contrast threshold was significantly higher after DMEK than after DSAEK (0.49±0.23 vs 0.25±0.18, P=0.043). Post-keratoplasty astigmatism, mean spherical equivalent, and HOA did not differ. Nine out of ten patients preferred the DMEK procedure. Visual outcome (4.80±1.14 vs 4.50±1.58, P=0.257), surgery associated pain and burden (DMEK: 1.30±0.48 vs DSAEK: 1.30±0.48, P=1.0), estimated time for recovery and rehabilitation (27.6±54.0 vs 24.9±54.8 days, P=0.173), and mean patient satisfaction (5.40±0.84 vs 5.00±1.05, P=0.257) were evaluated equally. CONCLUSION Patient satisfaction reached high, equal values after DMEK and after DSAEK. Nevertheless, patients preferred DMEK, if given a choice. Reasons for the preference may include better uncorrected and BCVA, and especially a better contrast sensitivity.
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Affiliation(s)
- A-K B Maier
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Charité, Germany
| | - E Gundlach
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Charité, Germany
| | - J Gonnermann
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Charité, Germany
| | - M K J Klamann
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Charité, Germany
| | - E Bertelmann
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Charité, Germany
| | - P W Rieck
- Eye Clinic am Kapellenberg, Potsdam, Germany
| | - A M Joussen
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Charité, Germany
| | - N Torun
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Charité, Germany
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Gonnermann J, von Sonnleithner C, Bertelmann E. Neubildungen der Lider und chirurgische Rekonstruktionen. Augenheilkunde up2date 2014. [DOI: 10.1055/s-0033-1358021] [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: 10/24/2022]
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Maier AKB, Wolf T, Gundlach E, Klamann MKJ, Gonnermann J, Bertelmann E, Joussen AM, Torun N. Intraocular pressure elevation and post-DMEK glaucoma following Descemet membrane endothelial keratoplasty. Graefes Arch Clin Exp Ophthalmol 2014; 252:1947-54. [DOI: 10.1007/s00417-014-2757-5] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Revised: 07/08/2014] [Accepted: 07/22/2014] [Indexed: 11/28/2022] Open
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Gonnermann J, Amiri S, Klamann M, Maier AKB, Joussen AM, Rieck PW, Torun N, Bertelmann E. [Endothelial cell loss after retropupillary iris-claw intraocular lens implantation]. Klin Monbl Augenheilkd 2014; 231:784-7. [PMID: 24992236 DOI: 10.1055/s-0034-1368453] [Citation(s) in RCA: 12] [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] [Indexed: 10/25/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the indication, visual and refractive outcome, endothelial cell loss and complication rate after implantation of a posterior iris-claw aphakic intraocular lens (IOL). PATIENTS AND METHODS This retrospective study comprised 62 eyes of 56 patients without adequate capsular support undergoing posterior iris-claw aphakic IOL implantation (Verisyse™/Artisan®) between 2006 and 2012. Mean follow-up was 34 months (range from 13 to 78 months). RESULTS The IOLs were inserted during primary lens surgery in 11 phakic eyes (17.8 %), during an IOL exchange procedure for dislocated posterior chamber IOLs in 34 eyes (54.8 %), and as a secondary procedure in 17 aphakic eyes (27.4 %). The final best spectacle-corrected visual acuity (BSCVA) in logMAR (mean 0.24 ± 0.45) improved significantly (p < 0.001) compared to the preoperative BSCVA (mean 0.61 ± 0.65). The mean spherical equivalent improved from preoperative 7,25 ± 5,04 diopters (D) (range - 10.25 to + 16.0 D) to - 0.21 ± 1.01 D (range - 4.0 to 3.0 D) postoperatively. Mean central endothelial cell density was 1844 ± 690 cells/mm(2) preoperatively. After surgery mean endothelial cell density decreased statistically not significant with a loss of 5.5 % to 1743 ± 721 cells/mm(2) (p > 0.05) at last follow-up visit. Complications included cystoid macular oedema in 4 eyes (6.4 %), early postoperative hypotony in 2 eyes (3.2 %), pupil ovalisation in 2 eyes (3.2 %), traumatic iris-claw IOL disenclavation in 2 eyes (3.2 %) and spontaneous IOL disenclavation in one eye (1.6 %). CONCLUSIONS Retropupillar iris-claw IOL provides good visual and refractive outcomes with a low endothelial cell loss and can be used for a wide range of indications in eyes without adequate capsular support.
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Affiliation(s)
- J Gonnermann
- Klinik für Augenheilkunde, Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin
| | - S Amiri
- Klinik für Augenheilkunde, Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin
| | - M Klamann
- Klinik für Augenheilkunde, Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin
| | - A-K B Maier
- Klinik für Augenheilkunde, Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin
| | - A M Joussen
- Klinik für Augenheilkunde, Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin
| | - P W Rieck
- Klinik für Augenheilkunde, Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin
| | - N Torun
- Klinik für Augenheilkunde, Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin
| | - E Bertelmann
- Klinik für Augenheilkunde, Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin
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Brockmann T, Gonnermann J, Brockmann C, Torun N, Joussen AM, Bertelmann E. Morphologic alterations on posterior iris-claw intraocular lenses after traumatic disenclavation. Br J Ophthalmol 2014; 98:1303-7. [DOI: 10.1136/bjophthalmol-2014-305364] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Gonnermann J, Maier AKB, Klamann MKJ, Brockmann T, Bertelmann E, Joussen AM, Torun N. Posterior iris-claw aphakic intraocular lens implantation and Descemet membrane endothelial keratoplasty. Br J Ophthalmol 2014; 98:1291-5. [DOI: 10.1136/bjophthalmol-2014-304948] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Klamann MKJ, Gonnermann J, Maier AKB, Bertelmann E, Joussen AM, Torun N. Influence of Selective Laser Trabeculoplasty (SLT) on combined clear cornea phacoemulsification and Trabectome outcomes. Graefes Arch Clin Exp Ophthalmol 2014; 252:627-31. [PMID: 24413683 DOI: 10.1007/s00417-014-2569-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Revised: 12/03/2013] [Accepted: 01/03/2014] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND In this retrospective comparative cohort outcome study, the influence of Selective Laser Trabeculoplasty (SLT) on combined clear cornea phacoemulsification and ab interno trabeculectomy (Trabectome) outcomes in Primary Open Angle Glaucoma (POAG), Pseudoexfoliation Glaucoma (PEX), and Pigmentary Glaucoma (PG) was examined. METHODS Combined clear cornea phacoemulsification and Trabectome were performed in 27 consecutive patients with POAG, in 27 patients with PEX, and in 20 patients with PG. Each group was divided into two subgroups including patients without SLT treatment prior to surgery and patients who had insufficient response to 360° SLT treatment three months prior to surgery. RESULTS In the SLT group, mean IOP at six months measured 13.33 ± 2.08 mmHg with an average decrease of 30 % from preoperative IOP in the POAG group, 12.10 ± 1.40 mmHg with an average decrease of 46 % in the PEX group, and 11.83 ± 2.21 mmHg with an average decrease of 38 % in the PG group. In eyes without previous SLT, mean IOP sixt 6 months measured 11.00 ± 1.73 mmHg with an average decrease of 38 % from preoperative IOP in the POAG group, 15.50 ± 1.41 mmHg with an average decrease of 35 % in the PEX group, and 15.67 ± 2.91 mmHg with an average decrease of 36 % in the PG group, respectively. CONCLUSIONS Prior SLT treatment seems not to negatively influence combined clear cornea phacoemulsification and Trabectome outcomes in glaucoma patients. However, SLT treatment may even have an additive effect on following combined Trabectome outcomes in patients with PEX and PG.
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Affiliation(s)
- Matthias K J Klamann
- Department of Ophthalmology, Charité, University Medicine Berlin, Augustenburger Platz 1, 13353, Berlin, Germany,
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von Sonnleithner C, Bergholz R, Gonnermann J, Torun N, Bertelmann E. Aqualase® Revisited: Endothelial Cell Loss Strongly Depends on Lens Density. Ophthalmic Res 2014; 51:9-14. [DOI: 10.1159/000354428] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Accepted: 07/15/2013] [Indexed: 11/19/2022]
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Bertelmann E, Torun N, Sonnleithner CV, Gonnermann J, Klamann MKJ. Vergleich der Ergebnisse nach Implantation von 5 torischen Intraokularlinsen hinsichtlich der Rotationstabilität. Klin Monbl Augenheilkd 2013. [DOI: 10.1055/s-0033-1363378] [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: 10/25/2022]
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Tsangaridou MA, Maier AK, Gonnermann J, Torun N. Tiefe anteriore lamelläre Keratoplastik (DALK) mittels „big-bubble“-Technik nach Anwar: erste Ergebnisse an der Universitätsaugenklinik Charité. Klin Monbl Augenheilkd 2013. [DOI: 10.1055/s-0033-1363400] [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: 10/25/2022]
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Torun N, Schroeter J, Bertelmann E, Gonnermann J, Brockmann M, Gundlach E, Maier AK. Erweitertes Indikationsspektrum für die isolierte Descemetmembrantransplantation (DMEK) – ein Erfolgskonzept. Klin Monbl Augenheilkd 2013. [DOI: 10.1055/s-0033-1363397] [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: 10/25/2022]
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Maier AK, Gundlach E, Wolf T, Gonnermann J, Klamann M, Bertelmann E, Joussen AM, Torun N. Ergebnisse nach mehr als 250 DMEKs. Klin Monbl Augenheilkd 2013. [DOI: 10.1055/s-0033-1363396] [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: 10/25/2022]
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Gonnermann J, Klamann MKJ, Maier AK, Bertelmann E, Joussen AM, Torun N. Einfluss der selektiven Lasertrabekuloplastik auf postoperative Ergebnisse mit dem Trabectome. Klin Monbl Augenheilkd 2013. [DOI: 10.1055/s-0033-1363369] [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: 10/25/2022]
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Klamann MKJ, Mai C, Sonnleithner CV, Klein JP, Gonnermann J, Maier AK, Torun N, Bertelmann E. Torische Hinterkammerlinsen nach perforierender Keratoplastik. Klin Monbl Augenheilkd 2013. [DOI: 10.1055/s-0033-1363377] [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: 10/25/2022]
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Klamann MKJ, Maier AKB, Gonnermann J, Torun N, Ruokonen PC. [Influence of corneal thickness on intraocular pressure measurements following Descemet's stripping automated endothelial keratoplasty (DSAEK)]. Ophthalmologe 2013; 109:1093-7. [PMID: 22752628 DOI: 10.1007/s00347-012-2623-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the effect of increased corneal thickness after Descemet's stripping automated endothelial keratoplasty (DSAEK) on intraocular pressure (IOP) measured by four different techniques. METHODS In this study 30 eyes from 30 patients with successful DSAEK treatment (group 1) and 30 eyes of 30 healthy subjects (group 2) were enrolled. The IOP was measured with iCare, IOPen, Goldmann applanation tonometry (GAT) and dynamic contour tonometry (DCT) techniques. Central corneal thickness (CCT) was measured by ultrasonic pachymetry. These data were used for statistical analysis. RESULTS The mean IOP measured by GAT, DCT, iCare and IOPen was 13.2, 16.1, 12.5 and 14.2 mmHg in group 1 and 13.4, 14.4, 14.4 and 13.3 mmHg in group 2, respectively. Correlations between IOP and CCT were not statistically significant in either group. CONCLUSION The results of IOP measurements by the iCare, IOPen, GAT and DCT techniques seem to be unrelated to artificially thickened corneas after DSAEK. In spite of partially good correlation between the four techniques a direct exchange of the devices is not recommended on account of the wide dispersion of values.
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Affiliation(s)
- M K J Klamann
- Department of Ophthalmology, University Medicine Charité Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland.
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Affiliation(s)
- Johannes Gonnermann
- Department of Ophthalmology, University Medicine Charité Berlin , Berlin , Germany
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Gonnermann J, Torun N, Klamann MK, Maier AK, Von Sonnleithner C, Rieck PW, Bertelmann E. Reply: To PMID 23721944. Am J Ophthalmol 2013; 156:849-50. [PMID: 24053897 DOI: 10.1016/j.ajo.2013.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Accepted: 07/10/2013] [Indexed: 10/26/2022]
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Gonnermann J, Torun N, Klamann MKJ, Maier AK, von Sonnleithner C, Rieck PW, Bertelmann E. Posterior iris-claw aphakic intraocular lens implantation in children. Am J Ophthalmol 2013; 156:382-386.e1. [PMID: 23721944 DOI: 10.1016/j.ajo.2013.03.002] [Citation(s) in RCA: 22] [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] [Received: 10/29/2012] [Revised: 03/01/2013] [Accepted: 03/01/2013] [Indexed: 11/15/2022]
Abstract
PURPOSE To evaluate the indications, visual outcomes, and complication rate after posterior implantation of an iris-claw aphakic intraocular lens (IOL) in children. DESIGN Noncomparative retrospective cohort study. METHODS setting: Institutional practice. patients/intervention procedures: Seven eyes of 4 children without adequate capsular support had posterior chamber iris-claw aphakic IOL implantation between 2007 and 2012. main outcome measures: Visual acuity, endothelial cell changes, intraoperative and postoperative complications. RESULTS The mean age of the 3 boys and 1 girl was 12.0 ± 3.4 (SD) years (range 8-16 years). In all eyes, the mean postoperative best spectacle-corrected visual acuity (0.13 ± 0.17 logMAR) was statistically significantly better at the last follow-up than at 1 day preoperatively (0.60 ± 0.39 logMAR) (P < .05). The mean follow-up was 31 months (range 10-64 months). The mean endothelial cell density decreased from 3013 ± 155 cells/mm(2) preoperatively to 2831 ± 236 cells/mm(2) at last follow-up, representing a mean endothelial cell loss of 6.4%. No corneal decompensation, iritis, secondary glaucoma, or pupillary block occurred after surgery in any eye. Postoperative complications included transient postoperative hypotony in 1 eye and a traumatic dislocation of a posterior aphakic iris-claw IOL in 1 eye. CONCLUSION The posterior implantation technique of aphakic iris-claw IOL provided good visual outcomes with a favorable complication rate and can be used as a reasonable alternative for a wide range of indications in pediatric eyes without adequate capsular support.
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Affiliation(s)
- Johannes Gonnermann
- Department of Ophthalmology, Charité, University Medicine Berlin, Berlin, Germany.
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Klamann MKJ, Gonnermann J, Maier AKB, Ruokonen PC, Torun N, Joussen AM, Bertelmann E. Combined clear cornea phacoemulsification in the treatment of pseudoexfoliative glaucoma associated with cataract: significance of trabecular aspiration and ab interno trabeculectomy. Graefes Arch Clin Exp Ophthalmol 2013; 251:2195-9. [PMID: 23812010 DOI: 10.1007/s00417-013-2408-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [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: 03/11/2013] [Revised: 05/28/2013] [Accepted: 06/11/2013] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND In the present study, the effectiveness of combined cataract surgery and ab interno trabeculectomy (Trabectome) in exfoliation glaucoma (PEX) was compared with combined cataract surgery and trabecular aspiration. METHODS In this retrospective comparative cohort outcome study, 27 consecutive patients (mean age 73.41 years ± 10.78) in group 1 suffering from visually significant cataract and PEX glaucoma (mean preoperative IOP 23.41 mmHg ± 5.86) were treated with phacoemulsification combined with Trabectome; and 28 consecutive patients (73.83 years ± 8.94) were treated with phacoemulsification combined with trabecular aspiration (mean preoperative IOP 22.22 mmHg ± 6.33). The intraocular pressure (IOP) and the number of antiglaucoma eyedrops before and after surgery were evaluated. RESULTS Examinations were performed prior to surgery, 1 day, 6 weeks, 3 months, 6 months, and 1 year after surgery. In both groups there was a statistically significant decrease in postoperative IOP during the whole follow-up period. Comparing the two groups, there was a statistically significant lower IOP in the Trabectome group 1 day (p = 0.019), 6 months (p = 0.025), and 1 year (p = 0.019) after surgery. Between the two groups, there was no statistically significant difference in the number of antiglaucoma eyedrops at any time. CONCLUSIONS Both procedures have the ability to significantly lower the postoperative IOP during the first year. However, clear cornea phacoemulsification combined with Trabectome seems to be more effective in IOP reduction in cases of PEX glaucoma associated with cataract.
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Affiliation(s)
- Matthias K J Klamann
- Department of Ophthalmology, Charité, University Medicine Berlin, Augustenburger Platz 1, 13353, Berlin, Germany,
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Klamann M, Gonnermann J, Maier AK, Ruokonen P, Bertelmann E, Torun N. Einfluss der Vorderkammertiefe auf die Vermessung des Sehnervenkopfs mit OCT und HRT 3. Klin Monbl Augenheilkd 2013; 230:1029-33. [DOI: 10.1055/s-0032-1328528] [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: 10/26/2022]
Affiliation(s)
- M. Klamann
- Augenklinik, Universitätsmedizin Charité Berlin
| | | | - A.-K. Maier
- Augenklinik, “Friedrich C. Luft” Clinical Scientist-Pilotprogramm gefördert von der Volkswagen-Stiftung und der Stiftung Charité, Berlin
| | - P. Ruokonen
- Augenklinik, Universitätsmedizin Charité Berlin
| | | | - N. Torun
- Augenklinik, Universitätsmedizin Charité Berlin
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Klamann MKJ, Maier AKB, Gonnermann J, Ruokonen P, Bertelmann E, Torun N. [Influence of corneal thickness in keratoconic corneas on IOP measurement with IOPen, iCare, dynamic contour tonometry and Goldmann applanation tonometry]. Klin Monbl Augenheilkd 2013; 230:697-700. [PMID: 23670524 DOI: 10.1055/s-0032-1328408] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the effect of central corneal thickness (CCT) of keratoconic corneas on intraocular pressure (IOP) measurements as measured by four different techniques. PATIENTS AND METHODS Forty-one eyes of forty-one keratoconus patients (group 1) and fifty eyes of fifty healthy subjects (group 2) were enrolled. IOP was measured with iCare, IOPen, Goldmann applanation tonometry (GAT) and dynamic contour tonometry (DCT). CCT was measured by ultrasonic pachymetry. These data were used for statistical analysis. RESULTS The mean IOPs measured by GAT, DCT, iCare and IOPen were 11.4, 14.7, 10.8, and 15.7 mmHg in group 1; and 14.2, 15.4, 15.4 and 14.3 mmHg in group 2, respectively. Between both groups, there was a statistically significant difference in iCare (p < 0.001), GAT (p < 0.001) and IOPen (p = 0.040) measurements; with no difference between DCT (p = 0.266) measurements. IOPen measurements were significantly associated with CCT (r = - 0.314; p = 0.046). CONCLUSION IOPen seemed to be affected by CCT. IOP readings by iCare, GAT and DCT were found to be independent of CCT in keratoconic corneas.
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Affiliation(s)
- M K J Klamann
- Augenklinik, Universitätsmedizin Charité Berlin, Augustenburgerplatz 1, Berlin.
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Torun N, Bertelmann E, Klamann MKJ, Maier AK, Liekfeld A, Gonnermann J. Posterior chamber phakic intraocular lens to correct myopia: long-term follow-up. J Cataract Refract Surg 2013; 39:1023-8. [PMID: 23664355 DOI: 10.1016/j.jcrs.2013.01.041] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Revised: 01/19/2013] [Accepted: 01/22/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE To evaluate the long-term safety and efficacy of a refractive phakic intraocular lens (pIOL) (PRL) to correct moderate to high myopia. SETTING Department of Ophthalmology, University Medicine Charité Berlin, Berlin, Germany. DESIGN Retrospective cohort study. METHODS Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, intraocular pressure, endothelial cell loss, and adverse events were evaluated. RESULTS The study enrolled 53 eyes (mean spherical equivalent [SE] -12.17 diopters [D] ± 4.12 [SD]) of 29 patients. The mean age was 34.6 ± 9.2 years and the mean follow-up, 86 ± 21.2 months. The mean UDVA improved from 1.37 ± 0.28 logMAR preoperatively to 0.14 ± 0.19 logMAR at the last postoperative visit (P<.05). The mean CDVA improved from 0.10 ± 0.18 logMAR to -0.01 ± 0.09 logMAR (P<.05). The overall mean efficacy index and mean safety index were 0.9 and 1.21, respectively, at the last follow-up visit. The mean endothelial cell loss at the last follow-up was 6.4%. The complications were slight posterior chamber (PC) pIOL decentration (5 eyes, 9.4%), severe PC pIOL decentration resulting in pIOL removal (1 eye, 1.8%), glaucoma (4 eyes, 7.5%), clinically significant cortical lens opacification resulting in cataract surgery (4 eyes, 7.5%), clinically asymptomatic anterior subcapsular cataract formation (6 eyes, 11.3%), and retinal detachment (2 eyes, 3.8%). CONCLUSIONS Posterior chamber phakic pIOL implantation to correct moderate to high myopia provided predictable and stable refractive results but with a high rate of serious complications over the long term. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Necip Torun
- Departments of Ophthalmology, University Medicine Charité Berlin, Berlin, Germany.
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