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Pahlitzsch M, Davids AM, Winterhalter S, Zorn M, Reitemeyer E, Klamann MKJ, Torun N, Bertelmann E, Maier AK. Selective Laser Trabeculoplasty Versus MIGS: Forgotten Art or First-Step Procedure in Selected Patients with Open-Angle Glaucoma. Ophthalmol Ther 2021; 10:509-524. [PMID: 33963524 PMCID: PMC8319229 DOI: 10.1007/s40123-021-00347-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 04/24/2021] [Indexed: 01/04/2023] Open
Abstract
Introduction To evaluate the long-term effect on intraocular pressure (IOP) and glaucoma medication of selective laser trabeculoplasty (SLT) compared to minimally invasive glaucoma surgery (MIGS) in primary open-angle glaucoma (POAG) and its potential in clinical practice. Methods A total of 342 consecutive patients (stand-alone procedures) were included. One hundred and five patients underwent SLT treatment (360° SLT, 95–105 spots, Trabeculas SLT ARCLaser, Nürnberg, DE), 107 patients had an ab interno-derived trabeculotomy (Trabectome®, NeoMedix, Tustin, USA), and 130 patients received iStent inject® implantation (2 implants-Glaukos, CA, USA). IOP and glaucoma therapy were evaluated preoperatively, 1 day, 6 weeks, 3 months, 6 months, and 1, 2, and 3 years postoperatively. Statistical analysis was performed using a regression model and propensity matching score (reduced cohort number) using SPSS v20.0. Kaplan–Meier analysis was included using the following six criteria: criterion A (IOP ≤ 21 mmHg with or without medication, qualified success), criterion B (IOP ≤ 18 mmHg with or without medication, qualified success), criterion C (IOP ≤ 21 mmHg without medication, complete success), criterion D (IOP ≤ 18 mmHg without medication, complete success), criterion E (IOP ≤ 21 mmHg and IOP reduction > 20% after therapy), and criterion F (IOP ≤ 18 mmHg and IOP reduction > 20% after therapy). Results In the matched cohort, the SLT cohort showed an IOP reduction of 31.2% from 19.9 ± 2.3 to 13.7 ± 2.7 mmHg (p < 0.001) 3 years postoperatively; in Trabectome® IOP decreased by 31.4% from 20.5 ± 1.3 to 13.8 ± 2.0 mmHg (p < 0.001) and in iStent inject® by 29.9% from 19.5 ± 2.0 to 13.8 ± 2.7 mmHg (p < 0.001). Trabectome® and iStent inject® could not demonstrate a significant reduction in glaucoma therapy (Trabectome®p = 0.138, iStent inject®p = 0.612); a significant drop was noted in SLT (2.2 ± 1.2 to 1.7 ± 1.2, p = 0.046). SLT and MIGS achieved good to moderate survival rates using criterion A (93.3% SLT, 79.7% Trabectome®, 77.6% iStent inject®) and criterion B (74.5% SLT, 48.0% Trabectome®, 56.2% iStent inject®). As expected, low survival rates were obtained with non-filtering procedures: criterion C 11.1% in SLT, 6.5% in Trabectome®, 7.0% in iStent inject® and criterion D 3.0% in SLT, 4.3% in Trabectome®, 3.7% in iStent inject® in 3-year follow-up. Conclusion The SLT is a low-complication and effective method for reducing pressure in mild to moderate POAG. SLT is suitable as an initial procedure when setting up a step scheme; MIGS is the treatment of choice as a follow-up for mild to moderate forms of glaucoma and accepted topical therapy. Ethic approval had been given by the Ethikkommission Charité – Universitätsmedizin Berlin, EA4/047/20—retrospectively registered. Supplementary Information The online version contains supplementary material available at 10.1007/s40123-021-00347-0.
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Affiliation(s)
- Milena Pahlitzsch
- Department of Ophthalmology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
| | - Anja-Maria Davids
- Department of Ophthalmology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Sibylle Winterhalter
- Department of Ophthalmology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Malte Zorn
- Department of Ophthalmology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Emanuel Reitemeyer
- Department of Ophthalmology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Matthias K J Klamann
- Department of Ophthalmology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Necip Torun
- Department of Ophthalmology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Eckart Bertelmann
- Department of Ophthalmology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Anna-Karina Maier
- Department of Ophthalmology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
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Maier AKB, Arani P, Pahlitzsch M, Davids AM, Pilger D, Klamann MKJ, Winterhalter S. Influence of Selective Laser Trabeculoplasty (SLT) on the iStent inject® outcomes. BMC Ophthalmol 2020; 20:457. [PMID: 33213403 PMCID: PMC7678109 DOI: 10.1186/s12886-020-01723-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 11/09/2020] [Indexed: 11/29/2022] Open
Abstract
Background To evaluate the influence of Selective Laser Trabeculoplasty (SLT) on iStent inject® outcomes in open-angle glaucoma (OAG). Methods In this retrospective comparative cohort outcome study, 66 patients who were treated with two iStent inject® devices were included. Patients were divided into two subgroups consisting of patients without SLT treatment prior to surgery and patients who had been treated previously with 360° SLT but without sufficient response. Outcome measures included intraocular pressure (IOP) and number of antiglaucoma medications after 6 weeks with three, six, 12, and 24 month follow-ups. Results Mean preoperative IOP decreased from 20.4 ± 5.3 mmHg to 14.8 ± 3.0 mmHg for patients without SLT treatment prior to surgery (p = 0.001) and from 19.2 ± 4.5 mmHg to 14.0 ± 1.6 mmHg for patients with insufficient response to 360° SLT treatment (p = 0.027) at 12 months after iStent inject® implantation. No significant difference was found between the two groups (p > 0.05). The number of antiglaucoma medications did not change in both groups (p > 0.05) and showed no significant difference between the two groups (p > 0.05). Conclusion Prior SLT treatment seems to have no negative influence on the IOP lowering-effect of iStent inject® implantation in patients with OAG. It is therefore an appropriate incremental procedure with no exclusion criterion for an iStent inject® implantation.
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Affiliation(s)
- Anna-Karina B Maier
- Department of Ophthalmology, Campus Virchow- Klinikum, Charité - University Medicine Berlin, corporate member of Freie Universität Berlin, Humboldt- Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.
| | - Parisa Arani
- Department of Ophthalmology, Campus Virchow- Klinikum, Charité - University Medicine Berlin, corporate member of Freie Universität Berlin, Humboldt- Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Milena Pahlitzsch
- Department of Ophthalmology, Campus Virchow- Klinikum, Charité - University Medicine Berlin, corporate member of Freie Universität Berlin, Humboldt- Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Anja-Maria Davids
- Department of Ophthalmology, Campus Virchow- Klinikum, Charité - University Medicine Berlin, corporate member of Freie Universität Berlin, Humboldt- Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Daniel Pilger
- Department of Ophthalmology, Campus Virchow- Klinikum, Charité - University Medicine Berlin, corporate member of Freie Universität Berlin, Humboldt- Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Matthias K J Klamann
- Department of Ophthalmology, Campus Virchow- Klinikum, Charité - University Medicine Berlin, corporate member of Freie Universität Berlin, Humboldt- Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Sibylle Winterhalter
- Department of Ophthalmology, Campus Virchow- Klinikum, Charité - University Medicine Berlin, corporate member of Freie Universität Berlin, Humboldt- Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
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Pahlitzsch M, Gonnermann J, Maier AKB, Bertelmann E, Klamann MKJ, Erb C. Modified goniotomy as an alternative to trabectome in primary open angle glaucoma and pseudoexfoliation glaucoma: 1 year results. Can J Ophthalmol 2016; 52:92-98. [PMID: 28237157 DOI: 10.1016/j.jcjo.2016.07.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 07/07/2016] [Accepted: 07/25/2016] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To assess the outcome of modified goniotomy and trabeculotomy ab interno (Trabectome) surgery in adult primary open-angle glaucoma (POAG) and pseudoexfoliation (PEX) glaucoma. DESIGN Retrospective cohort outcome study. PARTICIPANTS Two hundred and thirty-six eyes of 236 patients. METHODS This cohort outcome study included 68 POAG (mean age: 65.7 ± 16.0 years) and 22 PEX glaucoma patients (mean age: 78.3 ± 7.9 years) in the modified goniotomy cohort and 119 POAG (mean age: 73.9 ± 9.6 years) and 27 PEX glaucoma patients (mean age: 75.2 ± 8.0 years) in the Trabectome cohort. Modified goniotomy is defined as combined ab interno cyclodialysis and goniotomy. The patients were followed up for 12 months, and we analysed the data using SPSS v19.0. RESULTS In POAG, the intraocular pressure (IOP) was significantly reduced by 4.6 mm Hg in the Trabectome cohort (p < 0.001) and by 5.8 mm Hg (p < 0.001) in the goniotomy group at 1-year follow-up. In PEX glaucoma, the mean IOP was reduced by 9.7 mm Hg (p = 0.002) in the Trabectome surgery and by 6.7 mm Hg (p = 0.004) in the goniotomy cohort 1 year later. Comparing both surgery techniques in POAG, no significant correlation was found in terms of IOP at any of the follow-up visits (IOP at 1 year, p = 0.553). In PEX glaucoma, the IOP, visual acuity, and number of glaucoma medications did not differ significantly between the 2 surgery techniques 1 year later (IOP: p = 0.300; VA: p = 0.391; therapy: p = 0.908). CONCLUSION Modified goniotomy and Trabectome surgery are reliable and effective tools for the management of moderate POAG and PEX glaucoma. There was no significant difference in IOP between the 2 procedures over a follow-up period of 1 year.
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Affiliation(s)
- Milena Pahlitzsch
- University College London Institute of Ophthalmology, London, United Kingdom.
| | - Johannes Gonnermann
- Campus Virchow Clinic, Department of Ophthalmology, Charite University Medicine, Berlin, Germany
| | - Anna-Karina B Maier
- Campus Virchow Clinic, Department of Ophthalmology, Charite University Medicine, Berlin, Germany
| | - Eckart Bertelmann
- Campus Virchow Clinic, Department of Ophthalmology, Charite University Medicine, Berlin, Germany
| | - Matthias K J Klamann
- Campus Virchow Clinic, Department of Ophthalmology, Charite University Medicine, Berlin, Germany
| | - Carl Erb
- Eye Clinic Wittenbergplatz, Berlin, Germany
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Gonnermann J, Bertelmann E, Pahlitzsch M, Maier-Wenzel AKB, Torun N, Klamann MKJ. Contralateral eye comparison study in MICS & MIGS: Trabectome® vs. iStent inject®. Graefes Arch Clin Exp Ophthalmol 2016; 255:359-365. [PMID: 27815624 DOI: 10.1007/s00417-016-3514-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 08/17/2016] [Accepted: 10/03/2016] [Indexed: 10/20/2022] Open
Abstract
PURPOSE To compare the safety and efficacy profile after combined micro-incision cataract surgery (MICS) and micro-invasive glaucoma surgery (MIGS) with the ab interno trabeculectomy (Trabectome®) in one eye versus two iStent® inject devices in the contralateral eye in patients with open-angle glaucoma (OAG) and cataract. METHODS This retrospective, intraindividual eye comparison study included 27 patients (54 eyes) who were treated with combined MICS and ab interno trabeculectomy (group I, Trabectome®) in one eye and two iStent® inject devices (group II, GTS 400) in the fellow eye. Primary outcome measures included intraocular pressure (IOP) and glaucoma medication after 6 weeks, 3, 6, and 12 months follow-up. Secondary outcome measures were number of postoperative interventions, complications, and best-corrected visual acuity (BCVA). RESULTS Mean preoperative IOP decreased from 22.3 ± 3.7 mmHg in group I and 21.3 ± 4.1 mmHg in group II to 15.6 ± 3.6 mmHg for Trabectome (p < 0.001) and 14.0 ± 2.3 mmHg for iStent inject (p < 0.001) at 12 months after surgery without a significant difference between the two groups (p > 0.05). No vision-threatening complications such as choroidal effusion, choroidal hemorrhage, or infection occurred. In each group trabeculectomy had to be performed in two eyes due to insufficient IOP lowering effect. CONCLUSIONS Ab interno trabeculectomy and iStent® inject were both effective in lowering IOP with a favourable and comparable safety profile in an intraindividual comparative study over a 12-months follow-up in OAG. However, longer follow-up of these patients will be necessary to determine long-term outcomes and to evaluate significant differences.
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Affiliation(s)
- Johannes Gonnermann
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
| | - Eckart Bertelmann
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Milena Pahlitzsch
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Anna-Karina B Maier-Wenzel
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Necip Torun
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Matthias K J Klamann
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
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Pahlitzsch M, Torun N, Pahlitzsch ML, Klamann MKJ, Gonnermann J, Bertelmann E, Pahlitzsch T. Correlation between anterior chamber characteristics and laser flare photometry immediately after femtosecond laser treatment before phacoemulsification. Eye (Lond) 2016; 30:1110-7. [PMID: 27229702 DOI: 10.1038/eye.2016.110] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 04/15/2016] [Indexed: 11/10/2022] Open
Abstract
PurposeTo assess the anterior chamber (AC) characteristics and its correlation to laser flare photometry immediately after femtosecond laser-assisted capsulotomy and photodisruption.Patients and methodsThe study included 97 cataract eyes (n=97, mean age 68.6 years) undergoing femtosecond laser-assisted cataract surgery (FLACS). Three cohorts were analysed relating to the flare photometry directly post femtosecond laser treatment (flare <100 n=28, 69.6±7 years; flare 100-249 n=47, 67.7±8 years; flare >249 photon counts per ms cohort n=22, 68.5±10 years). Flare photometry (KOWA FM-700), corneal topography (Oculus Pentacam, Germany: AC depth, volume, angle, pachymetry), axial length, pupil diameter, and endothelial cells were assessed before FLACS, immediately after femtosecond laser treatment and 1 day postoperative (LenSx Alcon, USA). Statistical data were analysed by SPSS v19.0, Inc.ResultsThe AC depth, AC volume, AC angle, central and thinnest corneal thickness showed a significant difference between flare <100 vs flare 100-249 10 min post femtosecond laser procedure (P=0.002, P=0.023, P=0.007, P=0.003, P=0.011, respectively). The AC depth, AC volume, and AC angle were significantly larger (P=0.001, P=0.007, P=0.003, respectively) in the flare <100 vs flare >249 cohort 10 min post femtosecond laser treatment.ConclusionsA flat AC, low AC volume, and a narrow AC angle were parameters associated with higher intraocular inflammation. These criteria could be used for patient selection in FLACS to reduce postoperative intraocular inflammation.
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Affiliation(s)
- M Pahlitzsch
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - N Torun
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - M L Pahlitzsch
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - M K J Klamann
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - J Gonnermann
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - E Bertelmann
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Berlin, Germany
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Pahlitzsch M, Torun N, Pahlitzsch ML, Klamann MKJ, Gonnermann J, Bertelmann E, Pahlitzsch T. Impact of the Femtosecond Laser in Line with the Femtosecond Laser-Assisted Cataract Surgery (FLACS) on the Anterior Chamber Characteristics in Comparison to the Manual Phacoemulsification. Semin Ophthalmol 2016; 32:456-461. [DOI: 10.3109/08820538.2015.1119859] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Milena Pahlitzsch
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Necip Torun
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | | | | | - Johannes Gonnermann
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Eckart Bertelmann
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Berlin, Germany
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Klamann MKJ, Gonnermann J, Pahlitzsch M, Maier AKJ, Torun N, Bertelmann E. iStent inject als stand-alone OP beim phaken Offenwinkelglaukom – Erste klinische Jahresdaten. Klin Monbl Augenheilkd 2015. [DOI: 10.1055/s-0035-1569181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Brockmann T, Pham A, Sonnleithner CV, Gonnermann J, Klamann MKJ, Torun N, Bertelmann E. Binokulare Trifokalität: Vergleich klinischer Ergebnisse voll-diffraktiver und apodisiert-diffraktiver bifokaler Multifokallinsen. Klin Monbl Augenheilkd 2015. [DOI: 10.1055/s-0035-1569159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Torun N, Steurer T, Maier AK, Gonnermann J, Klamann MKJ, Bertelmann E, Joussen AM. Therapieoptionen zur Behandlung der Limbusstammzellinsuffizienz. Klin Monbl Augenheilkd 2015. [DOI: 10.1055/s-0035-1569196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Gonnermann J, Bertelmann E, Pahlitzsch M, Maier-Wenzel AKB, Torun N, Klamann MKJ. Intraindividuelle Vergleichsstudie in MIGS: Trabectome® vs. iStent inject®. Klin Monbl Augenheilkd 2015. [DOI: 10.1055/s-0035-1569179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Pahlitzsch M, Torun N, Gonnermann J, Maier AK, Winterhalter S, Bertelmann E, Klamann MKJ. MIGS und Filtrationschirurgie: Einfluss auf die Quality of Life? Klin Monbl Augenheilkd 2015. [DOI: 10.1055/s-0035-1569177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Pahlitzsch M, Torun N, Erb C, Bruenner J, Maier AKB, Gonnermann J, Bertelmann E, Klamann MKJ. Significance of the disc damage likelihood scale objectively measured by a non-mydriatic fundus camera in preperimetric glaucoma. Clin Ophthalmol 2015; 9:2147-58. [PMID: 26640365 PMCID: PMC4662372 DOI: 10.2147/opth.s93213] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose To assess the correlation between the disc damage likelihood scale (DDLS) objectively measured by a non-mydriatic fundus camera, Heidelberg Retina Tomograph 3, and optic coherence tomography in preperimetric glaucoma. Methods One-hundred-twenty-five patients with preperimetric primary open-angle glaucoma (POAG) and pseudoexfoliation glaucoma (n=30) were included (mean age 58.9±15.9 years). All three devices graded the optic disc topography: Diagnosis 1 was defined as “outside normal limits”, while Diagnosis 2 as “borderline or outside normal limits”. Results For Diagnosis 1, a significant correlation was shown between DDLS and Moorfields regression analysis (P=0.022), and for Diagnosis 2 with glaucoma probability score analysis (P=0.024), in POAG. In pseudoexfoliation glaucoma, DDLS did not correlate significantly with Heidelberg Retina Tomograph 3 and optic coherence tomography. Regarding the area under the curve the highest predictive power was demonstrated by the objective DDLS (0.513–0.824) compared to Burk (0.239–0.343) and Mikelberg (0.093–0.270) coefficients. Conclusions The DDLS showed a significant correlation to the Moorfields regression analysis in preperimetric POAG. The objective DDLS showed the highest predictive power and thus is an additive tool in diagnosing preperimetric glaucoma.
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Affiliation(s)
- Milena Pahlitzsch
- Department of Ophthalmology, University Medicine Charité, Campus Virchow Clinic, Berlin, Germany
| | - Necip Torun
- Department of Ophthalmology, University Medicine Charité, Campus Virchow Clinic, Berlin, Germany
| | - Carl Erb
- Augenklinik am Wittenbergplatz, Berlin, Germany
| | - Jeanette Bruenner
- Department of Ophthalmology, University Medicine Charité, Campus Virchow Clinic, Berlin, Germany
| | - Anna Karina B Maier
- Department of Ophthalmology, University Medicine Charité, Campus Virchow Clinic, Berlin, Germany
| | - Johannes Gonnermann
- Department of Ophthalmology, University Medicine Charité, Campus Virchow Clinic, Berlin, Germany
| | - Eckart Bertelmann
- Department of Ophthalmology, University Medicine Charité, Campus Virchow Clinic, Berlin, Germany
| | - Matthias K J Klamann
- Department of Ophthalmology, University Medicine Charité, Campus Virchow Clinic, Berlin, Germany
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Maier AKB, Gundlach E, Gonnermann J, Klamann MKJ, Eulufi C, Joussen AM, Bertelmann E, Rieck P, Torun N. Anterior segment analysis and intraocular pressure elevation after penetrating keratoplasty and posterior lamellar endothelial keratoplasty. Ophthalmic Res 2014; 53:36-47. [PMID: 25531077 DOI: 10.1159/000365252] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 05/28/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND Peripheral anterior synechiae (PAS) is a common problem after penetrating keratoplasty (PK) and leads to intraocular pressure (IOP) elevation. This study examines the risk factors for IOP elevation and post-keratoplasty glaucoma. METHODS A retrospective analysis was performed of 47 eyes following PK and of 65 eyes following Descemet's stripping endothelial keratoplasty (DSEK) between 2009 and 2011. The assessment included preoperative history of corneal disease and glaucoma, response to treatment, IOP, and visual acuity. Irido-trabecular contacts (ITC), the angle opening distance (AOD 500) and the anterior chamber angle (ACA 500) were calculated. RESULTS The incidences of IOP elevation and post-keratoplasty glaucoma were 27-36% and 10-29%, respectively. The incidence did not differ significantly between both procedures. Pre-existing glaucoma increased the risk for developing IOP elevation and post-DSEK glaucoma. Eyes with bullous keratopathy (BK) developed significantly more IOP elevation (p = 0.01, d.f. = 1, χ(2) = 6.11) and post-keratoplasty glaucoma (p = 0.01, d.f. = 1, χ(2) = 6.22) than eyes with Fuchs' endothelial dystrophy. Eyes with ITC developed post-keratoplasty glaucoma significantly more often than eyes without ITC (p = 0.01, d.f. = 1, χ(2) = 6.63). CONCLUSION IOP elevation and post-keratoplasty glaucoma showed a high incidence. Risk factors like pre-existing glaucoma, BK and PAS elevated the rate of IOP elevation and post-keratoplasty glaucoma for both procedures.
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Affiliation(s)
- Anna-Karina B Maier
- Department of Ophthalmology, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Klamann MKJ. Glaukom – Neue diagnostische Optionen. Klin Monbl Augenheilkd 2014. [DOI: 10.1055/s-0034-1396490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Brünner J, Pahlitzsch M, Gonnermann J, Maier AKB, Schwenteck T, Torun N, Bertelmann E, Klamann MKJ. Vergleich von zwei Impedanztonometern (ICare, IOPen) versus Goldmann Applanationstonometrie auf der Basis des internationalen Standards für Augentonometer ISO 8612 in einem Glaukomkollektiv. Klin Monbl Augenheilkd 2014. [DOI: 10.1055/s-0034-1396505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Rübsam A, Tsangaridou MA, Maier AKB, Gonnermann J, Bertelmann E, Torun N, Klamann MKJ. Vergleich einer neuen dualen Scheimpflug-assistierten non-contact Tonometrie (Corvis ST) mit der Goldmann Applanationstonometrie (GAT) und der Dynamischen Contour Tonometrie (DCT). Klin Monbl Augenheilkd 2014. [DOI: 10.1055/s-0034-1396506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Maier AKB, Gundlach E, Gonnermann J, Klamann MKJ, Bertelmann E, Rieck PW, Joussen AM, Torun N. Retrospective contralateral study comparing Descemet membrane endothelial keratoplasty with Descemet stripping automated endothelial keratoplasty. Eye (Lond) 2014; 29:327-32. [PMID: 25412715 DOI: 10.1038/eye.2014.280] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Accepted: 08/13/2014] [Indexed: 01/23/2023] Open
Abstract
PURPOSE In this retrospective study, the visual outcomes and postoperative complications after Descemet stripping automated endothelial keratoplasty (DSAEK) and Descemet membrane endothelial keratoplasty (DMEK) in the fellow eye were compared. The patient's satisfaction was evaluated. METHODS A retrospective analysis of 10 patients, who underwent DSAEK in one eye and DMEK surgery in their fellow eye, was performed. Intraoperative and postoperative complications were recorded. Visual and refractive outcomes were evaluated, including higher-order aberrations (HOA) and contrast thresholds. A subjective questionnaire was used to evaluate patient satisfaction. RESULTS Best-corrected visual acuity (BCVA) was significantly better in DMEK when compared with DSAEK (0.16±0.10 vs 0.45±0.58 logMAR, P=0.043). Contrast threshold was significantly higher after DMEK than after DSAEK (0.49±0.23 vs 0.25±0.18, P=0.043). Post-keratoplasty astigmatism, mean spherical equivalent, and HOA did not differ. Nine out of ten patients preferred the DMEK procedure. Visual outcome (4.80±1.14 vs 4.50±1.58, P=0.257), surgery associated pain and burden (DMEK: 1.30±0.48 vs DSAEK: 1.30±0.48, P=1.0), estimated time for recovery and rehabilitation (27.6±54.0 vs 24.9±54.8 days, P=0.173), and mean patient satisfaction (5.40±0.84 vs 5.00±1.05, P=0.257) were evaluated equally. CONCLUSION Patient satisfaction reached high, equal values after DMEK and after DSAEK. Nevertheless, patients preferred DMEK, if given a choice. Reasons for the preference may include better uncorrected and BCVA, and especially a better contrast sensitivity.
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Affiliation(s)
- A-K B Maier
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Charité, Germany
| | - E Gundlach
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Charité, Germany
| | - J Gonnermann
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Charité, Germany
| | - M K J Klamann
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Charité, Germany
| | - E Bertelmann
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Charité, Germany
| | - P W Rieck
- Eye Clinic am Kapellenberg, Potsdam, Germany
| | - A M Joussen
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Charité, Germany
| | - N Torun
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Charité, Germany
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Maier AKB, Wolf T, Gundlach E, Klamann MKJ, Gonnermann J, Bertelmann E, Joussen AM, Torun N. Intraocular pressure elevation and post-DMEK glaucoma following Descemet membrane endothelial keratoplasty. Graefes Arch Clin Exp Ophthalmol 2014; 252:1947-54. [DOI: 10.1007/s00417-014-2757-5] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Revised: 07/08/2014] [Accepted: 07/22/2014] [Indexed: 11/28/2022] Open
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Gonnermann J, Maier AKB, Klamann MKJ, Brockmann T, Bertelmann E, Joussen AM, Torun N. Posterior iris-claw aphakic intraocular lens implantation and Descemet membrane endothelial keratoplasty. Br J Ophthalmol 2014; 98:1291-5. [DOI: 10.1136/bjophthalmol-2014-304948] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Klamann MKJ, Gonnermann J, Maier AKB, Bertelmann E, Joussen AM, Torun N. Influence of Selective Laser Trabeculoplasty (SLT) on combined clear cornea phacoemulsification and Trabectome outcomes. Graefes Arch Clin Exp Ophthalmol 2014; 252:627-31. [PMID: 24413683 DOI: 10.1007/s00417-014-2569-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Revised: 12/03/2013] [Accepted: 01/03/2014] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND In this retrospective comparative cohort outcome study, the influence of Selective Laser Trabeculoplasty (SLT) on combined clear cornea phacoemulsification and ab interno trabeculectomy (Trabectome) outcomes in Primary Open Angle Glaucoma (POAG), Pseudoexfoliation Glaucoma (PEX), and Pigmentary Glaucoma (PG) was examined. METHODS Combined clear cornea phacoemulsification and Trabectome were performed in 27 consecutive patients with POAG, in 27 patients with PEX, and in 20 patients with PG. Each group was divided into two subgroups including patients without SLT treatment prior to surgery and patients who had insufficient response to 360° SLT treatment three months prior to surgery. RESULTS In the SLT group, mean IOP at six months measured 13.33 ± 2.08 mmHg with an average decrease of 30 % from preoperative IOP in the POAG group, 12.10 ± 1.40 mmHg with an average decrease of 46 % in the PEX group, and 11.83 ± 2.21 mmHg with an average decrease of 38 % in the PG group. In eyes without previous SLT, mean IOP sixt 6 months measured 11.00 ± 1.73 mmHg with an average decrease of 38 % from preoperative IOP in the POAG group, 15.50 ± 1.41 mmHg with an average decrease of 35 % in the PEX group, and 15.67 ± 2.91 mmHg with an average decrease of 36 % in the PG group, respectively. CONCLUSIONS Prior SLT treatment seems not to negatively influence combined clear cornea phacoemulsification and Trabectome outcomes in glaucoma patients. However, SLT treatment may even have an additive effect on following combined Trabectome outcomes in patients with PEX and PG.
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Affiliation(s)
- Matthias K J Klamann
- Department of Ophthalmology, Charité, University Medicine Berlin, Augustenburger Platz 1, 13353, Berlin, Germany,
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Bertelmann E, Torun N, Sonnleithner CV, Gonnermann J, Klamann MKJ. Vergleich der Ergebnisse nach Implantation von 5 torischen Intraokularlinsen hinsichtlich der Rotationstabilität. Klin Monbl Augenheilkd 2013. [DOI: 10.1055/s-0033-1363378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [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] [What about the content of this article? (0)] [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] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Klamann MKJ, Maier AKB, Gonnermann J, Torun N, Ruokonen PC. [Influence of corneal thickness on intraocular pressure measurements following Descemet's stripping automated endothelial keratoplasty (DSAEK)]. Ophthalmologe 2013; 109:1093-7. [PMID: 22752628 DOI: 10.1007/s00347-012-2623-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the effect of increased corneal thickness after Descemet's stripping automated endothelial keratoplasty (DSAEK) on intraocular pressure (IOP) measured by four different techniques. METHODS In this study 30 eyes from 30 patients with successful DSAEK treatment (group 1) and 30 eyes of 30 healthy subjects (group 2) were enrolled. The IOP was measured with iCare, IOPen, Goldmann applanation tonometry (GAT) and dynamic contour tonometry (DCT) techniques. Central corneal thickness (CCT) was measured by ultrasonic pachymetry. These data were used for statistical analysis. RESULTS The mean IOP measured by GAT, DCT, iCare and IOPen was 13.2, 16.1, 12.5 and 14.2 mmHg in group 1 and 13.4, 14.4, 14.4 and 13.3 mmHg in group 2, respectively. Correlations between IOP and CCT were not statistically significant in either group. CONCLUSION The results of IOP measurements by the iCare, IOPen, GAT and DCT techniques seem to be unrelated to artificially thickened corneas after DSAEK. In spite of partially good correlation between the four techniques a direct exchange of the devices is not recommended on account of the wide dispersion of values.
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Affiliation(s)
- M K J Klamann
- Department of Ophthalmology, University Medicine Charité Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland.
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Affiliation(s)
- Johannes Gonnermann
- Department of Ophthalmology, University Medicine Charité Berlin , Berlin , Germany
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Affiliation(s)
- Johannes Gonnermann
- Department of Ophthalmology, Charité, University Medicine Berlin, Berlin, Germany.
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Affiliation(s)
- Matthias K J Klamann
- Department of Ophthalmology, Charité, University Medicine Berlin, Augustenburger Platz 1, 13353, Berlin, Germany,
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Affiliation(s)
- M K J Klamann
- Augenklinik, Universitätsmedizin Charité Berlin, Augustenburgerplatz 1, Berlin.
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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: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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Affiliation(s)
- Necip Torun
- Departments of Ophthalmology, University Medicine Charité Berlin, Berlin, Germany.
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Klamann MKJ, Grünert A, Maier AKB, Gonnermann J, Joussen AM, Huber KK. Comparison of functional and morphological diagnostics in glaucoma patients and healthy subjects. Ophthalmic Res 2013; 49:192-8. [PMID: 23306647 DOI: 10.1159/000345074] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2012] [Accepted: 10/10/2012] [Indexed: 11/19/2022]
Abstract
PURPOSE To evaluate the diagnostic value of microperimetry (MP), blue-on-yellow perimetry (B/YP), confocal scanning laser ophthalmoscopy (Heidelberg Retina Tomograph, HRT, III) and optical coherence tomography (OCT) in discriminating eyes with early glaucoma from healthy subjects. MATERIAL AND METHODS Prospective examination of 22 eyes of subjects with early primary open-angle glaucoma and 24 eyes of healthy control subjects. After a complete ophthalmological examination, B/YP, MP, OCT and HRT III were determined. Morphological and functional parameters were analysed. RESULTS Mean sensitivity threshold values obtained with B/YP and MP did not show significant differences between glaucoma patients and the control group (p = 0.321 and p = 0.281). Retinal nerve fibre layer (RNFL) thickness was significantly decreased in patients with glaucoma with both HRT III and OCT (p = 0.018 and p < 0.001). CONCLUSIONS While B/YP and MP had no ability to discriminate between subjects with early glaucoma and healthy subjects, RNFL thickness measured with HRT III and OCT showed a significant difference. In early primary open-angle glaucoma, morphological changes like RNFL thickness seem to occur prior to functional defects in the visual field.
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Affiliation(s)
- M K J Klamann
- Department of Ophthalmology, University Medicine Charité Berlin, DE–13353 Berlin, Germany. matthias.klamann @ charite.de
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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] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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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] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [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] [What about the content of this article? (0)] [Affiliation(s)] [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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Affiliation(s)
- Matthias K J Klamann
- Department of Ophthalmology, Charité-University Medicine Berlin, Berlin, Germany.
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Gonnermann J, Klein JP, Klamann MKJ, Maier AK, Pleyer U, Joussen AM, Bertelmann E. Dry eye symptoms in patients after eyelid reconstruction with full-thickness eyelid defects: using the Tomey TG-1000 thermographer. Ophthalmic Res 2012; 48:192-8. [PMID: 22890198 DOI: 10.1159/000339598] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Accepted: 05/05/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND Large full-thickness eyelid defects are conventionally reconstructed by either a Hughes flap or Cutler-Beard bridge flap. Since the structure of the eyelid and its components are necessary for the tear film production and stability, we investigated the outcome after eyelid reconstruction focusing on dry eye symptoms using a new thermographic device, the TG-1000. METHODS Seventeen eyes of patients formerly treated with Hughes flaps (n = 16) and a Cutler-Beard bridge flap (n = 1) were compared to untreated healthy eyes (n = 17) regarding the functional and aesthetic outcome. The follow-up ranged from 3 to 63 months (mean 24.88 ± 17.86). RESULTS There was no significant difference in Schirmer's test, break-up time and ocular surface temperature (p > 0.05) between patients after full-thickness eyelid reconstruction and a control group. Eleven patients had minor postoperative complications such as notching of the lid margin (11/17), epiphora (1/17), superficial punctate keratitis (6/17), trichiasis (2/17) and a mild tendency to eversion of the lid margin (6/17). More than 75% of the patients rated their postoperative aesthetic outcome as good or even excellent. CONCLUSION The new TG-1000 device is a simple and quick tool for screening of dry eye. This study shows that tarsoconjunctival grafts offer good aesthetic and functional outcome with sufficient tear film composition and stability.
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Affiliation(s)
- Johannes Gonnermann
- Department of Ophthalmology, Charité, University Medicine Berlin, Berlin, Germany.
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Huber KK, Maier AKB, Klamann MKJ, Rottler J, Özlügedik S, Rosenbaum K, Gonnermann J, Winterhalter S, Joussen AM. Glaucoma in penetrating keratoplasty: risk factors, management and outcome. Graefes Arch Clin Exp Ophthalmol 2012; 251:105-16. [DOI: 10.1007/s00417-012-2065-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Revised: 04/20/2012] [Accepted: 05/14/2012] [Indexed: 10/28/2022] Open
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Klamann MKJ, Maier AKB, Gonnermann J, Klein JP, Pleyer U. Measurement of dynamic ocular surface temperature in healthy subjects using a new thermography device. Curr Eye Res 2012; 37:678-83. [PMID: 22559822 DOI: 10.3109/02713683.2012.674610] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To investigate the routine use and applicability of a new ocular thermography device (TG 1000; Tomey Corp, Nagoya, Japan) in healthy individuals. METHODS Sixty eyes of 30 healthy subjects were included in this prospective study. Intraobserver reproducibility was tested with an ocular surface-oriented infrared radiation thermographic device in a non-contact manner. Using a standard examination protocol, the ocular surface temperature was assessed by dynamic thermal imaging over a time period of 10 s. The procedure was repeated three times during a single session by one examiner. Intraclass correlation coefficients (ICC) were calculated. RESULTS Ocular surface temperature measurements were highly reproducible. The mean ocular surface temperature was 34.02°C ± 0.22. The ICC was 0.947%, 0.949%, and 0.955% for minimum, maximum, and mean temperatures, respectively. CONCLUSION Ocular surface temperature measurements made using the Tomey TG 1000 in healthy subjects showed excellent intraobserver reproducibility. This novel non-invasive technique offers new options for increased understanding of the physiology of the ocular surface.
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Affiliation(s)
- Matthias K J Klamann
- Department of Ophthalmology, Charité - University Medicine Berlin, Berlin, Germany.
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Gonnermann J, Klein JP, Klamann MKJ, Maier AK, Pleyer U, Joussen AM, Bertelmann E. Evaluation des trockenen Auges bei Patienten nach tarsokonjunktivalen Lidrekonstruktionen mittels Tomey TG-1000 Thermographer. Klin Monbl Augenheilkd 2011. [DOI: 10.1055/s-0031-1297300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Maier AKB, Huber KK, Klamann MKJ, Rottler J, Özlügedik S, Winterhalter S, Rosenbaum K, Joussen AM. Sekundärglaukom nach Keratoplastik: Risikofaktoren, Management und Ergebnisse. Klin Monbl Augenheilkd 2010. [DOI: 10.1055/s-0030-1270041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Klamann MKJ, Maier AKB, Gonnermann J, Pavant T, Klein JP, Pleyer U. Temperaturgradient des Filterkissens als Erfolgskontrolle nach Trabekulektomie: Ergebnisse der Filterkissenbeurteilung mittels Thermografie TG 1000. Klin Monbl Augenheilkd 2010. [DOI: 10.1055/s-0030-1270026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Klamann MKJ, Viestenz A, Vorwerk C, Langenbucher A, Behrens-Baumann W. Einfluss biometrisch-optischer Determinanten auf die Vermessung des Sehnervenkopfes mit OCT 3 und HRT II. Klin Monbl Augenheilkd 2009. [DOI: 10.1055/s-0029-1242945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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