Phototherapeutic keratectomy for anterior stromal fibrosis following DMEK

Maier, Philip; Reinhard, Thomas

doi:10.1016/j.ajoc.2020.100849

Cited by 2 publications

(1 citation statement)

References 7 publications

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“…There are 3 published case reports that showed an increase in visual acuity, when performing PTK after DMEK 16 or DSEK. 17,18 In addition, there was 1 study including 10 eyes that analyzed the visual outcomes of PTK after DSEK.…”

Section: Discussionmentioning

confidence: 99%

Excimer Laser Phototherapeutic Keratectomy for Anterior Corneal Opacification After Descemet Membrane Endothelial Keratoplasty

Vernin,

Schrittenlocher,

Matthaei

et al. 2023

Cornea

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Purpose: The aim of this study was to assess the long-term outcome of excimer laser phototherapeutic keratectomy (PTK) for treating remaining anterior corneal opacities after Descemet membrane endothelial keratoplasty (DMEK). Methods: This cohort study analyzed 67 eyes of 66 patients undergoing PTK in addition to and after DMEK between 2012 and 2021 at the Department of Ophthalmology, University of Cologne. Patients who were treated by PTK after previous DMEK on the same eye were included. The outcome parameters were best corrected visual acuity (BCVA), changes in refraction, endothelial cell density, corneal densitometry, central corneal thickness, and total corneal higher order aberrations. Patients with visual limitations in addition to anterior opacification were analyzed separately for their visual outcome. Eyes with severe visual limitations that have a very limited visual potential were excluded from the study. In addition, patients with not at least 1 postoperative follow-up examination were excluded from the study. Results: In this study, 67 eyes of 66 patients met all inclusion criteria. The median follow-up period was 13.1 (quartiles: 4.1; 30.7; interquartile range 26.6) months. The mean (±SD) BCVA improved from (logarithm of the minimum angle of resolution) 0.54 (±0.32) to 0.38 (±0.27) at the first postoperative visit (P < 0.001) and remained significantly improved at all follow-up examinations compared with preoperative BCVA. Refraction and endothelial cell density did not change significantly after PTK. There was a significant decrease in corneal backscatter in the anterior corneal layer (P < 0.001), and the total higher order aberration (P = 0.02) and central corneal thickness were significantly reduced at the most recent postoperative visit (P < 0.001). No immune reactions were observed. Conclusions: Excimer laser PTK after DMEK for persisting anterior corneal opacities has the potential to significantly improve patients’ vision without affecting refractive parameters or endothelial cell density.

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Section: Discussionmentioning

confidence: 99%

Excimer Laser Phototherapeutic Keratectomy for Anterior Corneal Opacification After Descemet Membrane Endothelial Keratoplasty

Vernin,

Schrittenlocher,

Matthaei

et al. 2023

Cornea

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Handling regular and irregular astigmatism during cataract surgery

Hardten

2020

Current Opinion in Ophthalmology

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Purpose of review There are several different approaches to handling regular and irregular astigmatism during cataract surgery, but still much debate on which solutions are most effective given unique patient circumstances. In this review, we examine recent literature and studies to highlight some of the most effective ways to plan preoperatively, manage regular and irregular astigmatism during cataract surgery, as well as managing postoperative complications. Recent findings Recent developments in technology have provided increased courses of action for astigmatism management during cataract surgery. Additional options of toric IOLs with presbyopic platforms, light adjustable lenses, intraocular pinhole lenses, online technological tools and platforms, wavefront or topographic laser technology, and phototherapeutic keratectomy are all effective solutions to managing regular and irregular astigmatism. In this review, we will explore optimal approaches for unique situations. Summary With increased technology, research, and methods, correcting regular and irregular astigmatism during cataract surgery is achievable in most patients. With in-depth preoperative planning, analysis of patient-specific factors, and a tailored approach, surgeons can obtain excellent uncorrected vision for patients.

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Phototherapeutic keratectomy for anterior stromal fibrosis following DMEK

Cited by 2 publications

References 7 publications

Excimer Laser Phototherapeutic Keratectomy for Anterior Corneal Opacification After Descemet Membrane Endothelial Keratoplasty

Excimer Laser Phototherapeutic Keratectomy for Anterior Corneal Opacification After Descemet Membrane Endothelial Keratoplasty

Handling regular and irregular astigmatism during cataract surgery

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