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  • Ovid Technologies (Wolters Kluwer Health)  (17)
  • 1
    Online Resource
    Online Resource
    Host Genomics of the HIV-1 Reservoir Size and Its Decay Rate During Suppressive Antiretroviral Treatment
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  JAIDS Journal of Acquired Immune Deficiency Syndromes Vol. 85, No. 4 ( 2020-12-1), p. 517-524
    Details
    In: JAIDS Journal of Acquired Immune Deficiency Syndromes, Ovid Technologies (Wolters Kluwer Health), Vol. 85, No. 4 ( 2020-12-1), p. 517-524
    Abstract: The primary hurdle for the eradication of HIV-1 is the establishment of a latent viral reservoir early after primary infection. Here, we investigated the potential influence of human genetic variation on the HIV-1 reservoir size and its decay rate during suppressive antiretroviral treatment. Setting: Genome-wide association study and exome sequencing study to look for host genetic determinants of HIV-1 reservoir measurements in patients enrolled in the Swiss HIV Cohort Study, a nation-wide prospective observational study. Methods: We measured total HIV-1 DNA in peripheral blood mononuclear cells from study participants, as a proxy for the reservoir size at 3 time points over a median of 5.4 years, and searched for associations between human genetic variation and 2 phenotypic readouts: the reservoir size at the first time point and its decay rate over the study period. We assessed the contribution of common genetic variants using genome-wide genotyping data from 797 patients with European ancestry enrolled in the Swiss HIV Cohort Study and searched for a potential impact of rare variants and exonic copy number variants using exome sequencing data generated in a subset of 194 study participants. Results: Genome-wide and exome-wide analyses did not reveal any significant association with the size of the HIV-1 reservoir or its decay rate on suppressive antiretroviral treatment. Conclusions: Our results point to a limited influence of human genetics on the size of the HIV-1 reservoir and its long-term dynamics in successfully treated individuals.
    Type of Medium: Online Resource
    ISSN: 1525-4135
    URL: Article
    DOI: 10.1097/QAI.0000000000002473
    RVK:
    XA 10000
    RVK:
    XA 51942
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 2038673-4
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  • 2
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    Mini-DMEK for the Treatment of Chronic Focal Corneal Endothelial Decompensation
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Cornea Vol. 42, No. 1 ( 2023-01), p. 12-19
    Details
    In: Cornea, Ovid Technologies (Wolters Kluwer Health), Vol. 42, No. 1 ( 2023-01), p. 12-19
    Abstract: The purpose of the study was to evaluate the feasibility of mini-descemet membrane endothelial keratoplasty (“Mini-DMEK,” graft diameter 〈 5 mm) for the treatment of chronic focal corneal endothelial decompensation for reasons other than acute hydrops in patients with keratoconus. Methods: Of the 3010 patients registered in the prospective Cologne DMEK database, 16 patients with focal corneal endothelial decompensation treated with Mini-DMEK were identified. After exclusion of patients with acute hydrops in keratoconus (n = 9), indications for focal corneal endothelial decompensation were either defects in Descemet membrane after intraocular surgeries (n = 5) or corneal edema in the area of Haab striae in buphthalmus (n = 2). Best spectacle-corrected visual acuity, corneal thickness in the affected area, and rebubbling rates served as main outcome measures. Results: All patients showed a postoperative increase in the best spectacle-corrected visual acuity from preoperative logarithm of the minimum angle of resolution (logMAR) 1.1 (±0.7) to logMAR 0.3 (±0.2) after the first month ( P = 0.046) and to logMAR 0.3 (±0.2) after half a year (5–7 months) ( P = 0.025). The corneal thickness decreased from preoperative 757 μm (±125) to 603 μm (±121) after the first month ( P = 0.031) and to 593 μm (±131) after half a year (5–7 months) ( P = 0.031). Rebubbling was necessary in 43% of patients (3 of 7 eyes). In 2 patients, Mini-DMEK was performed as triple Mini-DMEK including cataract surgery. Conclusions: Mini-DMEK is an effective treatment option for focal chronic corneal endothelial decompensation caused by tears in Descemet membrane or other defects such as Haab striae. Mini-DMEK can also be performed as a triple procedure including cataract surgery (triple Mini-DMEK).
    Type of Medium: Online Resource
    ISSN: 0277-3740
    URL: Article
    DOI: 10.1097/ICO.0000000000003048
    RVK:
    XA 37258
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2045943-9
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  • 3
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    Microscope-Integrated Optical Coherence Tomography-Guided Drainage of Acute Corneal Hydrops in Keratoconus Combined With Suturing and Gas-Aided Reattachment of Descemet Membrane
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Cornea Vol. 38, No. 8 ( 2019-08), p. 1058-1061
    Details
    In: Cornea, Ovid Technologies (Wolters Kluwer Health), Vol. 38, No. 8 ( 2019-08), p. 1058-1061
    Abstract: The treatment of acute corneal hydrops due to keratoconus has so far been limited to awaiting the spontaneous resorption of corneal edema, supportive care, and finally keratoplasty. A recent publication describes the surgical reattachment of Descemet Membrane (DM) facilitated by pre-Descemetic sutures and anterior chamber air/gas filling. Here, we present a novel microscope-integrated intraoperative optical coherence tomography (MI-OCT)-guided technique for the immediate reattachment of DM in corneal hydrops due to keratoconus in 2 male patients with small central DM defects. Methods: Case series of 2 consecutive patients with acute corneal hydrops due to keratoconus. The novel technique consists of the MI-OCT-guided puncture and drainage of intrastromal fluid pockets combined with anterior chamber sulfur hexafluoride-fill and pre-descemetic sutures using a commercially available MI-OCT (iOCT; Haag Streit Surgical, Wedel, Germany). Results: After uneventful surgery, corneal edema showed fast resolution and DM was reattached to the corneal stroma. In both patient's central corneal thickness decreased after surgery and visual acuity improved. Conclusions: MI-OCT guided micropuncture of stromal edema combined with compression sutures and SF6 tamponade is a new therapeutic option in acute corneal hydrops with small Descemet membrane defects.
    Type of Medium: Online Resource
    ISSN: 0277-3740
    URL: Article
    DOI: 10.1097/ICO.0000000000001958
    RVK:
    XA 37258
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 2045943-9
    Location Call Number Limitation Availability
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  • 4
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    Effect of Iris Color on the Outcome of Descemet Membrane Endothelial Keratoplasty
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Cornea Vol. 39, No. 7 ( 2020-07), p. 846-850
    Details
    In: Cornea, Ovid Technologies (Wolters Kluwer Health), Vol. 39, No. 7 ( 2020-07), p. 846-850
    Abstract: To explore the impact of iris color on the outcome of Descemet membrane endothelial keratoplasty (DMEK). Methods: Consecutive cases of Fuchs endothelial dystrophy after DMEK were retrospectively analyzed from the prospective Cologne DMEK database between 2011 and 2017 at the University of Cologne, Germany. Iris pictures were graded by color into blue, green, or brown and compared regarding outcome parameters including best-corrected visual acuity (converted to logarithm of the minimal angle of resolution), central corneal thickness, endothelial cell density (ECD), each at preoperative (baseline) and postoperative 12 months, rebubbling rates, cystoid macular edema (CME), and immune rejections after surgery. Results: One thousand one hundred six eyes of 814 patients were included in this study that consisted of 354 blue eyes, 418 green eyes, and 244 brown eyes. There was no significant correlation between iris color and any parameter (best corrected visual acuity; P = 0.064 at preoperatively, P = 0.959 at 12 months) (ECD; P = 0.158 preoperatively, P = 0.859 at 12 months) (central corneal thickness; P = 0.148 preoperatively, P = 0.252 at 12 months). The loss of ECD at 12 months after surgery was 37.2% ± 1.0% in blue eyes, 37.2% ± 0.9% in green eyes, and 37.2% ± 1.2% in brown eyes ( P = 0.999). Immune rejections were 1.7%, 2.9%, and 0.8% ( P = 0.168) in blue, green, and brown eyes, respectively. Rebubbling rates and CME incidence were similar in each group ( P = 0.129, and P = 0.552 respectively). Conclusions: The iris color has no significant impact on the outcome after DMEK. Thus, DMEK can be applied effectively, regardless of the iris color.
    Type of Medium: Online Resource
    ISSN: 0277-3740
    URL: Article
    DOI: 10.1097/ICO.0000000000002305
    RVK:
    XA 37258
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 2045943-9
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  • 5
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    Long-Term Outcome of Descemet Membrane Endothelial Keratoplasty in Eyes With Fuchs Endothelial Corneal Dystrophy Versus Pseudophakic Bullous Keratopathy
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Cornea Vol. 41, No. 3 ( 2022-03), p. 304-309
    Details
    In: Cornea, Ovid Technologies (Wolters Kluwer Health), Vol. 41, No. 3 ( 2022-03), p. 304-309
    Abstract: The aim of this study was to compare the long-term outcome of Descemet membrane endothelial keratoplasty (DMEK) in patients with Fuchs endothelial corneal dystrophy (FECD) and pseudophakic bullous keratopathy (PBK). Methods: Records of consecutive DMEK surgeries performed between 2015 and 2016 at the Department of Ophthalmology, Cologne, Germany, were retrospectively reviewed from the prospective Cologne DMEK Database. Eyes with either PBK or FECD with a complete 3-year follow-up were enrolled. Main outcome parameters included central corneal thickness (CCT), peripheral corneal thickness (PCT), best spectacle-corrected visual acuity (BSCVA, logarithm of the Minimum Angle of Resolution), and endothelial cell count (ECC) before and after DMEK. Results: Four hundred two eyes from 402 patients were included (FECD n = 371, PBK n = 31). Preoperatively, CCT (FECD: 681.91 ± 146.78 μm; PBK: 932.25 ± 319.84 μm) and PCT (FECD: 732.26 ± 98.22 μm; PBK: 867.54 ± 88.72 μm) were significantly higher in the PBK group ( P 〈 0.01). Three years after DMEK, CCT (FECD: 526.56 ± 27.94 μm; PBK 663.71 ± 132.36 μm) was significantly lower in both groups compared with the preoperative values ( P 〈 0.01), whereas PCT showed no significant difference. PCT increased during the course in the PBK group from month 12 after DMEK (12 mo: 783.73 ± 127.73 μm; 24 mo: 837.50 ± 110.19 μm; 36 mo: 857.79 ± 140.76 μm). The increase in PCT correlated with an accelerated ECC loss starting 12 months after DMEK ( P = 0.036). Before DMEK, BSCVA in FECD was significantly higher ( P 〈 0.001) compared with that in PBK. After 3 years, BSCVA improved in FECD and PBK eyes without significant difference ( P = 0.239). Conclusions: Visual acuity after DMEK in PBK and FECD seems to be comparable during the long-term follow-up. Peripheral and central corneal edema seems to recur faster in eyes with PBK than in those with FECD. Therefore, using a donor graft with higher ECC or possibly a larger graft could be a promising approach for PBK patients.
    Type of Medium: Online Resource
    ISSN: 0277-3740
    URL: Article
    DOI: 10.1097/ICO.0000000000002737
    RVK:
    XA 37258
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 2045943-9
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  • 6
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    Excimer Laser Phototherapeutic Keratectomy for Anterior Corneal Opacification After Descemet Membrane Endothelial Keratoplasty
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Cornea ( 2023-9-28)
    Details
    In: Cornea, Ovid Technologies (Wolters Kluwer Health), ( 2023-9-28)
    Abstract: The aim of this study was to assess the long-term outcome of excimer laser phototherapeutic keratectomy (PTK) for treating remaining anterior corneal opacities after Descemet membrane endothelial keratoplasty (DMEK). Methods: This cohort study analyzed 67 eyes of 66 patients undergoing PTK in addition to and after DMEK between 2012 and 2021 at the Department of Ophthalmology, University of Cologne. Patients who were treated by PTK after previous DMEK on the same eye were included. The outcome parameters were best corrected visual acuity (BCVA), changes in refraction, endothelial cell density, corneal densitometry, central corneal thickness, and total corneal higher order aberrations. Patients with visual limitations in addition to anterior opacification were analyzed separately for their visual outcome. Eyes with severe visual limitations that have a very limited visual potential were excluded from the study. In addition, patients with not at least 1 postoperative follow-up examination were excluded from the study. Results: In this study, 67 eyes of 66 patients met all inclusion criteria. The median follow-up period was 13.1 (quartiles: 4.1; 30.7; interquartile range 26.6) months. The mean (±SD) BCVA improved from (logarithm of the minimum angle of resolution) 0.54 (±0.32) to 0.38 (±0.27) at the first postoperative visit ( P 〈 0.001) and remained significantly improved at all follow-up examinations compared with preoperative BCVA. Refraction and endothelial cell density did not change significantly after PTK. There was a significant decrease in corneal backscatter in the anterior corneal layer ( P 〈 0.001), and the total higher order aberration ( P = 0.02) and central corneal thickness were significantly reduced at the most recent postoperative visit ( P 〈 0.001). No immune reactions were observed. Conclusions: Excimer laser PTK after DMEK for persisting anterior corneal opacities has the potential to significantly improve patients’ vision without affecting refractive parameters or endothelial cell density.
    Type of Medium: Online Resource
    ISSN: 0277-3740
    URL: Article
    DOI: 10.1097/ICO.0000000000003396
    RVK:
    XA 37258
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2045943-9
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  • 7
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    Comparison of macular parameters after femtosecond laser–assisted and conventional cataract surgery in age-related macular degeneration
    Ovid Technologies (Wolters Kluwer Health) ; 2018
    In:  Journal of Cataract and Refractive Surgery Vol. 44, No. 1 ( 2018-01), p. 23-27
    Details
    In: Journal of Cataract and Refractive Surgery, Ovid Technologies (Wolters Kluwer Health), Vol. 44, No. 1 ( 2018-01), p. 23-27
    Type of Medium: Online Resource
    ISSN: 0886-3350
    URL: Article
    DOI: 10.1016/j.jcrs.2017.09.030
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
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  • 8
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    Graft Detachment Pattern After Descemet Membrane Endothelial Keratoplasty Comparing Air Versus 20% SF6 Tamponade
    Ovid Technologies (Wolters Kluwer Health) ; 2018
    In:  Cornea Vol. 37, No. 7 ( 2018-07), p. 834-839
    Details
    In: Cornea, Ovid Technologies (Wolters Kluwer Health), Vol. 37, No. 7 ( 2018-07), p. 834-839
    Abstract: The change from air to 20% sulfur hexafluoride (SF 6 ) as anterior chamber tamponade for Descemet membrane endothelial keratoplasty (DMEK) significantly reduced the rebubbling rate. Nonetheless, underlying mechanisms are not completely understood. In this study, we investigate the morphology of graft detachments after DMEK depending on the tamponade and its influence on postoperative rebubbling. Methods: In this retrospective analysis of prospective data of 204 consecutive patients who underwent DMEK with 100% air, or 20% SF 6 , we compared the SF 6 group with the air group regarding the number, lateral and axial diameter and localization of detachments, visual acuity (BSCVA), and incidence of rebubbling after 1 week (T1), after 1 (T2), 3 (T3), 6 (T4), and 12 (T5) months postoperatively. Results: The air group showed more detachments at all time points. Detachments in this group were of a larger axial diameter at T1, T4, and T5 and of a larger lateral diameter at T1, T3, T4, and T5 compared with the SF 6 group. Patients receiving SF 6 needed fewer rebubblings at T1 compared with patients receiving air (12.1% vs. 29.1%, P = 0.003), but not at T2 (15.1% vs. 19.1%, P = 0.56). There was no difference in postoperative BSCVA between the groups. Conclusions: Early graft attachment after DMEK, which is improved by the use of SF 6 as anterior chamber tamponade, is important for the overall rebubbling rate and improves wound-healing mechanisms between the graft and recipient cornea. Faster resolving air tamponade is associated with extended detachments especially inferiorly and mid-peripherally, but has no negative effect on the long-term BSCVA.
    Type of Medium: Online Resource
    ISSN: 0277-3740
    URL: Article
    DOI: 10.1097/ICO.0000000000001597
    RVK:
    XA 37258
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
    detail.hit.zdb_id: 2045943-9
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  • 9
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    Mini-Descemet Membrane Endothelial Keratoplasty for the Early Treatment of Acute Corneal Hydrops in Keratoconus
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Cornea Vol. 38, No. 8 ( 2019-08), p. 1043-1048
    Details
    In: Cornea, Ovid Technologies (Wolters Kluwer Health), Vol. 38, No. 8 ( 2019-08), p. 1043-1048
    Abstract: To describe a new surgical option for the treatment of acute corneal hydrops in keratoconus and to present the first results. Methods: This is a retrospective analysis of 3 patients who presented to our clinic with a massive corneal hydrops in acute keratoconus and were treated by mini-Descemet membrane endothelial keratoplasty (DMEK). According to the size and the shape of the gap in the patient's Descemet membrane (DM), 1 DMEK graft was trephined with a round 5-mm punch. The other grafts were trimmed with a razor blade to a width of about 3 mm and a length adjusted to the length of the defect of the recipients' DM. The graft was inserted with a regular intraocular lens shooter. Correct unfolding of the graft was controlled by using intraoperative optical coherence tomography. At the end of the surgery, the graft was attached to the posterior corneal surface by a small air bubble. Thereafter, the complete anterior chamber was filled with 20% SF 6 gas. Results: All 3 patients (age 32 ± 3 years on average) showed a rapid increase in uncorrected visual acuity from the logarithm of the minimum angle of resolution (LogMAR) 1.66 (±0.46) before mini-DMEK to the LogMAR 1.2 (±0.3) within 6 to 8 weeks after mini-DMEK. The thickest corneal point within the edematous cornea decreased in all 3 patients (1088 ± 280 μm before surgery vs. 630 ± 38 μm 1 week after surgery). One mini-DMEK failed in a first attempt. In this patient, the recipient DM was under strong tension and showed a pronounced dehiscence. Therefore, a small part of the recipient's DM around the preexisting gap in DM was removed before a second mini-DMEK graft was placed successfully. The other 2 patients developed partial graft detachment within 1 to 2 weeks after surgery. However, the corneas of these patients were dehydrated to physiological levels after mini-DMEK, and despite partial detachment, there was no relapse of the hydrops. Conclusions: Mini-DMEK could be helpful in patients with larger defects and detachments of DM in very ectatic corneas in the acute phase of corneal hydrops in acute keratoconus. These patients may not be successfully treated by intracameral gas application alone or in combination with pre-Descemetal sutures. Further investigations are needed to identify factors helping to decide on the best surgical approach in hydrops in acute keratoconus.
    Type of Medium: Online Resource
    ISSN: 0277-3740
    URL: Article
    DOI: 10.1097/ICO.0000000000002001
    RVK:
    XA 37258
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 2045943-9
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  • 10
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    Transferability of an Artificial Intelligence Algorithm Predicting Rebubblings After Descemet Membrane Endothelial Keratoplasty
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Cornea Vol. 42, No. 5 ( 2023-05), p. 544-548
    Details
    In: Cornea, Ovid Technologies (Wolters Kluwer Health), Vol. 42, No. 5 ( 2023-05), p. 544-548
    Abstract: To develop an artificial intelligence (AI) algorithm enabling corneal surgeons to predict the probability of rebubbling after Descemet membrane endothelial keratoplasty (DMEK) from images obtained using optical coherence tomography (OCT). Methods: Anterior segment OCT data of patients undergoing DMEK by 2 different DMEK surgeons (C.C. and B.B.; University of Cologne, Cologne, Germany) were extracted from the prospective Cologne DMEK database. An AI algorithm was trained by using a data set of C.C. to detect graft detachments and predict the probability of a rebubbling. The architecture of the AI model used in this study was called EfficientNet. This algorithm was applied to OCT scans of patients, which were operated by B.B. The transferability of this algorithm was analyzed to predict a rebubbling after DMEK. Results: The algorithm reached an area under the curve of 0.875 (95% confidence interval: 0.880–0.929). The cutoff value based on the Youden index was 0.214, and the sensitivity and specificity for this value were 78.9% (67.6%–87.7%) and 78.6% (69.5%–86.1%). Conclusions: The development of AI algorithms allows good transferability to other surgeons reaching a high accuracy in predicting rebubbling after DMEK based on OCT image data.
    Type of Medium: Online Resource
    ISSN: 0277-3740
    URL: Article
    DOI: 10.1097/ICO.0000000000003049
    RVK:
    XA 37258
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2045943-9
    Location Call Number Limitation Availability
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