1
|
Weiss JS, Rapuano CJ, Seitz B, Busin M, Kivelä TT, Bouheraoua N, Bredrup C, Nischal KK, Chawla H, Borderie V, Kenyon KR, Kim EK, Møller HU, Munier FL, Berger T, Lisch W. IC3D Classification of Corneal Dystrophies-Edition 3. Cornea 2024; 43:466-527. [PMID: 38359414 PMCID: PMC10906208 DOI: 10.1097/ico.0000000000003420] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 08/03/2023] [Revised: 09/08/2023] [Accepted: 09/24/2023] [Indexed: 02/17/2024]
Abstract
PURPOSE The International Committee for the Classification of Corneal Dystrophies (IC3D) was created in 2005 to develop a new classification system integrating current information on phenotype, histopathology, and genetic analysis. This update is the third edition of the IC3D nomenclature. METHODS Peer-reviewed publications from 2014 to 2023 were evaluated. The new information was used to update the anatomic classification and each of the 22 standardized templates including the level of evidence for being a corneal dystrophy [from category 1 (most evidence) to category 4 (least evidence)]. RESULTS Epithelial recurrent erosion dystrophies now include epithelial recurrent erosion dystrophy, category 1 ( COL17A1 mutations, chromosome 10). Signs and symptoms are similar to Franceschetti corneal dystrophy, dystrophia Smolandiensis, and dystrophia Helsinglandica, category 4. Lisch epithelial corneal dystrophy, previously reported as X-linked, has been discovered to be autosomal dominant ( MCOLN1 mutations, chromosome 19). Classic lattice corneal dystrophy (LCD) results from TGFBI R124C mutation. The LCD variant group has over 80 dystrophies with non-R124C TGFBI mutations, amyloid deposition, and often similar phenotypes to classic LCD. We propose a new nomenclature for specific LCD pathogenic variants by appending the mutation using 1-letter amino acid abbreviations to LCD. Pre-Descemet corneal dystrophies include category 1, autosomal dominant, punctiform and polychromatic pre-Descemet corneal dystrophy (PPPCD) ( PRDX3 mutations, chromosome 10). Typically asymptomatic, it can be distinguished phenotypically from pre-Descemet corneal dystrophy, category 4. We include a corneal dystrophy management table. CONCLUSIONS The IC3D third edition provides a current summary of corneal dystrophy information. The article is available online at https://corneasociety.org/publications/ic3d .
Collapse
Affiliation(s)
- Jayne S Weiss
- Departments of Ophthalmology, Pathology and Pharmacology, Louisiana State University Eye Center of Excellence, Louisiana State University Health Sciences Center, New Orleans, LA
| | - Christopher J Rapuano
- Cornea Service, Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA
| | - Berthold Seitz
- Department of Ophthalmology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Massimo Busin
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
- Istituto Internazionale per la Ricerca e Formazione in Oftalmologia, Forlì, Italy
| | - Tero T Kivelä
- Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Nacim Bouheraoua
- Department of Ophthalmology, Quinze-Vingts National Ophthalmology Hospital and Sorbonne Université, Paris, France
| | - Cecilie Bredrup
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Ken K Nischal
- Division of Pediatric Ophthalmology, Strabismus and Adult Motility, University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, Pittsburgh, PA
| | - Harshvardhan Chawla
- Department of Ophthalmology, Louisiana State University Health Sciences Center, New Orleans, LA
| | - Vincent Borderie
- Department of Ophthalmology, Quinze-Vingts National Ophthalmology Hospital and Sorbonne Université, Paris, France
| | - Kenneth R Kenyon
- Department of Ophthalmology, Tufts University School of Medicine and Harvard Medical School, Schepens Eye Research Institute and New England Eye Center, Boston, MA
| | - Eung Kweon Kim
- Corneal Dystrophy Research Institute, Yonsei University College of Medicine, Seoul, Korea
- Saevit Eye Hospital, Goyang, Korea
| | - Hans Ulrik Møller
- Department of Pediatric Ophthalmology, Aarhus University Hospital, Aarhus, Denmark
| | - Francis L Munier
- Retinoblastoma and Oculogenetic Units, Jules-Gonin Eye Hospital and Fondation Asile des Aveugle, University of Lausanne, Lausanne, Switzerland; and
| | - Tim Berger
- Department of Ophthalmology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Walter Lisch
- Department of Ophthalmology, Johannes Gutenberg University Mainz, Mainz, Germany
| |
Collapse
|
2
|
Knoeri J, Mhenni R, Friquet C, Hage A, Cuyaubère R, Borderie M, Leveziel L, Bouheraoua N, Borderie V. Comparison of optical aberrations in keratoconus with scleral versus rigid gas permeable lenses. Eur J Ophthalmol 2024; 34:394-398. [PMID: 38128913 DOI: 10.1177/11206721231221588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
PURPOSE to assess optical aberrations under scleral (SL) versus rigid gas permeable (RGP) lenses in patients with keratoconus. METHODS A prospective study including 25 eyes of 14 patients. The best-corrected visual acuity (BCVA) with corrective glasses, RGP and SL, stage of keratoconus (Amsler-Krumeich classification), minimum pachymetry, maximum keratometry, and corneal higher-order aberrations (i.e, total HOAs, coma, and trefoil) with RGP and with SL were collected. Aberrometry was performed using iTrace® aberrometer (Tracey Technologies, USA). RESULTS 80% of the included keratoconus patients were stage 4, with a mean age of 34.3 years (±8.8). There were no significant differences in mean BCVA (logMAR) between SL and RGP. The mean BCVAs were significantly better both with SL (p < 0.0001) and RGP (p < 0.0001) compared with corrective glasses. Total HOAs (p = 0.01), coma (p = 0.003) and trefoil (p = 0.008) were significantly lower with SL compared with RGP. The BCVA decreased with the stage of keratoconus in SL (p = 0.01) and RGP (p = 0.02). The BCVA decreased with decreasing minimum pachymetry in SL (p = 0.02) and RGP (p = 0.002), and with increasing maximum keratometry in SL (p = 0.02) and RGP (p = 0.01). Significant correlations were found between BCVA, total HOAs (p = 0.008), and coma (p = 0.02) in SL. CONCLUSION For the same keratoconus patients, total higher order, coma and trefoil optical aberrations were reduced with scleral lenses compared to rigid gas permeable lenses.
Collapse
Affiliation(s)
- Juliette Knoeri
- Sorbonne Université, GRC n°32, Transplantation et Thérapies Innovantes de la Cornée, AP-HP, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, 28 rue de Charenton, F-75012, Paris, France
| | - Rania Mhenni
- Sorbonne Université, GRC n°32, Transplantation et Thérapies Innovantes de la Cornée, AP-HP, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, 28 rue de Charenton, F-75012, Paris, France
| | - Chloé Friquet
- Sorbonne Université, GRC n°32, Transplantation et Thérapies Innovantes de la Cornée, AP-HP, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, 28 rue de Charenton, F-75012, Paris, France
| | - Alexandre Hage
- Sorbonne Université, GRC n°32, Transplantation et Thérapies Innovantes de la Cornée, AP-HP, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, 28 rue de Charenton, F-75012, Paris, France
| | - Roxane Cuyaubère
- Sorbonne Université, GRC n°32, Transplantation et Thérapies Innovantes de la Cornée, AP-HP, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, 28 rue de Charenton, F-75012, Paris, France
| | - Marie Borderie
- Sorbonne Université, GRC n°32, Transplantation et Thérapies Innovantes de la Cornée, AP-HP, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, 28 rue de Charenton, F-75012, Paris, France
| | - Loïc Leveziel
- Sorbonne Université, GRC n°32, Transplantation et Thérapies Innovantes de la Cornée, AP-HP, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, 28 rue de Charenton, F-75012, Paris, France
| | - Nacim Bouheraoua
- Sorbonne Université, GRC n°32, Transplantation et Thérapies Innovantes de la Cornée, AP-HP, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, 28 rue de Charenton, F-75012, Paris, France
| | - Vincent Borderie
- Sorbonne Université, GRC n°32, Transplantation et Thérapies Innovantes de la Cornée, AP-HP, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, 28 rue de Charenton, F-75012, Paris, France
| |
Collapse
|
3
|
Ittah-Cohen I, Knoeri MJ, Bourcier T, Merabet L, Bouheraoua N, Borderie VM. Infectious keratitis following corneal transplantation: A long-term cohort study. Clin Exp Ophthalmol 2024. [PMID: 38267255 DOI: 10.1111/ceo.14354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 10/26/2023] [Accepted: 12/22/2023] [Indexed: 01/26/2024]
Abstract
BACKGROUND To assess the long-term incidence and risk factors for post-keratoplasty infectious keratitis (IK), associated ocular pathogens, and antibiotic resistance profiles. METHODS Cohort study including 2553 consecutive penetrating, endothelial, and anterior lamellar keratoplasties performed between 1992 and 2020. Medical and microbiological records of patients clinically diagnosed with IK were retrospectively reviewed. MAIN OUTCOME MEASURES cumulative incidence of IK, infectious agent species, and antibiotics resistance profiles. RESULTS The average follow-up time after transplantation was 112 ± 96 months. Eighty-nine IK episodes were recorded; microbiological tests were positive in 55/89 (62%). The cumulated incidence of postoperative IK was 5.50%/10.25% at 10/20 years. The occurrence of at least one episode of IK after transplantation was associated with lower graft survival in the long term (p < 0.0001). Rejection risk (adjusted Hazard Ratio, 2.29) and postoperative epithelial complications (HR, 3.44) were significantly and independently associated with a higher incidence of postoperative IK. Infectious agents included 41 bacteria, 10 HSV, 6 fungi, and 1 Acanthamoeba. The rate of antibiotic resistance was 0% for vancomycin, 13% for fluoroquinolones, 20% for rifamycin, 59% for aminoglycosides, and 73% for ticarcillin. In 41% of cases, patients were under prophylactic topical antibiotics before the infectious episode. Topical antibiotics were significantly associated with increased resistance to penicillin, carbapenems, and aminoglycosides. CONCLUSION IK (mainly bacterial) is a frequent complication of corneal transplantation in the long term. Vancomycin and fluoroquinolones can be considered as first-line treatments. Prolonged postoperative antibiotic preventive treatment is not advisable as it may increase antibiotic resistance.
Collapse
Affiliation(s)
- Ian Ittah-Cohen
- Groupe de Recherche Clinique #32, Transplantation et Thérapies Innovantes de la Cornée, Sorbonne Université, Hôpital National des 15-20, Paris, France
| | - M Juliette Knoeri
- Groupe de Recherche Clinique #32, Transplantation et Thérapies Innovantes de la Cornée, Sorbonne Université, Hôpital National des 15-20, Paris, France
| | - Tristan Bourcier
- Department of Ophthalmology, New Civil Hospital, Strasbourg University Hospital, FMTS, University of Strasbourg, Strasbourg, France
- Gepromed, The Medical Device Hub for Patient Safety, Strasbourg, France
| | - Lilia Merabet
- Laboratory of Biology, Hôpital National des 15-20, Paris, France
| | - Nacim Bouheraoua
- Groupe de Recherche Clinique #32, Transplantation et Thérapies Innovantes de la Cornée, Sorbonne Université, Hôpital National des 15-20, Paris, France
| | - Vincent M Borderie
- Groupe de Recherche Clinique #32, Transplantation et Thérapies Innovantes de la Cornée, Sorbonne Université, Hôpital National des 15-20, Paris, France
| |
Collapse
|
4
|
Sellam A, Tourabaly M, Borderie V, Bouheraoua N. Evaluation of the efficacy and safety of pars plana vitrectomy with irido-zonulo-hyaloidotomy for malignant glaucoma. J Fr Ophtalmol 2024; 47:103963. [PMID: 37777420 DOI: 10.1016/j.jfo.2023.03.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/26/2023] [Accepted: 03/04/2023] [Indexed: 10/02/2023]
Abstract
PURPOSE To assess the efficacy and safety of pars plana vitrectomy with irido-zonulo-hyaloidotomy (IZH) for fluid misdirection syndrome (FMS) in pseudophakic eyes. METHODS This was a retrospective case series study of patients treated with pars plana vitrectomy with IZH for FMS between February 2017 and March 2020. Complete success was defined as central anterior chamber (AC) deepening with an intraocular pressure (IOP) of 21mmHg or less (on 2 consecutive visits at least 1 week apart) without topical or systemic glaucoma medications. Qualified success was defined as central AC deepening with an IOP of 21mmHg or less (on 2 consecutive visits at least 1 week apart) with topical or systemic glaucoma medications. RESULTS Twelve eyes of 12 patients with a diagnosis of FMS were included. The mean age of the population was 73.6±15.4 years [39-90] with a majority of women (58.3%). Prior surgeries at the time of FMS diagnosis were trabeculectomy (4 eyes) and non-perforating deep sclerectomy (2 eyes). At presentation, mean IOP was 38.2±9.8mmHg, which decreased to 17.9±7.7mmHg (P<0.0001) at final follow-up (mean follow-up of 4.9±4.3 months). Complete success was achieved in 6 eyes (50%) and qualified success in 10 eyes (83%), with two eyes failing treatment. There was no statistical significant relationship between demographic data and clinical success (P > 0.05). CONCLUSION Pars plana vitrectomy combined with IZH appears to be a safe and effective technique for the treatment of FMS in pseudophakic patients.
Collapse
Affiliation(s)
- A Sellam
- Centre hospitalier national d'ophtalmologie des Quinze-Vingts, Inserm-DGOS CIC 1423, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France
| | - M Tourabaly
- Centre hospitalier national d'ophtalmologie des Quinze-Vingts, Inserm-DGOS CIC 1423, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France
| | - V Borderie
- Centre hospitalier national d'ophtalmologie des Quinze-Vingts, Inserm-DGOS CIC 1423, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France; Sorbonne université, Inserm, CNRS, institut de la vision, 17, rue Moreau, 75012 Paris, France
| | - N Bouheraoua
- Centre hospitalier national d'ophtalmologie des Quinze-Vingts, Inserm-DGOS CIC 1423, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France; Sorbonne université, Inserm, CNRS, institut de la vision, 17, rue Moreau, 75012 Paris, France.
| |
Collapse
|
5
|
Borderie VM, Georgeon C, Sandali O, Bouheraoua N. Long-term outcomes of deep anterior lamellar versus penetrating keratoplasty for keratoconus. Br J Ophthalmol 2023; 108:10-16. [PMID: 37890880 PMCID: PMC10803977 DOI: 10.1136/bjo-2023-324230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 09/03/2023] [Indexed: 10/29/2023]
Abstract
AIMS To compare the long-term outcomes of deep anterior lamellar keratoplasty (DALK) with penetrating keratoplasty (PK) in keratoconus. METHODS Retrospective comparative case series (228 DALKs and 274 PKs). A biphasic linear model was used to describe the postoperative outcome of the endothelial cell density (ECD). Visual acuity, specular microscopy, corneal topography and optical coherence tomography findings were recorded. RESULTS Graft survival of the 502 keratoconus eyes was 96.7 at 10 years and 95.6% at 20 years. Visual acuity improved from 20/378±5.1 lines preoperatively to 20/32±2.1 lines at 30 months. The corneal ECD decreased from 2494±382 cells/mm2 to 1521±659 cells/mm2 at 10 years. The mean simulated keratometry increased from 44.88±2.54 D at 1 year to 46.60±3.0 D at 3 years. The mean follow-up was 103.4 months for DALKs and 106.1 months for PKs. The cumulated incidence of postoperative ocular hypertension requiring treatment was significantly higher in PKs than in DALKs. The early- and late-phase rates of ECD loss were significantly lower in DALKs than in PKs. These figures in DALKs were 50% of those observed in PKs. The simulated mean keratometry was significantly higher in DALKs than in PKs in the mid but not in the long term. No significant differences in visual acuity were observed between both groups. Manual dissection-DALK featured slower visual recovery than PK and big bubble-DALK, whereas big bubble-DALK and PK featured similar visual recovery. CONCLUSIONS DALK featuring higher endothelial survival and lower risk of postoperative ocular hypertension may be superior to PK when indicated for keratoconus.
Collapse
Affiliation(s)
- Vincent Michel Borderie
- Ophthalmology, Hôpital National des 15-20, Paris, Île-de-France, France
- GRC 32, Sorbonne Université, Paris, France
| | - Cristina Georgeon
- Ophthalmology, Hôpital National des 15-20, Paris, Île-de-France, France
- GRC 32, Sorbonne Université, Paris, France
| | - Otman Sandali
- Ophthalmology, Hôpital National des 15-20, Paris, Île-de-France, France
- GRC 32, Sorbonne Université, Paris, France
| | - N Bouheraoua
- Ophthalmology, Hôpital National des 15-20, Paris, Île-de-France, France
- GRC 32, Sorbonne Université, Paris, France
| |
Collapse
|
6
|
Bertret C, Leveziel L, Knoeri J, Georgeon C, Jamart C, Bouheraoua N, Borderie V. Freeze-dried amniotic membrane graft with a spongy layer in bilateral peripheral ulcerative keratitis: a case report. BMC Ophthalmol 2023; 23:387. [PMID: 37735358 PMCID: PMC10515264 DOI: 10.1186/s12886-023-03129-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 09/08/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Peripheral ulcerative keratitis (PUK) is a group of inflammatory corneal ulcers with stromal thinning and peripheral localization. Amniotic membranes (AM) are used for their anti-inflammatory and healing properties. A freeze-drying process now allows maintaining the AM viable for a long time at room temperature without altering its physical, biological, and morphologic characteristics. The effectiveness of spongy freeze-dried amniotic membrane (FD-AM) graft with multimodal imaging in the management of severe corneal thinning PUK has not been reported. CASE PRESENTATION A 67-year-old Caribbean man histologically diagnosed with ulcerative colitis, was referred to our tertiary eye care center for a deep nasal juxtalimbal ulcer of the left eye. He was treated with topical steroids and antibiotics, methylprednisolone pulses, and oral prednisone. Due to continuous stromal thinning with 100 μm of residual corneal thickness, the decision was made to perform surgery. Conjunctival resection, inlay and overlay spongy FD-AM (Visio Amtrix® S, Tissue Bank of France, FR) were performed to preserve globe integrity. Despite tapering off oral steroids, PUK developed in the fellow eye on the 2 months follow-up. Treatment with human monoclonal antibody against tumor necrosis factor-alpha was initiated to control the active underlying inflammation. Six months following surgery, the ulcer was healed and corneal thickness in front of the former ulceration was measured at 525 μm on anterior segment-optical coherence tomography. Confocal microscopy confirmed the integration of the amniotic membrane between the corneal epithelium and the anterior stroma. CONCLUSION Transplantation of FD-AM with a spongy layer was associated with restoration of normal corneal thickness in the PUK area. It seems to be a safe, effective, and easily accessible solution for the surgical management of PUK with impending perforation.
Collapse
Affiliation(s)
- Clara Bertret
- Sorbonne Université, GRC n°32, Transplantation et Thérapies Innovantes de la Cornée, AP- HP, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, 28 rue de Charenton, Paris, F-75012, France
| | - Loïc Leveziel
- Sorbonne Université, GRC n°32, Transplantation et Thérapies Innovantes de la Cornée, AP- HP, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, 28 rue de Charenton, Paris, F-75012, France
| | - Juliette Knoeri
- Sorbonne Université, GRC n°32, Transplantation et Thérapies Innovantes de la Cornée, AP- HP, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, 28 rue de Charenton, Paris, F-75012, France.
| | - Cristina Georgeon
- Sorbonne Université, GRC n°32, Transplantation et Thérapies Innovantes de la Cornée, AP- HP, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, 28 rue de Charenton, Paris, F-75012, France
| | - Céline Jamart
- Internal Medicine Department, AP-HP, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, 28 rue de Charenton, Paris, F-75012, France
| | - Nacim Bouheraoua
- Sorbonne Université, GRC n°32, Transplantation et Thérapies Innovantes de la Cornée, AP- HP, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, 28 rue de Charenton, Paris, F-75012, France
| | - Vincent Borderie
- Sorbonne Université, GRC n°32, Transplantation et Thérapies Innovantes de la Cornée, AP- HP, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, 28 rue de Charenton, Paris, F-75012, France
| |
Collapse
|
7
|
Amar J, El Kaim P, Scemla B, Boumendil J, Chotard G, Gabison E, Bouheraoua N. [Corneal perforations in patients on tyrosine kinase inhibitors]. J Fr Ophtalmol 2023:S0181-5512(23)00270-X. [PMID: 37357065 DOI: 10.1016/j.jfo.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/21/2023] [Accepted: 03/01/2023] [Indexed: 06/27/2023]
Affiliation(s)
- J Amar
- CHNO des Quinze-Vingts, IHU ForeSight, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France
| | - P El Kaim
- CHNO des Quinze-Vingts, IHU ForeSight, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France
| | - B Scemla
- CHNO des Quinze-Vingts, IHU ForeSight, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France
| | - J Boumendil
- CHNO des Quinze-Vingts, IHU ForeSight, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France
| | - G Chotard
- CHNO des Quinze-Vingts, IHU ForeSight, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France
| | - E Gabison
- Service d'ophtalmologie, fondation ophtalmologique Adolphe-de-Rothschild, 25, rue Manin, 75019 Paris, France; Université de Paris, Paris, France
| | - N Bouheraoua
- CHNO des Quinze-Vingts, IHU ForeSight, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France; Sorbonne université, Inserm, CNRS, institut de la Vision, 17, rue Moreau, 75012 Paris, France.
| |
Collapse
|
8
|
Saad S, Saad R, Goemaere I, Cuyaubere R, Borderie M, Borderie V, Bouheraoua N. Efficacy, Safety, and Outcomes following Accelerated and Iontophoresis Corneal Crosslinking in Progressive Keratoconus. J Clin Med 2023; 12:jcm12082931. [PMID: 37109267 PMCID: PMC10141117 DOI: 10.3390/jcm12082931] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/05/2023] [Accepted: 04/15/2023] [Indexed: 04/29/2023] Open
Abstract
PURPOSE To investigate the outcomes of accelerated (A-CXL) and iontophoresis (I-CXL) corneal crosslinking in a large retrospective cohort with progressive keratoconus. METHODS This retrospective observational cohort study included consecutive patients treated by A-CXL (9 mW/5.4 J/cm2) or I-CXL with a minimal follow-up of 12 months. Visual acuity, manifest refraction, topography, specular microscopy, and corneal optical coherence tomography (OCT) were evaluated at baseline and at the last visit. Progression was defined as an increase in the maximum topographic keratometry (Kmax) of 1D. RESULTS 302 eyes of 241 patients with a mean age of 25.2 ± 7.5 years were included from 2012 to 2019: 231 and 71 eyes in the A-CXL and I-CXL groups, respectively. The mean follow-up was 27.2 ± 13.2 months (maximum: 85.7 months). Preoperatively, the mean Kmax was 51.8 ± 4.0D, with no differences between groups. Mean topographic measurements and spherical equivalent remained stable during the follow-up. At the last visit, CXL failure was reported in 60 eyes (19.9%): 40 (14.7%) versus 20 (28.2%) in A-CXL versus I-CXL, respectively, p = 0.005. The likelihood of progression after CXL was significantly higher following I-CXL: RR = 1.62, CI95 = [1.02 to 2.59], p = 0.04. Demarcation line presence at 1 month was positively correlated with higher efficacy of CXL, p = 0.03. No endothelial damage was reported, especially in 51 thin corneas (range = 342-399 µm). CONCLUSIONS A-CXL seems more effective than I-CXL in stabilizing keratoconus; this is to be taken into account when a therapeutic indication is posed according to the aggressiveness of the keratoconus.
Collapse
Affiliation(s)
- Sami Saad
- CHNO Des Quinze-Vingts, IHU ForeSight, INSERM-DGOS CIC 1423, 28 Rue de Charenton, F-75012 Paris, France
| | - Rana Saad
- CHNO Des Quinze-Vingts, IHU ForeSight, INSERM-DGOS CIC 1423, 28 Rue de Charenton, F-75012 Paris, France
| | - Isabelle Goemaere
- CHNO Des Quinze-Vingts, IHU ForeSight, INSERM-DGOS CIC 1423, 28 Rue de Charenton, F-75012 Paris, France
| | - Roxane Cuyaubere
- CHNO Des Quinze-Vingts, IHU ForeSight, INSERM-DGOS CIC 1423, 28 Rue de Charenton, F-75012 Paris, France
| | - Marie Borderie
- CHNO Des Quinze-Vingts, IHU ForeSight, INSERM-DGOS CIC 1423, 28 Rue de Charenton, F-75012 Paris, France
| | - Vincent Borderie
- CHNO Des Quinze-Vingts, IHU ForeSight, INSERM-DGOS CIC 1423, 28 Rue de Charenton, F-75012 Paris, France
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012 Paris, France
| | - Nacim Bouheraoua
- CHNO Des Quinze-Vingts, IHU ForeSight, INSERM-DGOS CIC 1423, 28 Rue de Charenton, F-75012 Paris, France
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012 Paris, France
| |
Collapse
|
9
|
Memmi B, Knoeri J, Bouheraoua N, Borderie V. Intraocular Lens Calcification After Pseudophakic Endothelial Keratoplasty. Am J Ophthalmol 2023; 246:86-95. [PMID: 36457226 DOI: 10.1016/j.ajo.2022.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/29/2022] [Accepted: 10/18/2022] [Indexed: 01/24/2023]
Abstract
PURPOSE To determine the incidence and to document risk factors for intraocular lens (IOL) calcification after pseudophakic endothelial keratoplasty. METHODS We retrospectively studied 2700 consecutive penetrating, anterior lamellar and endothelial keratoplasties carried out between December 1992 and June 2022 at the National Eye Hospital, Paris, France. DESIGN Retrospective cohort study. RESULTS All IOL calcification cases were associated with endothelial keratoplasty. Out of 588 endothelial keratoplasty procedures, 576 eyes were pseudophakic at the end of surgery. Fourteen cases of IOL calcification were observed during follow-up. The cumulative incidence of IOL calcification after endothelial keratoplasty was 4.5%±1.3% at 60 months. Hydrophilic acrylic IOL material (P < .001) and use of SF6 for anterior chamber tamponade (P = .001) were significantly and independently associated with the cumulative incidence of IOL calcification. CONCLUSION The incidence of IOL calcifications seems to be around 5%. Ophthalmologists should avoid hydrophilic acrylic IOLs in patients with endothelial disorders. When the patient already has a hydrophilic IOL, SF6 should be avoided. The only effective treatment is IOL exchange.
Collapse
Affiliation(s)
- Benjamin Memmi
- From the GRC 32, Transplantation et Thérapies Innovantes de la Cornée, Sorbonne Université, Sorbonne Université, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France
| | - Juliette Knoeri
- From the GRC 32, Transplantation et Thérapies Innovantes de la Cornée, Sorbonne Université, Sorbonne Université, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France
| | - Nacim Bouheraoua
- From the GRC 32, Transplantation et Thérapies Innovantes de la Cornée, Sorbonne Université, Sorbonne Université, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France
| | - Vincent Borderie
- From the GRC 32, Transplantation et Thérapies Innovantes de la Cornée, Sorbonne Université, Sorbonne Université, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France.
| |
Collapse
|
10
|
Saad S, Labani S, Goemaere I, Cuyaubere R, Borderie M, Borderie V, Benkhatar H, Bouheraoua N. Corneal neurotization in the management of neurotrophic keratopathy: A review of the literature. J Fr Ophtalmol 2023; 46:83-96. [PMID: 36473789 DOI: 10.1016/j.jfo.2022.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 12/12/2022]
Abstract
Neurotrophic keratopathy (NK) is a rare degenerative disease in which damage to the corneal nerves leads to corneal hypoesthesia or anesthesia. Neurotrophic corneal ulcers are notoriously difficult to treat and can lead to blindness. Corneal neurotization (CN) is a recent surgical technique aimed at restoring corneal sensation and may offer a definitive treatment in the wake of NK. Herein, we review the surgical techniques utilized in direct and indirect CN. Technical considerations, outcomes, current limitations and future perspectives are also discussed. This article highlights the key points of this promising procedure and biological aspects that will help provide the best treatment options for patients with severe NK.
Collapse
Affiliation(s)
- S Saad
- CHNO des Quinze-Vingts, IHU FOReSIGHT, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France
| | - S Labani
- CHNO des Quinze-Vingts, IHU FOReSIGHT, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France
| | - I Goemaere
- CHNO des Quinze-Vingts, IHU FOReSIGHT, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France
| | - R Cuyaubere
- CHNO des Quinze-Vingts, IHU FOReSIGHT, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France
| | - M Borderie
- CHNO des Quinze-Vingts, IHU FOReSIGHT, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France
| | - V Borderie
- CHNO des Quinze-Vingts, IHU FOReSIGHT, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France; Sorbonne université, Inserm, CNRS, institut de la vision, 17, rue Moreau, 75012 Paris, France
| | - H Benkhatar
- CHNO des Quinze-Vingts, IHU FOReSIGHT, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France; Versailles Hospital Center, Department of Otorhinolaryngology-Head and Neck Surgery, Le Chesnay, France
| | - N Bouheraoua
- CHNO des Quinze-Vingts, IHU FOReSIGHT, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France; Sorbonne université, Inserm, CNRS, institut de la vision, 17, rue Moreau, 75012 Paris, France.
| |
Collapse
|
11
|
Levy A, Georgeon C, Knoeri J, Tourabaly M, Leveziel L, Bouheraoua N, Borderie VM. Corneal Epithelial Thickness Mapping in the Diagnosis of Ocular Surface Disorders Involving the Corneal Epithelium: A Comparative Study. Cornea 2022; 41:1353-1361. [PMID: 35349542 PMCID: PMC9555759 DOI: 10.1097/ico.0000000000003012] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 10/25/2021] [Accepted: 12/05/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to analyze the role of corneal epithelial thickness (ET) mapping provided by spectral domain optical coherence tomography in the diagnosis of ocular surface disorders (OSDs) involving the corneal epithelium. DESIGN This was a retrospective comparative study. METHODS Institutional settings are as follows. Study population includes 303 eyes with an OSD and 55 normal eyes (controls). Observation procedures include spectral domain optical coherence tomography with epithelial mapping in the central 6 mm. Main outcome measures include ET map classification (normal, doughnut, spoke-wheel, localized/diffuse, and thinning/thickening patterns) and ET data and statistics (minimum, maximum, and SD). A quantitative threshold was determined with receiver operating curves to distinguish pathological from normal corneas. Sensitivity and specificity of classification and quantitative data were calculated using all eyes to assess the ability to distinguish corneas with a given corneal disorder from other conditions. RESULTS Classification of full agreement between 3 readers was obtained in 75.4% to 99.4% of cases. Main OSD features were keratoconus (135 eyes), doughnut pattern (sensitivity/specificity = 56/94%), and max-min ET ≥ 13 μm (84/43%); limbal deficiency (56 eyes), spoke-wheel pattern (66/98%), and max-min ET ≥ 14 μm (91/59%); epithelial basement membrane dystrophy (55 eyes), inferior thickening pattern (55/92%), and central ET > 56 μm (53/81%); dry eye (21 eyes), superior thinning pattern (67/88%), and minimal ET ≤ 44 μm (86/48%); pterygium (10 eyes), nasal thickening pattern (100/86%), and nasal ET > 56 μm (80/71%); and in situ carcinoma (11 eyes), max ET > 60 μm (91/60%), and ET SD >5 μm (100/58%). CONCLUSIONS The epithelial map pattern recognition combined with quantitative analysis of ET is relevant for the diagnosis of OSDs and for distinguishing various OSDs from each other. Deep learning analysis of big data could lead to the fully automated diagnosis of these disorders.
Collapse
Affiliation(s)
- Arielle Levy
- GRC 32, Transplantation et Thérapies Innovantes de la Cornée, Sorbonne Université, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France.
| | - Cristina Georgeon
- GRC 32, Transplantation et Thérapies Innovantes de la Cornée, Sorbonne Université, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France.
| | - Juliette Knoeri
- GRC 32, Transplantation et Thérapies Innovantes de la Cornée, Sorbonne Université, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France.
| | - Moïse Tourabaly
- GRC 32, Transplantation et Thérapies Innovantes de la Cornée, Sorbonne Université, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France.
| | - Loïc Leveziel
- GRC 32, Transplantation et Thérapies Innovantes de la Cornée, Sorbonne Université, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France.
| | - Nacim Bouheraoua
- GRC 32, Transplantation et Thérapies Innovantes de la Cornée, Sorbonne Université, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France.
| | - Vincent M. Borderie
- GRC 32, Transplantation et Thérapies Innovantes de la Cornée, Sorbonne Université, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France.
| |
Collapse
|
12
|
Bennedjai A, Hennocq Q, Simon F, Testelin S, Devauchelle B, Tulasne JF, Bouheraoua N, Adam R, Nordmann JP, Khonsari RH. Orbital in juries in wartime: Historical study from Paul Tessier's work in Iran. J Fr Ophtalmol 2022; 45:628-632. [PMID: 35597681 DOI: 10.1016/j.jfo.2022.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 12/02/2021] [Revised: 01/17/2022] [Accepted: 02/01/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Paul Tessier was a leading French oculoplastic surgeon who took part in several surgical missions in Iran to manage victims of the Iraq-Iran conflict in the late 1980's and early 1990's. METHODS We collected the records of 322 patients who underwent surgical procedures for the management of wartime injuries by Paul Tessier's team in Iran from 1990 to 1993. We also report one of the most representative cases of orbital reconstruction performed by Tessier. RESULTS Mean age at the time of trauma was 20.65±7.04 years (range: 2--62). Craniofacial CT-scans were available for 54 patients. The bones of the upper third of the face and the orbital contents were affected in 124/322 patients (38.50%). Soft-tissue lesions of the upper third included 13 frontal lacerations (4.04%), 60 orbital injuries (18.63%) and 95 uni- or bilateral enucleations (29.50%). Thirty-nine uni- or bilateral lid injuries (12.11%) and 8 tear duct injuries (2.48%) were reported. A specific case of orbital reconstruction using antero-internal and posterior iliac bone grafts was reported as a representative example of Tessier's techniques. CONCLUSION This study highlights the challenges of orbital reconstruction in wartime injuries and provides insights on the work of one of the most renowned surgeons in this field.
Collapse
Affiliation(s)
- A Bennedjai
- Centre Hospitalier National d'Ophtalmologie des 15-20, Service 2, Université de Paris, Paris, France.
| | - Q Hennocq
- Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Service de chirurgie maxillo-faciale et chirurgie plastique, Université de Paris, Paris, France
| | - F Simon
- Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Service de chirurgie oto-rhino-laryngologie, Université de Paris, Paris, France
| | - S Testelin
- CHU Amiens Picardie-Service de chirurgie maxillo-faciale, Université de Picardie Jules Vernes, Amiens, France
| | - B Devauchelle
- CHU Amiens Picardie-Service de chirurgie maxillo-faciale, Université de Picardie Jules Vernes, Amiens, France
| | | | - N Bouheraoua
- Centre Hospitalier National d'Ophtalmologie des 15-20, Service 5, Sorbonne Université, Paris, France
| | - R Adam
- Centre Hospitalier National d'Ophtalmologie des 15-20, Service 2, Université de Paris, Paris, France
| | - J-P Nordmann
- Centre Hospitalier National d'Ophtalmologie des 15-20, Service 2, Université de Paris, Paris, France
| | - R H Khonsari
- Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Service de chirurgie maxillo-faciale et chirurgie plastique, Université de Paris, Paris, France
| |
Collapse
|
13
|
Olivier R, Knoeri J, Leveziel L, Negrier P, Georgeon C, Kobal A, Bouheraoua N, Baudouin C, Nordmann J, Brignole‐Baudouin F, Merabet L, Borderie V. Update on fungal keratitis in France: a case-control study. Acta Ophthalmol 2022; 100:159-163. [PMID: 34031997 DOI: 10.1111/aos.14910] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 01/08/2021] [Accepted: 05/01/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE To report an epidemiological update of documented fungal keratitis (FK) in a French tertiary ophthalmological centre from 2014 to 2018 in comparison with a previous period from 1993 to 2008. METHODS Sixty-two consecutive FK documented by microbiological corneal scrapings were compared with the 64 FK of the previous study. Amphotericin B and voriconazole eye drops were administered hourly. Population characteristics, clinical findings, aetiological organisms and treatments were analysed. RESULTS The most frequently identified fungi were Fusarium (61%), Aspergillus (6.5%) and Candida (5%). Thirty out of 44 cases examined with in vivo confocal microscopy (IVCM) presented filaments. Ten required conventional cross-linking, 9 therapeutic penetrating keratoplasty, and 2 enucleation. Risk factors significantly associated with the absence of response to medical treatment were patient age (p = 0.01), presence of a deep stromal infiltrate at presentation (p = 0.04) and high numbers of filaments in IVCM images (p = 0.01). The two populations were comparable in age, but not in sex ratio males/females (18/44 versus 37/26 in the previous study; p = 0.001). The frequency of contact lens-associated infection increased from 35.5% to 71% (p = 0.0001) between the two periods. Since then, filamentous FK increased from 69% (44/64) to 95% (59/62) (p = 0.0001). A history of keratoplasty was less frequently reported during the last period (3.2% (2/62) versus 17% (11/64) of cases (p = 0.01)). A clear decrease in the frequency of therapeutic keratoplasty was noted from 39% (25/64) to 14% (9/62) (p = 0.02). CONCLUSION The frequency of filamentous keratomycosis is currently increasing. Elderly patients and the presence of numerous filaments in IVCM are associated with poor clinical outcomes.
Collapse
Affiliation(s)
- Roxane Olivier
- GRC32 Sorbonne Université Centre Hospitalier National d'Ophtalmologie des Quinze‐Vingts Paris France
- Faculté de médecine Hyacinthe Bastaraud Pointe‐à‐Pitre France
| | - Juliette Knoeri
- GRC32 Sorbonne Université Centre Hospitalier National d'Ophtalmologie des Quinze‐Vingts Paris France
| | - Loïc Leveziel
- GRC32 Sorbonne Université Centre Hospitalier National d'Ophtalmologie des Quinze‐Vingts Paris France
| | - Pierre Negrier
- GRC32 Sorbonne Université Centre Hospitalier National d'Ophtalmologie des Quinze‐Vingts Paris France
| | - Cristina Georgeon
- GRC32 Sorbonne Université Centre Hospitalier National d'Ophtalmologie des Quinze‐Vingts Paris France
| | - Alfred Kobal
- GRC32 Sorbonne Université Centre Hospitalier National d'Ophtalmologie des Quinze‐Vingts Paris France
| | - Nacim Bouheraoua
- GRC32 Sorbonne Université Centre Hospitalier National d'Ophtalmologie des Quinze‐Vingts Paris France
- Sorbonne Université UM80 INSERM UMR 968 CNRS UMR 7210 Institut de la Vision IHU ForeSight Paris France
| | - Christophe Baudouin
- GRC32 Sorbonne Université Centre Hospitalier National d'Ophtalmologie des Quinze‐Vingts Paris France
- Sorbonne Université UM80 INSERM UMR 968 CNRS UMR 7210 Institut de la Vision IHU ForeSight Paris France
| | - Jean‐Philippe Nordmann
- GRC32 Sorbonne Université Centre Hospitalier National d'Ophtalmologie des Quinze‐Vingts Paris France
| | - Françoise Brignole‐Baudouin
- GRC32 Sorbonne Université Centre Hospitalier National d'Ophtalmologie des Quinze‐Vingts Paris France
- Sorbonne Université UM80 INSERM UMR 968 CNRS UMR 7210 Institut de la Vision IHU ForeSight Paris France
| | - Lilia Merabet
- GRC32 Sorbonne Université Centre Hospitalier National d'Ophtalmologie des Quinze‐Vingts Paris France
| | - Vincent Borderie
- GRC32 Sorbonne Université Centre Hospitalier National d'Ophtalmologie des Quinze‐Vingts Paris France
- Sorbonne Université UM80 INSERM UMR 968 CNRS UMR 7210 Institut de la Vision IHU ForeSight Paris France
| |
Collapse
|
14
|
Trinh L, Bouheraoua N, Muraine M, Baudouin C. Anterior chamber fibrin reaction during Descemet membrane endothelial keratoplasty. Am J Ophthalmol Case Rep 2022; 25:101323. [PMID: 35146197 PMCID: PMC8818478 DOI: 10.1016/j.ajoc.2022.101323] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 07/04/2021] [Accepted: 01/20/2022] [Indexed: 11/29/2022] Open
Abstract
Purpose To report a series of five cases of intraoperative spontaneous anterior chamber fibrin reaction during Descemet Membrane Endothelial Keratoplasty (DMEK). Methods We retrospectively collected demographic data and data for ocular disease history for each patient. Donor age, preoperative graft endothelial density, surgical complications on surgery and intraoperative OCT videos, intraoperative management and outcome were assessed. The same standardized DMEK technique was used for all patients. Results We report intraoperative fibrin formation in five eyes subjected to DMEK. Three pseudophakic eyes underwent single DMEK, and the other two underwent combined DMEK and cataract surgery. In one case, a fibrin filament was observed before graft insertion, with multiplication during surgery, whereas, in the other four cases, strands of fibrin from the iris appeared after graft insertion. This complication resulted in graft failure in four cases (80%). No recipient- or donor-related risk factor was identified. Conclusions and importance The anterior chamber fibrin reaction is a very uncommon complication of DMEK. The underlying pathophysiological mechanisms remain unknown, but analyses of surgical videos and intraoperative OCT suggest iris involvement. This phenomenon may be induced by chronic subclinical anterior chamber inflammation, due to a blood-aqueous barrier breakdown associated with acute iris trauma during surgery. Thus, intraoperative microtraumatism of the iris should be avoided.
Collapse
Affiliation(s)
- Liem Trinh
- CHNO des Quinze-Vingts, IHU Foresight, INSERM-DGOS CIC 1423, 28 Rue de Charenton, F, 75012, Paris, France
- Corresponding author. Centre Hospitalier National d’Ophtalmologie des Quinze-Vingts, 28 rue de Charenton, Paris, 75012, France.
| | - Nacim Bouheraoua
- CHNO des Quinze-Vingts, IHU Foresight, INSERM-DGOS CIC 1423, 28 Rue de Charenton, F, 75012, Paris, France
- Sorbonne Université, INSERM, CNRS, Institut de La Vision, 17 Rue Moreau, F, 75012, Paris, France
| | - Marc Muraine
- Department of Ophtalmology, Hospital Charles Nicolle, Rouen, France
| | - Christophe Baudouin
- CHNO des Quinze-Vingts, IHU Foresight, INSERM-DGOS CIC 1423, 28 Rue de Charenton, F, 75012, Paris, France
- Sorbonne Université, INSERM, CNRS, Institut de La Vision, 17 Rue Moreau, F, 75012, Paris, France
- Department of Ophthalmology, Ambroise Paré Hospital, AP-HP, University of Versailles Saint-Quentin-en-Yvelines, Boulogne-Billancourt, France
| |
Collapse
|
15
|
Sandali O, El Sanharawi M, Tahiri Joutei Hassani R, Roux H, Bouheraoua N, Borderie V. Early corneal pachymetry maps after cataract surgery and influence of 3D digital visualization system in minimizing corneal oedema. Acta Ophthalmol 2021; 100:e1088-e1094. [PMID: 34750943 DOI: 10.1111/aos.15060] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 05/20/2021] [Accepted: 10/25/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE To describe the early topography of corneal swelling occurring after cataract surgery and to evaluate the impact of the three-dimensional (3D) digital visualization system in minimizing corneal oedema. METHODS Prospective observational, single-centre, consecutive case series of 134 patients undergoing cataract surgery performed by the same surgeon, with either 3D or conventional visualization systems. Eyes were assigned to two groups based on their anterior chamber depth (group ACD ≤3 mm and group ACD >3 mm). Optical coherence tomography was performed to evaluate postoperative corneal swelling. RESULTS Three corneal swelling profiles were identified on the first postoperative day type 1, limited corneal oedema near peripheral corneal incisions; type 2, dome-shaped corneal swelling spreading from the principal corneal incision and reaching the paracentral cornea; type 3, continuous oedema spreading from the principal incision to central cornea, with a generalized oedema predominating in the upper part of the cornea. On the first day after surgery, in group ACD ≤3 mm, visual acuity was significantly better in patients undergoing surgery with 3D visualization (0.023 vs 0.072 logMar, p = 0.014) with reduced central corneal thickening 17.3 µm (±3.2) in comparison with conventional visualization 44.0 µm (±9.3) (p = 0.0082). In group ACD >3 mm, no significant association was found between the use of the 3D system and pachymetry changes and early visual rehabilitation. On day 21 after surgery, no significant differences in corneal pachymetry values were observed between the two surgical approaches in both groups. CONCLUSIONS We describe early postoperative corneal map profiles providing insight into the pathogenesis of postoperative corneal swelling and possible prevention strategies. By improving visualization of the narrow surgical space in patients with shallow anterior chambers, the 3D system could help to minimize postoperative corneal oedema.
Collapse
Affiliation(s)
- Otman Sandali
- Quinze‐Vingts National Ophthalmology Hospital Paris France
- Ambulatory Department Guillaume‐de‐Varye Hospital Bourges France
| | | | | | - Hillary Roux
- Ambulatory Department Guillaume‐de‐Varye Hospital Bourges France
| | | | | |
Collapse
|
16
|
Barugel R, David C, Kallel S, Borderie M, Cuyaubère R, Goemaere I, Borderie V, Bouheraoua N. Comparative Study of Asymmetric Versus Non-asymmetric Intrastromal Corneal Ring Segments for the Management of Keratoconus. J Refract Surg 2021; 37:552-561. [PMID: 34388067 DOI: 10.3928/1081597x-20210526-01] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare the outcomes obtained with models of asymmetric and non-asymmetric intracorneal ring segments (ICRS) in keratoconic eyes with asymmetric topo-graphic patterns. METHODS In this prospective observational study, ICRS were implanted alternately in patients with the same tomographic patterns of keratoconus assigned to four groups. Patients with the "duck" phenotype received one asymmetric or non-asymmetric ICRS and patients with the "snowman" pheno-type received two asymmetric or non-asymmetric ICRS. Visual, refractive, astigmatism, keratometric, and corneal aberrometry changes were evaluated over a 6-month follow-up period. RESULTS Sixty-eight eyes were analyzed. No significant difference was observed between the use of one asymmetric and one non-asymmetric ICRS in duck phenotypes. In snowman keratoconus, the inferior-superior index decreased significantly (P = .03) with asymmetric but not with non-asymmetric ICRS implantation. Total corneal higher order aberrations and coma rates were lower, but not significantly so, after the implantation of two asymmetric ICRS in snowman phenotypes (2.85 ± 0.89 to 2.60 ± 0.91 µm, P = .20 and 2.64 ± 0.93 to 2.39 ± 0.98 µm, P = .21), and significantly higher after the implantation of two non-asymmetric ICRS (2.56 ± 1.28 to 3.08 ± 1.62 µm, P = .02 and 2.34 ± 1.27 to 2.84 ± 1.62 µm, P = .02). CONCLUSIONS Asymmetric ICRS did not improve the outcomes of ICRS implantation in duck keratoconus. However, the implantation of two asymmetric ICRS was more effective than that of two non-asymmetric ICRS for decreasing vertical asymmetry and preventing increases in corneal aberration in the snowman phenotype of keratoconus. [J Refract Surg. 2021;37(8):552-561.].
Collapse
|
17
|
Saad S, Sellam A, Borderie V, Bouheraoua N. [OCT-guided aspiration of subfoveal perfluorocarbon liquid using a 27-gauge cannula]. J Fr Ophtalmol 2021; 44:1076-1078. [PMID: 34243999 DOI: 10.1016/j.jfo.2021.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 01/10/2021] [Indexed: 11/15/2022]
Affiliation(s)
- S Saad
- CHNO des Quinze-Vingts, Inserm-DGOS CIC 1423, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France
| | - A Sellam
- CHNO des Quinze-Vingts, Inserm-DGOS CIC 1423, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France.
| | - V Borderie
- CHNO des Quinze-Vingts, Inserm-DGOS CIC 1423, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France; Sorbonne Université, Inserm, CNRS, Institut de la Vision, 17, rue Moreau, 75012 Paris, France
| | - N Bouheraoua
- CHNO des Quinze-Vingts, Inserm-DGOS CIC 1423, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France; Sorbonne Université, Inserm, CNRS, Institut de la Vision, 17, rue Moreau, 75012 Paris, France
| |
Collapse
|
18
|
Hoarau G, Merabet L, Knoeri J, Georgeon C, Poirier P, Borderie V, Brignole-Baudouin F, Bouheraoua N. Microsporidial keratoconjunctivitis: Report of two imported cases. J Fr Ophtalmol 2021; 44:e551-e554. [PMID: 34148704 DOI: 10.1016/j.jfo.2020.12.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 12/08/2020] [Indexed: 11/20/2022]
Affiliation(s)
- G Hoarau
- CHNO des Quinze-Vingts, Inserm-DGOS CIC 1423, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France
| | - L Merabet
- CHNO des Quinze-Vingts, Inserm-DGOS CIC 1423, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France
| | - J Knoeri
- CHNO des Quinze-Vingts, Inserm-DGOS CIC 1423, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France
| | - C Georgeon
- CHNO des Quinze-Vingts, Inserm-DGOS CIC 1423, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France
| | - P Poirier
- Laboratoire de parasitologie-mycologie, 3IHP, centre hospitalier universitaire Gabriel-Montpied, 58, rue Montalembert, 63000 Clermont-Ferrand, France; Université Clermont-Auvergne, CNRS UMR 6023, laboratoire Micro-organismes: génome et environnement, Clermont-Ferrand, France
| | - V Borderie
- CHNO des Quinze-Vingts, Inserm-DGOS CIC 1423, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France; Sorbonne université, Inserm, CNRS, Institut de la Vision, 17, rue Moreau, 75012 Paris, France
| | - F Brignole-Baudouin
- CHNO des Quinze-Vingts, Inserm-DGOS CIC 1423, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France
| | - N Bouheraoua
- CHNO des Quinze-Vingts, Inserm-DGOS CIC 1423, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France; Sorbonne université, Inserm, CNRS, Institut de la Vision, 17, rue Moreau, 75012 Paris, France.
| |
Collapse
|
19
|
David C, Reinstein DZ, Archer TJ, Kallel S, Vida RS, Goemaere I, Cuyaubère R, Borderie M, Laroche L, Borderie V, Bouheraoua N. Postoperative Corneal Epithelial Remodeling After Intracorneal Ring Segment Procedures for Keratoconus: An Optical Coherence Tomography Study. J Refract Surg 2021; 37:404-413. [PMID: 34170769 DOI: 10.3928/1081597x-20210225-02] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To assess epithelial corneal remodeling by anterior segment optical coherence tomography (AS-OCT) after intracorneal ring segments (ICRS) implantation in keratoconic eyes. METHODS This prospective observational study included patients with keratoconus receiving ICRS of different arc lengths according to their tomographic pattern. AS-OCT and corneal topography (Scheimpflug camera) were performed before and 1, 3, and 6 months after surgery. Corneal pachymetry mapping was performed and total corneal and epithelial thicknesses (3-mm central and 16 points on 6-mm zone) were measured over the pupil center using AS-OCT. Topographic parameters were also assessed. RESULTS A total of 68 keratoconic eyes were analyzed (Amsler-Krumeich stages 1 to 4) in four groups of 17 eyes: 210° ICRS, 320° ICRS, double 160° ICRS, and single 160° ICRS. Corneal pachymetry mapping revealed that epithelial thickness increased significantly in the internal zones juxtaposed to the ICRS without smoothing during the postoperative period (P < .05). Mean maximum epithelial thickness increased from 67 ± 6 to 79 ± 7 µm for 210° ICRS, 66 ± 9 to 82 ± 4 µm for 320° ICRS, 63 ± 6 to 78 ± 7 µm for double 160° ICRS, and 62 ± 5 to 77 ± 5 µm for single 160° ICRS (P < .0001). Significant epithelial thickening at the apex of the cone was observed in all groups (P < .05). CONCLUSIONS Significant epithelial thickening occurs after ICRS implantation adjacent to the ICRS to compensate for the ridge created with a thickening of epithelium over the cone due to regularization of the stromal surface. [J Refract Surg. 2021;37(6):404-413.].
Collapse
|
20
|
David C, Kallel S, Trinh L, Goemaere I, Borderie V, Bouheraoua N. [Intracorneal ring segments in keratoconus management]. J Fr Ophtalmol 2021; 44:882-898. [PMID: 33895029 DOI: 10.1016/j.jfo.2020.10.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 04/19/2020] [Revised: 09/30/2020] [Accepted: 10/02/2020] [Indexed: 11/25/2022]
Abstract
Intracorneal ring segments (ICRS), used in the management of keratoconus since the 2000s, have enjoyed significant technological development. Various types of ICRS exist, whose arc length, thickness, and diameter can be chosen according to the desired effect on the spherical equivalent, keratometry and asphericity. Individualized implantation strategies, based on each patient's topographic and tomographic pattern, are constantly evolving. The surgical procedure is standardized, and complications remain very rare. Combined procedures (corneal collagen cross-linking and refractive photokeratectomy±topo-guided, phakic and pseudophakic intraocular lenses) are increasingly used and require a good knowledge of the effect of ICRS alone on the keratoconic cornea. The objective of this review is to summarize clinical practices used in the visual rehabilitation of keratoconic patients using the ICRS+- combined procedures.
Collapse
Affiliation(s)
- C David
- INSERM-DGOS CIC 1423, CHNO des Quinze-Vingts, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France
| | - S Kallel
- INSERM-DGOS CIC 1423, CHNO des Quinze-Vingts, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France
| | - L Trinh
- INSERM-DGOS CIC 1423, CHNO des Quinze-Vingts, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France
| | - I Goemaere
- INSERM-DGOS CIC 1423, CHNO des Quinze-Vingts, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France
| | - V Borderie
- INSERM-DGOS CIC 1423, CHNO des Quinze-Vingts, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France; Inserm, CNRS, Sorbonne université, institut de la Vision, 17, rue Moreau, 75012 Paris, France
| | - N Bouheraoua
- INSERM-DGOS CIC 1423, CHNO des Quinze-Vingts, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France; Inserm, CNRS, Sorbonne université, institut de la Vision, 17, rue Moreau, 75012 Paris, France.
| |
Collapse
|
21
|
Leveziel L, Knoeri J, Errera MH, Kobal A, Fardeau C, Bouheraoua N, Sahel JA, Baudouin C, Nordmann JP, Baudouin F, Merabet L, Borderie V. Anterior chamber tap cytology in acute postoperative endophthalmitis: a case-control study. Br J Ophthalmol 2021; 106:807-814. [PMID: 33574032 DOI: 10.1136/bjophthalmol-2020-317438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 07/09/2020] [Revised: 09/24/2020] [Accepted: 01/04/2021] [Indexed: 11/03/2022]
Abstract
AIMS To determine anterior chamber tap cytology characteristics in acute postoperative bacterial endophthalmitis. METHODS 488 eyes of 488 patients were included in this retrospective case-control study. The study group included 93 eyes with bacteriologically documented endophthalmitis and 85 eyes with clinical endophthalmitis. The control group included 33 eyes with non-infectious postoperative inflammation, 116 eyes with acute uveitis and 161 cataract surgery eyes with no ocular inflammation. Cytological analysis, direct examination and microbiological cultures were performed in aqueous humour (AqH) samples. Inclusion criteria for the study group were the following: suspected endophthalmitis within 30 days following cataract surgery by phacoemulsification, secondary lens implantation, pars plana vitrectomy or intravitreal injection; best-corrected visual acuity (BCVA) <20/400; hypopyon or cyclitic membrane; absence of visibility of the retina; vitritis at a slit-lamp examination or in ultrasound B-scan. RESULTS Cell line counts (mainly polymorphonuclear neutrophils) were significantly higher in the two endophthalmitis study subgroups than in the three control subgroups. The study group showed a predominance of polymorphonuclear neutrophils as opposed to the three control subgroups including uveitis (p<0.00001). The best sensitivity/specificity was obtained using a polymorphonuclear neutrophil threshold of 10 per field (sensitivity, 0.90; specificity, 0.75). The sensitivity of the bacterial culture was 32% in the AqH. High neutrophil count was associated with poorer initial BCVA (rs=0.62; p<0.00001) and higher risk of retinal detachment during (p=0.04) and after (p<0.001) hospitalisation. CONCLUSION Anterior chamber tap cytology is a quick and accessible tool complementary to culture and PCR for the management of acute postoperative endophthalmitis.
Collapse
Affiliation(s)
- Loic Leveziel
- Ophthalmology, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, Île-de-France, France
| | - Juliette Knoeri
- Ophthalmology, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, Île-de-France, France
| | - Marie-Helene Errera
- Ophthalmology, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, Île-de-France, France.,Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Alfred Kobal
- Laboratory of Biology, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, Ile-de-France, France
| | - Christine Fardeau
- Ophthalmology, Hôpital Universitaire Pitié Salpêtrière, Paris, Île-de-France, France
| | - Nacim Bouheraoua
- Ophthalmology, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, Île-de-France, France
| | - José Alain Sahel
- Ophthalmology, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, Île-de-France, France.,Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Christophe Baudouin
- Ophthalmology, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, Île-de-France, France
| | - Jean-Philippe Nordmann
- Ophthalmology, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, Île-de-France, France
| | - Françoise Baudouin
- Laboratory of Biology, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, Ile-de-France, France
| | - Lilia Merabet
- Laboratory of Biology, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, Ile-de-France, France
| | - Vincent Borderie
- Ophthalmology, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, Île-de-France, France
| |
Collapse
|
22
|
Tourabaly M, Knoeri J, Leveziel L, Bouheraoua N, Ameline B, Borderie V. Prevention of infection after corneal refractive surgery: a French survey. J Cataract Refract Surg 2021; 47:27-32. [PMID: 32826703 DOI: 10.1097/j.jcrs.0000000000000396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 06/02/2020] [Accepted: 07/30/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE To report the French refractive surgeons' real-life practices for preventing infection after corneal refractive surgery (photorefractive keratotomy [PRK], laser in situ keratomileusis [LASIK], and small-incision lenticule extraction). SETTING France. DESIGN Anonymous practice survey. METHODS The questionnaire was sent in a single email invitation to 400 declared refractive surgeons. The following information was recorded between December 2019 and April 2020, before the coronavirus pandemic: demographics data, preoperative evaluation and preparation of the patient, surgical management, immediate and postoperative protocol, and infections reported after corneal refractive surgery. RESULTS Eighty-three of 400 surgeons (20.75%) responded to the questionnaire; 55 (66.0%) performed more than 50 corneal refractive surgeries a year, and 25 (30.1%) performed more than 200 procedures a year. Thirty-six (43.4%) surgeons wore 3 protective items, 37 (44.6%) 2, 5 (6.0%) 1, and 5 (6.0%) zero. Seventy-seven (92.8%) surgeons used povidone-iodine for skin area disinfection and 54 (65%) for conjunctival fornix disinfection. The contact time of povidone-iodine was less than 3 minutes for 71 (85.0%) surgeons. Twenty surgeons (24.1%) reported at least 1 postrefractive surgery infection. Twenty percent of surgeons who wore sterile gloves for PRK reported postoperative infections compared with 62.5% for those who did not (P = .008). These figures were, respectively, 8.7% and 66.7% for the use of sterile gloves during LASIK (P = .002); 8.9% of surgeons who wore surgical masks for LASIK reported postoperative infections compared with 50.0% for those who did not (P = .01). CONCLUSIONS Practices are variable among French refractive surgeons. Wearing a surgical mask and sterile gloves during corneal refractive surgery appears to be advisable.
Collapse
Affiliation(s)
- Moïse Tourabaly
- From the Quinze-Vingts National Ophthalmology Hospital, Sorbonne University (Tourabaly, Knoeri, Leveziel, Bouheraoua, Ameline, Borderie), and the Vision Institute, Sorbonne University (Bouheraoua, Borderie), Paris, France
| | | | | | | | | | | |
Collapse
|
23
|
Trinh L, Bouheraoua N, Roman S, Auclin F, Labbé A, Baudouin C. Excimer laser programming of refractive astigmatism vs. anterior corneal astigmatism in the case of ocular residual astigmatism (ORA). J Fr Ophtalmol 2020; 44:189-195. [PMID: 33358474 DOI: 10.1016/j.jfo.2020.04.059] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 04/22/2020] [Indexed: 11/18/2022]
Abstract
PURPOSE To determine whether manifest refractive astigmatism (RA) or anterior corneal astigmatism (CA) is the best value for excimer laser programming in cases of ocular residual astigmatism (ORA). PATIENTS AND METHODS Patients who had undergone LASIK surgery with a disagreement between manifest refractive and corneal cylinder (ocular residual astigmatism ORA)>0.75 D were included retrospectively in this study. We calculated target induced astigmatism vector (TIA), surgically induced astigmatism vector (SIA), difference vector between the astigmatism correction programmed in the excimer laser and refractive astigmatism (DVRA), difference vector between the astigmatism correction programmed in the excimer laser and corneal astigmatism (DVCA) and difference vector between TIA and SIA (DV), by the Alpins method. Vectorial differences between DV and DVRA, and between DV and DVCA, were then calculated to determine whether RA or CA was closest to the ideal cylinder for laser programming. RESULTS Of a total of 104 eyes undergoing LASIK, 22 eyes of 12 patients (21.1%) had an ORA>0.75 D and were included. Mean ORA was 0.9±0.2 D and mean postoperative subjective cylinder was 0.45 D. The DV-DVRA difference vector was 0.57±0.2 D, and the DV-DVCA difference vector was 0.86±0.4 D (P=0.02). RA was closer than CA to the ideal astigmatism correction. CONCLUSION In cases of discrepancy between manifest astigmatism and corneal astigmatism, correction of manifest refractive astigmatism seems to give a better refractive result.
Collapse
Affiliation(s)
- L Trinh
- CHNO des Quinze-Vingts, IHU Foresight, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France.
| | - N Bouheraoua
- CHNO des Quinze-Vingts, IHU Foresight, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France; Sorbonne Université, Inserm, CNRS, Institut de la Vision, 17, rue Moreau, 75012 Paris, France
| | - S Roman
- CHNO des Quinze-Vingts, IHU Foresight, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France
| | - F Auclin
- CHNO des Quinze-Vingts, IHU Foresight, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France
| | - A Labbé
- CHNO des Quinze-Vingts, IHU Foresight, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France; Sorbonne Université, Inserm, CNRS, Institut de la Vision, 17, rue Moreau, 75012 Paris, France; Department of Ophthalmology, Ambroise Paré Hospital, AP-HP, University of Versailles Saint-Quentin-en-Yvelines, Boulogne-Billancourt, France
| | - C Baudouin
- CHNO des Quinze-Vingts, IHU Foresight, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France; Sorbonne Université, Inserm, CNRS, Institut de la Vision, 17, rue Moreau, 75012 Paris, France; Department of Ophthalmology, Ambroise Paré Hospital, AP-HP, University of Versailles Saint-Quentin-en-Yvelines, Boulogne-Billancourt, France
| |
Collapse
|
24
|
Saad S, Saad R, Jouve L, Kallel S, Trinh L, Goemaere I, Borderie V, Bouheraoua N. Corneal crosslinking in keratoconus management. J Fr Ophtalmol 2020; 43:1078-1095. [DOI: 10.1016/j.jfo.2020.07.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 07/09/2020] [Accepted: 07/30/2020] [Indexed: 01/04/2023]
|
25
|
Tourabaly M, Jabrane F, Banayan N, Borderie V, Bouheraoua N. [Mycotic aneurysm secondary to bacterial endocarditis in a 24-year-old man]. J Fr Ophtalmol 2020; 44:263-264. [PMID: 33190962 DOI: 10.1016/j.jfo.2020.03.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 03/25/2020] [Indexed: 11/25/2022]
Affiliation(s)
- M Tourabaly
- Inserm-DGOS CIC 1423, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France
| | - F Jabrane
- Inserm-DGOS CIC 1423, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France
| | - N Banayan
- Inserm-DGOS CIC 1423, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France
| | - V Borderie
- Inserm-DGOS CIC 1423, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France; Inserm, CNRS, Institut de la vision, Sorbonne université, 17, rue Moreau, 75012 Paris, France
| | - N Bouheraoua
- Inserm-DGOS CIC 1423, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France; Inserm, CNRS, Institut de la vision, Sorbonne université, 17, rue Moreau, 75012 Paris, France.
| |
Collapse
|
26
|
Affiliation(s)
- L Trinh
- Centre hospitalier national d'ophtalmologie des Quinze-Vingts, IHU de Foresight, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France.
| | - C Baudouin
- Centre hospitalier national d'ophtalmologie des Quinze-Vingts, IHU de Foresight, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France; Service d'ophtalmologie, hôpital Ambroise-Paré, AP-HP, université de Versailles Saint-Quentin-en-Yvelines, 9, avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France
| | - N Bouheraoua
- Centre hospitalier national d'ophtalmologie des Quinze-Vingts, IHU de Foresight, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France; Inserm, Sorbonne université, CNRS, institut de la Vision, 17, rue Moreau, 75012 Paris, France
| |
Collapse
|
27
|
Cuyaubère R, Jouve L, Borderie V, Bouheraoua N. [Bilateral prominent corneal nerves associated with primary amyloidosis]. J Fr Ophtalmol 2020; 44:472-474. [PMID: 33172716 DOI: 10.1016/j.jfo.2020.04.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 04/15/2020] [Indexed: 10/23/2022]
Affiliation(s)
- R Cuyaubère
- Inserm-DGOS CIC 1423, IHU ForeSight, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France
| | - L Jouve
- Inserm-DGOS CIC 1423, IHU ForeSight, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France
| | - V Borderie
- Inserm-DGOS CIC 1423, IHU ForeSight, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France; Inserm, CNRS, institut de la vision, Sorbonne université, 17, rue Moreau, 75012 Paris, France
| | - N Bouheraoua
- Inserm-DGOS CIC 1423, IHU ForeSight, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France; Inserm, CNRS, institut de la vision, Sorbonne université, 17, rue Moreau, 75012 Paris, France.
| |
Collapse
|
28
|
Da Cunha E, Georgeon C, Bouheraoua N, Putterman M, Brignole-Baudouin F, Borderie VM. Multimodal imaging of Hurler syndrome-related keratopathy treated with deep anterior lamellar keratoplasty. BMC Ophthalmol 2020; 20:433. [PMID: 33129306 PMCID: PMC7603712 DOI: 10.1186/s12886-020-01689-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 07/14/2020] [Accepted: 10/08/2020] [Indexed: 11/10/2022] Open
Abstract
Background Hurler syndrome-associated keratopathy is an exceedingly rare corneal disorder that requires corneal transplantation in advanced stages. Precise assessment of the corneal condition is necessary for deciding which type of keratoplasty (i.e., deep anterior lamellar or penetrating) should be proposed. We aimed to confront the results of multimodal imaging with those of histology in a case of Hurler syndrome-associated keratopathy. Case presentation A 16-year-old patient with Hurler’s syndrome treated with hematopoietic stem cell transplantation was referred for decreased vision related to advanced keratopathy. The patient was treated with deep anterior lamellar keratoplasty (DALK) in both eyes with uncomplicated outcome. Visual acuity improved from 0.1 (20/200) preoperatively to 0.32 (20/63) and 0.63 (20/32) after transplantation. The corneal endothelial cell density was 2400 cells/mm2 in both eyes 3 years after transplantation. In vivo confocal microscopy (IVCM) and spectral domain optical coherence tomography (SD-OCT) were performed preoperatively. The corneal buttons retrieved during keratoplasty were processed for histology. In SD-OCT scans, corneal opacities appeared as diffuse stromal hyperreflectivity associated with increased corneal thickness. IVCM showed diffuse cytoplasmic granular hyperreflectivity and rounded/ellipsoid aspects of keratocytes, presence of small intracellular vacuoles, and hyperreflective epithelial intercellular spaces. Bowman’s layer was thin and irregular. The corneal endothelium was poorly visualized but no endothelial damage was observed. Histology showed irregular orientation and organization of stromal lamellae, with the presence of macrophages whose cytoplasm appeared clear and granular. A perinuclear clear halo was visible within the epithelial basal cells. Bowman’s layer featured breaks and irregularities. Conclusions The observed corneal multimodal imaging features in mucopolysaccharidosis-related keratopathy were concordant with histology. Compared with standard histology, multimodal imaging allowed additional keratocyte features to be observed. It revealed both morphological and structural changes of all corneal layers but the endothelium. This information is essential for therapeutic management which should include DALK as the first-choice treatment in case of impaired visual acuity.
Collapse
Affiliation(s)
- Elodie Da Cunha
- GRC32, Transplantation et Thérapies Innovantes de la Cornée, Sorbonne université, Centre Hospitalier National d'Ophtalmologie des 15-20, 28 rue de Charenton, 75571 Cedex 12, Paris, France
| | - Cristina Georgeon
- GRC32, Transplantation et Thérapies Innovantes de la Cornée, Sorbonne université, Centre Hospitalier National d'Ophtalmologie des 15-20, 28 rue de Charenton, 75571 Cedex 12, Paris, France
| | - Nacim Bouheraoua
- GRC32, Transplantation et Thérapies Innovantes de la Cornée, Sorbonne université, Centre Hospitalier National d'Ophtalmologie des 15-20, 28 rue de Charenton, 75571 Cedex 12, Paris, France
| | - Marc Putterman
- Laboratoire (2), Centre Hospitalier National d'Ophtalmologie des 15-20, Paris, France
| | | | - Vincent M Borderie
- GRC32, Transplantation et Thérapies Innovantes de la Cornée, Sorbonne université, Centre Hospitalier National d'Ophtalmologie des 15-20, 28 rue de Charenton, 75571 Cedex 12, Paris, France.
| |
Collapse
|
29
|
Bennedjaï A, Bouheraoua N, Gatfossé M, Dupasquier-Fediaevsky L, Errera MH, Tazartes M, Borderie V, Hennocq Q, Dellal A, Riviere S, Heron E, Fain O, Mekinian A. Tocilizumab versus Rituximab in Patients with Moderate to Severe Steroid-resistant Graves' Orbitopathy. Ocul Immunol Inflamm 2020; 30:500-505. [PMID: 32965148 DOI: 10.1080/09273948.2020.1808688] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Introduction: To describe the efficacy of tocilizumab in patients with Graves' orbitopathy resistant or dependent to steroids and compare to rituximab treated patients.Patients and Methods: Graves's orbitopathy response was considered as decrease of at least 2 points of the CAS.Results: Twenty-one patients were included, 7 patients were treated with tocilizumab and 14 with rituximab. The primary was achieved in all 7 patients (100%) on tocilizumab and 9 out of 14 patients on (64%) rituximab (p = .17). Mean change in CAS was consistent with a decrease of 3.3 ± 0.5 points in patients on tocilizumab versus 2.5 ± 1.9 in patients on rituximab (p = .07). One patient on tocilizumab (14%) and 4 patients (29%) on rituximab experienced significant relapse during the follow-up. The difference in relapse-free survival was not significant in patients on tocilizumab (10.8 ± 4 months) compared with rituximab (17.88 ± 3.66).Conclusion: We showed a significant improvement in the CAS, visual acuity, diplopia, and proptosis with both tocilizumab and rituximab.
Collapse
Affiliation(s)
- Amin Bennedjaï
- Centre Hospitalier National d'Ophtalmologie Des 15-20, Sorbonne Universités, Paris, France
| | - Nacim Bouheraoua
- Centre Hospitalier National d'Ophtalmologie Des 15-20, Sorbonne Universités, Paris, France
| | - Marc Gatfossé
- AP-HP, Hôpital Saint Antoine, Service De Médecine Interne Et Inflammation-Immunopathology-Biotherapy Department (DMU i3), Sorbonne Universités, Paris, France.,UPMC Université Paris 06, UMR 7211, Département Hospitalo-UniversitaireInflammation-Immunopathologie-Biotherapie(DMU i3), Sorbonne Universités, Paris, France
| | | | - Marie-Hélène Errera
- Centre Hospitalier National d'Ophtalmologie Des 15-20, Sorbonne Universités, Paris, France.,Department of Ophthalmology, University of Pittsburgh Medical School, Pittsburgh, Pennsylvania, USA
| | - Michel Tazartes
- Centre Hospitalier National d'Ophtalmologie Des 15-20, Sorbonne Universités, Paris, France
| | - Vincent Borderie
- Centre Hospitalier National d'Ophtalmologie Des 15-20, Sorbonne Universités, Paris, France
| | - Quentin Hennocq
- AP-HP, Hôpital Pitié Salpêtrière, Service De Chirurgie Maxillo-faciale, Paris, France
| | | | - Sebastien Riviere
- AP-HP, Hôpital Saint Antoine, Service De Médecine Interne Et Inflammation-Immunopathology-Biotherapy Department (DMU i3), Sorbonne Universités, Paris, France.,UPMC Université Paris 06, UMR 7211, Département Hospitalo-UniversitaireInflammation-Immunopathologie-Biotherapie(DMU i3), Sorbonne Universités, Paris, France
| | - Emmanuel Heron
- Centre Hospitalier National d'Ophtalmologie Des 15-20, Sorbonne Universités, Paris, France
| | - Olivier Fain
- AP-HP, Hôpital Saint Antoine, Service De Médecine Interne Et Inflammation-Immunopathology-Biotherapy Department (DMU i3), Sorbonne Universités, Paris, France.,UPMC Université Paris 06, UMR 7211, Département Hospitalo-UniversitaireInflammation-Immunopathologie-Biotherapie(DMU i3), Sorbonne Universités, Paris, France
| | - Arsène Mekinian
- AP-HP, Hôpital Saint Antoine, Service De Médecine Interne Et Inflammation-Immunopathology-Biotherapy Department (DMU i3), Sorbonne Universités, Paris, France.,UPMC Université Paris 06, UMR 7211, Département Hospitalo-UniversitaireInflammation-Immunopathologie-Biotherapie(DMU i3), Sorbonne Universités, Paris, France
| |
Collapse
|
30
|
Georgeon C, Bouheraoua N, Borderie V. [In vivo histologic diagnosis of keratoconus by multimodal imaging]. J Fr Ophtalmol 2020; 44:132-134. [PMID: 32950289 DOI: 10.1016/j.jfo.2020.01.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 01/23/2020] [Accepted: 01/27/2020] [Indexed: 11/26/2022]
Affiliation(s)
- C Georgeon
- Centre hospitalier national d'ophtalmologie des XV-XX, 28, rue de Charenton, 75571 Paris cedex 12, France
| | - N Bouheraoua
- Centre hospitalier national d'ophtalmologie des XV-XX, 28, rue de Charenton, 75571 Paris cedex 12, France
| | - V Borderie
- Centre hospitalier national d'ophtalmologie des XV-XX, 28, rue de Charenton, 75571 Paris cedex 12, France.
| |
Collapse
|
31
|
Romito N, Trinh L, Goemaere I, Borderie V, Laroche L, Bouheraoua N. Corneal Remodeling After Myopic SMILE: An Optical Coherence Tomography and In Vivo Confocal Microscopy Study. J Refract Surg 2020; 36:597-605. [DOI: 10.3928/1081597x-20200713-01] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 06/12/2020] [Indexed: 11/20/2022]
|
32
|
Labani S, Basli E, Goemaere I, Borderie V, Laroche L, Bouheraoua N. Atypical severe diffuse lamellar keratitis presenting as concentric rings after femtosecond laser-assisted small-incision lenticule extraction (SMILE). J Fr Ophtalmol 2020; 43:e95-e99. [PMID: 32035631 DOI: 10.1016/j.jfo.2019.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 08/21/2019] [Accepted: 08/26/2019] [Indexed: 10/25/2022]
Affiliation(s)
- S Labani
- CHNO des Quinze-Vingts, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France
| | - E Basli
- CHNO des Quinze-Vingts, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France
| | - I Goemaere
- CHNO des Quinze-Vingts, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France
| | - V Borderie
- CHNO des Quinze-Vingts, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France; Sorbonne université, Inserm, CNRS, institut de la Vision, 17, rue Moreau, 75012 Paris, France
| | - L Laroche
- CHNO des Quinze-Vingts, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France; Sorbonne université, Inserm, CNRS, institut de la Vision, 17, rue Moreau, 75012 Paris, France
| | - N Bouheraoua
- CHNO des Quinze-Vingts, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France; Sorbonne université, Inserm, CNRS, institut de la Vision, 17, rue Moreau, 75012 Paris, France.
| |
Collapse
|
33
|
Tourabaly M, Chetrit Y, Provost J, Georgeon C, Kallel S, Temstet C, Bouheraoua N, Borderie V. Influence of graft thickness and regularity on vision recovery after endothelial keratoplasty. Br J Ophthalmol 2019; 104:1317-1323. [PMID: 31848210 DOI: 10.1136/bjophthalmol-2019-315180] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 09/03/2019] [Revised: 11/25/2019] [Accepted: 11/29/2019] [Indexed: 11/04/2022]
Abstract
AIM To assess the influence of graft thickness and regularity on visual recovery and postoperative wavefront aberrations after endothelial keratoplasty (EK). METHODS 150 EKs performed in eyes with corneal endothelial disorders and no other ocular comorbidities, preoperative and postoperative assessment with spectral domain optical coherence tomography and postoperative assessment with whole eye wavefront aberrometry were retrospectively analysed. Eyes were classified into five groups: Descemet Membrane Endothelial Keratoplasty (DMEK), nanothin Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) (15-49 µm), ultrathin DSAEK (50-99 µm), thin DSAEK (100-149 µm) and conventional DSAEK (150-250 µm). RESULTS The preoperative diagnosis was Fuchs dystrophy in 139 eyes (92.7%). The graft thickness measured after graft deswelling was in average 74 µm with a mean coefficient of variation of 17%. The average follow-up time was 32 months. The mean spectacle-corrected logarithm of minimum angle of resolution visual acuity improved from 0.76 (20/116) before surgery to 0.14 (20/27) at last follow-up visit. No significant differences in final visual acuity were found between the five groups. The time to reach 20/40 vision was significantly shorter in the DMEK and nanothin DSAEK groups compared with the remaining three DSAEK groups. No significant differences in postoperative aberrometry measurements were found between the five groups. Shorter time to reach 20/40 visual acuity was associated with better preoperative visual acuity and thinner graft. Higher final vision improvement was associated with poorer preoperative visual acuity. Higher postoperative high-order aberrations were associated with poorer preoperative visual acuity. CONCLUSION The main advantage of DMEK and nanothin DSAEK over thicker DSAEKs was the rapidity of visual recovery. Final quality of vision was not influenced by graft thickness and regularity.
Collapse
Affiliation(s)
- Moïse Tourabaly
- Department of Ophthalmology, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, Île-de-France, France
| | - Yaïr Chetrit
- Department of Ophthalmology, Assistance Publique - Hôpitaux de Paris, Pitié Salpêtrière University Hospital, Pierre et Marie Curie University Paris VI, Paris, France
| | - Julien Provost
- Department of Ophthalmology, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, Île-de-France, France
| | - Cristina Georgeon
- Department of Ophthalmology, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, Île-de-France, France
| | - Sofiène Kallel
- Department of Ophthalmology, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, Île-de-France, France
| | - Cyril Temstet
- Department of Ophthalmology, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, Île-de-France, France
| | - Nacim Bouheraoua
- Department of Ophthalmology, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, Île-de-France, France
| | - Vincent Borderie
- Department of Ophthalmology, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, Île-de-France, France
| |
Collapse
|
34
|
Goemaere I, Banayan N, Borderie V, Bouheraoua N. [In vivo confocal microscopy and optical coherence tomography in punctiform and polychromatic pre-Descemet's corneal dystrophy]. J Fr Ophtalmol 2019; 42:1131-1133. [PMID: 31732267 DOI: 10.1016/j.jfo.2019.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Accepted: 06/18/2019] [Indexed: 11/30/2022]
Affiliation(s)
- I Goemaere
- CHNO des Quinze-Vingts, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France
| | - N Banayan
- CHNO des Quinze-Vingts, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France
| | - V Borderie
- CHNO des Quinze-Vingts, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France; Sorbonne université, CNRS, Institut de la Vision, Inserm, 17, rue Moreau, 75012 Paris, France
| | - N Bouheraoua
- CHNO des Quinze-Vingts, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France; Sorbonne université, CNRS, Institut de la Vision, Inserm, 17, rue Moreau, 75012 Paris, France.
| |
Collapse
|
35
|
Rouimi F, Ouanezar S, Goemaere I, Bayle AC, Borderie V, Laroche L, Bouheraoua N. Presbyopia management with Q-factor modulation without additive monovision: One-year visual and refractive results. J Cataract Refract Surg 2019; 45:1074-1083. [PMID: 31126780 DOI: 10.1016/j.jcrs.2019.02.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 02/20/2019] [Accepted: 02/23/2019] [Indexed: 01/19/2023]
Abstract
PURPOSE To analyze refractive results after hyperopic presbyopia surgery by Q-factor modulation without additive monovision. SETTING Quinze-Vingts National Ophthalmology Hospital, Paris, France. DESIGN Prospective nonrandomized study. METHODS Forty-five hyperopic presbyopic patients not tolerating monovision were included. The target for the dominant eye was emmetropia, whereas that for the nondominant eye was emmetropia associated with a target Q factor of -0.8. The postoperative follow-up included assessments of spherical equivalent (SE) refraction, monocular and binocular corrected and uncorrected (UDVA) distance visual acuities, and binocular corrected and uncorrected (UNVA) near visual acuities. Corneal pachymetry, topography, aberrometry and an analysis of patient satisfaction were performed at the 12-month examination. RESULTS The study comprised 90 eyes of 45 consecutive patients. The mean age at surgery was 53.8 years ± 4.99 (SD). The mean preoperative SE was +2.33 ± 1.16 diopters (D) in the dominant eyes and +2.26 ± 1.17 D in the nondominant eyes. At 12 months postoperatively, 42 patients (93%) had a binocular UDVA of Snellen 20/20 and 37 patients (82%) had a binocular UNVA of Jaeger 2 (Parinaud 3). The mean SE at 12 months was -0.22 ± 0.35 D in the dominant eyes (P < .0001) and -0.83 ± 0.50 D in the nondominant eyes (P < .0001). Two eyes required retreatment. Overall, 39 patients (87%) said that they were satisfied and would recommend the intervention. CONCLUSION The Q-factor modulation without additive monovision aims to compensate for presbyopia by changing the Q factor of the nondominant eye to generate a greater depth of field in hyperopic presbyopic patients who are unable to tolerate monovision. The visual outcomes and quality of vision were satisfactory, and only a few patients required additional correction.
Collapse
Affiliation(s)
- Fabien Rouimi
- Quinze-Vingts National Ophthalmology Hospital, UPMC - Sorbonne Université, Paris, France
| | - Sofiane Ouanezar
- Quinze-Vingts National Ophthalmology Hospital, UPMC - Sorbonne Université, Paris, France
| | - Isabelle Goemaere
- Quinze-Vingts National Ophthalmology Hospital, UPMC - Sorbonne Université, Paris, France
| | - Anne Charlotte Bayle
- Quinze-Vingts National Ophthalmology Hospital, UPMC - Sorbonne Université, Paris, France
| | - Vincent Borderie
- Quinze-Vingts National Ophthalmology Hospital, UPMC - Sorbonne Université, Paris, France; Institut de la Vision, INSERM UMR S 968, UPMC - Sorbonne Université, Paris, France
| | - Laurent Laroche
- Quinze-Vingts National Ophthalmology Hospital, UPMC - Sorbonne Université, Paris, France; Institut de la Vision, INSERM UMR S 968, UPMC - Sorbonne Université, Paris, France
| | - Nacim Bouheraoua
- Quinze-Vingts National Ophthalmology Hospital, UPMC - Sorbonne Université, Paris, France; Institut de la Vision, INSERM UMR S 968, UPMC - Sorbonne Université, Paris, France.
| |
Collapse
|
36
|
Drouglazet-Moalic G, Levy O, Goemaere I, Borderie V, Laroche L, Bouheraoua N. Deep Intrastromal Arcuate Keratotomy With In Situ Keratomileusis (DIAKIK) for the Treatment of High Astigmatism After Keratoplasty: 2-Year Follow-up. J Refract Surg 2019; 35:239-246. [PMID: 30984981 DOI: 10.3928/1081597x-20190227-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 02/27/2019] [Indexed: 11/20/2022]
Abstract
PURPOSE To describe 2-year results of deep intrastromal arcuate keratotomy with in situ keratomileusis (DIAKIK) for the treatment of high astigmatism after keratoplasty. METHODS This prospective study included 20 eyes from 20 patients presenting with high astigmatism after keratoplasty. All were treated by two-step femtosecond laser surgery, with two intrastromal arcuate keratotomies and a corneal flap, followed a few months later by excimer photoablation after reopening of the flap. RESULTS At 24 months, both uncorrected (UDVA) and corrected (CDVA) distance visual acuity had improved from 1.12 ± 0.42 logMAR (20/200 Snellen) before surgery to 0.58 ± 0.23 logMAR (20/80 Snellen) (P < .001) and from 0.31 ± 0.26 logMAR (20/40 Snellen) to 0.20 ± 0.20 logMAR (20/32 Snellen) (P = .04), respectively. The mean spherical equivalent improved from -5.01 ± 4.35 to -1.54 ± 2.42 diopters. The mean efficacy index was 0.63. The mean correction index was 0.93 ± 0.32. The mean flattening index was 1.09 ± 0.75 and the mean safety index was 1.39. No graft rejection or epithelial ingrowth was observed. CONCLUSIONS This two-step procedure was an effective treatment for high astigmatism after keratoplasty. The use of both femtosecond and excimer lasers helped to avoid some complications that would have jeopardized the grafts. Refractive and topographic stability was good 2 years after surgery. [J Refract Surg. 2019;35(4):239-246.].
Collapse
|
37
|
Atia R, Jouve L, Georgon C, Laroche L, Borderie V, Bouheraoua N. [In vivo confocal microscopy and optical coherence tomography in stromal corneal dystrophies]. J Fr Ophtalmol 2019; 42:200-205. [PMID: 30679118 DOI: 10.1016/j.jfo.2018.04.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 04/15/2018] [Accepted: 04/16/2018] [Indexed: 10/27/2022]
Affiliation(s)
- R Atia
- Centre hospitalier national d'ophtalmologie des Quinze-Vingts, 75012 Paris, France
| | - L Jouve
- Centre hospitalier national d'ophtalmologie des Quinze-Vingts, 75012 Paris, France
| | - C Georgon
- Centre hospitalier national d'ophtalmologie des Quinze-Vingts, 75012 Paris, France
| | - L Laroche
- Centre hospitalier national d'ophtalmologie des Quinze-Vingts, 75012 Paris, France; Institut de la vision, Sorbonne université, UPMC univ Paris 06, UMR S 968, 75012 Paris, France
| | - V Borderie
- Centre hospitalier national d'ophtalmologie des Quinze-Vingts, 75012 Paris, France; Institut de la vision, Sorbonne université, UPMC univ Paris 06, UMR S 968, 75012 Paris, France
| | - N Bouheraoua
- Centre hospitalier national d'ophtalmologie des Quinze-Vingts, 75012 Paris, France; Institut de la vision, Sorbonne université, UPMC univ Paris 06, UMR S 968, 75012 Paris, France.
| |
Collapse
|
38
|
Romito N, Basli E, Goemaere I, Borderie V, Laroche L, Bouheraoua N. Persistent corneal fibrosis after explantation of a small-aperture corneal inlay. J Cataract Refract Surg 2018; 45:367-371. [PMID: 30584010 DOI: 10.1016/j.jcrs.2018.11.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 10/30/2018] [Accepted: 11/04/2018] [Indexed: 11/26/2022]
Abstract
The KAMRA small-aperture corneal inlay can compensate for presbyopia. A small number of complications have been reported, including glare, halos, decentration, iron deposition, compromised distance and night vision, infectious keratitis and reversal corneal haze. We describe a case of corneal fibrosis after small-aperture corneal inlay implantation and its persistence after late explantation. The postoperative period was uneventful, with good uncorrected near and distance visual acuities. Six years after implantation, the patient reported vision loss in the left eye. A slitlamp evaluation and optical coherence tomography showed stromal opacity and a stromal hyperreflective signal at the level of the small-aperture corneal inlay. The corneal inlay was removed, but persistent decreased visual acuity and fibrosis were observed even 8 months after explantation and did not respond to steroids. Long-term monitoring with multimodal imaging methods is important to detect late adverse events after small-aperture corneal inlay implantation.
Collapse
Affiliation(s)
- Norman Romito
- Quinze-Vingts National Ophthalmology Hospital, UPMC-Sorbonne Université, Paris, France
| | - Elena Basli
- Quinze-Vingts National Ophthalmology Hospital, UPMC-Sorbonne Université, Paris, France
| | - Isabelle Goemaere
- Quinze-Vingts National Ophthalmology Hospital, UPMC-Sorbonne Université, Paris, France
| | - Vincent Borderie
- Quinze-Vingts National Ophthalmology Hospital, UPMC-Sorbonne Université, Paris, France; Institut de la Vision, UPMC-Sorbonne Université, INSERM, CNRS UMR 7210, Paris, France
| | - Laurent Laroche
- Quinze-Vingts National Ophthalmology Hospital, UPMC-Sorbonne Université, Paris, France; Institut de la Vision, UPMC-Sorbonne Université, INSERM, CNRS UMR 7210, Paris, France
| | - Nacim Bouheraoua
- Quinze-Vingts National Ophthalmology Hospital, UPMC-Sorbonne Université, Paris, France; Institut de la Vision, UPMC-Sorbonne Université, INSERM, CNRS UMR 7210, Paris, France.
| |
Collapse
|
39
|
Ouanezar S, Sandali O, Atia R, Temstet C, Georgeon C, Laroche L, Borderie V, Bouheraoua N. Contribution of Fourier-domain optical coherence tomography to the diagnosis of keratoconus progression. J Cataract Refract Surg 2018; 45:159-166. [PMID: 30367937 DOI: 10.1016/j.jcrs.2018.09.024] [Citation(s) in RCA: 7] [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: 01/29/2018] [Revised: 08/30/2018] [Accepted: 09/07/2018] [Indexed: 12/31/2022]
Abstract
PURPOSE To determine the anatomic criteria for diagnosing keratoconus progression by corneal optical coherence tomography (OCT). SETTING Quinze-Vingts National Ophthalmology Hospital, Paris, France. DESIGN Prospective case series. METHODS Scanning-slit corneal topography (Orbscan II) and Fourier-domain corneal OCT (RTVue) were performed in eyes with mild to moderate keratoconus (progressive or nonprogressive [stable] ectasia) at each examination to assess the keratoconus. Disease progression was defined as an increase of at least 1.0 diopter (D) in the steepest keratometry (K) measurement over 6 months. RESULTS Of the 134 eyes of 134 patients with mild to moderate keratoconus, 98 had had progressive ectasia and 36 nonprogressive ectasia. The mean maximum K increased significantly in the progressive group (2.1 D ± 1.2 [SD], P < .0001) and remained constant in the stable group (-0.03 ± 0.39 D, P = .31). The mean thinnest corneal thickness increased significantly in the progressive group (-7.98 ± 9.3 μm, P < .0001) and remained constant in the stable group (-0.52 ± 4.21 μm, P = .22). The change in maximum K was significantly correlated with changes in the thinnest corneal thickness (r = -0.61, P < .0001). A cutoff value of -5 μm for the change in thinnest corneal thickness was identified on receiver operating characteristic curves as a threshold separating cases of progressive and stable keratoconus (area under the curve, 0.79; sensitivity, 68%; specificity, 89%). CONCLUSIONS Topographic data partly reflected the structural changes occurring during the progression of corneal ectasia. Based on the pachymetric parameters provided by OCT, corneal and epithelial thinning was correlated with corneal deformation. The use of corneal OCT might therefore improve the diagnostic sensitivity for keratoconus progression.
Collapse
Affiliation(s)
- Sofiane Ouanezar
- Quinze-Vingts National Ophthalmology Hospital, UPMC-Sorbonne Université, Paris, France
| | - Otman Sandali
- Quinze-Vingts National Ophthalmology Hospital, UPMC-Sorbonne Université, Paris, France
| | - Raphael Atia
- Quinze-Vingts National Ophthalmology Hospital, UPMC-Sorbonne Université, Paris, France
| | - Cyrille Temstet
- Quinze-Vingts National Ophthalmology Hospital, UPMC-Sorbonne Université, Paris, France
| | - Cristina Georgeon
- Quinze-Vingts National Ophthalmology Hospital, UPMC-Sorbonne Université, Paris, France
| | - Laurent Laroche
- Quinze-Vingts National Ophthalmology Hospital, UPMC-Sorbonne Université, Paris, France; Institut de la Vision, Institut National de la Santé et de la Recherche Médicale UMR S968, UPMC-Sorbonne Université, Paris, France
| | - Vincent Borderie
- Quinze-Vingts National Ophthalmology Hospital, UPMC-Sorbonne Université, Paris, France; Institut de la Vision, Institut National de la Santé et de la Recherche Médicale UMR S968, UPMC-Sorbonne Université, Paris, France
| | - Nacim Bouheraoua
- Quinze-Vingts National Ophthalmology Hospital, UPMC-Sorbonne Université, Paris, France; Institut de la Vision, Institut National de la Santé et de la Recherche Médicale UMR S968, UPMC-Sorbonne Université, Paris, France.
| |
Collapse
|
40
|
Atia R, Lejoyeux R, Georgon C, Andreiuolo F, Laroche L, Borderie V, Bouheraoua N. [Corneal intraepithelial neoplasia: Dysplasia and carcinoma in situ]. J Fr Ophtalmol 2018; 41:881-883. [PMID: 30340878 DOI: 10.1016/j.jfo.2018.01.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Accepted: 01/26/2018] [Indexed: 11/30/2022]
Affiliation(s)
- R Atia
- Service d'ophtalmologie 5, Centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France
| | - R Lejoyeux
- Service d'ophtalmologie 5, Centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France
| | - C Georgon
- Service d'ophtalmologie 5, Centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France
| | - F Andreiuolo
- Service de neuropathology, hôpital Sainte-Anne, 1, rue Cabanis, 75014 Paris, France
| | - L Laroche
- Service d'ophtalmologie 5, Centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France; Sorbonne Université, Paris VI, Inserm UMR S 968, Institut de la Vision, 75012 Paris, France
| | - V Borderie
- Service d'ophtalmologie 5, Centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France; Sorbonne Université, Paris VI, Inserm UMR S 968, Institut de la Vision, 75012 Paris, France
| | - N Bouheraoua
- Service d'ophtalmologie 5, Centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France; Sorbonne Université, Paris VI, Inserm UMR S 968, Institut de la Vision, 75012 Paris, France.
| |
Collapse
|
41
|
Chehaibou I, Sandali O, Ameline B, Bouheraoua N, Borderie V, Laroche L. Bilateral infectious keratitis after small-incision lenticule extraction. J Cataract Refract Surg 2018; 42:626-30. [PMID: 27113888 DOI: 10.1016/j.jcrs.2016.03.024] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2016] [Revised: 03/08/2016] [Accepted: 03/09/2016] [Indexed: 12/28/2022]
Abstract
UNLABELLED We report the clinical features and management of a patient with severe bilateral infectious keratitis developing after simultaneous bilateral small-incision lenticule extraction. A 39-year-old man was referred to our emergency department 2 days after a small-incision lenticule extraction procedure for moderate myopia. He reported decreased vision, photophobia, and pain bilaterally. Visual acuity was counting fingers in the right eye and hand motion in the left eye. Slitlamp examination showed multiple white corneal infiltrates at the corneal cap-stromal bed interface. The interface was first rinsed with povidone-iodine 10.0% and then with vancomycin (50 mg/mL). Fortified antibiotics eyedrops administration was initiated. Cultures showed Streptococcus pneumonia. Anterior segment spectral-domain optical coherence tomography scans were performed daily. Once the infection was controlled 4 days later, corticosteroids eyedrops were begun. Three months postoperatively, the patient had a corrected distance visual acuity of 20/32 in the right eye and 20/25 in the left eye. FINANCIAL DISCLOSURE None of the authors has a financial or proprietary interest in any material or method mentioned.
Collapse
Affiliation(s)
- Ismaël Chehaibou
- From Quinze-Vingts National Eye Hospital, UPMC - Sorbonne Universities, Paris, France.
| | - Otman Sandali
- From Quinze-Vingts National Eye Hospital, UPMC - Sorbonne Universities, Paris, France
| | - Barbara Ameline
- From Quinze-Vingts National Eye Hospital, UPMC - Sorbonne Universities, Paris, France
| | - Nacim Bouheraoua
- From Quinze-Vingts National Eye Hospital, UPMC - Sorbonne Universities, Paris, France
| | - Vincent Borderie
- From Quinze-Vingts National Eye Hospital, UPMC - Sorbonne Universities, Paris, France
| | - Laurent Laroche
- From Quinze-Vingts National Eye Hospital, UPMC - Sorbonne Universities, Paris, France
| |
Collapse
|
42
|
Atia R, Bonnel S, Vallos M, Laroche L, Borderie V, Bouheraoua N. [Spontaneous choroidal hemorrhage associated with novel oral anticoagulants: A report of two cases and literature review]. J Fr Ophtalmol 2018; 41:767-772. [PMID: 30213607 DOI: 10.1016/j.jfo.2018.01.007] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 01/14/2018] [Accepted: 01/15/2018] [Indexed: 11/16/2022]
Abstract
New direct oral anticoagulants (DOAC) have been approved for treatment and prevention of some thromboembolic diseases: acute and chronic phase of thromboembolic disease, deep venous thrombosis prophylaxis in orthopedic surgery and prevention of stroke in patients with atrial fibrillation. These molecules are an alternative to heparins and vitamin K antagonists. Among these, rivaroxaban (Xarelto®, Bayer Schering Pharma) is a direct factor Xa inhibitor, and dabigatran etexilate (Pradaxa®, Boehringer Ingelheim) is a direct free thrombin inhibitor. These molecules are almost the ideal anticoagulant: oral administration, few drug and food interactions, wide therapeutic target, and especially no lab monitoring. However, their use remains associated with hemorrhagic complications such as gastrointestinal, intracranial or urinary hemorrhages. We describe two clinical cases of spontaneous choroidal hemorrhage in patients treated with direct oral anticoagulants (rivaroxaban and dabigatran etexilate) for atrial fibrillation. These cases show that an ocular hemorrhagic risk exists with these drugs. Patients treated with DOAC should have the therapeutic dose adjusted based on creatinine clearance. Special monitoring should be performed in patients with age-related macular degeneration or with hypertension even though meta-analysis shows that the risk of intraocular bleeding is reduced by 22% compared with warfarin.
Collapse
Affiliation(s)
- R Atia
- Service d'ophtalmologie 5, centre national d'ophtalmologie des Quinze-Vingts, UPMC, Sorbonne université, 28, rue de Charenton, 75012 Paris, France
| | - S Bonnel
- Service d'ophtalmologie 5, centre national d'ophtalmologie des Quinze-Vingts, UPMC, Sorbonne université, 28, rue de Charenton, 75012 Paris, France
| | - M Vallos
- Service d'hématologie, hôpital de la pitié salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - L Laroche
- Service d'ophtalmologie 5, centre national d'ophtalmologie des Quinze-Vingts, UPMC, Sorbonne université, 28, rue de Charenton, 75012 Paris, France; INSERM UMR S 968, UPMC, institut de la Vision, Sorbonne université, 17 rue Moreau, 75012 Paris, France
| | - V Borderie
- Service d'ophtalmologie 5, centre national d'ophtalmologie des Quinze-Vingts, UPMC, Sorbonne université, 28, rue de Charenton, 75012 Paris, France; INSERM UMR S 968, UPMC, institut de la Vision, Sorbonne université, 17 rue Moreau, 75012 Paris, France
| | - N Bouheraoua
- Service d'ophtalmologie 5, centre national d'ophtalmologie des Quinze-Vingts, UPMC, Sorbonne université, 28, rue de Charenton, 75012 Paris, France; INSERM UMR S 968, UPMC, institut de la Vision, Sorbonne université, 17 rue Moreau, 75012 Paris, France.
| |
Collapse
|
43
|
Chehaibou I, Georgeon C, Laroche L, Borderie V, Bouheraoua N. [Imaging of posterior corneal dystrophies]. J Fr Ophtalmol 2018; 41:669-671. [PMID: 30193896 DOI: 10.1016/j.jfo.2018.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Accepted: 01/26/2018] [Indexed: 11/26/2022]
Affiliation(s)
- I Chehaibou
- Service d'ophtalmologie 5, Centre National d'ophtalmologie des Quinze-Vingts, UPMC - Sorbonne Université, 28, rue de Charenton, 75012 Paris, France
| | - C Georgeon
- Service d'ophtalmologie 5, Centre National d'ophtalmologie des Quinze-Vingts, UPMC - Sorbonne Université, 28, rue de Charenton, 75012 Paris, France
| | - L Laroche
- Service d'ophtalmologie 5, Centre National d'ophtalmologie des Quinze-Vingts, UPMC - Sorbonne Université, 28, rue de Charenton, 75012 Paris, France; Institut de la Vision, INSERM UMR S 968, UPMC - Sorbonne Université, 17, rue Moreau, 75012 Paris, France
| | - V Borderie
- Service d'ophtalmologie 5, Centre National d'ophtalmologie des Quinze-Vingts, UPMC - Sorbonne Université, 28, rue de Charenton, 75012 Paris, France; Institut de la Vision, INSERM UMR S 968, UPMC - Sorbonne Université, 17, rue Moreau, 75012 Paris, France
| | - N Bouheraoua
- Service d'ophtalmologie 5, Centre National d'ophtalmologie des Quinze-Vingts, UPMC - Sorbonne Université, 28, rue de Charenton, 75012 Paris, France; Institut de la Vision, INSERM UMR S 968, UPMC - Sorbonne Université, 17, rue Moreau, 75012 Paris, France.
| |
Collapse
|
44
|
Borderie VM, Levy O, Georgeon C, Bouheraoua N. Simultaneous penetrating keratoplasty and amniotic membrane transplantation in eyes with a history of limbal stem cell deficiency. J Fr Ophtalmol 2018; 41:583-591. [PMID: 30166235 DOI: 10.1016/j.jfo.2018.01.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 11/20/2017] [Revised: 12/28/2017] [Accepted: 01/09/2018] [Indexed: 01/05/2023]
Abstract
PURPOSE To describe the outcomes of simultaneous penetrating keratoplasty (PK) and amniotic membrane transplantation (AMT) performed both as a ring-shaped graft and as a temporary patch in eyes with a history of limbal stem cell deficiency (LSCD). METHODS Prospective observational case series including 48 simultaneous PK/AMT procedures (48 patients) in eyes with a history of partial or total LSCD. Patients with total LSCD were first treated with limbal stem cell transplantation. The preoperative indication was graft failure in 58.3% of cases. Most recipients (89.6%) were at high-risk for rejection. RESULTS The mean graft reepithelialization time was 29.2±30.8 days. Graft reepithelialization was achieved in 30 days in 70.8% of cases. No AMT-related adverse events were observed. The mean time from keratoplasty-to-last visit was 84.5±54.5 months. The 3-year graft survival rate was 62.5%. Recurrence of corneal epithelial defects after graft reepithelialization (47.9%) was associated with lower graft survival (P=0.004). In eyes with successful grafts at the last visit, the mean LogMAR visual acuity was 1.90 (20/1575)±5 lines before keratoplasty and 0.89 (20/155)±10 lines at 5 years. A ring of amniotic membrane was visible between the graft stroma and the corneal epithelium on slit-lamp examination and optical coherence tomography in all successful cases. CONCLUSIONS In this series of eyes with a history of LSCD and at high-risk of rejection, simultaneous PK and AMT were associated with satisfactory graft survival and no additional adverse events.
Collapse
Affiliation(s)
- V M Borderie
- CIC 1423, Pierre et Marie Curie University Paris 06, Centre Hospitalier National d'Ophtalmologie des XV-XX, Institut de la Vision, 28, rue de Charenton, 75571 Paris, France.
| | - O Levy
- CIC 1423, Pierre et Marie Curie University Paris 06, Centre Hospitalier National d'Ophtalmologie des XV-XX, Institut de la Vision, 28, rue de Charenton, 75571 Paris, France
| | - C Georgeon
- CIC 1423, Pierre et Marie Curie University Paris 06, Centre Hospitalier National d'Ophtalmologie des XV-XX, Institut de la Vision, 28, rue de Charenton, 75571 Paris, France
| | - N Bouheraoua
- CIC 1423, Pierre et Marie Curie University Paris 06, Centre Hospitalier National d'Ophtalmologie des XV-XX, Institut de la Vision, 28, rue de Charenton, 75571 Paris, France
| |
Collapse
|
45
|
Atia R, Jouve L, Sandali O, Laroche L, Borderie V, Bouheraoua N. Early Epithelial Remodeling After Standard and Iontophoresis-Assisted Corneal Cross-linking as Evaluated by Spectral-Domain Optical Coherence Tomography. J Refract Surg 2018; 34:551-558. [DOI: 10.3928/1081597x-20180702-01] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 06/18/2018] [Indexed: 11/20/2022]
|
46
|
Atia R, Jouve L, Knoeri J, Georgeon C, Laroche L, Borderie V, Bouheraoua N. [Corneal collagen cross-linking to treat infectious keratitis]. J Fr Ophtalmol 2018; 41:560-568. [PMID: 29903589 DOI: 10.1016/j.jfo.2017.12.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 10/22/2017] [Revised: 12/06/2017] [Accepted: 12/07/2017] [Indexed: 11/24/2022]
Abstract
Infectious keratitis are a frequent cause of ocular morbidity. Today, new treatments are necessary to combat the emergence of antibiotic resistant germs. Corneal collagen cross-linking has been suggested to treat corneal infectious (PACK-CXL). Its action would be both antimicrobial and protective for the cornea, increasing its biochemical resistence to proteolytic enzymes. In vivo, PACK-CXL might demonstrate good efficacy against bacterial keratitis, contrary to herpetic keratitis for which it is contraindicated. For fungal or amoebic keratitis, results are uncertain regarding its safety and efficacy. The purpose of this paper is to clarify the use of corneal collagen cross-linking to treat infectious keratitis.
Collapse
Affiliation(s)
- R Atia
- Service d'ophtalmologie 5, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France
| | - L Jouve
- Service d'ophtalmologie 5, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France
| | - J Knoeri
- Service d'ophtalmologie 5, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France
| | - C Georgeon
- Service d'ophtalmologie 5, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France
| | - L Laroche
- Service d'ophtalmologie 5, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France; Inserm UMR S 968, université Pierre-et-Marie-Curie-Paris-VI, institut de la vision, 75012 Paris, France
| | - V Borderie
- Service d'ophtalmologie 5, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France; Inserm UMR S 968, université Pierre-et-Marie-Curie-Paris-VI, institut de la vision, 75012 Paris, France
| | - N Bouheraoua
- Service d'ophtalmologie 5, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France; Inserm UMR S 968, université Pierre-et-Marie-Curie-Paris-VI, institut de la vision, 75012 Paris, France.
| |
Collapse
|
47
|
Touhami S, Jouve L, Atia R, Georgeon C, Laroche L, Borderie V, Bouheraoua N. Optical coherence tomography and confocal microscopy aspects of a Schnyder's corneal dystrophy case. J Fr Ophtalmol 2018; 41:e207-e209. [PMID: 29778283 DOI: 10.1016/j.jfo.2018.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Revised: 02/15/2018] [Accepted: 02/16/2018] [Indexed: 10/16/2022]
Affiliation(s)
- S Touhami
- Service d'ophtalmologie 5, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France; Inserm UMR S 968, institut de la vision, Sorbonne Université, 75012 Paris, France
| | - L Jouve
- Service d'ophtalmologie 5, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France
| | - R Atia
- Service d'ophtalmologie 5, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France
| | - C Georgeon
- Service d'ophtalmologie 5, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France
| | - L Laroche
- Service d'ophtalmologie 5, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France; Inserm UMR S 968, institut de la vision, Sorbonne Université, 75012 Paris, France
| | - V Borderie
- Service d'ophtalmologie 5, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France; Inserm UMR S 968, institut de la vision, Sorbonne Université, 75012 Paris, France
| | - N Bouheraoua
- Service d'ophtalmologie 5, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France; Inserm UMR S 968, institut de la vision, Sorbonne Université, 75012 Paris, France.
| |
Collapse
|
48
|
Gavrilov JC, Atia R, Borderie V, Laroche L, Bouheraoua N. Unilateral corneal ectasia after small-incision lenticule extraction in a 43-year-old patient. J Cataract Refract Surg 2018; 44:403-406. [PMID: 29703293 DOI: 10.1016/j.jcrs.2018.01.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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: 12/21/2017] [Revised: 01/21/2018] [Accepted: 01/29/2018] [Indexed: 11/18/2022]
Abstract
Unilateral corneal ectasia developed after small-incision lenticule extraction for mild myopia in a 43-year-old man with preoperative asymmetric astigmatism. The ectasia was diagnosed 4 years postoperatively. Preoperative data showed asymmetric astigmatism with no signs of forme fruste keratoconus. Inferior anterior curvature steepening exceeded 2.00 diopters without bulging of the posterior curvature, and pachymetric thickness exceeded 515 μm. Corneal ectasia can occur after small-incision lenticule extraction in patients older than 40 years with preoperative asymmetric astigmatism.
Collapse
Affiliation(s)
- Jean Christophe Gavrilov
- From the Quinze-Vingts National Ophthalmology Hospital (Gavrilov, Atia, Borderie, Laroche, Bouheraoua) and the Institut de la Vision (Borderie, Laroche, Bouheraoua), UPMC-Sorbonne Universities, INSERM, CNRS UMR 7210, Paris, France
| | - Raphael Atia
- From the Quinze-Vingts National Ophthalmology Hospital (Gavrilov, Atia, Borderie, Laroche, Bouheraoua) and the Institut de la Vision (Borderie, Laroche, Bouheraoua), UPMC-Sorbonne Universities, INSERM, CNRS UMR 7210, Paris, France
| | - Vincent Borderie
- From the Quinze-Vingts National Ophthalmology Hospital (Gavrilov, Atia, Borderie, Laroche, Bouheraoua) and the Institut de la Vision (Borderie, Laroche, Bouheraoua), UPMC-Sorbonne Universities, INSERM, CNRS UMR 7210, Paris, France
| | - Laurent Laroche
- From the Quinze-Vingts National Ophthalmology Hospital (Gavrilov, Atia, Borderie, Laroche, Bouheraoua) and the Institut de la Vision (Borderie, Laroche, Bouheraoua), UPMC-Sorbonne Universities, INSERM, CNRS UMR 7210, Paris, France
| | - Nacim Bouheraoua
- From the Quinze-Vingts National Ophthalmology Hospital (Gavrilov, Atia, Borderie, Laroche, Bouheraoua) and the Institut de la Vision (Borderie, Laroche, Bouheraoua), UPMC-Sorbonne Universities, INSERM, CNRS UMR 7210, Paris, France.
| |
Collapse
|
49
|
Jouve L, Borderie V, Sandali O, Temstet C, Basli E, Laroche L, Bouheraoua N. Conventional and Iontophoresis Corneal Cross-Linking for Keratoconus: Efficacy and Assessment by Optical Coherence Tomography and Confocal Microscopy. Cornea 2017; 36:153-162. [PMID: 28060061 DOI: 10.1097/ico.0000000000001062] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To compare the efficacy, safety, and microstructural corneal changes during 2 years after conventional corneal collagen cross-linking (C-CXL) and transepithelial corneal CXL by iontophoresis (I-CXL) for keratoconus. METHODS Eighty eyes of 80 patients with progressive keratoconus were treated by C-CXL (n = 40) or I-CXL (n = 40). Patients were investigated before surgery and 1, 3, 6, 12, and 24 months after treatment. We measured central corneal thickness and maximal simulated keratometry values (Kmax) and performed specular microscopy and in vivo confocal microscopy at each time point. The demarcation line was assessed 1 month after treatment. RESULTS Kmax remained stable after I-CXL during the entire study period (P = 0.56), whereas the average keratometry increased by 0.2 diopter (50.9 ± 5.6-51.1 ± 5.2). Kmax significantly decreased 1 (P = 0.02) to 2 years (P < 0.01) after C-CXL, with an average decrease of 1.1 diopters (49.9 ± 4.5-48.8 ± 4.2). The failure rate of I-CXL was 20% and that of C-CXL 7.5%. The demarcation line was superficially visible in 35% of cases after I-CXL compared with 95% of cases after C-CXL. Endothelial cell density and central corneal thickness remained stable during the entire study period. The change in Kmax 2 years after C-CXL and I-CXL and the preoperative Kmax were negatively correlated (r = 0.14, P = 0.013, and r = 0.17, P = 0.007, respectively). CONCLUSIONS I-CXL halted progression of keratoconus less efficiently than did C-CXL after 2 years of follow-up. Longer prospective studies are still needed to ensure I-CXL efficacy.
Collapse
Affiliation(s)
- Léa Jouve
- *Quinze-Vingts National Ophthalmology Hospital, UPMC-Sorbonne Universities, Paris, France; †INSERM UMR S 968, Institut de la Vision, Paris, France; ‡Sorbonne Universities, UPMC Univ Paris 06, UMR S 968, Institut de la Vision, Paris, France; and §CNRS, UMR 7210, Paris, France
| | | | | | | | | | | | | |
Collapse
|
50
|
Levy O, Labbé A, Borderie V, Hamiche T, Dupas B, Laroche L, Baudouin C, Bouheraoua N. Increased corneal sub-basal nerve density in patients with Sjögren syndrome treated with topical cyclosporine A. Clin Exp Ophthalmol 2017; 45:455-463. [DOI: 10.1111/ceo.12898] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 11/27/2016] [Accepted: 12/05/2016] [Indexed: 01/08/2023]
Affiliation(s)
- Ora Levy
- Department V, Quinze-Vingts National Ophthalmology Hospital; UPMC-Sorbonne Universities; Paris France
- Quinze-Vingts National Ophthalmology Hospital; DHU Sight Restore, INSERM-DHOS CIC; Paris France
| | - Antoine Labbé
- Department III, Quinze-Vingts National Ophthalmology Hospital; Versailles-Saint-Quentin en Yvelines University; Paris France
- Sorbonne Universities, UPMC Univ Paris 06, UMR S 968, Vision Institute; Paris France
- CNRS, UMR 7210; Paris France
- Quinze-Vingts National Ophthalmology Hospital; DHU Sight Restore, INSERM-DHOS CIC; Paris France
| | - Vincent Borderie
- Department V, Quinze-Vingts National Ophthalmology Hospital; UPMC-Sorbonne Universities; Paris France
- Sorbonne Universities, UPMC Univ Paris 06, UMR S 968, Vision Institute; Paris France
- CNRS, UMR 7210; Paris France
- Quinze-Vingts National Ophthalmology Hospital; DHU Sight Restore, INSERM-DHOS CIC; Paris France
| | - Taous Hamiche
- Department V, Quinze-Vingts National Ophthalmology Hospital; UPMC-Sorbonne Universities; Paris France
- Quinze-Vingts National Ophthalmology Hospital; DHU Sight Restore, INSERM-DHOS CIC; Paris France
| | - Bénédicte Dupas
- Department III, Quinze-Vingts National Ophthalmology Hospital; Versailles-Saint-Quentin en Yvelines University; Paris France
- Quinze-Vingts National Ophthalmology Hospital; DHU Sight Restore, INSERM-DHOS CIC; Paris France
| | - Laurent Laroche
- Department V, Quinze-Vingts National Ophthalmology Hospital; UPMC-Sorbonne Universities; Paris France
- Sorbonne Universities, UPMC Univ Paris 06, UMR S 968, Vision Institute; Paris France
- CNRS, UMR 7210; Paris France
- Quinze-Vingts National Ophthalmology Hospital; DHU Sight Restore, INSERM-DHOS CIC; Paris France
| | - Christophe Baudouin
- Department III, Quinze-Vingts National Ophthalmology Hospital; Versailles-Saint-Quentin en Yvelines University; Paris France
- Sorbonne Universities, UPMC Univ Paris 06, UMR S 968, Vision Institute; Paris France
- CNRS, UMR 7210; Paris France
- Quinze-Vingts National Ophthalmology Hospital; DHU Sight Restore, INSERM-DHOS CIC; Paris France
| | - Nacim Bouheraoua
- Department V, Quinze-Vingts National Ophthalmology Hospital; UPMC-Sorbonne Universities; Paris France
- Sorbonne Universities, UPMC Univ Paris 06, UMR S 968, Vision Institute; Paris France
- CNRS, UMR 7210; Paris France
- Quinze-Vingts National Ophthalmology Hospital; DHU Sight Restore, INSERM-DHOS CIC; Paris France
| |
Collapse
|