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Michael R, Wirkner K, Engel C, Loeffler M, Kirsten T, Rauscher FG. Feasibility and repeatability of ocular biometry measured with IOLMaster 700 in a large population-based study. Ophthalmic Physiol Opt 2023. [PMID: 37083081 DOI: 10.1111/opo.13148] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 09/28/2022] [Revised: 04/04/2023] [Accepted: 04/05/2023] [Indexed: 04/22/2023]
Abstract
PURPOSE To evaluate the feasibility and repeatability of IOLMaster 700 biometry measurements in an adult population. Furthermore, to assess the value of the Quality Indicators (QIs) provided by the device. METHOD As part of the large population-based Leipzig Research Centre for Civilization Diseases (LIFE) Adult-Study, randomly selected participants from Leipzig, Germany were evaluated with the ZEISS IOLMaster 700. Age range was 26-85 years, with 53% of participants above 70 years of age. Axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT) and keratometry (K) were assessed in 1767 right eyes. Measurements were repeated twice and in a subset of 1331 eyes, three times. Measurement feasibility was evaluated for three levels; successful, with warnings and failed, using the inbuilt QIs. Repeatability was assessed as within-subject standard deviation (SD) and repeatability limits were calculated. RESULTS First measurement success rate for phakic eyes was over 99% for AL, CCT, ACD, over 98% for LT and over 97% for K. K had 16% eyes with warnings and the recommendation to repeat the measurement. Excluding the measurements with warnings resulted in a reduction of mean SD for AL from 48 to 4 μm and for mean K from 0.08 to 0.04 D. Repeatability for phakic eyes was 8 μm for AL, CCT, ACD and LT and 2.3 μm for CCT; 0.07 D and 0.12 D for mean K and delta K, respectively, for phakic cases without warnings (two measurements). CONCLUSIONS In our population-based sample, the IOLMaster 700 collected data for AL, CCT, ACD, LT and K from the vast majority of eyes. Considering the built-in QIs improved the measurement variability substantially. Repeatability measurements indicate that clinically meaningful changes can be detected reliably with this instrument.
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Affiliation(s)
- Ralph Michael
- Institute for Medical Informatics, Statistics, and Epidemiology (IMISE), Leipzig University, Leipzig, Germany
- Medical Informatics Center - Dept. of Medical Data Science, Leipzig University Medical Centre, Leipzig, Germany
| | - Kerstin Wirkner
- Institute for Medical Informatics, Statistics, and Epidemiology (IMISE), Leipzig University, Leipzig, Germany
- Leipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, Leipzig, Germany
| | - Christoph Engel
- Institute for Medical Informatics, Statistics, and Epidemiology (IMISE), Leipzig University, Leipzig, Germany
- Leipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, Leipzig, Germany
| | - Markus Loeffler
- Institute for Medical Informatics, Statistics, and Epidemiology (IMISE), Leipzig University, Leipzig, Germany
- Leipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, Leipzig, Germany
| | - Toralf Kirsten
- Institute for Medical Informatics, Statistics, and Epidemiology (IMISE), Leipzig University, Leipzig, Germany
- Medical Informatics Center - Dept. of Medical Data Science, Leipzig University Medical Centre, Leipzig, Germany
- Leipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, Leipzig, Germany
| | - Franziska G Rauscher
- Institute for Medical Informatics, Statistics, and Epidemiology (IMISE), Leipzig University, Leipzig, Germany
- Medical Informatics Center - Dept. of Medical Data Science, Leipzig University Medical Centre, Leipzig, Germany
- Leipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, Leipzig, Germany
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Lim YL, Mond H, Michael R, Liew TS, Chu E, Health P, Visagathilagar T, Basioni N, Chia J, Bharatula S. Seven-day holter monitoring detects more significant arrhythmias than 24-hour and 3-day monitoring. Eur Heart J 2023. [DOI: 10.1093/eurheartj/ehac779.014] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background/Introduction
24-hour Holter monitors have been used widely to assess patients with suspected and known arrhythmias. Recent studies have shown increased yield of arrhythmia detection with longer durations of Holter monitoring.
Purpose
The aim of the study was to evaluate the incremental yield in significant arrhythmias detected using a 7-day continuous Holter monitor, as compared to what can be achieved within a 24-hour and 48 to 72 hours study.
Methods
A retrospective study of patients from 72 sites in two geographical locations, A and B, who completed a continuous 7-days patch monitor study was performed. 801 of these studies detected significant arrhythmias; pauses 3 seconds or more (PA), ventricular tachycardia of 6 beats or more (VT), and paroxysmal atrial fibrillation (PAF). The day of the first occurrence of a significant arrhythmia was noted and tallied to determine the incremental yield of a multiday Holter monitoring.
Results
Of 801 total cases detected with significant arrhythmia, only 278 (35%) were detected in the first 24hours, while 523 (65%) cases were detected after Day 1. 331 (41%) had first significant arrhythmia detected after the 3rd day of monitoring, with 68 (44%) being PA, 125 (40%) PAF, and 138 (41%) VT. Notably, in Group A, 31 (72%) of total VT detected and 35 (72%) of total PAF detected were first picked up after Day 1, 21 (49%) of total VT were first detected only after the 3rd day of monitoring.
Conclusions
1-day (24-hour) monitoring period fails to detect a significant number of potentially serious cardiac arrhythmias. Extended continuous Holter monitoring increases the yield of detection, with a substantial fraction (40-49%) detected after the 3rd day of monitoring. No difference in results obtained between two geographical locations demonstrates strong evidence that findings are consistent across different sites. Review of current practice and guidelines is necessary to further expand usage of multiday Holter monitoring, thus increasing benefits to patients.
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Affiliation(s)
- Y L Lim
- Cardioscan Asia , Singapore , Singapore
| | - H Mond
- Cardioscan Asia , Singapore , Singapore
| | - R Michael
- Cardioscan Asia , Singapore , Singapore
| | - T S Liew
- Cardioscan Asia , Singapore , Singapore
| | - E Chu
- Cardioscan Asia , Singapore , Singapore
| | - P Health
- Cardioscan Asia , Singapore , Singapore
| | | | - N Basioni
- Cardioscan Asia , Singapore , Singapore
| | - J Chia
- Cardioscan Asia , Singapore , Singapore
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Michael R, Wirkner K, Engel C, Loeffler M, Kirsten T, Rauscher F. Ocular biometry in adults from a population‐based study in Germany. Acta Ophthalmol 2022. [DOI: 10.1111/j.1755-3768.2022.0262] [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] [Indexed: 02/11/2023]
Affiliation(s)
- Ralph Michael
- Institute for Medical Informatics, Statistics and Epidemiology Leipzig University Leipzig Germany
| | - Kerstin Wirkner
- Leipzig Research Centre for Civilization Diseases (LIFE) Leipzig University Leipzig Germany
| | - Christoph Engel
- Institute for Medical Informatics, Statistics and Epidemiology Leipzig University Leipzig Germany
| | - Markus Loeffler
- Institute for Medical Informatics, Statistics and Epidemiology Leipzig University Leipzig Germany
| | - Toralf Kirsten
- Medical Informatics Center ‐ Dept. of Medical Data Science Leipzig University Medical Center Leipzig Germany
| | - Franziska Rauscher
- Institute for Medical Informatics, Statistics and Epidemiology Leipzig University Leipzig Germany
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D’Antin JC, Tresserra F, Barraquer RI, Michael R. Soemmerring's Rings Developed around IOLs, in Human Donor Eyes, Can Present Internal Transparent Areas. Int J Mol Sci 2022; 23:13294. [PMID: 36362082 PMCID: PMC9656497 DOI: 10.3390/ijms232113294] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 09/13/2022] [Revised: 10/26/2022] [Accepted: 10/27/2022] [Indexed: 02/09/2024] Open
Abstract
Soemmerring's rings consist of a ring of lens epithelial derived cells that grow along the periphery of an aphakic lens capsule, or around an intraocular lens. These rings when visualized frontally, appear opaque, however, in some cases the cells that compose these rings are organized in the same fashion as those in normal transparent adult lenses. Thus, our purpose was to test whether any part of the adult Soemmerring's ring could be transparent and how this related to morphological factors. To study this, 16 Soemmerring's rings were extracted from donor eye globes. After imaging, they were thickly sectioned sagittally in order to analyze the degrees of transparency of different areas. All samples were also histologically analyzed using alpha smooth muscle actin, Vimentin, wheat germ agglutinin and DAPI. Our results showed that many samples had some transparent areas, mostly towards the center of their cross-section. Of the factors that we analyzed, only lens fiber organization at the bow region and an increased area of mature lens fiber cells had a significant relation to the degree of transparency at the center. Thus, we can conclude that as Soemmerring's rings mature, they can develop organized and transparent areas of lens cells.
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Affiliation(s)
- Justin Christopher D’Antin
- Institut Universitari Barraquer, Universitat Autònoma de Barcelona, 08021 Barcelona, Spain
- Centro de Oftalmología Barraquer, 08021 Barcelona, Spain
| | - Francesc Tresserra
- Department of Pathology, Institut Universitari Dexeus, 08028 Barcelona, Spain
| | - Rafael I. Barraquer
- Institut Universitari Barraquer, Universitat Autònoma de Barcelona, 08021 Barcelona, Spain
- Centro de Oftalmología Barraquer, 08021 Barcelona, Spain
- Department of Medicine, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, 08017 Barcelona, Spain
| | - Ralph Michael
- Institut Universitari Barraquer, Universitat Autònoma de Barcelona, 08021 Barcelona, Spain
- Centro de Oftalmología Barraquer, 08021 Barcelona, Spain
- Institute for Medical Informatics, Statistics, and Epidemiology (IMISE), Leipzig University, 04109 Leipzig, Germany
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Gómez‐Benlloch A, Montesel A, Pareja‐Aricò L, Mingo‐Botín D, Michael R, Barraquer RI, Alió J. Causes of corneal transplant failure: a multicentric study. Acta Ophthalmol 2021; 99:e922-e928. [PMID: 33421330 DOI: 10.1111/aos.14708] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 04/03/2020] [Revised: 11/08/2020] [Accepted: 11/10/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE To identify the causes of failure of the different surgical corneal graft techniques: penetrating keratoplasty (PK), deep anterior lamellar keratoplasty (DALK), Descemet stripping automated endothelial keratoplasty (DSAEK) and Descemet membrane endothelial keratoplasty (DMEK). METHODS This multicentric retrospective study enrolled a consecutive cohort of patients who had undergone any type of keratoplasty between 2001 and 2016. The clinical data were obtained from the patient's medical records, following ethical guidelines, permissions and data protection. The main outcome measured in the study was the cause of graft failure, defined as any irreversible loss of graft transparency capable of compromising vision. The main causes of graft failure were classified as follows: (A) primary graft failure (PGF), (B) immunological rejection, (C) non-rejection (which includes endothelial decompensation without rejection, IOP elevation/glaucoma, diseases of the ocular surface, recurrence of the primary disease, wound dehiscence/hypotonia and trauma, among others) and (D) specific causes of lamellar keratoplasty failure. A descriptive study of the obtained data was carried out. The distribution of the causes of failure was evaluated according to the type of corneal transplant. RESULTS Our research included a cohort of 571 keratoplasty failures, of which 509 met the inclusion criteria. The analysis of the causes of the PK failure showed that immunological allograft rejection represented the main cause, with 28.2% of the failures, followed by surface diseases (17.8%) and endothelial decompensation without rejection (17.3%). For the PK re-grafts group, the main cause of failure was immunological allograft rejection (34.0%), followed by diseases of the ocular surface (18.5%). For the DALK group, the failures mainly occurred due to surface diseases such as limbal stem cell insufficiency, infectious keratitis, keratolysis or persistent epithelial defect (37.8%). However, the main reason for failure in the DSAEK group was endothelial decompensation without rejection (31.9%) while primary graft failure was the main cause of failure in the DMEK group (64.1%). CONCLUSION The main reason for failure in PK was immunological allograft rejection, both in primary and secondary transplants. The leading causes for failure were diseases of the ocular surface in the DALK population, endothelial decompensation without rejection in DSAEK and primary graft failure in DMEK.
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Affiliation(s)
- Alba Gómez‐Benlloch
- Centro de Oftalmología Barraquer Barcelona Spain
- Institut Universitari Barraquer Universitat Autònoma de Barcelona Barcelona Spain
| | | | - Luis Pareja‐Aricò
- Hospital Clínico Universitario de Valladolid Universidad de Valladolid Valladolid Spain
| | | | - Ralph Michael
- Centro de Oftalmología Barraquer Barcelona Spain
- Institut Universitari Barraquer Universitat Autònoma de Barcelona Barcelona Spain
| | - Rafael I. Barraquer
- Centro de Oftalmología Barraquer Barcelona Spain
- Institut Universitari Barraquer Universitat Autònoma de Barcelona Barcelona Spain
- Universitat Internacional de Catalunya Barcelona Spain
| | - Jorge Alió
- Vissum Miranza Alicante Spain
- Division of Ophthalmology Universidad Miguel Hernández Alicante Spain
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Rauscher FG, Francke M, Hiemisch A, Kiess W, Michael R. Ocular biometry in children and adolescents from 4 to 17 years: a cross-sectional study in central Germany. Ophthalmic Physiol Opt 2021; 41:496-511. [PMID: 33960004 DOI: 10.1111/opo.12814] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 09/22/2020] [Accepted: 02/25/2021] [Indexed: 12/17/2022]
Abstract
PURPOSE To evaluate ocular biometry in a large paediatric population as a function of age and sex in children of European descent. METHODS Children were examined as part of the LIFE Child Study (Leipzig Research Centre for Civilization Disease), a population-based study in Leipzig, Germany. Altogether, 1907 children, aged from 4 to 17 years, were examined with the Lenstar LS 900. Data from the right eye was analysed for axial length, central corneal thickness, flat and steep corneal radii, aqueous depth, lens thickness and vitreous depth. Wavefront-based autorefraction was employed for analysis. RESULTS Axial length increased in girls from 21.6 mm (4 years) up to 23.4 mm (17 years); this increase (0.174 mm per year) was statistically significant up to age 14 (23.3 mm). Axial length increased in boys from 22.2 mm (4 years) up to 23.9 mm (17 years); this increase (0.178 mm per year) was statistically significant up to age 10 (23.3 mm). No change was observed for central corneal thickness (average: girls 550 µm; boys 554 µm). Corneal curvature in girls was somewhat flatter at age 4 (7.70 mm) compared to age 10 (7.78 mm), whereas it was constant in boys (7.89 mm). Aqueous depth at age 4 was 2.73 mm for girls and 2.86 mm for boys, with the same rate of increase per year (girls: 0.046 mm; boys: 0.047 mm) from age 4 to 10. At age 17, aqueous depth was 3.06 mm in girls and 3.20 mm in boys. Lens thickness was reduced from age 4 (3.75 mm) to age 10 (3.47 mm) in girls and from age 4 (3.73 mm) to age 10 (3.44 mm) in boys, with the same rate of decrease per year of 0.046 and 0.047 mm, respectively. At age 17, lens thickness was 3.52 mm in girls and 3.50 mm in boys. Vitreous depth at age 4 was 14.51 mm for girls and 15.08 mm for boys; with 0.156 mm (girls) or 0.140 mm (boys) increase per year until age 14 (girls: 16.08 mm; boys: 16.48 mm). At age 17, vitreous depth was 16.29 mm in girls and 16.62 mm in boys. CONCLUSIONS Eye growth (axial length) in girls showed a lag of about four years compared to boys. Aqueous depth increase matches the lens thickness decrease from ages 4 to 10 years in girls and boys. Lens thickness minimum is reached at 11 years in girls and at 12 years in boys. All dimensions of the optical ocular components are closely correlated with axial length. These data may serve as normative values for the assessment of eye growth in central European children and will provide a basis for monitoring refractive error development.
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Affiliation(s)
- Franziska G Rauscher
- Institute for Medical Informatics, Statistics, and Epidemiology (IMISE), Leipzig University, Leipzig, Germany.,Leipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, Leipzig, Germany
| | - Mike Francke
- Institute for Medical Informatics, Statistics, and Epidemiology (IMISE), Leipzig University, Leipzig, Germany.,Paul-Flechsig-Institute of Brain Research, Leipzig University, Leipzig, Germany
| | - Andreas Hiemisch
- Leipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, Leipzig, Germany.,Department of Women and Child Health, University Hospital for Children and Adolescents and Center for Pediatric Research (CPL), Leipzig University, Leipzig, Germany
| | - Wieland Kiess
- Leipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, Leipzig, Germany.,Department of Women and Child Health, University Hospital for Children and Adolescents and Center for Pediatric Research (CPL), Leipzig University, Leipzig, Germany
| | - Ralph Michael
- Institute for Medical Informatics, Statistics, and Epidemiology (IMISE), Leipzig University, Leipzig, Germany.,Institut Universitari Barraquer, Universitat Autònoma de Barcelona, Barcelona, Spain
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Rauscher FG, Hiemisch A, Kiess W, Michael R. Feasibility and repeatability of ocular biometry measured with Lenstar LS 900 in a large group of children and adolescents. Ophthalmic Physiol Opt 2021; 41:512-522. [PMID: 33772832 DOI: 10.1111/opo.12807] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 09/22/2020] [Accepted: 02/16/2021] [Indexed: 12/18/2022]
Abstract
PURPOSE To evaluate the feasibility and repeatability of Lenstar LS 900 biometry measurements in a paediatric population. METHODS Children were examined as part of the LIFE Child Study (Leipzig Research Centre for Civilization Diseases), a population-based study in Leipzig, Germany. Altogether, 1917 children, aged from 3.5 to 17.5 years, were assessed with the Haag Streit Lenstar LS 900. Three consecutive measurements of the right eye were analysed for axial length, central corneal thickness, anterior chamber depth, aqueous depth, lens thickness and flat and steep corneal radii. The number of successful measurements and repeatability were evaluated for each parameter and three age bands (3.5 to 6.5 years, 6.5 to 10.5 years and 10.5 to 17.5 years). RESULTS Best measurement feasibility was found for axial length and central corneal thickness (91% to 100%), followed by flat and steep corneal radii (86% to 100%), anterior chamber and aqueous depth (76% to 92%) and lens thickness (50% to 81%), with higher numbers for older children. Repeatability values (in mm) were: axial length 0.025 to 0.035; central corneal thickness 0.003 to 0.027; aqueous depth 0.024 to 0.058; anterior chamber 0.024 to 0.054; lens thickness 0.034 to 0.067. An overall trend showed better repeatability for older children, especially for central corneal thickness, aqueous depth and lens thickness. CONCLUSIONS For ocular biometry in the paediatric population, axial length, central corneal thickness, flat and steep corneal radii can be measured very reliably even in children from 4 years old onward using the Lenstar LS 900. Lens thickness can be quantified in a limited number of younger children. Repeatability was high for all variables investigated. Repeatability improved with age, reaching adult values in the adolescent age band. Established repeatability limits can be applied in future studies as a quality parameter.
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Affiliation(s)
- Franziska G Rauscher
- Institute for Medical Informatics, Statistics, and Epidemiology (IMISE), Leipzig University, Leipzig, Germany.,Leipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, Leipzig, Germany
| | - Andreas Hiemisch
- Leipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, Leipzig, Germany.,Department of Women and Child Health, University Hospital for Children and Adolescents and Center for Pediatric Research (CPL), Leipzig University, Leipzig, Germany
| | - Wieland Kiess
- Leipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, Leipzig, Germany.,Department of Women and Child Health, University Hospital for Children and Adolescents and Center for Pediatric Research (CPL), Leipzig University, Leipzig, Germany
| | - Ralph Michael
- Institute for Medical Informatics, Statistics, and Epidemiology (IMISE), Leipzig University, Leipzig, Germany.,Institut Universitari Barraquer, Universitat Autònoma de Barcelona, Barcelona, Spain
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Michael R, D'Antin JC, Pinilla Cortés L, Burd HJ, Sheil B, Barraquer RI. Deformations and Ruptures in Human Lenses With Cortical Cataract Subjected to Ex Vivo Simulated Accommodation. Invest Ophthalmol Vis Sci 2021; 62:12. [PMID: 33427852 PMCID: PMC7804572 DOI: 10.1167/iovs.62.1.12] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose Human cortical opacities are most commonly accompanied by changes in lens fiber structure in the equatorial region at the lens nucleus–cortex interface. Cortex and nucleus have different elastic properties, which change with age. We therefore subjected ex vivo lenses to simulated accommodation and studied the internal deformations to better understand the mechanism of cortical cataract formation. Methods Nine human donor lenses (33–88 years old) were tested using a bespoke radial stretching device for anterior eye segments. Seven of the lenses exhibited cortical cataracts. The other two lenses, without cataract, were used as controls. Frontal and cross-sectional images of the lens obtained during stretching facilitated measurements on equatorial lens diameter and central lens thickness in the stretched and unstretched states. Results Stretching caused the lens equatorial diameter to increase in all cases. Conversely, the lens central thickness showed no systematic variation during stretching. For four of the lenses with cortical cataract, ruptures were observed during stretching at the nucleus–cortex boundary adjacent to the cortical cataracts. Ruptures were not observed in the control lenses or in the three other lenses with cortical cataract. Conclusions Internal ruptures can occur in aged ex vivo lenses subjected to simulated disaccommodation. These ruptures occur at the nucleus–cortex interface; at this location, a significant stiffness discontinuity is expected to develop with age. It is hypothesized that ruptures occur in in vivo lenses during accommodation—or attempted accommodation.
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Affiliation(s)
- Ralph Michael
- Centro de Oftalmología Barraquer, Barcelona, Spain.,Institut Universitari Barraquer, Universitat Autònoma de Barcelona, Barcelona, Spain.,University Eye Clinic, Paracelsus Medical University, Salzburg, Austria
| | - Justin Christopher D'Antin
- Centro de Oftalmología Barraquer, Barcelona, Spain.,Institut Universitari Barraquer, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Laura Pinilla Cortés
- Centro de Oftalmología Barraquer, Barcelona, Spain.,Institut Universitari Barraquer, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Harvey John Burd
- Department of Engineering Science, University of Oxford, Oxford, United Kingdom
| | - Brian Sheil
- Department of Engineering Science, University of Oxford, Oxford, United Kingdom
| | - Rafael I Barraquer
- Centro de Oftalmología Barraquer, Barcelona, Spain.,Institut Universitari Barraquer, Universitat Autònoma de Barcelona, Barcelona, Spain.,Universitat Internacional de Catalunya, Barcelona, Spain
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Pesaresi M, Bonilla-Pons SA, Sebastian-Perez R, Di Vicino U, Alcoverro-Bertran M, Michael R, Cosma MP. The Chemokine Receptors Ccr5 and Cxcr6 Enhance Migration of Mesenchymal Stem Cells into the Degenerating Retina. Mol Ther 2020; 29:804-821. [PMID: 33264643 DOI: 10.1016/j.ymthe.2020.10.026] [Citation(s) in RCA: 7] [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: 06/03/2020] [Revised: 10/02/2020] [Accepted: 10/23/2020] [Indexed: 02/07/2023] Open
Abstract
Cell therapy approaches hold great potential for treating retinopathies, which are currently incurable. This study addresses the problem of inadequate migration and integration of transplanted cells into the host retina. To this end, we have identified the chemokines that were most upregulated during retinal degeneration and that could chemoattract mesenchymal stem cells (MSCs). The results were observed using a pharmacological model of ganglion/amacrine cell degeneration and a genetic model of retinitis pigmentosa, from both mice and human retinae. Remarkably, MSCs overexpressing Ccr5 and Cxcr6, which are receptors bound by a subset of the identified chemokines, displayed improved migration after transplantation in the degenerating retina. They also led to enhanced rescue of cell death and to preservation of electrophysiological function. Overall, we show that chemokines released from the degenerating retinae can drive migration of transplanted stem cells, and that overexpression of chemokine receptors can improve cell therapy-based regenerative approaches.
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Affiliation(s)
- Martina Pesaresi
- Center for Genomic Regulation (CRG), Barcelona Institute of Science and Technology, Dr. Aiguader 88, Barcelona 08003, Spain
| | - Sergi A Bonilla-Pons
- Center for Genomic Regulation (CRG), Barcelona Institute of Science and Technology, Dr. Aiguader 88, Barcelona 08003, Spain; Universitat de Barcelona (UB), Barcelona 08028, Spain
| | - Ruben Sebastian-Perez
- Center for Genomic Regulation (CRG), Barcelona Institute of Science and Technology, Dr. Aiguader 88, Barcelona 08003, Spain
| | - Umberto Di Vicino
- Center for Genomic Regulation (CRG), Barcelona Institute of Science and Technology, Dr. Aiguader 88, Barcelona 08003, Spain
| | - Marc Alcoverro-Bertran
- Center for Genomic Regulation (CRG), Barcelona Institute of Science and Technology, Dr. Aiguader 88, Barcelona 08003, Spain
| | - Ralph Michael
- Institut Universitari Barraquer, Universitat Autónoma de Barcelona, Barcelona 08021, Spain; Centro de Oftalmología Barraquer, Barcelona 08021, Spain
| | - Maria Pia Cosma
- Center for Genomic Regulation (CRG), Barcelona Institute of Science and Technology, Dr. Aiguader 88, Barcelona 08003, Spain; Universitat Pompeu Fabra (UPF), Barcelona 08003, Spain; ICREA, Passeig de Lluis Companys 23, Barcelona 08010, Spain; Bioland Laboratory (Guangzhou Regenerative Medicine and Health Guangdong Laboratory), Guangzhou 510005, China.
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Anton-Sales I, D'Antin JC, Fernández-Engroba J, Charoenrook V, Laromaine A, Roig A, Michael R. Bacterial nanocellulose as a corneal bandage material: a comparison with amniotic membrane. Biomater Sci 2020; 8:2921-2930. [PMID: 32314754 DOI: 10.1039/d0bm00083c] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Corneal trauma and ulcerations are leading causes of corneal blindness around the world. These lesions require attentive medical monitoring since improper healing or infection has serious consequences in vision and quality of life. Amniotic membrane grafts represent the common solution to treat severe corneal wounds. However, amniotic membrane's availability remains limited by the dependency on donor tissues, its high price and short shelf life. Consequently, there is an active quest for biomaterials to treat injured corneal tissues. Nanocellulose synthetized by bacteria (BNC) is an emergent biopolymer with vast clinical potential for skin tissue regeneration. BNC also exhibits appealing characteristics to act as an alternative corneal bandage such as; high liquid holding capacity, biocompatibility, flexibility, natural - but animal free-origin and a myriad of functionalization opportunities. Here, we present an initial study aiming at testing the suitability of BNC as corneal bandage regarding preclinical requirements and using amniotic membrane as a benchmark. Bacterial nanocellulose exhibits higher mechanical resistance to sutures and slightly longer stability under in vitro and ex vivo simulated physiological conditions than amniotic membrane. Additionally, bacterial nanocellulose offers good conformability to the shape of the eye globe and easy manipulation in medical settings. These excellent attributes accompanied by the facts that bacterial nanocellulose is stable at room temperature for long periods, can be heat-sterilized and is easy to produce, reinforce the potential of bacterial nanocellulose as a more accessible ocular surface bandage.
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Anton-Sales I, D'Antin JC, Fernández-Engroba J, Charoenrook V, Laromaine A, Roig A, Michael R. Correction: Bacterial nanocellulose as a corneal bandage material: a comparison with amniotic membrane. Biomater Sci 2020; 8:6414. [DOI: 10.1039/d0bm90095h] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Correction for ‘Bacterial nanocellulose as a corneal bandage material: a comparison with amniotic membrane’ by Irene Anton-Sales et al., Biomater. Sci., 2020, 8, 2921–2930, DOI: 10.1039/D0BM00083C.
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Affiliation(s)
- Irene Anton-Sales
- Institut de Ciència de Materials de Barcelona (ICMAB)
- Campus UAB
- Catalonia E-08193
- Spain
| | - Justin Christopher D'Antin
- Institut Universitari Barraquer
- Universitat Autònoma de Barcelona
- Barcelona
- Spain
- Centro de Oftalmología Barraquer
| | - Jorge Fernández-Engroba
- Institut Universitari Barraquer
- Universitat Autònoma de Barcelona
- Barcelona
- Spain
- Centro de Oftalmología Barraquer
| | - Victor Charoenrook
- Institut Universitari Barraquer
- Universitat Autònoma de Barcelona
- Barcelona
- Spain
- Centro de Oftalmología Barraquer
| | - Anna Laromaine
- Institut de Ciència de Materials de Barcelona (ICMAB)
- Campus UAB
- Catalonia E-08193
- Spain
| | - Anna Roig
- Institut de Ciència de Materials de Barcelona (ICMAB)
- Campus UAB
- Catalonia E-08193
- Spain
| | - Ralph Michael
- Institut Universitari Barraquer
- Universitat Autònoma de Barcelona
- Barcelona
- Spain
- Centro de Oftalmología Barraquer
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Michael R. Autologous cell regeneration of the crystalline lens. Acta Ophthalmol 2019. [DOI: 10.1111/j.1755-3768.2019.8067] [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] [Indexed: 11/27/2022]
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Anton‐Sales I, Christopher D’Antin J, Fernandez J, Charoenrook V, Barraquer RI, Laromaine A, Roig A, Michael R. Bacterial nanocellulose compared to the amniotic membrane as a potential corneal bandage material. Acta Ophthalmol 2019. [DOI: 10.1111/j.1755-3768.2019.5164] [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] [Indexed: 11/29/2022]
Affiliation(s)
- Irene Anton‐Sales
- Insitute of Materials Science of Barcelona (ICMAB‐CSIC) Barcelona Spain
| | | | | | | | | | - Anna Laromaine
- Insitute of Materials Science of Barcelona (ICMAB‐CSIC) Barcelona Spain
| | - Anna Roig
- Insitute of Materials Science of Barcelona (ICMAB‐CSIC) Barcelona Spain
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Koch CR, D'Antin JC, Tresserra F, Barraquer RI, Michael R. Histological comparison of in vitro and in vivo development of peripheral posterior capsule opacification in human donor tissue. Exp Eye Res 2019; 188:107807. [PMID: 31539543 DOI: 10.1016/j.exer.2019.107807] [Citation(s) in RCA: 6] [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: 04/17/2019] [Revised: 09/16/2019] [Accepted: 09/16/2019] [Indexed: 01/05/2023]
Abstract
In order to study the mechanisms involved in the development of posterior capsule opacification (PCO) we compared in vivo developed PCO with PCO formed in tissue culture with focus on the periphery of the lens capsule to evaluate lens regeneration potential. We studied three human tissue groups: Cultured lens capsules after mock cataract surgery (n = 6, 30 days), lens capsules from donors that had previously undergone cataract surgery (IOL capsules) (n = 12) and intact lenses (n = 6). All samples were stained with Vimentin, alpha Smooth Muscle Actin, Picro Sirius Red (for collagen) and Paired box protein (Pax6). We found that cultured capsules and less developed IOL capsules consisted mainly of monolayers of mesenchymal cells, while more developed IOL capsules, contained lens epithelial cells (LECs), globular cells and lens fiber cells. Many IOL capsule samples expressed collagen I and III in areas where cells were in contact with the IOL. Pax6 had a similar dispersed distribution in less developed IOL capsules and cultured capsules, while more developed IOL capsules and intact lenses, concentrated Pax6 in LECs at the equatorial lens bow. The similarities between cultured capsules and less developed IOL capsules indicate that our in vitro developed PCO is comparable to early in vivo developed PCO. The similar morphology of more developed IOL capsules and intact lenses seems to indicate an attempt at lens regeneration.
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Affiliation(s)
- Camila Ribeiro Koch
- Institut Universitari Barraquer, Universitat Autònoma de Barcelona, Barcelona, Spain; Department of Ophthalmology, University of São Paulo, São Paulo, Brazil
| | - Justin Christopher D'Antin
- Institut Universitari Barraquer, Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Oftalmología Barraquer, Barcelona, Spain
| | | | - Rafael I Barraquer
- Institut Universitari Barraquer, Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Oftalmología Barraquer, Barcelona, Spain; Universitat Internacional de Catalunya, Barcelona, Spain.
| | - Ralph Michael
- Institut Universitari Barraquer, Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Oftalmología Barraquer, Barcelona, Spain
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15
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de la Paz MF, Salvador-Culla B, Charoenrook V, Temprano J, Álvarez de Toledo J, Grabner G, Michael R, Barraquer RI. Osteo-odonto-, Tibial bone and Boston keratoprosthesis in clinically comparable cases of chemical injury and autoimmune disease. Ocul Surf 2019; 17:476-483. [DOI: 10.1016/j.jtos.2019.04.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 03/05/2019] [Accepted: 04/09/2019] [Indexed: 01/16/2023]
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16
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Barraquer RI, Pareja-Aricò L, Gómez-Benlloch A, Michael R. Risk factors for graft failure after penetrating keratoplasty. Medicine (Baltimore) 2019; 98:e15274. [PMID: 31027083 PMCID: PMC6831321 DOI: 10.1097/md.0000000000015274] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 03/04/2019] [Accepted: 03/25/2019] [Indexed: 11/30/2022] Open
Abstract
The objective of our study was to define principal risk factors for graft failure in patients who underwent penetrating keratoplasty (PK).Retrospective data obtained from a cohort of 895 penetrating keratoplasties performed between 2001 and 2006 were analysed. Recipient related factors, graft characteristics, and surgical technique were assessed in a univariate analysis and with a multivariate proportional hazard model to detect principal risk factors for definitive graft failure.Multivariate analysis showed clear significance for diagnosis and number of previous grafts and border line significance for the oldest donor age group. Patients with keratoconus had the best 10-year survival estimate (95%), followed by endothelial and stromal dystrophies (both 55%), infectious leukomas (49%), trauma (33%) and chemical burns (14%). Primary PK grafts had a survival rate of 81%, second grafts of 33% and third or more grafts of 16%. Overall 10-year survival estimate based on univariate analysis was found to be 65%.In conclusion, we found that primary diagnosis and previous graft failures in the recipient are the most important risk factors of graft failure after a PK.
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Affiliation(s)
- Rafael Ignacio Barraquer
- Institut Universitari Barraquer, Universitat Autònoma de Barcelona
- Centro de Oftalmología Barraquer
- Universitat Internacional de Catalunya, Barcelona
| | - Luis Pareja-Aricò
- Institut Universitari Barraquer, Universitat Autònoma de Barcelona
- Hospital Clinico Universitario Valladolid, Universidad de Valladolid, Valladolid, Spain
| | - Alba Gómez-Benlloch
- Institut Universitari Barraquer, Universitat Autònoma de Barcelona
- Centro de Oftalmología Barraquer
| | - Ralph Michael
- Institut Universitari Barraquer, Universitat Autònoma de Barcelona
- Centro de Oftalmología Barraquer
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17
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Michael R, Pareja-Aricò L, Rauscher FG, Barraquer RI. Cortical Cataract and Refractive Error. Ophthalmic Res 2019; 62:157-165. [PMID: 30921809 DOI: 10.1159/000496865] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 11/06/2018] [Accepted: 01/11/2019] [Indexed: 11/19/2022]
Abstract
PURPOSE To evaluate the relationship between the presence of cortical cataract and accommodation effort, using refractive error as a proxy. METHODS Patients between 50 and 90 years, scheduled for cataract surgery, were selected with the help of a photographic database. Nuclear and cortical cataract were graded and patients grouped having no cataract, pure cortical, mixed or pure nuclear cataract. Refraction data at the time of the photograph was converted to estimated spherical equivalent refractive error each patient would have had at the age of 45 years. RESULTS From the initial 239 eyes from 239 patients, cases with myopia below -6.5 dpt and hyperopia above 6.5 dpt were excluded, resulting in 199 cases for final analysis. Eyes with no cataract showed the lowest median refractive error (-3.65 dpt), followed by the pure nuclear group (-2.69 dpt). The median refractive error for pure cortical (-0.23 dpt) and mixed cataracts (-0.87 dpt) were close to emmetropia. Cortical cataracts were found in 37% of myopes, 82% of emmetropes, and 85% of hyperopes. CONCLUSION Emmetropes and hyperopes tend to develop more cortical cataract than myopes. These cortical cataracts might be caused by shear stress inside the crystalline lens due to accommodation efforts at the time of onset of presbyopia.
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Affiliation(s)
- Ralph Michael
- Centro de Oftalmología Barraquer, Barcelona, Spain, .,Institut Universitari Barraquer, Universitat Autònoma de Barcelona, Barcelona, Spain,
| | - Luis Pareja-Aricò
- Institut Universitari Barraquer, Universitat Autònoma de Barcelona, Barcelona, Spain.,Hospital Clinico Universitario Valladolid, Universidad de Valladolid, Valladolid, Spain
| | - Franziska G Rauscher
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany.,Leipzig Research Centre for Civilization Diseases, Leipzig University, Leipzig, Germany
| | - Rafael I Barraquer
- Centro de Oftalmología Barraquer, Barcelona, Spain.,Institut Universitari Barraquer, Universitat Autònoma de Barcelona, Barcelona, Spain.,Universitat Internacional de Catalunya, Barcelona, Spain
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D'Antin JC, Barraquer RI, Tresserra F, Michael R. Prevention of posterior capsule opacification through intracapsular hydrogen peroxide or distilled water treatment in human donor tissue. Sci Rep 2018; 8:12739. [PMID: 30143742 PMCID: PMC6109042 DOI: 10.1038/s41598-018-31178-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 04/09/2018] [Accepted: 08/14/2018] [Indexed: 12/18/2022] Open
Abstract
In order to determine whether posterior capsule opacification after cataract surgery, could be delayed or inhibited through the application of hydrogen peroxide (H2O2) or distilled water (H2Od),we extracted lens capsules from 25 human donor eye globes. Samples were treated for 5 min with either 30 mM H2O2 or H2Od or used as controls, and cultured for one month, during which dark field and tilt illumination photos were taken. These were used to observe and quantify, time until cellular growth and confluence on the posterior capsule. After culture, histological sections were stained for H&E, α-SMA, Ki-67 and vimentin and evaluated. We prevented cellular growth in 50% of H2Od and 58% H2O2 of treated samples. The overall prevention of cell growth compared to cultured controls was significant for both treatments while there was no significant difference between them. In the cases where cellular growth was not prevented, both treatments significantly delay cellular growth. Until day 28 none of the treated samples of either type that had shown growth reached total confluence. All cultured controls reached total confluence before treated samples (median = day 11.5). Also, histologically, there was a clear morphological difference between cultured controls and treated samples.
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Affiliation(s)
- Justin Christopher D'Antin
- Institut Universitari Barraquer, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Oftalmología Barraquer, Barcelona, Spain
| | - Rafael I Barraquer
- Institut Universitari Barraquer, Universitat Autònoma de Barcelona, Barcelona, Spain. .,Centro de Oftalmología Barraquer, Barcelona, Spain. .,Universitat Internacional de Catalunya, Barcelona, Spain.
| | | | - Ralph Michael
- Institut Universitari Barraquer, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Oftalmología Barraquer, Barcelona, Spain
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Miller MB, Chan WS, Curtis AF, Boissoneault J, Michael R, Staud R, Berry RB, McCrae CS. 0909 Opioid Use and Sleep among Adults with Chronic Pain: A Daily Process Model. Sleep 2018. [DOI: 10.1093/sleep/zsy061.908] [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] [Indexed: 11/14/2022] Open
Affiliation(s)
| | | | | | | | - R Michael
- University of Florida, Gainesville, FL
| | - R Staud
- University of Florida, Gainesville, FL
| | - R B Berry
- University of Florida, Gainesville, FL
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20
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Charoenrook V, Michael R, de la Paz MF, Temprano J, Barraquer RI. Comparison of long-term results between osteo-odonto-keratoprosthesis and tibial bone keratoprosthesis. Ocul Surf 2018; 16:259-264. [DOI: 10.1016/j.jtos.2018.02.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 02/19/2018] [Accepted: 02/26/2018] [Indexed: 10/17/2022]
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21
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Nischler C, Michael R, Wintersteller C, Marvan P, Emesz M, Van Rijn LJ, Van Den Berg TJ, Wilhelm H, Coeckelbergh T, Barraquer RI, Grabner G, Hitzl W. Cataract and Pseudophakia in Elderly European Drivers. Eur J Ophthalmol 2018; 20:892-901. [DOI: 10.1177/112067211002000513] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Christian Nischler
- Department of Ophthalmology, Paracelsus Private Medical University Salzburg, Salzburg - Austria
| | | | - Christine Wintersteller
- Department of Ophthalmology, Paracelsus Private Medical University Salzburg, Salzburg - Austria
| | - Patrick Marvan
- Department of Ophthalmology, Paracelsus Private Medical University Salzburg, Salzburg - Austria
| | - Martin Emesz
- Department of Ophthalmology, Paracelsus Private Medical University Salzburg, Salzburg - Austria
| | | | | | - Helmut Wilhelm
- Department of Ophthalmology, University of Tübingen, Tübingen - Germany
| | - Tanja Coeckelbergh
- Department of Ophthalmology, Universitair Ziekenhuis Antwerpen, Antwerpen - Belgium
| | | | - Günther Grabner
- Department of Ophthalmology, Paracelsus Private Medical University Salzburg, Salzburg - Austria
| | - Wolfgang Hitzl
- Department of Ophthalmology, Paracelsus Private Medical University Salzburg, Salzburg - Austria
- Research Office, Paracelsus Private Medical University Salzburg, Salzburg - Austria
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22
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D'antin J, Barraquer R, Michael R. Effects of short oxidative stress exposure on lens epithelial cells. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.0s073] [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] [Indexed: 11/29/2022]
Affiliation(s)
- J.C. D'antin
- Instituto Barraquer; Investigación; Barcelona Spain
| | | | - R. Michael
- Instituto Barraquer; Investigación; Barcelona Spain
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23
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Barraquer RI, Pinilla Cortés L, Allende MJ, Montenegro GA, Ivankovic B, D'Antin JC, Martínez Osorio H, Michael R. Validation of the Nuclear Cataract Grading System BCN 10. Ophthalmic Res 2017; 57:247-251. [PMID: 28288454 DOI: 10.1159/000456720] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 01/18/2017] [Indexed: 11/19/2022]
Abstract
PURPOSE To evaluate a new nuclear cataract grading system which is intended as a surgical guidance system to predict lens hardness before cataract surgery. METHODS The new BCN 10 grading system consists of frontal and cross-sectional slit-lamp images of human eye lenses, ranging from a completely transparent lens nucleus to a totally black nuclear cataract. Validation was done with 9 observers for 110 cases. Two modalities were applied, and observers were asked to use only whole digits and then half digits for grading. RESULTS Repeatability with regard to test-retest differences showed a mean limit of agreement of 1.70 for whole digits and 1.32 for half digits. The absolute test-retest difference was close to zero for low as well high degrees of cataracts. Reliability for the entire group of 9 observers yielded an intraclass correlation coefficient which was within the same confidence interval, i.e., 0.991-0.995, for whole digits and half digits. CONCLUSIONS BCN 10 grading repeatability was not affected by the severity of the cataract. It showed very good repeatability. Repeatability was significantly higher when the observers used half digits compared to whole digits. Reliability was found to be very good as well, independently of the use of whole or half digits.
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Affiliation(s)
- Rafael I Barraquer
- Institut Universitari Barraquer, Universitat Autònoma de Barcelona, Barcelona, Spain
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24
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Burd HJ, Montenegro GA, Panilla Cortés L, Barraquer RI, Michael R. Equatorial wrinkles in the human lens capsule. Exp Eye Res 2017; 159:77-86. [PMID: 28202286 DOI: 10.1016/j.exer.2017.02.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 11/29/2016] [Accepted: 02/09/2017] [Indexed: 11/26/2022]
Abstract
Equatorial wrinkles, or crenations, have been previously observed around the equator in coronal images of the human ocular lens. However, wrinkles are typically not apparent when the lens is viewed from saggital directions. In the current paper, the existence and geometry of these wrinkles is shown to be consistent with a mechanical model of the isolated lens, in which the capsule is held in a state of residual tension by a spatially uniform internal pressure. The occurrence of equatorial wrinkles is therefore seen to be a mechanical consequence of the spheroidal shape of the lens capsule and an excess intralenticular pressure. New observations are made, on post mortem lenses, on the geometric arrangement of these equatorial wrinkles. These observations indicate a well-defined pattern in which wrinkles exists along meridional lines in the equatorial regions of the lens. A preliminary 'puncture test' is used to demonstrate that the residual stresses within the capsule in the equatorial region of the lens are broadly consistent with the proposed mechanical model of the lens capsule. It is suggested that the presence of equatorial wrinkles may have an influence on the mechanical performance of the capsule during the accommodation process.
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Affiliation(s)
- H J Burd
- Department of Engineering Science, University of Oxford, Parks Road, Oxford OX1 3PJ, UK.
| | - G A Montenegro
- Institut Universitari Barraquer, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - L Panilla Cortés
- Institut Universitari Barraquer, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - R I Barraquer
- Institut Universitari Barraquer, Universitat Autonoma de Barcelona, Barcelona, Spain; Centro de Oftalmología Barraquer, Universitat Internacional de Catalunya, Barcelona, Spain
| | - R Michael
- Institut Universitari Barraquer, Universitat Autonoma de Barcelona, Barcelona, Spain
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Michael R, Pinilla Cortés L, Montenegro G, D'Antin J, Barraquer R. Cortical cataracts: the case for mechanical stress. Acta Ophthalmol 2016. [DOI: 10.1111/j.1755-3768.2016.0048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Charoenrook V, Michael R, de la Paz MF, Ding A, Barraquer RI, Temprano J. Osteokeratoprosthesis Using Tibial Bone: Surgical Technique and Outcomes. Ocul Surf 2016; 14:495-506. [PMID: 27503376 DOI: 10.1016/j.jtos.2016.07.002] [Citation(s) in RCA: 14] [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: 01/07/2016] [Revised: 07/25/2016] [Accepted: 07/26/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE To analyze the anatomical and functional results of keratoprosthesis using tibial bone autograft. METHODS We reviewed 113 charts of patients who underwent tibial bone osteokeratoprothesis implantation at the Centro de Oftalmologia Barraquer. Kaplan-Meier survival curves with 95% confidence interval were calculated for functional success, defined as best corrected visual acuity (BCVA) ≥0.05 on the decimal scale, and for anatomical success, defined as retention of the keratoprosthesis lamina. Multivariate analysis was used to test the impact of clinical factors on anatomical and functional survival rates. RESULTS Based on Kaplan-Meier analyses, tibial bone keratoprosthesis 5-year and 10-year anatomical survival rates were 69.5% and 53.5%, respectively. Functional survival rate at 5 years was 33% and at 10 years was 19.2%. Considering primary diagnosis, chemical burn had better anatomical and functional survival rates than autoimmune or infectious diseases. Patient age did not have a significant effect on keratoprosthesis survival rates. About 48.7% of the patients who underwent surgery had complications: keratoprosthesis extrusion, glaucoma, retinal detachment and buccal mucosa necrosis were the most frequent ones. CONCLUSION Half of the patients with tibial bone KPro had retained the keratoprosthesis after 10 years post-surgery and one-fifth of them had visual acuity of 0.05 or better at the same period. Considering that these patients have no other way to recover their vision either because they have no canine tooth or their buccal or dental conditions are not adequate for OOKP, this modified surgery is their only hope.
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Affiliation(s)
- Victor Charoenrook
- Centro de Oftalmología Barraquer, Universitat Internacional de Catalunya, Barcelona, Spain; Institut Universitari Barraquer, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Ralph Michael
- Institut Universitari Barraquer, Universitat Autonoma de Barcelona, Barcelona, Spain.
| | - Maria Fideliz de la Paz
- Centro de Oftalmología Barraquer, Universitat Internacional de Catalunya, Barcelona, Spain; Institut Universitari Barraquer, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Angela Ding
- Centro de Oftalmología Barraquer, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Rafael I Barraquer
- Centro de Oftalmología Barraquer, Universitat Internacional de Catalunya, Barcelona, Spain; Institut Universitari Barraquer, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Jose Temprano
- Centro de Oftalmología Barraquer, Universitat Internacional de Catalunya, Barcelona, Spain
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27
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Bausili MM, Alvarez de Toledo J, Barraquer RI, Michael R, Tresserra F, de la Paz MF. Histopathology Findings of Corneal Buttons in Congenital Aniridia Patients. Ophthalmic Res 2016; 56:202-206. [PMID: 27160090 DOI: 10.1159/000444930] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 02/22/2016] [Indexed: 11/19/2022]
Abstract
PURPOSE To evaluate the corneal button of primary penetrating keratoplasty of patients diagnosed with congenital aniridia. The study took place at the Instituto Universitario Barraquer and the Centro de Oftalmología Barraquer. METHODS A retrospective analysis of cases diagnosed with congenital aniridia was carried out. We analyzed 13 corneal buttons of 11 eyes with congenital aniridia. We only included those patients who underwent penetrating keratoplasty for the first time. The corneal buttons were analyzed for histological characteristics of the presence of vascularization, the presence or not of Bowman's layer, the thickness of the stroma and Descemet's membrane, and endothelium layer alterations. RESULTS We found alterations in the epithelium and stroma in all patients, although this loss of architecture was not seen in Descemet's membrane and the endothelial population. CONCLUSION Patients with advanced congenital aniridic keratopathy may be good candidates for deep or superficial anterior lamellar keratoplasty for the preservation of normal endothelium and Descemet's membrane, along with limbal stem cell transplantation, to address epithelial and stromal pathology.
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28
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Vrensen GFJM, Otto C, Lenferink A, Liszka B, Montenegro GA, Barraquer RI, Michael R. Protein profiles in cortical and nuclear regions of aged human donor lenses: A confocal Raman microspectroscopic and imaging study. Exp Eye Res 2015; 145:100-109. [PMID: 26611157 DOI: 10.1016/j.exer.2015.11.009] [Citation(s) in RCA: 6] [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: 06/17/2015] [Revised: 10/26/2015] [Accepted: 11/10/2015] [Indexed: 10/22/2022]
Abstract
A combination of Raman spectroscopy, imaging, hierarchical cluster analysis (HCA) and peak ratio analysis was used to analyze protein profiles in the superficial cortex (SC), deep cortex (DC) and nucleus of old human lenses with cortical, nuclear and mixed cataracts. No consistent differences were observed in protein spectra and after cluster analysis between the three locations irrespective of the presence or absence of cortical opacities and/or coloration. A sharp increase (∼15%-∼33%) in protein content from SC to DC, normal for human lenses, was found in 7 lenses. In 4 lenses, characterized by the absence of cortical opacities, the SC has a protein content of ∼35%. A significant increase in the disulfide-to-protein ratio is found only in the SC of the 7 cortical cataracts. No changes were found in sulfhydryl-to-protein ratio. The relative contents of α-helices and β-sheets increase from SC to nucleus. β-Sheets are more common in the SC of lenses with cortical cataract. The absence of significant and consistent changes in protein profiles between nucleus and cortex even in cases of severe coloration is not favoring the prevailing concept that ubiquitous protein oxidation is a key factor for age related nuclear (ARN) cataracts. The observations favor the idea that multilamellar bodies or protein aggregates at very low volume densities are responsible for the rise in Mie light scatter as a main cause of ARN cataracts leaving the short-range-order of the fiber cytoplasm largely intact. The absence of significant changes in the protein spectra of the deep cortical opacities, milky white as a result of the presence of vesicle-like features, indicate they are packed with relatively undisturbed crystallins.
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Affiliation(s)
- Gijs F J M Vrensen
- Department of Ophthalmology, Leiden University Medical Center, University of Leiden, The Netherlands
| | - Cees Otto
- Medical Cell Bio Physics, University of Twente, Enschede, The Netherlands
| | - Aufried Lenferink
- Medical Cell Bio Physics, University of Twente, Enschede, The Netherlands
| | - Barbara Liszka
- Medical Cell Bio Physics, University of Twente, Enschede, The Netherlands
| | - Gustavo A Montenegro
- Institut Universitari Barraquer, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Rafael I Barraquer
- Institut Universitari Barraquer, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ralph Michael
- Institut Universitari Barraquer, Universitat Autònoma de Barcelona, Barcelona, Spain; University Eye Clinic, Paracelsus Medical University, Salzburg, Austria.
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D'Antin J, Pinilla Cortés L, Montenegro G, Barraquer R, Michael R. Evaluation of a portable manual stretching device to simulate accommodation. Acta Ophthalmol 2015. [DOI: 10.1111/j.1755-3768.2015.0333] [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] [Indexed: 11/30/2022]
Affiliation(s)
- J.C. D'Antin
- Investigación; Instituto Barraquer; Barcelona Spain
| | | | | | | | - R. Michael
- Investigación; Instituto Barraquer; Barcelona Spain
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Pinilla Cortés L, Burd HJ, Montenegro GA, D'Antin JC, Mikielewicz M, Barraquer RI, Michael R. Experimental protocols for ex vivo lens stretching tests to investigate the biomechanics of the human accommodation apparatus. Invest Ophthalmol Vis Sci 2015; 56:2926-32. [PMID: 26024078 DOI: 10.1167/iovs.14-15744] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To explore alternative experimental protocols to investigate the biomechanical behavior of the crystalline lens and zonules using ex vivo stretching. METHODS Radial stretching tests were conducted on the anterior segment (consisting of lens, zonules, ciliary body, and sclera) of four pairs of presbyopic human donor eyes. A simple mechanical model is used to describe the behavior of the anterior segment when tested in this way. Each pair of samples was initially stretched with the ciliary body intact. One sample was retested after cutting the ciliary body radially, and the other sample was retested after removing the lens. RESULTS The external forces needed to stretch the sample with the ciliary body intact were significantly greater than for the tests in which the ciliary body had been cut. The forces measured with the ciliary body intact and lens in situ were comparable to the sum of the forces measured in the tests in which the ciliary body had been cut (lens in situ) and the forces measured in the tests on the intact ciliary body with the lens removed. CONCLUSIONS When stretching tests are conducted on the anterior segment, significant circumferential tensions develop in the ciliary body. This means that the forces applied to the lens and zonules cannot be related directly to the forces applied by the external loading system. If radial cuts are introduced in the ciliary body prior to testing, however, then this difficulty does not arise.
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Affiliation(s)
- Laura Pinilla Cortés
- Institut Universitari Barraquer Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Harvey John Burd
- Department of Engineering Science, University of Oxford, Oxford, United Kingdom
| | - Gustavo A Montenegro
- Institut Universitari Barraquer Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Marek Mikielewicz
- Institut Universitari Barraquer Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Rafael I Barraquer
- Institut Universitari Barraquer Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ralph Michael
- Institut Universitari Barraquer Universitat Autònoma de Barcelona, Barcelona, Spain
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de Rezende Couto Nascimento V, de la Paz MF, Rosandic J, Stoiber J, Seyeddain O, Grabner G, Alvarez de Toledo J, Barraquer RI, Michael R. Influence of Primary Diagnosis and Complications on Visual Outcome in Patients Receiving a Boston Type 1 Keratoprosthesis. Ophthalmic Res 2014; 52:9-16. [DOI: 10.1159/000358332] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Accepted: 01/03/2014] [Indexed: 11/19/2022]
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Michael R, Otto C, Lenferink A, Gelpi E, Montenegro GA, Rosandić J, Tresserra F, Barraquer RI, Vrensen GFJM. Absence of amyloid-beta in lenses of Alzheimer patients: a confocal Raman microspectroscopic study. Exp Eye Res 2013; 119:44-53. [PMID: 24333259 DOI: 10.1016/j.exer.2013.11.016] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [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: 09/17/2013] [Revised: 11/15/2013] [Accepted: 11/26/2013] [Indexed: 12/13/2022]
Abstract
We have compared the protein profiles in plaques and tangles in the hippocampus of post-mortem Alzheimer brains and in opaque and clear regions in the deep cortex of eye lenses of the same donors. From the 7 Alzheimer donors studied, 1 had pronounced bilateral cortical lens opacities, 1 moderate and 5 only minor or no cortical opacities. We focused on beta-sheet levels, a hallmarking property of amyloid-beta, the major protein of plaques and tau protein, the major protein of tangles in Alzheimer brains. Confocal Raman microspectroscopy and imaging was used in combination with hierarchical cluster analysis. Plaques and tangles show high levels of beta-sheets with a beta-sheet to protein ratio of 1.67. This ratio is 1.12 in unaffected brain tissue surrounding the plaques and tangles. In the lenses this ratio is 1.17 independently of the presence or absence of opacities. This major difference in beta-sheet conformation between hippocampus and lens is supported by Congo red and immunostaining of amyloid-beta and tau which were positive for plaques and tangles in the hippocampus but fully negative for the lens irrespective of the presence or absence of opacities. In line with a previous study (Michael et al., 2013) we conclude that cortical lens opacities are not typical for Alzheimer patients and are not hallmarked by accumulation of amyloid-beta, and can thus not be considered as predictors or indicators of Alzheimer disease as claimed by Goldstein et al. (2003).
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Affiliation(s)
- Ralph Michael
- Institut Universitari Barraquer, Universitat Autònoma de Barcelona, Barcelona, Spain; University Eye Clinic, Paracelsus Medical University, Salzburg, Austria.
| | - Cees Otto
- Medical Cell Bio Physics, University of Twente, Enschede, The Netherlands
| | - Aufried Lenferink
- Medical Cell Bio Physics, University of Twente, Enschede, The Netherlands
| | - Ellen Gelpi
- Neurological Tissue Bank of the Biobanc-Hospital Clinic-Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Gustavo A Montenegro
- Institut Universitari Barraquer, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jurja Rosandić
- Institut Universitari Barraquer, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Rafael I Barraquer
- Institut Universitari Barraquer, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Gijs F J M Vrensen
- Department of Ophthalmology, Leiden University Medical Center, The Netherlands
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de la Paz MF, Stoiber J, de Rezende Couto Nascimento V, de Toledo JA, Seyeddain O, Hitzl W, Grabner G, Barraquer RI, Michael R. Anatomical survival and visual prognosis of Boston type I keratoprosthesis in challenging cases. Graefes Arch Clin Exp Ophthalmol 2013; 252:83-90. [DOI: 10.1007/s00417-013-2481-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Revised: 09/23/2013] [Accepted: 09/25/2013] [Indexed: 11/30/2022] Open
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Rajamanickam M, Michael R, Sampath V, John JA, Viswabandya A, Srivastava A. Should ice be used in the treatment of acute haemarthrosis in haemophilia? Haemophilia 2013; 19:e267-8. [DOI: 10.1111/hae.12163] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2013] [Indexed: 11/29/2022]
Affiliation(s)
- M. Rajamanickam
- Department of Physical Medicine and Rehabilitation; Christian Medical College; Vellore; India
| | - R. Michael
- Department of Physical Medicine and Rehabilitation; Christian Medical College; Vellore; India
| | - V. Sampath
- Department of Physical Medicine and Rehabilitation; Christian Medical College; Vellore; India
| | - J. A. John
- Department of Physical Medicine and Rehabilitation; Christian Medical College; Vellore; India
| | - A. Viswabandya
- Department of Haematology; Christian Medical College; Vellore; India
| | - A. Srivastava
- Department of Haematology; Christian Medical College; Vellore; India
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Michael R, Rosandić J, Montenegro GA, Lobato E, Tresserra F, Barraquer RI, Vrensen GFJM. Absence of beta-amyloid in cortical cataracts of donors with and without Alzheimer's disease. Exp Eye Res 2012; 106:5-13. [PMID: 23142516 DOI: 10.1016/j.exer.2012.10.012] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [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: 12/25/2011] [Revised: 10/19/2012] [Accepted: 10/25/2012] [Indexed: 11/16/2022]
Abstract
Eye lenses from human donors with and without Alzheimer's disease (AD) were studied to evaluate the presence of amyloid in cortical cataract. We obtained 39 lenses from 21 postmortem donors with AD and 15 lenses from age-matched controls provided by the Banco de Ojos para Tratamientos de la Ceguera (Barcelona, Spain). For 17 donors, AD was clinically diagnosed by general physicians and for 4 donors the AD diagnosis was neuropathologically confirmed. Of the 21 donors with AD, 6 had pronounced bilateral cortical lens opacities and 15 only minor or no cortical opacities. As controls, 7 donors with pronounced cortical opacities and 8 donors with almost transparent lenses were selected. All lenses were photographed in a dark field stereomicroscope. Histological sections were analyzed using a standard and a more sensitive Congo red protocol, thioflavin staining and beta-amyloid immunohistochemistry. Brain tissue from two donors, one with cerebral amyloid angiopathy and another with advanced AD-related changes and one cornea with lattice dystrophy were used as positive controls for the staining techniques. Thioflavin, standard and modified Congo red staining were positive in the control brain tissues and in the dystrophic cornea. Beta-amyloid immunohistochemistry was positive in the brain tissues but not in the cornea sample. Lenses from control and AD donors were, without exception, negative after Congo red, thioflavin, and beta-amyloid immunohistochemical staining. The results of the positive control tissues correspond well with known observations in AD, amyloid angiopathy and corneas with lattice dystrophy. The absence of staining in AD and control lenses with the techniques employed lead us to conclude that there is no beta-amyloid in lenses from donors with AD or in control cortical cataracts. The inconsistency with previous studies of Goldstein et al. (2003) and Moncaster et al. (2010), both of which demonstrated positive Congo red, thioflavin, and beta-amyloid immunohistochemical staining in AD and Down syndrome lenses, is discussed.
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Affiliation(s)
- Ralph Michael
- Institut Universitari Barraquer, Universitat Autònoma de Barcelona, Laforja 88, 08021 Barcelona, Spain.
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Michael R, Mikielewicz M, Gordillo C, Montenegro GA, Pinilla Cortés L, Barraquer RI. Elastic Properties of Human Lens Zonules as a Function of Age in Presbyopes. ACTA ACUST UNITED AC 2012; 53:6109-14. [DOI: 10.1167/iovs.11-8702] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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de Araujo AL, Charoenrook V, de la Paz MF, Temprano J, Barraquer RI, Michael R. The role of visual evoked potential and electroretinography in the preoperative assessment of osteo-keratoprosthesis or osteo-odonto-keratoprosthesis surgery. Acta Ophthalmol 2012; 90:519-25. [PMID: 21595859 DOI: 10.1111/j.1755-3768.2010.02086.x] [Citation(s) in RCA: 12] [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] [Indexed: 11/30/2022]
Abstract
PURPOSE To determine the value of electroretinography (ERG) and visual evoked potential (VEP) in predicting visual outcome in patients undergoing osteo-keratoprosthesis (OKP) or osteo-odonto-keratoprosthesis (OOKP) surgery. METHODS We performed a retrospective cohort study of 143 eyes in 101 patients who underwent OKP or OOKP surgery. The subjects underwent ERG, VEP testing or both up to 6 months prior to surgery. The ERG and VEP results were classified into four categories based on wave amplitude, latency and configuration. The main outcome was the maximum best-corrected visual acuity (maxBCVA) reached at any time postoperatively. RESULTS One hundred thirty-four cases had undergone preoperative ERG, 82 VEP and 73 both examinations. The sensitivities of ERG and VEP to detect maxBCVA≥0.05 were 68.5% and 87%, respectively, while the specificity was 63.2% for ERG and 47.4% for VEP. The maxBCVA was significantly better in patients with normal ERG (p=0.033) and those with normal VEP (p=0.048), once having defined appropriate normal and abnormal cut-off levels. When comparing fellow eyes in patients who underwent surgery in both eyes, maxBCVA was better in the eyes that had better VEP results (p=0.013). CONCLUSION Eyes demonstrating normal ERG or VEP achieved better visual outcome than those with abnormal results. In addition, VEP proved instrumental in determining the eye with the best prognosis when comparing both eyes of a given patient.
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Affiliation(s)
- Aline L de Araujo
- Institut Universitari Barraquer, Universitat Autònoma de Barcelona, Barcelona, Spain
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Satoh M, Terata S, Kikuya M, Ohkubo T, Hashimoto T, Hara A, Hirose T, Obara T, Metoki H, Inoue R, Asayama K, Nakayama M, Kanno A, Totsune K, Hoshi H, Satoh H, Sato H, Imai Y, Palmer S, Germaine W, Iff S, Craig J, Mitchell P, Wang JJ, Strippoli G, Palmer S, Craig J, Navaneethan S, Tonelli M, Pellegrini F, Strippoli G, Stracke S, Ernst F, Robinson D, Schwahn C, John U, Felix SB, Volzke H, Mysula I, Gozhenko A, Susla O, Minutolo R, Gabbai FB, Agarwal R, Bellizzi V, Nappi F, Conte G, De Nicola L, Smith E, Tomlinson L, Ford M, Mcmahon L, Rajkumar C, Holt S, Lee S, Kim I, Lee D, Rhee H, Song S, Seong E, Kwak I, Redal-Baigorri B, Rasmusen K, Goya Heaf J, Sombolos K, Tsakiris D, John B, Vlahakos D, Siamopoulos K, Vargiemezis V, Nikolaidis P, Iatrou C, Dafnis E, Argyropoulos C, Xynos K, Ramona H, Jos D, Guido F, Patrick D, Dominique L, Begona MYK, Antoon DS, Marc VS, Hellberg M, Wiberg EM, Hoglund P, Simonsen O, Clyne N, Manfredini F, Manfredini F, Bolignano D, Rastelli S, Barilla A, Bertoli S, Ciurlino D, Messa P, Fabrizi F, Zuccala A, Rapana R, Fatuzzo P, Rapisarda F, Bonanno G, Lombardi L, De Paola L, Cupisti A, Fuiano G, Lucisano G, Tripepi G, Catizone L, Zoccali C, Mallamaci F, Ishigami T, Ishigami T, Yamamoto R, Nagasawa Y, Isaka Y, Konta T, Iseki K, Moriyama T, Yamagata K, Tsuruya K, Yoshida H, Fujimoto S, Asahi K, Watanabe T, Morales E, Gutierrez E, Forteza A, Bellot R, Sanchez V, Sanz MP, Evangelista A, Cortina J, Praga M, Hung CC, Yang ML, Hwang SJ, Chen HC, Saglimbene VM, Palmer S, Craig J, Pellegrini F, Vecchio M, Ruospo M, De Berardis G, Strippoli G, DI Iorio B, Bellasi A, Pota A, Russo L, Russo D, Nakano C, Nakano C, Hamano T, Fujii N, Obi Y, Matsui I, Mikami S, Inoue K, Shimomura A, Rakugi H, Isaka Y, Yen CY, Wang HH, Hung CC, Hwang SJ, Chen HC, Postorino M, Postorino M, Cutrupi S, Pizzini P, Marino C, D'arrigo G, Tripepi G, Zoccali C, Ghasemi H, Afshar R, Afshar R, Shabpirai H, Davati A, Zerafatjou N, Abdi S, Khorsand Askari M, Almeida E, Lavinas C, Teixeira C, Raimundo M, Nogueira C, Ferreira M, Sampaio A, Henriques I, Teixeira C, Gomes Da Costa A, Leal M, Ekart R, Hojs N, Pecovnik Balon B, Bevc S, Dvorsak B, Stropnik Galuf T, Hojs R, Lin WH, Guo CY, Wang WM, Yang DC, Kuo TH, Liu MF, Wang MC, Hara S, Tanaka K, Tsuji H, Ohmoto Y, Amaka K, Ubara Y, Arase K, Yilmaz MI, Solak Y, Saglam M, Yaman H, Unal HU, Gok M, Cetinkaya H, Biyik Z, Gaipov A, Caglar K, Tonbul HZ, Turk S, Wang HH, Yen CY, Hung CC, Hwang SJ, Chen HC, Krivoshiev S, Krivoshiev S, Koteva A, Kraev Z, Mihaylov G, Shikov P, David R, Jeffrey J, Andrew S, Michael R, Charmot D, Fouda R, Abdelhamid Y, Alsayed D, Salah S, Belal D, Salem M, Ahmed H, Vecchio M, Palmer S, Saglimbene VM, Ruospo M, Gargano L, Pellegrini F, Strippoli G, Tisljar M, Horvatic I, Bozic B, Crnjakovic Palmovic J, Bacalja J, Bulimbasic S, Galesic Ljubanovic D, Galesic K, Choi JS, Kim CS, Park JW, Bae EH, MA SK, Kim SW, Choi JS, Kim CS, Park JW, Bae EH, MA SK, Kim SW. Clinical Nephrology - Epidemiology I. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Abstract
PURPOSE To investigate the effect of iris pigment and pupil size in ultraviolet radiation (UVR)-induced cataract. METHODS Brown-Norway rats (pigmented) and Fischer-344 rats (non-pigmented) were unilaterally exposed in vivo to 5 kJ/m(2) UVR. Each strain was split into two groups, each receiving either mydriatic (tropicamide) or miotic (pilocarpine) eye-drops. One week after exposure, the degree of ocular inflammation and damage in the anterior segment was determined. The lenses were extracted, photographed and the degree of forward light scattering (cataract) was quantified. RESULTS The cataract types differed between the two strains. All Fischer rats developed macroscopically identifiable UVR cataract while only 41% of Brown-Norway rats did so. All groups except the miotic Brown-Norway developed significant light scattering. The Fischer rats developed 3-4-fold more lens light scattering than the Brown-Norway rats. The miotic Fischer group exhibited significantly more light scattering than the mydriatic Fischer group. There was no significant difference in light scattering between the two Brown-Norway groups. There was a correlation between ocular inflammation and degree of light scattering, with Brown-Norway rats exhibiting less inflammation and lens light scattering. CONCLUSIONS Pigmented rats develop less UVR cataract and less ocular inflammation than non-pigmented rats. Pupil size plays a smaller role in UVR cataract development in pigmented rats than in non-pigmented. The role of UVR-induced ocular inflammation in cataract development is still ambiguous.
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Affiliation(s)
- Stefan Löfgren
- Karolinska Institutet, St. Erik's Eye Hospital, Stockholm, Sweden.
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Abstract
Cataract is a visible opacity in the lens substance, which, when located on the visual axis, leads to visual loss. Age-related cataract is a cause of blindness on a global scale involving genetic and environmental influences. With ageing, lens proteins undergo non-enzymatic, post-translational modification and the accumulation of fluorescent chromophores, increasing susceptibility to oxidation and cross-linking and increased light-scatter. Because the human lens grows throughout life, the lens core is exposed for a longer period to such influences and the risk of oxidative damage increases in the fourth decade when a barrier to the transport of glutathione forms around the lens nucleus. Consequently, as the lens ages, its transparency falls and the nucleus becomes more rigid, resisting the change in shape necessary for accommodation. This is the basis of presbyopia. In some individuals, the steady accumulation of chromophores and complex, insoluble crystallin aggregates in the lens nucleus leads to the formation of a brown nuclear cataract. The process is homogeneous and the affected lens fibres retain their gross morphology. Cortical opacities are due to changes in membrane permeability and enzyme function and shear-stress damage to lens fibres with continued accommodative effort. Unlike nuclear cataract, progression is intermittent, stepwise and non-uniform.
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Affiliation(s)
- R Michael
- Institut Universitari Barraquer, Universitat Autònoma de Barcelona, Laforja 88, 08021 Barcelona, Spain.
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Michael R, Guevara O, de la Paz M, Alvarez de Toledo J, Barraquer RI. Neural contrast sensitivity calculated from measured total contrast sensitivity and modulation transfer function. Acta Ophthalmol 2011; 89:278-83. [PMID: 19909292 DOI: 10.1111/j.1755-3768.2009.01665.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE To test the feasibility of calculating neural contrast sensitivity function (neural CSF) from conventionally measured total contrast sensitivity function (total CSF) and measured modulation transfer function (MTF). Neural CSF considers the retina and the brain, whereas total CSF considers the optical eye media, the retina and the brain together. METHODS We studied three groups comprising nine eyes each: one group with normal ocular optics but retinal alterations (mild diabetic retinopathy), one with altered ocular optics and normal retina (keratoconus), and a normal control group. RESULTS Total CSF in the keratoconus and retinopathy groups was significantly lower compared to the control group. Modulation transfer function for keratoconus was lower, and in the retinopathy group was similar to that of the control group. Calculated neural CSF in the diabetes mellitus group was lower than in the control group whereas in the keratoconus group it was similar to that of the control group, with overestimations for some keratoconus cases. CONCLUSION It is possible to calculate a meaningful neural CSF from measured total CSF and MTF data. The neural CSF represents a CSF adjusted for optical aberrations. This would allow comparison of the neural component of visual function in eyes with different optical aberrations.
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Affiliation(s)
- Ralph Michael
- Institut Universitari Barraquer, Universitat Autònoma de Barcelona, Spain.
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De La Paz MF, De Toledo JÁ, Charoenrook V, Sel S, Temprano J, Barraquer RI, Michael R. Impact of clinical factors on the long-term functional and anatomic outcomes of osteo-odonto-keratoprosthesis and tibial bone keratoprosthesis. Am J Ophthalmol 2011; 151:829-839.e1. [PMID: 21310387 DOI: 10.1016/j.ajo.2010.11.011] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [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: 05/17/2010] [Revised: 11/08/2010] [Accepted: 11/09/2010] [Indexed: 11/29/2022]
Abstract
PURPOSE To report the long-term functional and anatomic outcomes of osteo-odonto-keratoprosthesis and tibial bone keratoprosthesis; to analyze the influence of clinical factors, such as surgical technique, primary diagnosis, age, and postoperative complications, on the final outcome. DESIGN Retrospective cohort study. METHODS setting: Centro de Oftalmología Barraquer, between 1974 and 2005. PARTICIPANTS Two hundred twenty-seven patients. intervention: Biological keratoprosthesis using osteo-odonto-keratoprosthesis or tibial bone keratoprosthesis. main outcome measures: Functional survival with success defined as best-corrected visual acuity ≥0.05; anatomic survival with success defined as retention of the keratoprosthesis lamina. RESULTS Osteo-odonto-keratoprosthesis and tibial bone keratoprosthesis have comparable anatomic survival at 5 and 10 years of follow-up, but osteo-odonto-keratoprosthesis has a significantly better functional success than tibial bone keratoprosthesis at the same time periods. Among the primary diagnoses, Stevens-Johnson syndrome, chemical burn, and trachoma have generally good functional and anatomic outcomes and the least favorable prognosis is for ocular cicatricial pemphigoid. Younger patients fared better than those in older age groups. The most frequent complications were extrusion (28%), retinal detachment (16%), and uncontrolled glaucoma (11%). The glaucoma group had the best anatomic success but the worst functional results, only exceeded by the retinal detachment group in terms of functional outcome. CONCLUSION Clinical factors, such as surgical technique, primary diagnosis, age, and postoperative complications, can affect the long-term anatomic and functional successes of biological keratoprosthesis. Knowledge about the impact of each of these factors on survival can help surgeons determine the best approach in every particular case.
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Affiliation(s)
- María Fideliz De La Paz
- Centro de Oftalmología Barraquer, Barcelona, Spain; Institut Universitari Barraquer, Universitat Autònoma de Barcelona, Barcelona, Spain
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van Rijn LJ, Nischler C, Michael R, Heine C, Coeckelbergh T, Wilhelm H, Grabner G, Barraquer RI, van den Berg TJTP. Prevalence of impairment of visual function in European drivers. Acta Ophthalmol 2011; 89:124-31. [PMID: 19832733 DOI: 10.1111/j.1755-3768.2009.01640.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE This study aimed to investigate the prevalence of impairment of visual function amongst European drivers. METHODS A total of 2422 drivers from five European countries underwent a battery of visual function tests, including tests for visual acuity (VA), visual field (VF), contrast sensitivity, straylight (glare sensitivity) and useful field of view (UFOV). Subjects belonged to the following age categories: 45-54 years; 55-64 years; 65-74 years, and ≥ 75 years. A group of subjects aged 20-30 years served as a reference group. Results were compared with current standards for the visual function of drivers in the EU. RESULTS Visual acuity in 0.5% of the younger group and 5.3% of the eldest group was below the standard required for driving. Visual acuity after proper refraction adhered to the standard in the majority of cases. Visual field results were below standard or questionable in 2.7% and 2.4%, respectively, of subjects in the eldest group. In this eldest group, impaired contrast sensitivity was present in 6.3%, increased glare sensitivity in 29.5% and impaired UFOV in 21.6% of subjects, but, as there are no standards for these criteria, the exact level of prevalence depends on the definition of impairment. CONCLUSIONS Prevalences of impairment of visual functions that are not included in current standards (particularly contrast sensitivity and glare sensitivity) are much higher than prevalences of functions that are included (VA and VF).
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Affiliation(s)
- Laurentius J van Rijn
- Department of Ophthalmology, Vrije University Medical Centre, Amsterdam, The Netherlands.
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Mikielewicz M, Kotliar K, Barraquer RI, Michael R. Air-pulse corneal applanation signal curve parameters for the characterisation of keratoconus. Br J Ophthalmol 2011; 95:793-8. [DOI: 10.1136/bjo.2010.188300] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Montenegro GA, Marvan P, Dexl A, Picó A, Canut MI, Grabner G, Barraquer RI, Michael R. Posterior capsule opacification assessment and factors that influence visual quality after posterior capsulotomy. Am J Ophthalmol 2010; 150:248-53. [PMID: 20541740 DOI: 10.1016/j.ajo.2010.02.026] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [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: 01/05/2010] [Revised: 02/26/2010] [Accepted: 02/28/2010] [Indexed: 11/29/2022]
Abstract
PURPOSE To study the correlation between posterior capsule opacification (PCO) and intraocular straylight and visual acuity. DESIGN Prospective noninterventional study. METHODS We measured visual acuity (VA), logarithm of minimal angle of resolution (logMAR) and intraocular straylight (C-Quant straylight parameter log[s]) under photopic conditions before and 2 weeks after YAG capsulotomy in 41 patients (53 eyes) from the Centro de Oftalmología Barraquer in Barcelona and the University Eye Clinic, Paracelsus Medical University in Salzburg. Photopic pupil diameter was also measured. To document the level of opacification, pupils were dilated and photographs were taken with a slit lamp, using retroillumination and the reflected light of a wide slit beam at an angle of 45 degrees. PCO was subjectively graded on a scale of 0 to 10 and using the POCOman system. A multiple regression analysis was performed to evaluate factors that influence straylight after capsulotomy. RESULTS Straylight correlated well with retroillumination and reflected-light PCO scores, whereas VA only correlated with retroillumination. Both VA and straylight improved after capsulotomy. Straylight values varied widely after capsulotomy. Multiple regression analysis showed that older age, large ocular axial length, hydrophobic acrylic intraocular lenses (IOLs), and small capsulotomies are factors that increased intraocular straylight. CONCLUSION Intraocular straylight is a useful tool in the assessment of PCO. It correlates well with PCO severity scoring methods. When performing a posterior capsulotomy, factors such as age, IOL material, axial length, and capsulotomy size must be taken into consideration, as they influence intraocular straylight.
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Affiliation(s)
- Gustavo A Montenegro
- Institut Universitari Barraquer, Universitat Autònoma de Barcelona, Laforja 88, Barcelona, Spain
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Piñero DP, Alio JL, Barraquer RI, Michael R, Jiménez R. Corneal biomechanics, refraction, and corneal aberrometry in keratoconus: an integrated study. Invest Ophthalmol Vis Sci 2009; 51:1948-55. [PMID: 19907021 DOI: 10.1167/iovs.09-4177] [Citation(s) in RCA: 95] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose. To evaluate the relationship of corneal biomechanical properties to refraction and corneal aberrometry in keratoconic eyes. Methods. A total of 81 consecutive keratoconic eyes of 81 patients ranging in age from 11 to 58 years were included in the study. Three groups were differentiated according to the severity of keratoconus: mild (37 eyes), moderate (24 eyes), and severe (20 eyes). Visual acuity, refraction, corneal topography, and corneal aberrations were evaluated. In addition, corneal biomechanics were analyzed in relation to two parameters: corneal hysteresis (CH) and corneal resistance factor (CRF). Correlations between these biomechanical factors and the remaining clinical parameters were investigated. Results. CH and CRF in the severe keratoconus group were significantly lower than those in the other two groups (P < or = 0.01). A significant difference in CRF was found between mild and moderate cases (P = 0.04). A moderate correlation was found between the CRF and mean keratometry in the overall sample (r = -0.564). In addition, a significant, strong correlation was found between the spherical-like root mean square (RMS) and the CRF only in the severe keratoconus group (r = -0.655). Multiple regression analysis revealed that CRF correlated significantly with keratometry and the corneal spherical-like RMS (R(2) = 0.40, P < 0.01). Conclusions. The CRF correlates with the magnitude of corneal spherical-like aberrations, especially in severe keratoconus. It should be considered an additional factor in keratoconus grading.
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Affiliation(s)
- David P Piñero
- Keratoconus Unit, Instituto Oftalmológico de Alicante, Vissum Corporation, Alicante, Spain
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Michael R, van Rijn LJ, van den Berg TJTP, Barraquer RI, Grabner G, Wilhelm H, Coeckelbergh T, Emesz M, Marvan P, Nischler C. Association of lens opacities, intraocular straylight, contrast sensitivity and visual acuity in European drivers. Acta Ophthalmol 2009; 87:666-71. [PMID: 18786129 DOI: 10.1111/j.1755-3768.2008.01326.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To study the relationship between lens opacity and intraocular straylight, visual acuity and contrast sensitivity. METHODS We investigated 2422 drivers in five clinics in different European Union (EU) member states aged between 20 and 89 years as part of a European study into the prevalence of visual function disorders in drivers. We measured visual acuity [Early Treatment Diabetic Retinopathy Study (ETDRS) chart], contrast sensitivity (Pelli-Robson chart) and intraocular straylight (computerized straylight meter). Lens opacities were graded with the Lens Opacities Classification System III (LOCS) without pupillary dilation. Participants answered the National Eye Institute Visual Functioning Questionnaire - 25. RESULTS Intraocular straylight was related more strongly to LOCS score than to both visual acuity and contrast sensitivity. Visual acuity and contrast sensitivity were correlated to each other well, but to intraocular straylight to a much lesser extent. Self-reported visual quality was best related to contrast sensitivity; night driving difficulty was best related to visual acuity. CONCLUSION Straylight is found to have added value for visual function assessment in drivers, whereas if visual acuity is known contrast sensitivity has limited added value.
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Lutz HJ, Michael R, Gahl B, Savolainen H. Local versus General Anaesthesia for Carotid Endarterectomy – Improving the Gold Standard ? Eur J Vasc Endovasc Surg 2008; 36:145-149. [DOI: 10.1016/j.ejvs.2008.03.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2008] [Accepted: 03/15/2008] [Indexed: 10/22/2022]
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