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V Saunier, A Robinet Perrin, C Costet, D Touboul
PURPOSE: To assess the reproducibility of single-pass cutting for preparation of ultra-thin (≤120μm) donor cornea grafts in Descemet stripping automated endothelial keratoplasty (DSAEK). METHODS: All consecutive patients of DSAEK performed using the MORIA One Use microkeratome (MORIA, Antony, France) in between June 2014 and August 2015. Patient and donor central corneal thickness (CTT), microkeratome head, remaining stromal bed thickness (RSBT), number of cut and graft thickness at 1 month and 6 months postoperatively were recorded in this single-center prospective study...
October 18, 2016: Journal Français D'ophtalmologie
Joann J Kang, David C Ritterband, Kevin Lai, Jeffrey M Liebmann, John A Seedor
PURPOSE: To evaluate visual outcomes and complications after Descemet stripping automated endothelial keratoplasty (DSAEK) in patients with previous glaucoma surgery. METHODS: A retrospective chart review was conducted of 129 procedures in 102 eyes of 96 patients who underwent DSAEK and previous glaucoma surgery at New York Eye and Ear Infirmary of Mt Sinai. The mean length of follow-up was 29.1 ± 25.5 months. Patients with postoperative follow-up duration of less than 3 months were excluded from analysis...
October 14, 2016: Cornea
Lorena Sepsakos, Kevin Shah, T Peter Lindquist, William Barry Lee, Edward Holland
PURPOSE: To evaluate the rate of rejection after Descemet stripping automated endothelial keratoplasty (DSAEK) in patients with Fuchs endothelial dystrophy (ED) and to analyze potential risk factors for rejection. METHODS: An observational retrospective chart review of 400 patients with Fuchs ED was performed. The primary outcome was the rate of endothelial graft rejection. Secondary outcomes included graft clarity after rejection, medications at the time of rejection, and preoperative graft thickness...
October 5, 2016: Cornea
Yoav Nahum, Irit Bahar, Massimo Busin
PURPOSE: To report the use of Descemet stripping automated endothelial keratoplasty (DSAEK) for treatment of sterile corneal perforations accompanying endothelial decompensation. METHODS: In this multicenter interventional case series, we reviewed the medical records of all tectonic DSAEK surgeries performed at Villa Serena-Villa Igea private Hospitals (Forlì, Italy) and Rabin Medical Center (Petach Tikva, Israel) between January 2014 and March 2016. RESULTS: Three patients with endothelial decompensation and sterile corneal perforation (n = 2) or impending corneal perforation (n = 1) underwent DSAEK between 2014 and 2015 at Villa Igea Hospital, Forlì, Italy, and Rabin Medical Center, Petach Tikva, Israel...
October 5, 2016: Cornea
Sonja Heinzelmann, Daniel Böhringer, Philipp Eberwein, Thomas Reinhard, Philip Maier
PURPOSE: Although the functional results following DMEK are better than after DSAEK, DSAEK still seems to be the standard procedure, as surgeons fear losing grafts during DMEK graft preparation. Therefore, eye banks offer precut DMEK grafts for direct use by the surgeon. Here, we analysed the functional results and complication rates for a precut technique compared to fresh preparations. METHODS: We retrospectively compared 453 standard to 11 precut (1-2 days before surgery) DMEK cases...
October 8, 2016: Graefe's Archive for Clinical and Experimental Ophthalmology
Katie M Hallahan, Brian Cost, Jeff M Goshe, William J Dupps, Sunil K Srivastava, Justis P Ehlers
PURPOSE: To correlate intraoperative interface fluid dynamics during Descemet stripping automated endothelial keratoplasty (DSAEK) surgery using intraoperative optical coherence tomography (iOCT) in the PIONEER (Prospective Intraoperative and Perioperative Ophthalmic ImagiNg with Optical CohEncE TomogRaphy) study with postoperative outcomes. DESIGN: Prospective consecutive, interventional, comparative case series PARTICIPANTS: One hundred and seventy-eight eyes of 173 patients undergoing DSAEK from the Cole Eye Institute, Cleveland, USA...
October 1, 2016: American Journal of Ophthalmology
Ester Fernández López, Elsie Chan
PURPOSE: There is currently limited information regarding the outcomes of endothelial keratoplasty in eyes with cytomegalovirus (CMV) endotheliitis. We report the results of Descemet stripping automated endothelial keratoplasty (DSAEK) for endothelial failure secondary to CMV. METHODS: This is a retrospective review of 4 eyes of 4 patients with CMV endotheliitis and DSAEK. CMV was confirmed in each case by a positive aqueous tap on qualitative polymerase chain reaction...
September 21, 2016: Cornea
Mor M Dickman, Pieter J Kruit, Lies Remeijer, Jeroen van Rooij, Allegonda Van der Lelij, Robert H J Wijdh, Frank J H M van den Biggelaar, Tos T J M Berendschot, Rudy M M A Nuijts
OBJECTIVE: To compare visual acuity, refraction, endothelial cell density (ECD), and complications after Descemet stripping automated endothelial keratoplasty (DSAEK) and ultrathin DSAEK (UT-DSAEK). DESIGN: A multicenter, prospective, double-masked, randomized, controlled clinical trial. PARTICIPANTS: From 66 patients with irreversible corneal endothelial dysfunction dues to Fuchs' dystrophy who enrolled from 4 tertiary medical centers in the Netherlands, 66 eyes were studied...
September 19, 2016: Ophthalmology
Kuan-I Wu, Hsiao-Sang Chu, Amy Shih-I Pai, Yu-Chih Hou, Szu-Yuan Lin, Wei-Li Chen, Fung-Rong Hu
PURPOSE: To assess the surgical and clinical outcomes of anterior lamellar keratoplasty using anterior corneal buttons from Descemet stripping automated endothelial keratoplasty (DSAEK) donor tissue. METHODS: Retrospective data from 8 patients with unilateral limbal dermoids, treated between February 2011 and January 2016 at National Taiwan University Hospital, were analyzed. Donor corneas for DSAEK were divided into anterior and posterior lamellae using a 350-μm microkeratome...
September 8, 2016: Cornea
Sosuke Ishiyama, Yosai Mori, Ryohei Nejima, Toshihiko Tokudome, Shigeto Shimmura, Kazunori Miyata, Shiro Amano
PURPOSE: To compare the long-term outcomes of visual function and endothelial cell survival after Descemet stripping automated endothelial keratoplasty (DSAEK) and penetrating keratoplasty (PK). METHODS: The cohort included 108 eyes from 97 patients who underwent primary PK and 85 eyes from 78 patients who underwent primary DSAEK at Miyata Eye Hospital in Japan. Uncorrected visual acuity, best spectacle-corrected visual acuity (BSCVA), endothelial cell density, and four components from Fourier harmonic analysis of topography data (spherical component, regular astigmatism component, asymmetry component, and higher-order irregularity component) were retrospectively compared between PK and DSAEK at each time point for 5 years using mixed-effects models...
August 24, 2016: Cornea
Akira Kobayashi, Hideaki Yokogawa, Natsuko Mori, Kazuhisa Sugiyama
BACKGROUND: To report the feasibility of intraoperative spectral domain optical coherence tomography (OCT) using the RESCAN 700 for the visualization and evaluation of precut Descemet's stripping automated endothelial keratoplasty (DSAEK) and prestripped Descemet's membrane endothelial keratoplasty (DMEK) donor tissue. METHODS: Precut DSAEK (n = 11), prestripped DMEK (n = 4) preserved in a viewing chamber were examined by intraoperative OCT. Wholly intact donor corneas for penetrating keratoplasty (PK) (n = 8) were also examined as controls...
2016: BMC Ophthalmology
Daniel Sarezky, Stephen E Orlin
PURPOSE: To report a case of bilateral Urrets-Zavalia syndrome (UZS) after Descemet stripping automated endothelial keratoplasty (DSAEK). METHODS: Case report. RESULTS: A 61-year-old patient with Fuchs endothelial dystrophy initially developed UZS in the left eye after DSAEK. Thirteen months later, she underwent combined cataract surgery and DSAEK in the right eye, and postoperatively she was noted to have elevated intraocular pressure and a fixed and dilated pupil on the first postoperative day...
August 3, 2016: Cornea
Arisa Okada, Ichiya Sano, Yoshifumi Ikeda, Etsuko Fujihara, Masaki Tanito
A 73-year-old woman with a corneal perforation of undetermined etiology was treated with corneal patch grafting. A residual partial-thickness corneal button obtained during a previous Descemet stripping automated endothelial keratoplasty (DSAEK) surgery and stored at -80°C in Optisol GS for 3 months was used as a patch graft. Five days postoperatively, the anterior chamber was reformed and the perforation was masked by the donor cornea. During the next several weeks, gradual displacement of the anterior edge of the donor cornea in the limbal direction occurred...
January 2016: Case Reports in Ophthalmology
N Luft, M Dirisamer, S Priglinger
Descemet membrane endothelial keratoplasty (DMEK) is the gold standard for the treatment of corneal endothelial disease, first and foremost Fuchs' endothelial dystrophy. Superior visual rehabilitation as well as lower and decreasing complication rates can be obtained with DMEK than with Descemet stripping automated endothelial keratoplasty (DSAEK) - still the most commonly performed type of posterior lamellar keratoplasty. Recent advancements in the DMEK method include the establishment of a standardised and reproducible surgical "no touch" technique and the emerging role of eye banks, which are able to prepare convenient pre-cut DMEK grafts...
July 25, 2016: Klinische Monatsblätter Für Augenheilkunde
S Siebelmann, B Bachmann, A Lappas, T Dietlein, M Hermann, S Roters, C Cursiefen, P Steven
BACKGROUND: Optical coherence tomography (OCT) is the clinical gold standard for anterior and posterior segment imaging. Since OCT devices have been integrated into surgical microscopes, this technique is also available intraoperatively in anterior segment surgery. OCT is well established in imaging very thin or transparent structures as they appear in corneal or glaucoma surgery. Therefore, intraoperative OCT can deliver important information for the surgeon which is superior to the normal surgical microscope...
August 2016: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
Sophia Y Wang, Devon H Ghodasra, Sejal R Amin, Shahzad I Mian, K Thiran Jayasundera
An 85-year-old man with remote thermal sclerostomy and Descemet's stripping automated endothelial keratoplasty (DSAEK) in the right eye presented urgently for pain and blurred vision in that eye. Examination revealed bleb purulence and vitreous cellular aggregates concerning for endophthalmitis. Microscopy of a vitreous sample revealed yeast and pseudohyphae. He developed corneal infiltrates consistent with fungal infection. Therapy included topical, intravitreal, and systemic antifungals voriconazole and amphotericin...
July 1, 2016: Ophthalmic Surgery, Lasers & Imaging Retina
C Cursiefen, F Schaub, B O Bachmann
BACKGROUND: The spectrum of operative interventions in corneal disorders requiring keratoplasty has been expanded considerably in recent years. In addition to the standard technique with full-thickness replacement of the cornea (perforating keratoplasty), lamellar techniques have been introduced. The aim of this review is to highlight current opportunities, indications and complications, as well as possible strategies to standardise lamellar keratoplasties. MATERIALS AND METHODS: Our own data and a review of the literature in PubMed are summarised...
September 2016: Klinische Monatsblätter Für Augenheilkunde
Amir Norouzpour, Siamak Zarei-Ghanavati
PURPOSE: To report hydrophilic acylic intraocular lens (IOL) opacification after Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) in an eye with multiple prior intraocular surgeries and iatrogenic aniridia. CASE REPORT: A 34-year-old woman with history of penetrating keratoplasty (PKP) for advanced keratoconus and subsequent Urrets-Zavalia Syndrome (UZS) underwent phacoemulsification and hydrophilic acrylic IOL implantation for her cataract. In order to control post-PKP glaucoma, multiple glaucoma surgeries including two glaucoma drainage implants were performed...
April 2016: Journal of Ophthalmic & Vision Research
Mozhgan Rezaei Kanavi, Mohammad Ali Javadi, Tahmineh Motevasseli, Tahereh Chamani, Mahnoush Rezaei Kanavi, Bahareh Kheiri, Sare Safi
PURPOSE: To report changing trends in indications and techniques of corneal transplantation in Iran. METHODS: We reviewed eye bank records of 47,129 patients who had undergone corneal transplantation between 2006 and 2013 at different eye centers throughout Iran. RESULTS: The most common indication for corneal transplantation was keratoconus (KCN, n = 21,350 eyes, 45.3%), followed by bullous keratopathy (BK, n = 8,566 eyes, 18.2%), corneal opacity and scar (COS, n = 7,158 eyes, 15...
April 2016: Journal of Ophthalmic & Vision Research
Konstantinos Droutsas, Apostolos Lazaridis, Chrysanthi Koutsandrea, Klio I Chatzistefanou, Marilita M Moschos, Walter Sekundo
PURPOSE: To report the explantation of a detached and opaque donor disc as an alternative to secondary keratoplasty in a case of persistent graft detachment followed by spontaneous clearance of the recipient cornea after non-Descemet stripping automated endothelial keratoplasty (non-DSAEK). RESULTS: Four months after graft explantation, BSCVA was 0.5 and endothelial cell density (ECD) was 1,221 cells/m(2). After 13 months, BSCVA was still 0.6 while ECD had fell to 800, and 2 years later, the endothelium decompensated...
May 2016: Case Reports in Ophthalmology
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