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Fabian K, Kessler LJ, Augustin VA, Auffarth GU, Khoramnia R. [Unilateral posterior lenticonus]. Ophthalmologie 2024; 121:171. [PMID: 38078939 DOI: 10.1007/s00347-023-01959-6] [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] [Subscribe] [Scholar Register] [Accepted: 11/08/2023] [Indexed: 03/07/2024]
Affiliation(s)
| | | | | | | | - Ramin Khoramnia
- David J. Apple Center for Vision Research, Augenklinik, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland.
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Kovalchuk B, Khoramnia R, Son HS, Meis J, Winkler P, Naujokaitis T, Köppe MK, Auffarth GU, Augustin VA. Longitudinal Evaluation of Biomechanical Indices in Fellow Eyes of Patients With Keratoconus Classified as Having Very Asymmetric Ectasia With Normal Topography. J Refract Surg 2024; 40:e48-e56. [PMID: 38190558 DOI: 10.3928/1081597x-20231204-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
PURPOSE To evaluate the biomechanical longitudinal variability and progression of tomographically normal fellow eyes of patients with keratoconus. METHODS Of 513 patients with keratoconus, 30 patients with tomographically normal fellow eyes were included in this study. Tomographic and biomechanical parameters of the Pentacam and Corvis ST (Oculus Optikgeräte GmbH) were analyzed in multiple follow-up examinations, including the ABCD grading, Belin/Ambrósio Enhanced Ectasia total deviation index (BAD-D), Corvis Biomechanical Index (CBI), Corvis Biomechanical Factor (CBiF), and Tomographic and Biomechanical Index (TBI). A mixed regression model was applied. The results were compared to a healthy control group (n = 17) and a keratoconus group (n = 20). RESULTS Within a maximum observation period of 3.3 years, no fellow eye (0%) showed a progression to tomographically evident keratoconus. No significant change in tomographic or biomechanical parameters was detected over the study period. The indices BAD-D, CBI, CbiF, and TBI exhibited a certain variability over time, whereas the tomographic ABC parameters and maximum keratometry barely changed. This was also shown in the control group and for all parameters in the keratoconus group, except the TBI. CONCLUSIONS During the observation period none of the normal fellow eyes progressed to tomographically detectable keratoconus. However, biomechanical parameters CBI, CbiF, and TBI showed pathological values in 43.3% of eyes and certain variability. Subsequent studies with a longer observation period are warranted to confirm the biomechanical trends seen in this study and to rate the ability of single measurements to diagnose early keratoconus. [J Refract Surg. 2024;40(1):e48-e56.].
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Friedrich M, Baur ID, Yildirim TM, Augustin VA, Khoramnia R, Auffarth GU. Laboratory Analysis of Causative Factors for the Final Incision Size due to Intraocular Lens Injector Insertion. Ophthalmol Sci 2024; 4:100356. [PMID: 37869017 PMCID: PMC10587621 DOI: 10.1016/j.xops.2023.100356] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 06/07/2023] [Accepted: 06/20/2023] [Indexed: 10/24/2023]
Abstract
Purpose In intraocular lens (IOL) implantation, insertion of the IOL injector enlarges the clear corneal incision. A larger incision size (IS) is associated with a higher risk for surgically induced astigmatism and endophthalmitis. The goal of this study was to determine which parameters most influence the final IS. Design Experimental study. Subjects A total of 126 cadaver porcine eyes were included in this study. Methods We analyzed 409 clear corneal incisions made with 126 injectors from 13 injector models. We noted the vertical diameter and the tip angulation for every model. The corneal thickness of each incision location was measured using Scheimpflug tomography. The IS was measured before and after injector insertion and described as preoperative and final ISs, respectively. During surgery, the insertion depth and incision length were documented. A mixed effects model was applied to analyze the influence of the parameters on the final IS. Main Outcome Measures Influence on the final IS. Results Increases in the vertical diameter of the injector tip, the preoperative IS and the insertion depth, and a reduction of incision length were all significantly associated with increased final IS (P < 0.05). The conditional Pseudo-R2-Measure was 0.92. The preoperative IS had the largest standardized estimated effect on the final IS, followed by the vertical diameter of the injector tip, insertion depth, and lastly, incision length. Neither corneal thickness nor the tip angle of the injector had a significant effect on the final IS (P > 0.05). Conclusions The IOL injector's vertical diameter should be as small as possible to ensure a minimal final IS. The injector's insertion depth may be minimized, and the incision length should be long enough to reduce the final IS. Further studies are needed to confirm the findings in human autopsy eyes and in clinical practice. Financial Disclosures Proprietary or commercial disclosure may be found after the references in the Footnotes and Disclosures at the end of this article..
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Affiliation(s)
- Maximilian Friedrich
- Department of Ophthalmology, The David J Apple International Laboratory for Ocular Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Isabella D. Baur
- Department of Ophthalmology, The David J Apple International Laboratory for Ocular Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Timur M. Yildirim
- Department of Ophthalmology, The David J Apple International Laboratory for Ocular Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Victor A. Augustin
- Department of Ophthalmology, The David J Apple International Laboratory for Ocular Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Ramin Khoramnia
- Department of Ophthalmology, The David J Apple International Laboratory for Ocular Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Gerd U. Auffarth
- Department of Ophthalmology, The David J Apple International Laboratory for Ocular Pathology, University Hospital Heidelberg, Heidelberg, Germany
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Kovalchuk B, Auffarth GU, Khoramnia R, Augustin VA. Fusarium Keratitis on the Rise - a Clinical Review. Klin Monbl Augenheilkd 2023. [PMID: 37673089 DOI: 10.1055/a-2120-7752] [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: 09/08/2023]
Abstract
Fungal keratitis due to Fusarium species is a rare but serious ocular disease. Due to its rapid progression, often late diagnostic confirmation as well as limited topical treatment options, this is potentially sight threatening. Increasing contact lens use and global climate change have been suggested to be factors leading to an increase in cases of fusarium keratitis, even in regions with moderate climate. Early recognition and initiation of antimycotic treatment, as well as early surgical treatment by penetrating keratoplasty are decisive for the outcome.
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Augustin VA, Son HS, Yildirim TM, Meis J, Łabuz G, Auffarth GU, Khoramnia R. Refractive outcomes after DMEK: meta-analysis. J Cataract Refract Surg 2023; 49:982-987. [PMID: 37144644 DOI: 10.1097/j.jcrs.0000000000001212] [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: 12/18/2022] [Accepted: 04/28/2023] [Indexed: 05/06/2023]
Abstract
In this meta-analysis and systematic literature review of refractive outcomes after Descemet membrane endothelial keratoplasty (DMEK), the extent of the refractive shift and an overview of reasons for refractive shift after DMEK are provided. The PubMed library was screened for articles containing the terms "Descemet membrane endothelial keratoplasty," "DMEK," "Descemet membrane endothelial keratoplasty combined with cataract surgery," "triple-DMEK" combined with "refractive outcomes," "refractive shift," and "hyperopic shift." The refractive outcomes after DMEK were analyzed and compared using a fixed and random effects model. The overall mean change of the spherical equivalent outcome when compared with the preoperative value in cases of DMEK or when compared with the preoperative target refraction in cases of DMEK combined with cataract surgery was +0.43 diopters (D) (95% CI, 0.31-0.55). When DMEK is combined with cataract surgery, a target refraction of -0.5 D is recommended to achieve emmetropia. Changes in the posterior corneal curvature are identified as the main cause of the refractive hyperopic shift.
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Affiliation(s)
- Victor A Augustin
- From the David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany (Augustin, Son, Yildirim, Łabuz, Auffarth, Khoramnia); Institute of Medical Biometry, University of Heidelberg, Heidelberg, Germany (Meis)
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Mackenbrock LHB, Weindler JN, Augustin VA, Auffarth GU, Khoramnia R. [Christmas Tree Cataract Imaged with Optical Coherence Tomography]. Ophthalmologie 2023; 120:885. [PMID: 37147533 DOI: 10.1007/s00347-023-01868-8] [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] [Subscribe] [Scholar Register] [Accepted: 04/13/2023] [Indexed: 05/07/2023]
Affiliation(s)
- Lars H B Mackenbrock
- Augenklinik, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland
| | - Jan N Weindler
- Augenklinik, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland
| | - Victor A Augustin
- Augenklinik, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland
| | - Gerd U Auffarth
- Augenklinik, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland
| | - Ramin Khoramnia
- Augenklinik, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland.
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Augustin VA, Son HS, Kovalchuk B, Yildirim TM, Köppe MK, Auffarth GU, Khoramnia R. Biomechanical Analysis of Tomographically Regular Keratoconus Fellow Eyes Using Corvis ST. Klin Monbl Augenheilkd 2023; 240:944-951. [PMID: 37567232 DOI: 10.1055/a-2130-7503] [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] [Indexed: 08/13/2023]
Abstract
BACKGROUND Keratoconus is a bilateral, yet asymmetric disease. In rare cases, the second eye may show no signs of tomographic changes. The purpose of this study was to analyze the biomechanical characteristics in tomographically regular keratoconus fellow eyes. MATERIALS AND METHODS This retrospective, consecutive case series analyzed 916 eyes of 458 patients who presented to our keratoconus clinic between November 2020 and October 2022. Primary outcome measures included best-corrected visual acuity (BCVA), tomographic Scheimpflug analysis using Pentacam AXL (Oculus, Wetzlar, Germany), and biomechanical assessment using Corvis ST (Oculus, Wetzlar, Germany). Tomographic changes were assessed via analysis of the anterior and posterior curvature, K-max, thinnest corneal thickness (TCT), the Belin/Ambrosio Deviation Display (BAD-D), and the ABCD-Grading. Biomechanical changes were analyzed using Corvis Biomechanical Index (CBI) and Tomographic Biomechanical Index (TBI). RESULTS Of 916 eyes, 34 tomographically regular fellow eyes (7.4%) were identified and included in the analysis. Overall, the mean BCVA was - 0.02 ± 0.13 logMAR. Tomographic analysis showed mean K-max of 43.87 ± 1.21 D, mean TCT of 532 ± 23 µm, and mean BAD-D of 1.02 ± 0.43. Biomechanical analysis demonstrated mean CBI of 0.28 ± 0.26 and mean TBI of 0.34 ± 0.30. While normal CBI-values were observed in 16 (47%) of 34 eyes, only 13 eyes (38%) showed a regular TBI and only 7 eyes (21%) showed regular TBI and CBI. The sensitivity of CBI and TBI to detect a tomographically normal keratoconus fellow eye was 53% and 62%, respectively. CONCLUSION A highly asymmetric corneal ectasia with regular tomographic finding in a fellow eye is rare among keratoconus patients. In such cases, a biomechanical analysis may be useful in detecting early signs of corneal ectasia. In our analysis, the TBI showed high sensitivity for detecting a biomechanical abnormality in tomographically regular fellow eyes.
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Affiliation(s)
- Victor A Augustin
- Universitäts-Augenklinik Heidelberg, David J. Apple International Laboratory for Ocular Pathology und International Vision Correction Research Centre (IVCRC), Heidelberg, Deutschland
| | - Hyeck-Soo Son
- Universitäts-Augenklinik Heidelberg, David J. Apple International Laboratory for Ocular Pathology und International Vision Correction Research Centre (IVCRC), Heidelberg, Deutschland
| | - Bogdana Kovalchuk
- Universitäts-Augenklinik Heidelberg, David J. Apple International Laboratory for Ocular Pathology und International Vision Correction Research Centre (IVCRC), Heidelberg, Deutschland
| | - Timur Mert Yildirim
- Universitäts-Augenklinik Heidelberg, David J. Apple International Laboratory for Ocular Pathology und International Vision Correction Research Centre (IVCRC), Heidelberg, Deutschland
| | - Maximilian K Köppe
- Universitäts-Augenklinik Heidelberg, David J. Apple International Laboratory for Ocular Pathology und International Vision Correction Research Centre (IVCRC), Heidelberg, Deutschland
| | - Gerd U Auffarth
- Universitäts-Augenklinik Heidelberg, David J. Apple International Laboratory for Ocular Pathology und International Vision Correction Research Centre (IVCRC), Heidelberg, Deutschland
| | - Ramin Khoramnia
- Universitäts-Augenklinik Heidelberg, David J. Apple International Laboratory for Ocular Pathology und International Vision Correction Research Centre (IVCRC), Heidelberg, Deutschland
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Yildirim TM, Auffarth GU, Henningsen N, Łabuz G, Augustin VA, Son HS, Mackenbrock LHB, Khoramnia R. Differential Diagnosis of Changes in Intraocular Lenses. Klin Monbl Augenheilkd 2023; 240:952-959. [PMID: 37567234 DOI: 10.1055/a-2130-6944] [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] [Indexed: 08/13/2023]
Abstract
Differentiating between various intraocular lens (IOL) changes can be a challenge. In particular, certain IOL models carry the risk of late postoperative calcification. A major cause of IOL exchange surgery could be avoided if appropriate modifications were made during the IOL manufacturing process. The use of a hydrophilic acrylate carries the risk of IOL calcification, especially when a secondary procedure, such as a pars plana vitrectomy or other procedures using gas or air, is performed. In secondary IOL calcification, there is a wide range of opacification patterns, which are usually located in the centre on the anterior surface of the IOL or sometimes elsewhere. Often, granular deposits accumulate just below or on the surface of the IOL, leading to significant deterioration in visual quality and eventually requiring IOL exchange surgery. Therefore, in the case of eyes requiring secondary surgical intraocular intervention in the future, the use of hydrophilic IOLs should be critically evaluated. With regard to hydrophobic IOL materials, there are clear differences in the susceptibility to the formation of glistenings. Over time, there has been a significant decrease in glistening formation over the past 30 years due to optimisation of the material. With hydrophobic IOLs, special care should also be taken to avoid mechanical damage. In general, the only treatment option for functionally-impairing IOL opacification is surgical lens exchange, which carries potential risks of complications. In cases with a low degree of functional impairment, and especially in eyes with additional ocular diseases, it may be difficult to weigh the risk of additional surgery against the potential benefit. In some cases, it may be more appropriate not to perform an IOL exchange despite the IOL opacification. Recent visualisation methods that allow high-resolution analysis of the opacities in vivo and in vitro may be used in the future to estimate the functional effects of various IOL material changes on the optical quality.
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Affiliation(s)
| | | | | | - Grzegorz Łabuz
- Augenklinik, UniversitätsKlinikum Heidelberg, Deutschland
| | | | - Hyeck-Soo Son
- Augenklinik, UniversitätsKlinikum Heidelberg, Deutschland
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Scharf D, Chychko L, Augustin VA, Khoramnia R, Auffarth GU. [Implantation of an aniridia ring for complicated cataract and iris defects]. Ophthalmologie 2023; 120:755-758. [PMID: 35925348 DOI: 10.1007/s00347-022-01682-8] [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] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/08/2022] [Accepted: 06/13/2022] [Indexed: 06/15/2023]
Affiliation(s)
- Debora Scharf
- Universitätsaugenklinik Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland.
| | - Lizaveta Chychko
- Universitätsaugenklinik Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland
| | - Victor A Augustin
- Universitätsaugenklinik Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland
| | - Ramin Khoramnia
- Universitätsaugenklinik Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland
| | - Gerd U Auffarth
- Universitätsaugenklinik Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland
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Augustin VA, Blöck L, Hegenbart U, Auffarth GU, Khoramnia R. [Belantamab mafodotin-associated keratopathy-A common and treatment-affecting side effect]. Ophthalmologie 2023; 120:418-422. [PMID: 35925327 DOI: 10.1007/s00347-022-01660-0] [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] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/01/2022] [Accepted: 05/05/2022] [Indexed: 04/29/2023]
Affiliation(s)
- Victor A Augustin
- Universitäts-Augenklinik Heidelberg, INF 400, David J. Apple International Laboratory for Ocular Pathology und International Vision Correction Research Centre (IVCRC), 69120, Heidelberg, Deutschland.
| | - Louise Blöck
- Universitäts-Augenklinik Heidelberg, INF 400, David J. Apple International Laboratory for Ocular Pathology und International Vision Correction Research Centre (IVCRC), 69120, Heidelberg, Deutschland
| | - Ute Hegenbart
- Medizinische Klinik V (Hämatologie/Onkologie), Amyloidose Zentrum Heidelberg, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - Gerd U Auffarth
- Universitäts-Augenklinik Heidelberg, INF 400, David J. Apple International Laboratory for Ocular Pathology und International Vision Correction Research Centre (IVCRC), 69120, Heidelberg, Deutschland
| | - Ramin Khoramnia
- Universitäts-Augenklinik Heidelberg, INF 400, David J. Apple International Laboratory for Ocular Pathology und International Vision Correction Research Centre (IVCRC), 69120, Heidelberg, Deutschland
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Naujokaitis T, Khoramnia R, Auffarth GU, Augustin VA. [Ophthalmomyiasis externa acquired in Germany]. Ophthalmologie 2023; 120:76-78. [PMID: 35278102 DOI: 10.1007/s00347-022-01603-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 12/09/2021] [Accepted: 02/17/2022] [Indexed: 01/25/2023]
Affiliation(s)
- Tadas Naujokaitis
- Universitäts-Augenklinik Heidelberg, INF 400, 69120, Heidelberg, Deutschland
| | - Ramin Khoramnia
- Universitäts-Augenklinik Heidelberg, INF 400, 69120, Heidelberg, Deutschland
| | - Gerd U Auffarth
- Universitäts-Augenklinik Heidelberg, INF 400, 69120, Heidelberg, Deutschland
| | - Victor A Augustin
- Universitäts-Augenklinik Heidelberg, INF 400, 69120, Heidelberg, Deutschland.
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Augustin VA, Köppe MK, Son HS, Meis J, Yildirim TM, Khoramnia R, Auffarth GU. Scheimpflug Versus Optical Coherence Tomography to Detect Subclinical Corneal Edema in Fuchs Endothelial Corneal Dystrophy. Cornea 2022; 41:1378-1385. [PMID: 34864801 DOI: 10.1097/ico.0000000000002925] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 06/25/2021] [Accepted: 09/20/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this research was to compare the ability of Scheimpflug and anterior segment optical coherence tomography (OCT) in detecting subclinical corneal edema in patients with Fuchs endothelial corneal dystrophy (FECD) without clinical corneal edema. METHODS In this single-center, consecutive case series, 47 eyes of 29 patients with FECD were analyzed. The main outcome measures were anterior/posterior keratometry and central/thinnest corneal thickness. The criteria for subclinical corneal edema were loss of regular isopachs, displacement of the thinnest point of the cornea, and presence of posterior surface depression. Tomographic analyses were performed using Scheimpflug imaging (Pentacam HR) and OCT (anterior segment swept-source optical coherence tomography). RESULTS The measurement of the continuous variables revealed a significant difference between the 2 devices. The anterior curvature was steeper and the posterior curvature was flatter when measured with OCT ( P < 0.001). The OCT showed a lower central corneal thickness and thinnest corneal thickness ( P < 0.001). The agreement between both devices to detect subclinical corneal edema was high. The interdevice reliability for loss of parallel isopachs as measured by Cohen kappa coefficient was 0.84; for the displacement of the thinnest point of the cornea, it was 0.6, and for the focal posterior corneal surface depression, it was 0.62. Subclinical corneal edema was detected in 72.3% of the patients with both devices. In only 2 cases (4.3%), subclinical corneal edema was detected by one of the devices. CONCLUSIONS Scheimpflug and OCT imaging were both able to detect tomographic patterns of subclinical corneal edema. Therefore, both devices can help decision-making, favoring early endothelial keratoplasty in symptomatic patients with FECD without clinical corneal edema.
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Affiliation(s)
- Victor A Augustin
- Department of Ophthalmology, University of Heidelberg, David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Heidelberg, Germany; and
| | - Max K Köppe
- Department of Ophthalmology, University of Heidelberg, David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Heidelberg, Germany; and
| | - Hyeck-Soo Son
- Department of Ophthalmology, University of Heidelberg, David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Heidelberg, Germany; and
| | - Jan Meis
- Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
| | - Timur M Yildirim
- Department of Ophthalmology, University of Heidelberg, David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Heidelberg, Germany; and
| | - Ramin Khoramnia
- Department of Ophthalmology, University of Heidelberg, David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Heidelberg, Germany; and
| | - Gerd U Auffarth
- Department of Ophthalmology, University of Heidelberg, David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Heidelberg, Germany; and
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Kovalchuk B, Khoramnia R, Tóth M, Horner S, Auffarth GU, Augustin VA. [Fusarium Keratitis-an upcoming threat in Germany?]. Ophthalmologie 2022; 119:1022-1034. [PMID: 35925324 DOI: 10.1007/s00347-022-01646-y] [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] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/07/2022] [Accepted: 04/08/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Fungal keratitis due to Fusarium species is known to be typical of developing countries; however, with the increasing use of contact lenses a rise of Fusarium keratitis has been observed in Germany. METHODS In a monocentric retrospective study, we analyzed all patients who presented to our university eye hospital with infectious keratitis between January 2011 and December 2021 and had a proof of Fusarium species in either microscopy, culture or PCR. RESULTS We could identify 13 patients with a proof of Fusarium species. A significant increase of cases in 2021 was observed. In 76.9% of our cases the patients were female and in 76.9% the patients had a history of prior contact lens use. In only 4 cases the initial corneal sample gave a positive result for Fusarium. On average the suspicion of fungal keratitis arose 13.1 days after onset of symptoms, correct diagnosis was achieved after 14.6 days. All isolated specimens showed resistance against at least one of the common fungicides. In 70% of our cases treatment with penetrating keratoplasty was necessary. The patients showed a 57.1% recurrence rate after penetrating keratoplasty. In 80% of our cases best documented visual acuity after Fusarium keratitis was ≤ 0.4. CONCLUSION Due to difficult detection and a high resistance rate to common antifungals, Fusarium keratitis is prone to delayed diagnosis and limited treatment outcomes. Whenever risk factors are present and infectious keratitis does not respond to antibiotics, antimycotic treatment must be initiated. Early keratoplasty may be necessary.
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Affiliation(s)
- Bogdana Kovalchuk
- Univ.-Augenklinik Heidelberg, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland
| | - Ramin Khoramnia
- Univ.-Augenklinik Heidelberg, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland
| | - Marcell Tóth
- Pathologisches Institut, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - Susanne Horner
- Zentrum für Infektiologie: Medizinische Mikrobiologie und Hygiene, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - Gerd U Auffarth
- Univ.-Augenklinik Heidelberg, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland
| | - Victor A Augustin
- Univ.-Augenklinik Heidelberg, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland.
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Auffarth GU, Naujokaitis T, Blöck L, Daghbashyan A, Meis J, Augustin VA, Khoramnia R, Yildirim TM. Development and Verification of an Adjustment Factor for Determining the Axial Length Using Optical Biometry in Silicone Oil-Filled Eyes. Diagnostics (Basel) 2022; 12:diagnostics12010163. [PMID: 35054331 PMCID: PMC8775324 DOI: 10.3390/diagnostics12010163] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 01/08/2022] [Accepted: 01/10/2022] [Indexed: 11/16/2022] Open
Abstract
The aim of this prospective clinical study was to establish and verify an adaptation for axial length (AL) measurement in silicone oil (SO)-filled pseudophakic eyes with a Scheimpflug and partial coherence interferometry (PCI)-based biometer. The AL was measured with a Pentacam AXL (OCULUS Optikgeräte GmbH, Wetzler, Germany) and IOLMaster 700 (Carl Zeiss Meditec, Jena, Germany). The coefficients of variation (CoV) and the mean systematic difference (95% confidence interval (CI)) between the devices were calculated. After implementing a setting for measuring AL in tamponaded eyes with a Pentacam based on data of 29 eyes, another 12 eyes were examined for verification. The mean AL obtained with the Pentacam was 25.53 ± 1.94 mm (range: 21.70 to 30.76 mm), and with IOLMaster, 24.73 ± 1.97 mm (ranged 20.84 to 29.92 mm), resulting in a mean offset of 0.80 ± 0.08 mm (95% CI: 0.77, 0.83 mm), p < 0.001. The AL values of both devices showed a strong linear correlation (r = 0.999). Verification data confirmed good agreement, with a statistically and clinically non-significant mean difference of 0.02 ± 0.04 (95% CI: −0.01, 0.05) mm, p = 0.134. We implemented a specific adaptation for obtaining reliable AL values in SO-filled eyes with the Pentacam AXL.
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Affiliation(s)
- Gerd U. Auffarth
- International Vision Correction Research Centre, Department of Ophthalmology, University of Heidelberg, 69120 Heidelberg, Germany; (T.N.); (L.B.); (A.D.); (V.A.A.); (R.K.); (T.M.Y.)
- Correspondence: ; Tel.: +49-6221-56-6624
| | - Tadas Naujokaitis
- International Vision Correction Research Centre, Department of Ophthalmology, University of Heidelberg, 69120 Heidelberg, Germany; (T.N.); (L.B.); (A.D.); (V.A.A.); (R.K.); (T.M.Y.)
| | - Louise Blöck
- International Vision Correction Research Centre, Department of Ophthalmology, University of Heidelberg, 69120 Heidelberg, Germany; (T.N.); (L.B.); (A.D.); (V.A.A.); (R.K.); (T.M.Y.)
| | - Anna Daghbashyan
- International Vision Correction Research Centre, Department of Ophthalmology, University of Heidelberg, 69120 Heidelberg, Germany; (T.N.); (L.B.); (A.D.); (V.A.A.); (R.K.); (T.M.Y.)
| | - Jan Meis
- Institute of Medical Biometry, University of Heidelberg, 69120 Heidelberg, Germany;
| | - Victor A. Augustin
- International Vision Correction Research Centre, Department of Ophthalmology, University of Heidelberg, 69120 Heidelberg, Germany; (T.N.); (L.B.); (A.D.); (V.A.A.); (R.K.); (T.M.Y.)
| | - Ramin Khoramnia
- International Vision Correction Research Centre, Department of Ophthalmology, University of Heidelberg, 69120 Heidelberg, Germany; (T.N.); (L.B.); (A.D.); (V.A.A.); (R.K.); (T.M.Y.)
| | - Timur M. Yildirim
- International Vision Correction Research Centre, Department of Ophthalmology, University of Heidelberg, 69120 Heidelberg, Germany; (T.N.); (L.B.); (A.D.); (V.A.A.); (R.K.); (T.M.Y.)
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Auffarth GU, Son HS, Koch M, Weindler J, Merz P, Daphna O, Marcovich AL, Augustin VA. Implantation of an Artificial Endothelial Layer for Treatment of Chronic Corneal Edema. Cornea 2021; 40:1633-1638. [PMID: 34294634 PMCID: PMC8963521 DOI: 10.1097/ico.0000000000002806] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 04/26/2021] [Accepted: 05/12/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to describe a novel device that may serve as an alternative to Descemet membrane endothelial keratoplasty (DMEK) for the treatment of chronic corneal edema. METHODS The EndoArt (EyeYon Medical, Israel) is a flexible, 50-μm thin artificial endothelial layer that matches the cornea's posterior curvature and functions as a fluid barrier at the posterior stroma, replacing the diseased endothelium. Similar to a DMEK approach, it is implanted into the anterior chamber, carefully positioned on the posterior stroma, and secured using an air-gas mixture. Two patients with chronic corneal edema resulting from endothelial decompensation underwent implantation of the new artificial lamella. RESULTS In patient 1, the central corneal thickness (CCT) decreased from 730 μm preoperatively to 593 μm at 1 day postoperatively. In patient 2, the CCT decreased from 761 μm preoperatively to 487 μm at 1 day postoperatively. Both patients reported high satisfaction and an overall brighter visual quality. Although dislocation of the lamella occurred in both cases, the CCT was promptly restored after a repositioning procedure and remained stable at the 17-month follow-up (CCT of 526 and 457 μm for patients 1 and 2, respectively). In contrast to DMEK donor tissue, the artificial lamella is sufficiently robust to allow easy intraocular manipulation without the risk of damaging the implant. It is easily removable and does not require any immunosuppressive treatment because of its nonbiological nature. CONCLUSIONS Implantation of the EndoArt led to rapid corneal deturgescence and CCT restoration, presenting a possible option for patients with chronic corneal edema.
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Affiliation(s)
- Gerd U. Auffarth
- David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany;
| | - Hyeck-Soo Son
- David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany;
| | - Matthias Koch
- David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany;
| | - Jan Weindler
- David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany;
| | - Patrick Merz
- David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany;
| | | | - Arie L. Marcovich
- EyeYon Medical, Ness Ziona, Israel;
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel; and
- Department of Ophthalmology, Kaplan Medical Center, Rehovot, Israel.
| | - Victor A. Augustin
- David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany;
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Augustin VA, Son HS, Baur I, Zhao L, Auffarth GU, Khoramnia R. Detecting subclinical keratoconus by biomechanical analysis in tomographically regular keratoconus fellow eyes. Eur J Ophthalmol 2021; 32:11206721211063740. [PMID: 34841930 DOI: 10.1177/11206721211063740] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE To analyze the tomographically non-affected second eyes of keratoconus patients using the Corvis ST to detect any biomechanical abnormalities or subclinical keratoconus. METHODS In this retrospective, single-center, consecutive case series 244 eyes of 122 keratoconus patients were analyzed between November 2020 and February 2021. Fourteen fellow eyes fulfilled the inclusion criteria and showed no clinical or tomographic signs of keratoconus. Main outcome measures included best-corrected visual acuity, tomographic and biomechanical analyses using Scheimpflug imaging: Pentacam and Corvis ST (Oculus, Wetzlar, Germany). Tomographic analyses included anterior and posterior simulated keratometry, K-Max, central corneal thickness, thinnest corneal thickness, Belin/Ambrosio Ectasia Display, and the ABCD grading system. For biomechanical analyses, the corneal biomechanical index (CBI) and tomographic biomechanical index were used. RESULTS The mean best-corrected visual acuity was 0.01 ± 0.10 logMAR. Mean K-Max was 43.79 ± 1.12 D, mean central corneal thickness 529 ± 25 µm, mean thinnest corneal thickness 524 ± 23 µm, and mean Belin/Ambrosio Ectasia Display 1.0 ± 0.32. The mean CBI was 0.30 ± 0.21. Regular CBI values were found in six of 14 patients. The mean tomographic biomechanical index was 0.47 ± 0.22 with regular values observed in only two of 14 patients. No signs of tomographic or biomechanical abnormalities were shown in only one of 14 keratoconus fellow eyes, with regular ABCD, Belin/Ambrosio Ectasia Display, CBI and tomographic biomechanical index values. CONCLUSIONS Tomographically normal fellow eyes of keratoconus patients are rare. In these cases, a biomechanical analysis of the cornea may help detect a subclinical keratoconus. The tomographic biomechanical index was the most sensitive index to verify a mild ectasia.
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Affiliation(s)
- Victor A Augustin
- David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), 27178Department of Ophthalmology, 9144University of Heidelberg, Heidelberg, Germany
| | - Hyeck-Soo Son
- David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), 27178Department of Ophthalmology, 9144University of Heidelberg, Heidelberg, Germany
| | - Isabella Baur
- David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), 27178Department of Ophthalmology, 9144University of Heidelberg, Heidelberg, Germany
| | - Ling Zhao
- David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), 27178Department of Ophthalmology, 9144University of Heidelberg, Heidelberg, Germany
| | - Gerd U Auffarth
- David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), 27178Department of Ophthalmology, 9144University of Heidelberg, Heidelberg, Germany
| | - Ramin Khoramnia
- David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), 27178Department of Ophthalmology, 9144University of Heidelberg, Heidelberg, Germany
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Augustin VA, Weller JM, Kruse FE, Tourtas T. Influence of corneal guttae and nuclear cataract on contrast sensitivity. Br J Ophthalmol 2020; 105:1365-1370. [PMID: 32907813 DOI: 10.1136/bjophthalmol-2019-315206] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 09/24/2019] [Revised: 03/19/2020] [Accepted: 08/17/2020] [Indexed: 11/03/2022]
Abstract
AIMS To evaluate the contrast sensitivity in patients with nuclear cataract and corneal guttae compared to patients with nuclear cataract without guttae. METHODS In this retrospective, single-centre case series, 50 eyes of 50 patients fulfilling the inclusion criteria were enrolled. Patients with corneal guttae and nuclear cataract (n=25, study group) underwent triple Descemet membrane endothelial keratoplasty (DMEK). Patients with nuclear cataract and healthy corneas underwent cataract surgery (n=25, control group). Inclusion criteria were preoperative best-corrected visual acuity ≥20/40, no corneal oedema and similar lens opacity (nuclear opalescence 2.0-2.9). Outcome measures included MARS letter and OPTEC 6500P contrast sensitivity test, corneal volume, central corneal thickness and anterior and posterior corneal densitometry. RESULTS Preoperative MARS letter and OPTEC 6500P contrast sensitivity was significantly worse in the study group (MARS: p<0.001; OPTEC 6500P: p<0.007 at low spatial frequencies in daylight with and without glare and nightlight without glare). After surgery, there was no significant difference in MARS letter contrast sensitivity between groups (p=0.225). OPTEC 6500P contrast sensitivity remained significantly lower in the study group in daylight and nightlight with and without glare at most spatial frequencies (p<0.01) postoperatively. Preoperative and postoperative corneal volume, central corneal thickness and anterior corneal densitometry were equal in both groups (p>0.05). Posterior densitometry was significantly higher in the study group than in the control group preoperatively (p<0.001) but turned into equal values postoperatively (p=0.07). CONCLUSIONS Corneal guttae cause an additional significant decrease in contrast sensitivity in eyes with nuclear cataract. This is in favour of performing a triple DMEK even in eyes with a visual acuity of ≥20/40.
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Affiliation(s)
- Victor A Augustin
- Department of Ophthalmology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Julia M Weller
- Department of Ophthalmology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Friedrich E Kruse
- Department of Ophthalmology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Theofilos Tourtas
- Department of Ophthalmology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
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Arrigo A, Knutsson KA, Rajabjan F, Augustin VA, Bandello F, Parodi MB. Combined central retinal vein occlusion and branch retinal artery occlusion treated with intravitreal dexamethasone implant: A case report. Eur J Ophthalmol 2020; 31:NP74-NP76. [PMID: 32106703 DOI: 10.1177/1120672120909181] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To report a case of combined central retinal vein occlusion and branch retinal artery occlusion in a 51-year-old male with a very good response to dexamethasone implant therapy. METHODS This is a descriptive case report based on data from clinical records, patient observation and follow-ups, and analysis of acquired diagnostic tests. RESULTS A 51-year-old man presented with sudden vision loss and best-corrected visual acuity of 20/40 in his left eye. A pale inferotemporal arterial branch course area along with increased vascular tortuosity, retinal hemorrhages, optic disk swelling, and macular edema were observed on slit lamp biomicroscopy examination. Right eye was normal. Diagnosis of combined central retinal vein occlusion and branch retinal artery occlusion in left eye was confirmed by fluorescein angiography and color fundoscopy, respectively. Optical coherence tomography confirmed subretinal fluid and intraretinal cysts with a prominent middle-limiting membrane in the inner synaptic portion of the outer plexiform layer, corresponding to areas of paracentral acute middle maculopathy. Intravitreal dexamethasone implant was administered to the patient. One month later, visual acuity was recovered with complete absorption of macular edema. Functional and anatomical stabilization were confirmed after 24 months. CONCLUSION Combined central retinal vein occlusion and branch retinal artery occlusion represents a rare condition, with variable functional outcomes due to the long-term complications such as macular edema. We hypothesize that prompt diagnosis and immediate intravitreal corticosteroid implant therapy reduced macular edema, thus contributing to arterial perfusion improvement, which in this case lead to a full sustainable recovery with limited functional and anatomical damage.
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Affiliation(s)
- Alessandro Arrigo
- Department of Ophthalmology, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Karl Anders Knutsson
- Cornea and Ocular Surface Unit, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Firuzeh Rajabjan
- Department of Ophthalmology, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Victor A Augustin
- Department of Ophthalmology, University Hospital Erlangen, Erlangen, Germany
| | - Francesco Bandello
- Department of Ophthalmology, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Maurizio Battaglia Parodi
- Department of Ophthalmology, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
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Lau N, Hajjar Sesé A, Augustin VA, Kuit G, Wilkins MR, Tourtas T, Kruse FE, Højgaard-Olsen K, Manuel R, Armitage WJ, Larkin DF, Tuft SJ. Fungal infection after endothelial keratoplasty: association with hypothermic corneal storage. Br J Ophthalmol 2018; 103:1487-1490. [PMID: 30563913 DOI: 10.1136/bjophthalmol-2018-312709] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 06/09/2018] [Revised: 11/17/2018] [Accepted: 12/01/2018] [Indexed: 11/04/2022]
Abstract
PURPOSE To compare the incidence of fungal infection after endothelial keratoplasty (EK) when donor tissue had been stored in hypothermic medium or organ culture. METHODS We describe the clinical features of 10 cases of fungal infection (keratitis or endophthalmitis) following EK identified at three European centres. Case definition was the culture of fungus or a positive PCR from the host cornea or anterior chamber after EK. A survey of the incidence of infection after EK was conducted by the European Eye Bank Association. The main outcome measure was the number of cases in which donor tissue had been stored in hypothermic medium compared with organ culture. RESULTS The 10 cases occurred between 2014 and 2017. All donor corneas had been stored in hypothermic medium sourced from three US eye banks. Three pairs of mate corneas caused infections in six recipients. Candida spp were identified from nine cases, with one isolate of Purpureocillium lilacinum. Data on 16 862 corneas supplied for EK were available from 16 European eye banks for the 5-year period from 2012. There were 17 reported cases of infection, of which 15 (88%) were fungal infections and 14 (82%) were Candida spp. Fungal infection was reported from 3 of 14 476 (0.02%) corneas supplied in organ culture compared with 12 of 2386 (0.50%) corneas supplied in hypothermic medium (p<0.0001). The incidence of infection after hypothermic storage was similar for material sourced from Europe (0.52%) or the USA (0.61%). CONCLUSIONS Infection after EK is strongly associated with Candida spp. The possible explanations for the higher incidence of infection when tissue is stored in hypothermic medium are discussed.
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Affiliation(s)
- Nicola Lau
- Corneal Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Aida Hajjar Sesé
- Department of Ophthalmology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Victor A Augustin
- Department of Ophthalmology, University Hospital Erlangen, Germany, Erlangen.,Department of Ophthalmology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Geert Kuit
- Corneal Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Mark R Wilkins
- Corneal Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Theofilos Tourtas
- Department of Ophthalmology, University Hospital Erlangen, Germany, Erlangen.,Department of Ophthalmology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Friedrich E Kruse
- Department of Ophthalmology, University Hospital Erlangen, Germany, Erlangen.,Department of Ophthalmology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Klavs Højgaard-Olsen
- Department of Ophthalmology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Rohini Manuel
- National Infection Service, Public Health England, London, UK
| | - W John Armitage
- Tissue and Eye Services, NHS Blood and Transplant, Bristol, UK.,Translational Health Sciences, University of Bristol, Bristol, UK.,European Eye Bank Association, Veneto Eye Bank Foundation, Zelarino, Italy
| | - Daniel F Larkin
- Corneal Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Stephen J Tuft
- Corneal Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK
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Augustin VA, Weller JM, Kruse FE, Tourtas T. Can we predict the refractive outcome after triple Descemet membrane endothelial keratoplasty? Eur J Ophthalmol 2018; 29:165-170. [DOI: 10.1177/1120672118785282] [Citation(s) in RCA: 8] [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] [Indexed: 11/16/2022]
Abstract
Purpose: To analyze and correlate corneal parameters with refractive shift after Descemet membrane endothelial keratoplasty combined with cataract surgery (triple Descemet membrane endothelial keratoplasty). Methods: This single-center retrospective observational case series included 152 eyes of 152 consecutive patients undergoing triple Descemet membrane endothelial keratoplasty in the first eye for Fuchs endothelial corneal dystrophy. Patients were examined preoperatively, as well as at 3, 6, and 12 months after surgery. The main outcome measures were: refractive shift (predicted refractive outcome based on intraocular lens calculation compared to actual postoperative refractive outcome), central corneal thickness, corneal volume, anterior and posterior corneal curvature, and corneal densitometry. These parameters were analyzed and correlated with the refractive shift after surgery. Results: After 3 months from surgery, a mean refractive shift of +1.12 ± 1.10 D was observed and remained stable until the last follow-up at 12 months (+1.24 ± 1.07 D). Correlation analysis showed a weak but significant positive correlation between refractive shift and preoperative posterior curvature (rho = 0.314; p = 0.002) or preoperative posterior densitometry (rho = 0.227; p = 0.008). No correlation was found between refractive shift and preoperative central corneal thickness, corneal volume, anterior curvature, or anterior/mid-cornea densitometry. Conclusion: Changes of the posterior cornea may have an influence on the refractive shift. Patients with flatter posterior corneal curvature or higher posterior corneal density seem to exhibit a higher hyperopic shift. The weak correlations indicate a poor predictive value of any preoperative parameter used in our study.
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Affiliation(s)
- Victor A Augustin
- Department of Ophthalmology, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Julia M Weller
- Department of Ophthalmology, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Friedrich E Kruse
- Department of Ophthalmology, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Theofilos Tourtas
- Department of Ophthalmology, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
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Laschke MW, Augustin VA, Sahin F, Anschütz D, Metzger W, Scheuer C, Bischoff M, Aktas C, Menger MD. Surface modification by plasma etching impairs early vascularization and tissue incorporation of porous polyethylene (Medpor®) implants. J Biomed Mater Res B Appl Biomater 2015; 104:1738-1748. [DOI: 10.1002/jbm.b.33528] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 07/23/2015] [Accepted: 08/30/2015] [Indexed: 12/22/2022]
Affiliation(s)
- Matthias W. Laschke
- Institute for Clinical & Experimental Surgery; Saarland University; 66421 Homburg/Saar Germany
| | - Victor A. Augustin
- Institute for Clinical & Experimental Surgery; Saarland University; 66421 Homburg/Saar Germany
| | - Fadime Sahin
- INM-Leibniz Institute for New Materials; 66123 Saarbrücken Germany
| | - Dieter Anschütz
- INM-Leibniz Institute for New Materials; 66123 Saarbrücken Germany
| | - Wolfgang Metzger
- Department of Trauma, Hand, and Reconstructive Surgery; Saarland University; 66421 Homburg/Saar Germany
| | - Claudia Scheuer
- Institute for Clinical & Experimental Surgery; Saarland University; 66421 Homburg/Saar Germany
| | - Markus Bischoff
- Institute of Medical Microbiology and Hygiene; Saarland University; 66421 Homburg/Saar Germany
| | - Cenk Aktas
- INM-Leibniz Institute for New Materials; 66123 Saarbrücken Germany
| | - Michael D. Menger
- Institute for Clinical & Experimental Surgery; Saarland University; 66421 Homburg/Saar Germany
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