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Reinhard Graft Ocular

Thabo Lapp, Philip Maier, Daniel Böhringer, Thomas Reinhard
The surgical technique of limbokeratoplasty (limbo-KP) was initially established for the treatment of severe limbal deficiencies. Besides improving visual acuity, surgery is aimed at ensuring complete, long-lasting epithelialization of the ocular surface. Due to the extension of the indication spectrum, limbo-KPs are also used in various forms of epithelial/stromal corneal dystrophies such as lattice and granular (transforming growth factor beta-induced [TGFBI] gene mutation associated) dystrophies. The objective of limbo-KP is to ensure prolonged clear graft survival without a recurrence of the dystrophy as otherwise observed after conventional keratoplasty...
April 12, 2018: Klinische Monatsblätter Für Augenheilkunde
Claus Cursiefen, Eric Viaud, Felix Bock, Bernard Geudelin, Antoine Ferry, Pavla Kadlecová, Michel Lévy, Salman Al Mahmood, Sylvie Colin, Eric Thorin, François Majo, Beatrice Frueh, Frank Wilhelm, Tobias Meyer-Ter-Vehn, Gerd Geerling, Daniel Böhringer, Thomas Reinhard, Daniel Meller, Uwe Pleyer, Björn Bachmann, Berthold Seitz
OBJECTIVE: Eye drops of aganirsen, an antisense oligonucleotide preventing insulin receptor substrate-1 expression, inhibited corneal neovascularization in a previous dose-finding phase II study. We aimed to confirm these results in a phase III study and investigated a potential clinical benefit on visual acuity (VA), quality of life (QoL), and need for transplantation. DESIGN: Multicenter, double-masked, randomized, placebo-controlled phase III study. PARTICIPANTS: Analysis of 69 patients with keratitis-related progressive corneal neovascularization randomized to aganirsen (34 patients) or placebo (35 patients)...
September 2014: Ophthalmology
Ludwig M Heindl, Konrad R Koch, Franziska Bucher, Deniz Hos, Philipp Steven, Hans-Reinhard Koch, Claus Cursiefen
PURPOSE: This study aims to analyze the feasibility of Descemet membrane endothelial keratoplasty (DMEK) in the management of corneal endothelial decompensation in eyes with glaucoma implants. CASE REPORT: A 62-year-old male with bullous keratopathy after trabeculectomy and Baerveldt shunt implantation for contusion glaucoma of the right eye (case 1) underwent surgical tube trimming with a DMEK procedure. A 54-year-old male with Descemet stripping automated endothelial keratoplasty (DSAEK) failure and dislocation in the presence of an Ahmed glaucoma valve and an artificial iris in the right eye (case 2) was treated by removal of the DSAEK graft and subsequent DMEK procedure...
September 2013: Optometry and Vision Science: Official Publication of the American Academy of Optometry
Sonja Heinzelmann, Daniel Böhringer, Philip C Maier, Thomas Reinhard
PURPOSE: Descemet-stripping automated endothelial keratoplasty (DSAEK) is an advanced method of lamellar endothelial keratoplasty. In comparison with penetrating keratoplasty, visual rehabilitation seems to be faster. Final visual outcome of DSAEK, however, seems to be limited, especially in comparison with Descemet membrane endothelial keratoplasty (DMEK). DSAEK cases without graft failure often do not show any definite correlate for the reduced optical performance. In this study, we tried to correlate visual acuity following DSAEK with interface reflectivity as measured by a rotating Scheimpflug system...
February 2014: Acta Ophthalmologica
Philipp Eberwein, Susanne Issleib, Daniel Böhringer, Hans Mittelviefhaus, Johannes Schwartzkopff, Juergen Finke, Thomas Reinhard
PURPOSE: To assess the expression of human leucocyte antigen (HLA)-DR in epithelial cells and cluster of differentiation (CD8)-positive lymphocytes as possible markers of chronic ocular graft versus host disease (cGvHD) after hematological stem cell transplantation (HSCT). METHODS: Twenty-seven consecutive patients with dry-eye symptoms following HSCT (24 [89%] with peripheral blood stem cell transplantation and 3 [11%] with bone marrow transplants; 17 [63%] familiar allogenic grafts) and 19 age-matched controls were included...
2013: Molecular Vision
Florian Birnbaum, Antonia Wiggermann, Philip C Maier, Daniel Böhringer, Thomas Reinhard
BACKGROUND: Postoperative astigmatism following penetrating keratoplasty is a major problem after corneal transplantation. The main goal of new trephination techniques such as femtosecond laser or excimer-laser trephination is to improve refractive and visual outcomes. The femtosecond laser technique makes profiled corneal trephinations such as the top hat or mushroom profile possible. We present the postoperative outcome of femtosecond laser-assisted penetrating keratoplasties. METHODS: We performed 123 femtosecond laser-assisted penetrating keratoplasties in 119 patients...
January 2013: Graefe's Archive for Clinical and Experimental Ophthalmology
Philipp Eberwein, Daniel Böhringer, Johannes Schwartzkopff, Florian Birnbaum, Thomas Reinhard
OBJECTIVE: To present the technique and report the results of up to 36 months after allogenic central penetrating limbo-keratoplasty in conjunction with conjunctivoplasty, mitomycin C (MMC), and amniotic membrane (AM) transplantation in patients with bilateral limbal stem cell deficiency (LSCD). DESIGN: Retrospective, consecutive subject cohort study. PARTICIPANTS: Case records of 20 eyes from 20 patients who presented with bilateral LSCD due to aniridia, chemical/thermal burn, cicatrizing pemphigoid, and chronic ocular surface inflammation and who were treated at the University Eye Hospital, Freiburg...
May 2012: Ophthalmology
Tina Dietrich-Ntoukas, Claus Cursiefen, Henrike Westekemper, Philipp Eberwein, Thomas Reinhard, Hartmut Bertz, Johannes Nepp, Anita Lawitschka, Arnd Heiligenhaus, Berthold Seitz, Elisabeth M Messmer, Tobias Meyer-ter-Vehn, Nadezda Basara, Hildegard Greinix, Manuel B Datiles, Stephanie J Lee, Steven Z Pavletic, Daniel Wolff
PURPOSE: Ocular chronic graft-versus-host disease (cGVHD) is one of the most frequent long-term complications after hematopoietic stem cell transplantation and is often associated with significant morbidity and reduced quality of life. METHODS: The German/Austrian/Swiss Consensus Conference on Clinical Practice in cGVHD aimed to summarize the currently available evidence for diagnosis and (topical) treatment and to summarize different treatment modalities of ocular cGVHD...
March 2012: Cornea
P Eberwein, T Reinhard
The transplantation of limbal stem cells is one of the most challenging surgical approaches in ocular surface reconstruction. Partial and unilateral limbal stem cell insufficiency (LSCI) can be treated by fractionated abrasion or autologous limbal stem cell transplantation from the fellow eye. In cases of advanced bilateral and partial LSCI, ex vivo expansion of limbal stem cells on amniotic membranes or fibrin can be performed but all patients with complete bilateral LSCI must rely on allogenic limbal stem cell transplantation with high immunological risks...
September 2011: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
F Birnbaum, P Maier, T Reinhard
The femtosecond laser technique allows completely new trephination methods in penetrating keratoplasty with profiles in the graft and the host cornea. The most common so-called profiled trephinations are the top hat and mushroom profiles. Due to the profile it is easier to get a watertight wound closure intraoperatively and due to the larger wound surface the wound healing is faster and more stable. This will possibly allow an earlier suture removal with final visual rehabilitation. First clinical results show that femtosecond laser-assisted penetrating keratoplasty is a safe surgical procedure...
February 2010: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
P Maier, A Broszinski, U Heizmann, T Reinhard
PURPOSE: The secretion of transforming growth factor (TGF)-beta (2) into the aqueous humour is important for maintaining the immunological privilege of the anterior ocular segment that promotes corneal allograft survival. Levels of total TGF-beta (2), however, were similar in eyes with and without immune reactions following penetrating keratoplasty (PK). In this study, we tested the hypothesis whether the activated form of TGF-beta (2) is decreased in eyes with immune reactions following PK...
April 2008: Eye
Daniel Böhringer, Thomas Reinhard, Rainer Sundmacher
BACKGROUND: Influencing factors on medium-term and long-term clear graft survival following penetrating keratoplasty are mostly basically known but their quantitative importance and interaction are far less well established. Due to abundance and complex interaction of influencing factors, comprehensive collection of pre- and postoperative data is imperative. Furthermore, application of stringent quality control as addressed in the German transplantation law established in 1997 is only possible if comprehensive data are available within a database system...
April 2003: Klinische Monatsblätter Für Augenheilkunde
Thomas Reinhard, Alexander Reis, Susanne Mayweg, Hermann Oberhuber, Georg Mathis, Rainer Sundmacher
BACKGROUND: Topical corticosteroids are the only effective measure in serious inflammatory corneal and conjunctival diseases. Although results obtained with topical cyclosporin A are encuraging it is not effective in all patients. The mode of action of Fk506 is similar to that of cyclosporin A, i.e. it exerts an inhibitory effect on transcription of interleukin 2 in T lymphocytes. The immunosuppressive potential of Fk506, however, is much larger. Furthermore, it penetrates more easily into cornea and conjunctiva...
March 2002: Klinische Monatsblätter Für Augenheilkunde
T Reinhard, D Böhringer, R Sundmacher
PURPOSE: Accelerated chronic endothelial cell loss may be the main reason for limited prognosis of penetrating corneal grafts in glaucoma eyes. This hypothesis, however, has not yet been proven and is examined in this article. METHODS: Three groups of normal-risk keratoplasty patients were followed up prospectively. Group I consisted of 172 patients (without glaucoma history and without postoperative increase in intraocular pressure), group II comprised 15 patients (with glaucoma history, but without postoperative increase in intraocular pressure), and group III consisted of seven patients (with glaucoma history and with postoperative increase in intraocular pressure)...
December 2001: Journal of Glaucoma
F E Kruse, T Reinhard
Proliferation of the corneal epithelium originates in undifferentiated, long-lived stem cells that are located in the basal limbal epithelium. Stem cells are important for corneal epithelial regeneration and wound healing. Depletion of stem cells due to accidents as well as malfunctions of stem cells due to inborn or inflammatory diseases result in limbal stem cell deficiency. Limbal deficiency is characterized by conjunctivalization of the cornea with vascularization and opacification. Partial limbal deficiency can be treated by removing ingrown conjunctival epithelium thus allowing normal limbal epithelium to repopulate the cornea...
September 2001: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
A Reis, T Reinhard, R Sundmacher, C Althaus, A Voiculescu, B Kutkuhn
BACKGROUND: Up to now ophthalmologists have only a small number of substances in their therapeutic armamentarium for the treatment of ocular immunological disorders. These are very potent agents, and any rapidly proliferating cells are extremely sensitive to such agents, thus the possibility of severe side effects is great. Mycophenolatemofetil (MMF) has been shown to be effective in preventing acute graft rejection following clinical renal and cardiac transplantation with a low risk of adverse events...
November 1998: Klinische Monatsblätter Für Augenheilkunde
T Reinhard, C Kallmann, A Cepin, E Godehardt, R Sundmacher
BACKGROUND: It was the purpose of this retrospective study to evaluate the effect of a preoperative history of glaucoma on graft survival after penetrating keratoplasty. PATIENTS AND METHODS: Six hundred and forty-six penetrating keratoplasties with generally good prognosis were analyzed retrospectively. Indications for surgery were corneal dystrophy, degeneration and scarring. Only first keratoplasties in corneas without severe vascularization or acute inflammation were included...
September 1997: Graefe's Archive for Clinical and Experimental Ophthalmology
R Sundmacher, T Reinhard
BACKGROUND: Severe stem cell deficiencies uniformly lead to superficial conjunctivalization of corneal grafts with subsequent functional failure. We sought better long-term results by transplanting central corneolimbal grafts and simultaneously protecting the graft and its stem cells from immunological destruction by means of systemic administration of ciclosporin A. PATIENTS AND METHODS: In an ongoing pilot study, up to April 1995 20 eyes with stem cell dysfunctions of various etiology (e...
August 1996: Graefe's Archive for Clinical and Experimental Ophthalmology
T Reinhard, R Sundmacher, P Heering
BACKGROUND: It was the purpose of this study to compile the results of all high-risk keratoplasties (kp) performed in our hospital under systemic ciclosporin A (Ci A) cover from 1987 through 1994. METHODS: One hundred and thirty-one keratoplasties were performed. Ci A was administered for an average period of 9.4 months. We aimed at trough levels of 100-150 ng/ml (monoclonal RIA/TDx). The 29 kp in group A were second or third repeat kp and/or the recipient cornea had severe deep vascularization in all quadrants and/or a transplant position at the limbus was inevitable (expected risk: only immune reactions)...
August 1996: Graefe's Archive for Clinical and Experimental Ophthalmology
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