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Kecik M, Kropp M, Thumann G, Pajic B, Guber J, Guber I. Intradevice Repeatability and Interdevice Comparison of Two Specular Microscopy Devices in a Real-Life Setting: Tomey EM-4000 and Nidek CEM-530. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1110. [PMID: 39064539 PMCID: PMC11278872 DOI: 10.3390/medicina60071110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 06/28/2024] [Accepted: 07/02/2024] [Indexed: 07/28/2024]
Abstract
Background and Objectives: The purpose of this study was to compare two commercially available specular microscopes (Tomey EM-4000 and Nidek CEM-530) in a real-life clinical setting in terms of intra- and interdevice variability. The study was conducted on all patients seen in a clinical practice specializing in anterior segment pathologies, regardless of the purpose of their visit. Materials and Methods: In total, 112 eyes of 56 patients (age 23-85 years old) were included in the study. Each eye was measured three times with each device (for a total of six measurements), and results for central corneal thickness (CCT) and corneal endothelial cell density (ECD) were recorded. The results were then evaluated with the D'Agostino-Pearson normality test and compared with a Wilcoxon signed-rank test, t-test, ANOVA or Mann-Whitney test for intra- and interdevice variability. Results: Both specular microscopes produced very reliable reproducible intradevice results: The Tomey EM-4000 measured an ECD of 2390 ± 49.57 cells/mm2 (mean ± standard error of mean); the range was 799-3010 cells/mm2. The determined CCT was 546 ± 5.104 µm (mean ± standard error of mean [SEM]); the range was 425-615 µm. The measurements with the Nidek CEM-530 revealed an ECD of 2417 ± 0.09 cells/mm2 (mean ± SEM); the range was 505-3461 cells/mm2 (mean ± SEM). The mean CCT detected was 546.3 ± 4.937 µm (mean ± SEM); the range was 431-621 µm. The interdevice differences were statistically significant for both parameters, ECD (p = 0.0175) and CCT (p = 0.0125) (p < 0.05). Conclusions: The Nidek CEM-530 and the Tomey EM-4000 both produced reliable and reproducible results in terms of ECD and CCT. The absolute measurements were statistically significantly different for CCT and ECD for both devices; the Nidek produces slightly higher values.
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Affiliation(s)
- Mateusz Kecik
- Department of Ophthalmology, University of Geneva, 1205 Geneva, Switzerland; (M.K.); (M.K.); (G.T.); (B.P.)
- Experimental Ophthalmology, University of Geneva, 1205 Geneva, Switzerland
| | - Martina Kropp
- Department of Ophthalmology, University of Geneva, 1205 Geneva, Switzerland; (M.K.); (M.K.); (G.T.); (B.P.)
- Experimental Ophthalmology, University of Geneva, 1205 Geneva, Switzerland
| | - Gabriele Thumann
- Department of Ophthalmology, University of Geneva, 1205 Geneva, Switzerland; (M.K.); (M.K.); (G.T.); (B.P.)
- Experimental Ophthalmology, University of Geneva, 1205 Geneva, Switzerland
| | - Bojan Pajic
- Department of Ophthalmology, University of Geneva, 1205 Geneva, Switzerland; (M.K.); (M.K.); (G.T.); (B.P.)
- Experimental Ophthalmology, University of Geneva, 1205 Geneva, Switzerland
- Eye Clinic ORASIS, Swiss Eye Research Foundation, 5734 Reinach, Switzerland
- Faculty of Sciences, Department of Physics, University of Novi Sad, Trg Dositeja Obradovica 4, 21000 Novi Sad, Serbia
- Faculty of Medicine of the Military Medical Academy, University of Defense, 11000 Belgrade, Serbia
| | - Josef Guber
- Department of Ophthalmology, University of Basel, 4001 Basel, Switzerland;
| | - Ivo Guber
- Department of Ophthalmology, University of Geneva, 1205 Geneva, Switzerland; (M.K.); (M.K.); (G.T.); (B.P.)
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Yang S, Zhang J, Tan Y, Wang Y. Unraveling the mechanobiology of cornea: From bench side to the clinic. Front Bioeng Biotechnol 2022; 10:953590. [PMID: 36263359 PMCID: PMC9573972 DOI: 10.3389/fbioe.2022.953590] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 09/06/2022] [Indexed: 11/18/2022] Open
Abstract
The cornea is a transparent, dome-shaped structure on the front part of the eye that serves as a major optic element and a protector from the external environment. Recent evidence shows aberrant alterations of the corneal mechano-environment in development and progression of various corneal diseases. It is, thus, critical to understand how corneal cells sense and respond to mechanical signals in physiological and pathological conditions. In this review, we summarize the corneal mechano-environment and discuss the impact of these mechanical cues on cellular functions from the bench side (in a laboratory research setting). From a clinical perspective, we comprehensively review the mechanical changes of corneal tissue in several cornea-related diseases, including keratoconus, myopia, and keratectasia, following refractive surgery. The findings from the bench side and clinic underscore the involvement of mechanical cues in corneal disorders, which may open a new avenue for development of novel therapeutic strategies by targeting corneal mechanics.
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Affiliation(s)
- Shu Yang
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China
- Tianjin Eye Institute, Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Hospital, Tianjin, China
- Department of Ophthalmology, The First People’s Hospital of Huzhou, Huzhou, Zhejiang, China
| | - Jing Zhang
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China
- Tianjin Eye Institute, Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Hospital, Tianjin, China
- School of Optometry, Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Youhua Tan
- Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
- Department of Biomedical Engineering, Hong Kong Polytechnic University, Hong Kong SAR, China
- *Correspondence: Youhua Tan, ; Yan Wang,
| | - Yan Wang
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China
- Tianjin Eye Institute, Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Hospital, Tianjin, China
- *Correspondence: Youhua Tan, ; Yan Wang,
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Liu YC, Morales-Wong F, Patil M, Han SB, Lwin NC, Teo EPW, Ang HP, Yussof NZM, Mehta JS. Femtosecond laser-assisted corneal transplantation with a low-energy, liquid-interface system. Sci Rep 2022; 12:6959. [PMID: 35484198 PMCID: PMC9050694 DOI: 10.1038/s41598-022-11461-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 04/25/2022] [Indexed: 11/26/2022] Open
Abstract
Femtosecond laser-assisted keratoplasty has been proposed as a treatment option for corneal transplantation. In this study, we investigated and compared the outcomes of Ziemer Z8 femtosecond laser (FSL)-assisted penetrating keratoplasty (PK) using a liquid interface versus flat interface. Thirty fresh porcine eyes underwent FSL-assisted PK with the Z8 using different levels of energies (30%, 90% or 150%) and different interfaces (liquid or flat). The real-time intraocular pressure (IOP) changes, incision geometry, corneal endothelial damage, as well as the accuracy of laser cutting and tissue reaction, were performed and compared. We found that the overall average IOP at all laser trephination stages was significantly higher with the flat interface, regardless of the energy used (68.9 ± 15.0 mmHg versus 46.1 ± 16.6 mmHg; P < 0.001). The overall mean laser-cut angle was 86.2º ± 6.5º and 88.2º ± 1.0º, for the liquid and flat platform respectively, indicating minimal deviation from the programmed angle of 90º. When high energy (150%) was used, the endothelial denuded area was significantly greater with the flat interface than with liquid interface (386.1 ± 53.6 mm2 versus 139.0 ± 10.4 mm2P = 0.02). The FSL cutting did not cause obvious tissue reaction alongside the laser cut on histological evaluation. The results indicated a liquid interface is the preferable choice in FSL-assisted corneal transplantation.
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Affiliation(s)
- Yu-Chi Liu
- Tissue Engineering and Cell Therapy Group, Singapore Eye Research Institute, The Academia, 20 College Road, Discovery Tower, Level 6, Singapore, 169856, Singapore. .,Cornea and Refractive Surgery Group, Singapore Eye Research Institute, Singapore, Singapore. .,Cornea and External Eye Diseases, Singapore National Eye Centre, Singapore, Singapore. .,Duke-NUS Graduate Medical School, Ophthalmology Academic Clinical Program, Singapore, Singapore.
| | - Fernando Morales-Wong
- Tissue Engineering and Cell Therapy Group, Singapore Eye Research Institute, The Academia, 20 College Road, Discovery Tower, Level 6, Singapore, 169856, Singapore.,Cornea and External Eye Diseases, Singapore National Eye Centre, Singapore, Singapore.,Faculty of Medicine, University Hospital "Dr Jose Eleuterio Gonzalez", Autonomous University of Nuevo Leon, San Nicolás de los Garza, Mexico
| | - Moushmi Patil
- Cornea and External Eye Diseases, Singapore National Eye Centre, Singapore, Singapore
| | - Sang Beom Han
- Department of Ophthalmology, Kangwon National University School of Medicine, Kangwon National University Hospital, Chuncheon-si, Republic of Korea
| | - Nyein C Lwin
- Tissue Engineering and Cell Therapy Group, Singapore Eye Research Institute, The Academia, 20 College Road, Discovery Tower, Level 6, Singapore, 169856, Singapore
| | - Ericia Pei Wen Teo
- Tissue Engineering and Cell Therapy Group, Singapore Eye Research Institute, The Academia, 20 College Road, Discovery Tower, Level 6, Singapore, 169856, Singapore
| | - Heng Pei Ang
- Tissue Engineering and Cell Therapy Group, Singapore Eye Research Institute, The Academia, 20 College Road, Discovery Tower, Level 6, Singapore, 169856, Singapore
| | - Nur Zah M Yussof
- Tissue Engineering and Cell Therapy Group, Singapore Eye Research Institute, The Academia, 20 College Road, Discovery Tower, Level 6, Singapore, 169856, Singapore
| | - Jodhbir S Mehta
- Tissue Engineering and Cell Therapy Group, Singapore Eye Research Institute, The Academia, 20 College Road, Discovery Tower, Level 6, Singapore, 169856, Singapore.,Cornea and Refractive Surgery Group, Singapore Eye Research Institute, Singapore, Singapore.,Cornea and External Eye Diseases, Singapore National Eye Centre, Singapore, Singapore.,Duke-NUS Graduate Medical School, Ophthalmology Academic Clinical Program, Singapore, Singapore
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