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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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Mai C, Bergholz R, Bertelmann E. Mundschleimhauttransplantation in der Augenheilkunde. Klin Monbl Augenheilkd 2013. [DOI: 10.1055/s-0033-1363360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [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] [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] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Brockmann T, Brockmann C, Maier AK, Schroeter J, Pleyer U, Bertelmann E, Joussen AM, Torun N. Pathomechanismen der Transplantatablösung nach Descemet's membrane endothelial keratoplasty (DMEK). Klin Monbl Augenheilkd 2013. [DOI: 10.1055/s-0033-1363399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Brockmann T, Brockmann C, Nietzsche S, Bertelmann E, Strobel J, Dawczynski J. Scanning electron microscopic characteristics of commercially available 1- and 3-piece intraocular lenses. J Cataract Refract Surg 2013; 39:1893-9. [DOI: 10.1016/j.jcrs.2013.04.046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Gonnermann J, Maier AKB, Klein JP, Bertelmann E, Pleyer U, Klamann MKJ. Evaluation of Ocular Surface Temperature in Patients with Pterygium. Curr Eye Res 2013; 39:359-64. [PMID: 24215483 DOI: 10.3109/02713683.2013.844262] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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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] [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] [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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Erb-Eigner K, Warmuth C, Taupitz M, Willerding G, Bertelmann E, Asbach P. Impact of magnetic field strength and receiver coil in ocular MRI: a phantom and patient study. ROFO-FORTSCHR RONTG 2013; 185:830-7. [PMID: 23888471 DOI: 10.1055/s-0033-1335796] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE Generally, high-resolution MRI of the eye is performed with small loop surface coils. The purpose of this phantom and patient study was to investigate the influence of magnetic field strength and receiver coils on image quality in ocular MRI. MATERIALS AND METHODS The eyeball and the complex geometry of the facial bone were simulated by a skull phantom with swine eyes. MR images were acquired with two small loop surface coils with diameters of 4 cm and 7 cm and with a multi-channel head coil at 1.5 and 3 Tesla, respectively. Furthermore, MRI of the eye was performed prospectively in 20 patients at 1.5 Tesla (7 cm loop surface coil) and 3 Tesla (head coil). These images were analysed qualitatively and quantitatively and statistical significance was tested using the Wilcoxon-signed-rank test (a p-value of less than 0.05 was considered to indicate statistical significance). RESULTS The analysis of the phantom images yielded the highest mean signal-to-noise ratio (SNR) at 3 Tesla with the use of the 4 cm loop surface coil. In the phantom experiment as well as in the patient studies the SNR was higher at 1.5 Tesla by applying the 7 cm surface coil than at 3 Tesla by applying the head coil. Concerning the delineation of anatomic structures no statistically significant differences were found. CONCLUSION Our results show that the influence of small loop surface coils on image quality (expressed in SNR) in ocular MRI is higher than the influence of the magnetic field strength. The similar visibility of detailed anatomy leads to the conclusion that the image quality of ocular MRI at 3 Tesla remains acceptable by applying the head coil as a receiver coil.
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Mai C, Bertelmann E. Oral mucosal grafts: old technique in new light. Ophthalmic Res 2013; 50:91-8. [PMID: 23838636 DOI: 10.1159/000351631] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Accepted: 03/27/2013] [Indexed: 11/19/2022]
Abstract
PURPOSE To present an update on indications and efficacy of oral mucosal grafts in the clinical management of ocular surface diseases focusing on the new developments of the last 5 years. METHODS Pubmed research on the databases of the years 2007 up to 2012 for the key words mucous membrane graft and eye, fornix reconstruction, eyelid reconstruction, and conjunctival replacement. RESULTS Well-documented clinical indications for oral mucosal grafting to the ocular surface include correction of restricted socket syndrome, ocular adnexal reconstruction after tumor resection, cicatricial ocular surface diseases and therapy-refractory pterygia. New indications are conjunctival insufficiency after filtrating glaucoma surgery and the combination of mucosa and amniotic membrane grafting for fornix reconstruction. Moreover, different strategies for ex vivo mucous epithelial cell expansion are under discussion. CONCLUSIONS Oral mucosal grafting is a viable option for the replacement of the conjunctiva. Advantages include easily accessibility of grafts in sufficient size even for repeated procedures and a high stability of the grafts. On the other hand, nasal mucosal grafts are superior for some indications due to the lack of goblet cells in the oral mucosa.
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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] [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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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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Bertelmann E, Torun N, Pleyer U. [Present state of the art in topical and systemic immunosuppression after keratoplasty]. Klin Monbl Augenheilkd 2013; 230:505-11. [PMID: 23695847 DOI: 10.1055/s-0032-1328549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Today MMF can be considered as standard treatment besides cyclosporin A for immunosuppression after high-risk perforating keratoplasty. The efficacy of systemic MMF for this indication has been documented in several clinical studies including multicentre designs. Whether or not MPA therapy offers further advantages is currently under discussion. Sirolimus and tacrolimus are effective but could not achieve clinical importance due to higher rates of side effects. An additional benefit of combination therapies is not proven by clinical studies up to date. Everolimus shows pre-clinically a promising immunosuppressive and antiproliferative effect. Topical preparations of immunosuppressants as monotherapy are obviously insufficient as alternatives for systemic immunosuppressive therapy. Whether or not topical combination therapies will become established as alternatives to systemic treatment has to be demonstrated in the following years.
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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] [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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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: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [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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Mai C, Bertelmann E. Mundschleimhauttransplantation in der Augenheilkunde – alte Technik in neuem Licht. Klin Monbl Augenheilkd 2012. [DOI: 10.1055/s-0032-1331516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Klein JP, Waffenschmidt E, Bertelmann E. Auswertung des postoperativen Verlaufs des MICS Zuganges bei Cataract-Operationen im Kindesalter. Klin Monbl Augenheilkd 2012. [DOI: 10.1055/s-0032-1331562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Bertelmann E, Mai C. Benigne Neoplasien der Orbita: Chirurgische Ergebnisse am CVK über 7 Jahre. Klin Monbl Augenheilkd 2012. [DOI: 10.1055/s-0032-1331542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Gonnermann J, Klamann MKJ, Maier AK, Joussen AM, Bertelmann E, Rieck P, Torun N. Ergebnisse einer irisfixierten Hinterkammer-Intraokularlinse (inverse Verisyse®). Klin Monbl Augenheilkd 2012. [DOI: 10.1055/s-0032-1331531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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97
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Torun N, Schroeter J, Eulufi C, Bertelmann E, Brockmann M, Maier AK. 1 Jahres Ergebnisse der Descemet-Membran Endothelkeratoplastik (DMEK) an der Augenklinik Charité. Klin Monbl Augenheilkd 2012. [DOI: 10.1055/s-0032-1331527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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98
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Klamann MKJ, Gonnermann J, Maier AKB, Ruokonen PC, Torun N, Bertelmann E. Kombinierte Clear-Cornea-Phakoemulsifikation in der Behandlung des Pseudoexfoliationsglaukoms: Stellenwert der Trabekelaspiration und der Trabekulotomie ab interno (Trabectome). Klin Monbl Augenheilkd 2012. [DOI: 10.1055/s-0032-1331547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Gonnermann J, Klamann MK, Maier AK, Rjasanow J, Joussen AM, Bertelmann E, Rieck PW, Torun N. Visual outcome and complications after posterior iris-claw aphakic intraocular lens implantation. J Cataract Refract Surg 2012; 38:2139-43. [PMID: 23036355 DOI: 10.1016/j.jcrs.2012.07.035] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2012] [Revised: 07/28/2012] [Accepted: 07/31/2012] [Indexed: 10/27/2022]
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Klamann MKJ, Maier AKB, Gonnermann J, Klein JP, Bertelmann E, Pleyer U. Ocular surface temperature gradient is increased in eyes with bacterial corneal ulcers. Ophthalmic Res 2012; 49:52-6. [PMID: 23154469 DOI: 10.1159/000343774] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2012] [Accepted: 08/28/2012] [Indexed: 11/19/2022]
Abstract
AIMS To investigate the ocular surface temperature gradient in eyes with bacterial corneal ulcers. METHODS Prospective examination of 12 eyes with bacterial corneal ulcers (group 1) and 12 control eyes (group 2). Infrared thermal imaging (Tomey TG 1000) was used to study the temperature of the ocular surface. The mean, minimum and maximum temperature of the ocular surface and temperature course over a time period of 10 s of sustained eye opening were evaluated. Furthermore, a correlation between the overall corneal temperature and the temperature at the base of the corneal ulcers was determined. RESULTS A significant difference between both groups was present. Mean corneal temperature was 35.6°C ± 0.9 in group 1 and 34.8°C ± 0.8 in group 2 (p = 0.033). The temperature course over 10 s of sustained eye opening was -0.6°C ± 0.4 in group 1 and -0.3°C ± 0.2 in group 2 (p = 0.045). There was a close correlation between the mean temperature at the base of the corneal ulcer and the overall corneal temperature (r = 0.92, p < 0.001). CONCLUSION Infrared thermal imaging can be used to objectively determine the increased ocular surface temperature in patients with bacterial corneal ulcers. The use of dynamic thermography may offer new options to monitor ocular surface alterations.
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