19 results on '"F. Birnbaum"'
Search Results
2. [Adenoviral keratoconjunctivitis].
- Author
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Pleyer U and Birnbaum F
- Subjects
- Cyclosporine administration & dosage, Diagnosis, Differential, Humans, Ophthalmic Solutions, Treatment Outcome, Adenoviridae Infections diagnosis, Adenoviridae Infections prevention & control, Eye Infections, Viral diagnosis, Eye Infections, Viral prevention & control, Keratoconjunctivitis diagnosis, Keratoconjunctivitis prevention & control
- Abstract
Keratoconjunctivitis caused by adenoviruses (epidemic keratoconjunctivitis, EKC, ICD-10 B30.0+) is common, can be severe and may cause significant morbidity. In the early stages of adenoviral infections it is often difficult to differentiate the clinical presentation from other causes of a red eye. Because of its highly contagious nature that can rapidly lead to epidemic outbreaks, prompt viral identification and prevention of further spread are major challenges. Even today the diagnosis is still mainly clinical, with laboratory tests only rarely contributing. New diagnostic tests, such as the Rapid Pathogen Detector (RPS, Sarasota FL) AdenoPlus detection kit, that are practical, rapid and inexpensive to use in the general practice may obviate these problems. Because of its highly resistant properties to desiccation and highly developed escape mechanisms which protect the virus from the host's immune response, long-term problems often remain. Remnants of viral proteins often persist on the corneal surface of Bowman's layer for a long time and may lead to the formation of subepithelial infiltrates. No treatment other than symptomatic eye drops is available. The major sequelae are subepithelial infiltrates, which are difficult to treat. Cyclosporin A eye drops are a good option with a low risk profile. The use of topical steroids can possibly be disadvantageous but can be discussed at all stages of the disease. As nosocomial spread of adenoviruses is relatively common, preventive measures remain a major responsibility for ophthalmologists.
- Published
- 2015
- Full Text
- View/download PDF
3. [Integrity of the anterior capsulotomy after femtosecond laser-assisted cataract surgery].
- Author
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Birnbaum F
- Subjects
- Female, Humans, Male, Anterior Capsular Rupture, Ocular etiology, Anterior Capsule of the Lens injuries, Cataract Extraction adverse effects, Laser Therapy adverse effects, Phacoemulsification adverse effects
- Published
- 2014
- Full Text
- View/download PDF
4. [Immunosuppressives to prevent rejection reactions after allogeneic corneal transplantation].
- Author
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Lapp T, Maier P, Birnbaum F, Schlunck G, and Reinhard T
- Subjects
- Humans, Keratitis etiology, Transplantation, Homologous adverse effects, Corneal Transplantation adverse effects, Graft Rejection etiology, Graft Rejection prevention & control, Immunosuppressive Agents administration & dosage, Keratitis prevention & control, Premedication methods
- Abstract
In order to prevent rejection of an allogeneic corneal transplant after perforating (high risk) keratoplasty, active agents from different classes of pharmacological substances are used, as with solid organ transplantation. In addition to glucocorticoids, antiproliferative agents, small molecule inhibitors and antibodies, those belonging to the group of macrolides with their many derivatives represent an interesting class of substances in this context. As a supplement to cyclosporin A (CSA) the most successful macrolide in transplantation medicine, animal experiments are currently being carried out to test newer macrolide derivatives, such as sanglifehrin A (SFA). This overview describes the classes of drugs and modes of action of currently administered standard medications in the clinical routine and new developments are presented.
- Published
- 2014
- Full Text
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5. Contrast sensitivity with bifocal intraocular lenses is halved, as measured with the Freiburg Vision Test (FrACT), yet patients are happy.
- Author
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Anton A, Böhringer D, Bach M, Reinhard T, and Birnbaum F
- Subjects
- Adult, Aged, Aged, 80 and over, Female, Humans, Lens Implantation, Intraocular, Male, Middle Aged, Phacoemulsification, Prosthesis Design, Retrospective Studies, Surveys and Questionnaires, Treatment Outcome, Contrast Sensitivity physiology, Lenses, Intraocular, Patient Satisfaction, Pseudophakia physiopathology, Vision Tests, Visual Acuity physiology
- Abstract
Background: As the desire for spectacle independence following cataract surgery grows, so does interest in the implantation of multifocal intraocular lenses. However, glare phenomena, reduced intermediate vision and loss of image quality are known problems associated with this new generation of lenses. We compared the functional results achieved by the implantation of the diffractive-refractive Acri.LISA 366D lenses to those achieved from implanting monofocal Acri.Smart 46LC lenses., Methods: In a retrospective data analysis we followed ten patients who received bifocal intraocular lenses (Acri.LISA 366D) and ten patients who received monofocal intraocular lenses (Acri.Smart 46LC). Lenses were always implanted in both eyes. In each group we assessed visual acuity and contrast sensitivity with the Freiburg Vison Test (FrACT) at multiple distances ranging from 0.5 to 5 m. Additionally, we assessed near vision with the Birkhaeuser charts. We also evaluated photopic phenomena and patient satisfaction using a standardised questionnaire. One patient in the Acri.LISA group and six patients in the control group missed the recommended follow-up visits., Results: We found good uncorrected distance and near visual acuity. Only three of nine patients wore glasses occasionally. Although their contrast sensitivity decreased by a factor of two compared to the control group, patients did not complain about visual disturbances. Patient satisfaction was predominantly high following Acri.LISA 366D implantation., Conclusions: With the Acri.LISA 366D, patients demonstrate excellent near and distance vision, albeit with reduced contrast sensitivity. Acri Lisa is a viable option in patients that do not want to depend on spectacles.
- Published
- 2014
- Full Text
- View/download PDF
6. Clinical results of 123 femtosecond laser-assisted penetrating keratoplasties.
- Author
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Birnbaum F, Wiggermann A, Maier PC, Böhringer D, and Reinhard T
- Subjects
- Adult, Astigmatism diagnosis, Astigmatism physiopathology, Corneal Diseases immunology, Corneal Diseases physiopathology, Corneal Diseases surgery, Corneal Topography, Female, Fluocortolone therapeutic use, Glucocorticoids therapeutic use, Graft Rejection drug therapy, Graft Rejection immunology, Humans, Male, Middle Aged, Prednisolone analogs & derivatives, Prednisolone therapeutic use, Refraction, Ocular physiology, Suture Techniques, Tomography, Optical Coherence, Treatment Outcome, Visual Acuity physiology, Wound Healing physiology, Astigmatism etiology, Keratoplasty, Penetrating methods, Laser Therapy methods, Postoperative Complications
- Abstract
Background: Postoperative astigmatism following penetrating keratoplasty is a major problem after corneal transplantation. The main goal of new trephination techniques such as femtosecond laser or excimer-laser trephination is to improve refractive and visual outcomes. The femtosecond laser technique makes profiled corneal trephinations such as the top hat or mushroom profile possible. We present the postoperative outcome of femtosecond laser-assisted penetrating keratoplasties., Methods: We performed 123 femtosecond laser-assisted penetrating keratoplasties in 119 patients. The main outcome measures were intraoperative specifics, astigmatism, and irregularity in Orbscan corneal topography, as well as the occurrence of immune reactions and side-effects., Results: All sutures have been removed in 49 of these 123 eyes. Their mean follow-up was 13.9 ± 4.5 months. Time to complete suture removal (n = 49) was 12.0 ± 3.7 months in the mushroom group and 9.8 ± 2.1 months in the top hat group. Mean astigmatism in Orbscan topography was 6.4 ± 3.0 diopters in the mushroom and 5.8 ± 4.6 diopters in the top hat group (all sutures out)., Conclusions: Femtosecond laser-assisted penetrating keratoplasty is a safe surgical technique. Due to the steps in profiled trephinations, the wound area is larger and theoretically the wound healing is, thus, faster and more stable. Complete suture removal is possible at an earlier time point compared to conventional penetrating keratoplasty. However, refractive results are not superior to those following conventional trephination.
- Published
- 2013
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7. [Corneal tumour following anterior chamber lens implantation in a patient with Marfan syndrome. Case study of a 57-year-old patient].
- Author
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Lapp T, Birnbaum F, Evert M, Reinhard T, and Auw-Hädrich C
- Subjects
- Humans, Male, Middle Aged, Treatment Outcome, Anterior Chamber surgery, Corneal Diseases etiology, Corneal Diseases surgery, Eye Neoplasms etiology, Eye Neoplasms surgery, Lens Implantation, Intraocular adverse effects, Marfan Syndrome complications
- Abstract
A 57-year-old male patient with Marfan syndrome presented at our clinic with a whitish gelatinous corneal tumour in the right eye. The initial examination revealed pronounced corneal oedema, bullous keratopathy, as well as an iris-fixed anterior chamber lens implanted 7 years previously. After the tumour was removed, the anterior chamber lens was explanted and keratoplasty was explanted and a two stage keratoplasty was performed. Histological analysis of the tumour and the cornea revealed vimentin and a number of smooth muscle actin (SMA)-positive tumour cells. The cornea below the tumour displayed a partially absent Bowman's layer and extensive pannus tissue. The characteristics of the corneal tumour and the subjacent cornea as described above are typical of secondary corneal myxoma. The influence of Marfan syndrome, a systemic connective tissue disorder present in the patient, on the etiopathogenesis of the corneal myxoma could not be fully determined.
- Published
- 2012
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8. [Perspectives of femtosecond laser-assisted keratoplasty].
- Author
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Birnbaum F, Maier P, and Reinhard T
- Subjects
- Astigmatism surgery, Descemet Stripping Endothelial Keratoplasty instrumentation, Epikeratophakia instrumentation, Equipment Design, Follow-Up Studies, Humans, Microsurgery instrumentation, Postoperative Complications diagnosis, Sutures, Tissue and Organ Harvesting instrumentation, Tomography, Optical Coherence, Visual Acuity physiology, Wound Healing physiology, Corneal Diseases surgery, Corneal Surgery, Laser instrumentation, Corneal Transplantation instrumentation, Keratoplasty, Penetrating instrumentation
- Abstract
The femtosecond laser technique allows completely new trephination procedures in penetrating and lamellar keratoplasty. With femtosecond laser-assisted penetrating keratoplasty it is possible to perform profiled trephination, such as top hat and mushroom profiles. Thus, it is easier to get a watertight wound closure intraoperatively and due to the larger wound surface wound healing is faster and allows early complete suture removal. In lamellar keratoplasty the femtosecond laser enables the surgeon to cut to any depth in the corneas resulting in thin corneal donor buttons, e.g. for DSAEK. In this manuscript an overview is given of the state of the art and of the perspectives of femtosecond laser keratoplasty.
- Published
- 2011
- Full Text
- View/download PDF
9. [Femtosecond laser-assisted penetrating keratoplasty].
- Author
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Birnbaum F, Maier P, and Reinhard T
- Subjects
- Equipment Design, Humans, Suture Techniques, Astigmatism prevention & control, Fuchs' Endothelial Dystrophy surgery, Keratoconus surgery, Keratomileusis, Laser In Situ instrumentation, Keratoplasty, Penetrating instrumentation, Postoperative Complications prevention & control, Refraction, Ocular
- Abstract
The femtosecond laser technique allows completely new trephination methods in penetrating keratoplasty with profiles in the graft and the host cornea. The most common so-called profiled trephinations are the top hat and mushroom profiles. Due to the profile it is easier to get a watertight wound closure intraoperatively and due to the larger wound surface the wound healing is faster and more stable. This will possibly allow an earlier suture removal with final visual rehabilitation. First clinical results show that femtosecond laser-assisted penetrating keratoplasty is a safe surgical procedure. The long term results after complete suture removal will show whether the astigmatism results are better than those of conventional trephination techniques.
- Published
- 2010
- Full Text
- View/download PDF
10. [Cyclosporin A eyedrops for keratitis nummularis after adenovirus keratoconjunctivitis].
- Author
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Böhringer D, Birnbaum F, and Reinhard T
- Subjects
- Adenovirus Infections, Human drug therapy, Chronic Disease, Humans, Keratoconjunctivitis drug therapy, Ophthalmic Solutions, Adenovirus Infections, Human complications, Corneal Opacity drug therapy, Cyclosporine administration & dosage, Immunosuppressive Agents administration & dosage, Keratitis drug therapy, Keratoconjunctivitis complications
- Abstract
Keratoconjunctivitis is a common infectious disease of the eye surface, which is caused by adenovirus. The chronic form is keratitis nummularis. Cyclosporin A is a calcineurin inhibitor which has been used in ophthalmology for approximately 15 years for local therapy of chronic inflammation of the eye surface. Since the 1990s this medication has proven effective for the treatment of keratitis nummularis. The indications for treatment with cyclosporin A eyedrops are given when a reduction in vision due to keratitis nummularis has not shown any improvement within 6 weeks after acute inflammation.
- Published
- 2008
- Full Text
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11. [Penetrating keratoplasty with intrastromal corneal ring. A prospective randomized study].
- Author
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Birnbaum F, Schwartzkopff J, Böhringer D, and Reinhard T
- Subjects
- Adult, Astigmatism etiology, Humans, Postoperative Complications etiology, Surgical Wound Dehiscence etiology, Visual Acuity, Astigmatism prevention & control, Corneal Stroma surgery, Fuchs' Endothelial Dystrophy surgery, Keratoconus surgery, Keratoplasty, Penetrating instrumentation, Postoperative Complications prevention & control, Prostheses and Implants, Titanium, Vitallium
- Abstract
Background: The purpose of the study was to evaluate the efficacy and safety of Krumeichs' intrastromal corneal ring following penetrating keratoplasty. Postoperative astigmatism and occurrence of complications were the main criteria of this study., Material and Methods: A total of 20 patients were included in this prospectively randomized study (10 patients with and 10 patients without corneal ring). Follow-up examinations were performed 6 weeks, 4, 12, and 18 months postoperatively, including best corrected visual acuity and Orbscan corneal topography., Results: The mean follow-up time is currently 18.9+/-2.8 months. The mean astigmatism (Orbscan) is 3.9 D in the group with ring and 4.0 D in the group without a ring. Spontaneous suture rupture occurred in five patients with corneal ring., Conclusions: The use of the intrastromal corneal ring following penetrating keratoplasty caused no reduction of postoperative astigmatism. The reason for the spontaneous suture ruptures is unclear.
- Published
- 2008
- Full Text
- View/download PDF
12. [Steam cautery of the cornea in microbial keratitis].
- Author
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Maier P, Birnbaum F, and Reinhard T
- Subjects
- Humans, Steam, Cautery methods, Eye Infections, Bacterial pathology, Eye Infections, Bacterial surgery, Keratitis pathology, Keratitis surgery
- Abstract
In some cases topical antimicrobial treatment of microbial keratitis or corneal ulcers remains unsuccessful, with increasing infiltration of the corneal stroma. In this situation the steam cautery procedure developed by Karl Wessely in 1911 can lead to rapid healing of the inflammatory process, avoiding further corneal surgery. In this article we describe the steam cautery technique and discuss its indications for microbial keratitis.
- Published
- 2008
- Full Text
- View/download PDF
13. Topical pimecrolimus does not prolong clear graft survival in a rat keratoplasty model.
- Author
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Birnbaum F, Schwartzkopff J, Scholz C, and Reinhard T
- Subjects
- Administration, Topical, Animals, Antigens, CD metabolism, Cornea metabolism, Cornea pathology, Female, Immunoenzyme Techniques, Rats, Rats, Inbred F344, Rats, Inbred Lew, Tacrolimus administration & dosage, Cornea drug effects, Disease Models, Animal, Graft Survival drug effects, Immunosuppressive Agents administration & dosage, Keratoplasty, Penetrating, Tacrolimus analogs & derivatives
- Abstract
Background: Long-term application of topical steroids following penetrating keratoplasty is disadvantageous due to side effects (steroid response, cataract, surface disorders). In this study we investigated the efficacy of topical pimecrolimus regarding clear graft survival following allogeneic orthotopic keratoplasty in rats., Methods: A total of 46 penetrating keratoplasties were performed using Fisher rats (allogeneic groups) and Lewis rats (syngeneic group) as donors and Lewis rats as recipients: group 1 (n = 11), allogeneic control without therapy; group 2 (n = 12), syngeneic control; group 3 (n = 11), mycophenolate mofetil (MMF) 40 mg/kg body weight; group 4 (n = 12), pimecrolimus 1% ointment twice daily. Four animals of each group were sacrificed for immunohistological evaluation on day 14. Therapy was administered for 18 days. The grafts were evaluated once every 3 days regarding opacity, oedema and vascularisation. Graft rejection was defined as total graft opacity., Results: Mean rejection-free graft survival was 11.4 days in group 1 (allogeneic control), 100 days (total follow-up time) in group 2 (syngeneic control), 24.0 days in group 3 (MMF 40 mg/kg) and 11.6 days in group 4 (topical pimecrolimus). The immunohistological evaluation showed no statistically significant difference in cell infiltration of the grafts comparing groups 1 and 4., Conclusions: Topical immunosuppression with pimecrolimus does not prolong graft survival in the allogeneic keratoplasty rat model.
- Published
- 2007
- Full Text
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14. [Intracameral application of corticosteroids for treating severe endothelial rejection after penetrating keratoplasty].
- Author
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Birnbaum F, Maier P, and Reinhard T
- Subjects
- Anti-Inflammatory Agents administration & dosage, Anti-Inflammatory Agents therapeutic use, Dexamethasone administration & dosage, Dexamethasone therapeutic use, Drug Administration Routes, Endothelium, Corneal immunology, Graft Rejection immunology, Humans, Adrenal Cortex Hormones administration & dosage, Anterior Chamber, Graft Rejection drug therapy, Keratoplasty, Penetrating adverse effects
- Abstract
Immune reaction is the main cause for graft failure following penetrating keratoplasty. Endothelial immune reaction is the most frequent and most dangerous subtype of rejection because destruction of the graft endothelium can lead to graft failure. "Acute" endothelial rejection is treated by administration of topical and systemic steroids. Intracameral application of corticosteroids by means of an anterior chamber flush is an adjunctive measure that can stop the immune reaction immediately. This measure is thus recommended in all intermediate and severe endothelial rejections.
- Published
- 2007
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- View/download PDF
15. [Immune suppression following perforating keratoplasty].
- Author
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Birnbaum F, Reis A, and Reinhard T
- Subjects
- Drug Therapy, Combination, Graft Survival drug effects, Humans, Prognosis, Corneal Opacity prevention & control, Graft Rejection prevention & control, Immunosuppressive Agents therapeutic use, Keratoplasty, Penetrating, Postoperative Complications prevention & control
- Published
- 2007
- Full Text
- View/download PDF
16. [Topical immunosuppressives after penetrating keratoplasty].
- Author
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Birnbaum F, Reis A, and Reinhard T
- Subjects
- Administration, Topical, Animals, Corneal Opacity immunology, Graft Rejection immunology, Graft Survival drug effects, Humans, Immunosuppressive Agents adverse effects, Postoperative Complications immunology, Corneal Opacity drug therapy, Graft Rejection drug therapy, Immunosuppressive Agents administration & dosage, Keratoplasty, Penetrating, Postoperative Complications drug therapy
- Abstract
Topical steroids are routinely used in the postoperative treatment following penetrating keratoplasty. Due to the known side effects such as steroid-response glaucoma, cataract, and surface disorders, a broader armamentarium of topical immunomodulating drugs with comparable efficacy, better tolerance and less side effects is desirable. Cyclosporine A and FK506 eye drops are a promising alternative. A new approach involves subconjunctival drug delivering implants and locally applied antiangiogenic substances, which still have to be tested in clinical studies.
- Published
- 2007
- Full Text
- View/download PDF
17. [Systemic immunosuppressives after penetrating keratoplasty].
- Author
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Reis A, Birnbaum F, and Reinhard T
- Subjects
- Administration, Oral, Administration, Topical, Animals, Humans, Immunosuppressive Agents adverse effects, Infusions, Intravenous, Ophthalmic Solutions, Corneal Opacity prevention & control, Graft Rejection prevention & control, Immunosuppressive Agents administration & dosage, Keratoplasty, Penetrating, Postoperative Complications prevention & control
- Abstract
Immunologic rejection is the main cause of corneal graft failure. If corneal transplantation is performed in a high-risk situation without the use of systemic immunosuppression, corneal graft failure has to be expected in over 50% of patients within the first postoperative year. The clonal expansion of graft-specific lymphocytes occurs in lymphoid tissues. As topical steroids do not reach the secondary lymphoid organs, and even systemic steroids do not interfere sufficiently with the clonal expansion of activated T cells, it is essential to administer systemic immunosuppressives in order to achieve clear graft survival. As corneal transplantation is not a life-saving procedure, the profile of side-effects is a central issue when choosing an immunosuppressive medication.
- Published
- 2007
- Full Text
- View/download PDF
18. Endothelial cell loss after autologous rotational keratoplasty.
- Author
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Birnbaum F, Reinhard T, Böhringer D, and Sundmacher R
- Subjects
- Adult, Cell Count, Cell Death, Corneal Diseases surgery, Humans, Rotation, Transplantation, Autologous, Endothelium, Corneal pathology, Keratoplasty, Penetrating adverse effects, Postoperative Complications
- Abstract
Purpose: To investigate whether it may be possible to ascertain the influence of immunological factors on chronic endothelial cell loss by comparing chronic endothelial cell loss after autologous rotational penetrating keratoplasty and after homologous penetrating keratoplasty., Methods: For six patients who had undergone autologous rotational penetrating keratoplasty the relative annual loss of endothelial cells was calculated by means of an exponential regression analysis. The findings were compared with those in a homogeneous historical control group (53 patients undergoing homologous penetrating keratoplasty for keratoconus)., Results: After autologous rotational keratoplasty relative annual loss of endothelial cells was 1.1%+/-2.6% (mean +/- standard deviation). Relative annual loss of endothelial cells in the control-group was 16.7%+/-20.8%., Conclusions: The results of the study lead to the assumption that immunological influences might be the main cause for chronic endothelial cell loss after homologous penetrating keratoplasty.
- Published
- 2005
- Full Text
- View/download PDF
19. [Functional results after autologous rotational keratoplasty. A retrospective study].
- Author
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Birnbaum F, Reinhard T, Ulbricht T, Hausser J, and Sundmacher R
- Subjects
- Adult, Follow-Up Studies, Humans, Retrospective Studies, Rotation, Transplantation, Autologous methods, Treatment Outcome, Vision Tests, Cicatrix diagnosis, Cicatrix surgery, Corneal Diseases diagnosis, Corneal Diseases surgery, Corneal Transplantation methods, Recovery of Function, Visual Acuity
- Abstract
Background: Autologous rotational keratoplasty is a therapeutic option in patients with central corneal scars. Its advantage compared to allogeneic procedures is the absence of immunologic destruction. In this retrospective analysis, long-term results are presented., Patients: Since 1988, autologous rotational keratoplasty was performed in 19 patients. The trephine size varied between 7.0 mm and 9.0 mm. Mean follow-up was 7.1+/-4.6 years., Results: In 16 of the patients, the graft center remained clear during the entire follow-up period. Visual acuity improved from 0.25+/-0.16 preoperatively to 0.34+/-0.27 postoperatively with spectacles and to 0.43+/-0.3 with contact lenses. The mean postoperative astigmatism was 6.41+/-3.87 dpt with irregular components in six patients., Conclusion: Only a few postoperative graft complications were observed. Especially in patients with a markedly elevated risk for immune reactions (e.g., small infants), autologous rotational keratoplasty is a safe alternative to allogenic procedures.
- Published
- 2004
- Full Text
- View/download PDF
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