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Refractive Surgical Procedures: HELP
Articles from Iowa
Based on 68 articles published since 2009
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These are the 68 published articles about Refractive Surgical Procedures that originated from Iowa during 2009-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3
1 Editorial Predicting Refractive Success in the Age of More Precise Measurements. 2018

Oetting, Thomas A. ·Iowa City, Iowa. Electronic address: thomas-oetting@uiowa.edu. ·Ophthalmology · Pubmed #29935670.

ABSTRACT: -- No abstract --

2 Review Hyperopic small-incision lenticule extraction. 2019

Moshirfar, Majid / Bruner, Cameron D / Skanchy, David F / Shah, Tirth. ·Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City. · Utah Lions Eye Bank, Murray. · Hoopes Durrie Rivera Research Center, Hoopes Vision, Draper, Utah. · McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas. · Department of Ophthalmology and Visual Sciences, W.K. Kellogg Eye Center, University of Michigan Medical School, Ann Arbor, Michigan. · Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA. ·Curr Opin Ophthalmol · Pubmed #31033739.

ABSTRACT: PURPOSE OF REVIEW: Small-incision lenticule extraction (SMILE) has shown great promise in the treatment of myopia; however, the literature is less extensive in its hyperopic counterpart. The purpose of this review is to detail the recent advancements and outcomes of SMILE in the treatment of hyperopic eye disease. RECENT FINDINGS: SMILE has demonstrated similar visual outcomes, regression rates, centration ability, safety profiles, and wound healing as hyperopic laser-assisted in situ keratomileusis (LASIK). Lenticule preservation and implantation show further promise in the correction of higher degrees of hyperopia. SUMMARY: Based on the current literature, SMILE represents a viable surgical alternative to LASIK in the correction of hyperopia. Lenticule intrastromal keratoplasty and small-incision lenticule intrastromal keratoplasty may be able to correct severe hyperopia in patients who would not otherwise be candidates for refractive surgery.

3 Review Cataract surgery in the patient that cannot lie flat. 2010

Rogers, Gina M / Goins, Kenneth M. ·Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, Iowa City, Iowa 52242, USA. ·Curr Opin Ophthalmol · Pubmed #19935422.

ABSTRACT: PURPOSE OF REVIEW: At times a patient requiring cataract surgery cannot be positioned flat rendering the case challenging. In addition, sometimes the medical condition that limits the patient's ability to lie supine also carries an increased risk of being placed under general anesthesia making topical anesthesia a safer option. The surgeon must often use ingenuity in positioning in order to carry out a successful surgery. This review will highlight different techniques employed for cataract surgery in a patient that cannot lie supine. RECENT FINDINGS: There is a small amount of published literature describing techniques of cataract surgery in the patient who cannot lie supine. We hope to highlight the various techniques that have been described in the literature. SUMMARY: Cataract surgery can become more complex when the patient cannot be positioned with their head flat on the operating table. With creative alterations to normal positioning, successful phacoemulsification can be executed.

4 Article Retrospective analysis of ocular neuropathies in diabetic dogs following cataract surgery. 2019

Foote, Braidee C / Michau, Tammy M / Welihozkiy, Anja / Stine, Jessica M. ·Iowa State University, Ames, IA, USA. · BluePearl Veterinary Partners, Tampa, FL, USA. ·Vet Ophthalmol · Pubmed #30095212.

ABSTRACT: OBJECTIVES: To describe and compare the cumulative incidence and clinical progression of ocular neuropathies in diabetic dogs vs nondiabetic dogs following cataract surgery. METHODS: Medical records of 196 diabetic and 442 nondiabetic dogs who underwent cataract surgery between 2004 and 2015 were reviewed. The percentage of patients affected by neuropathy and potential risk factors were compared between groups. RESULTS: Patients with diabetes mellitus (DM) were 20.4 times more likely to develop an ocular neuropathy than patients without DM (12.24% vs 0.68%). Twenty-four diabetic patients were affected by mononeuropathies or polyneuropathies including Horner's syndrome (n = 20), facial neuropathy (n = 5), and neurogenic keratoconjunctivitis sicca (NKCS) (n = 5). The odds of a diabetic patient developing Horner's syndrome and NKCS were 86.3 and 20.7 times higher than a nondiabetic patient, respectively. The average duration of DM prior to diagnosis of neuropathy was 659 days (range 110-2390 days; median 559 days). Complete resolution was achieved in 10 of 22 neuropathies (45%) within an average of 248 days (range 21-638 days; median 187 days) after diagnosis. CONCLUSIONS: The odds of developing an ocular neuropathy, specifically Horner's syndrome and NKCS, are statistically higher in diabetic patients compared to nondiabetic patients. Neuropathies were observed as a long-term complication in this group of diabetic patients, and complete resolution of the neuropathy was observed in less than half of the affected population.

5 Article Incidence and Outcomes of Positive Donor Corneoscleral Rim Fungal Cultures after Keratoplasty. 2017

Vislisel, Jesse M / Goins, Kenneth M / Wagoner, Michael D / Schmidt, Gregory A / Aldrich, Benjamin T / Skeie, Jessica M / Reed, Cynthia R / Zimmerman, M Bridget / Greiner, Mark A. ·Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, Iowa City, Iowa. · Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, Iowa City, Iowa; Iowa Lions Eye Bank, Coralville, Iowa. · Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, Iowa City, Iowa; Cornea Research Center, Stephen A. Wynn Institute for Vision Research, Iowa City, Iowa. · Iowa Lions Eye Bank, Coralville, Iowa. · Department of Biostatistics, University of Iowa College of Public Health, Iowa City, Iowa. · Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, Iowa City, Iowa; Cornea Research Center, Stephen A. Wynn Institute for Vision Research, Iowa City, Iowa; Iowa Lions Eye Bank, Coralville, Iowa. Electronic address: mark-greiner@uiowa.edu. ·Ophthalmology · Pubmed #27817919.

ABSTRACT: PURPOSE: To determine the incidence of positive corneoscleral donor rim fungal cultures after keratoplasty and to report clinical outcomes of grafts with culture-positive donor rims. DESIGN: Retrospective cohort study. PARTICIPANTS: Consecutive donor corneas and keratoplasty recipients at a single tertiary referral center over 20 years. METHODS: Patient charts were reviewed to determine the incidence of positive donor rim fungal cultures and clinical outcomes of all grafts using contaminated tissue. MAIN OUTCOME MEASURES: The primary outcome measures were positive donor rim fungal culture results and the development of postkeratoplasty fungal infection using corresponding corneal tissue. The secondary outcome measure was the impact of postoperative prophylaxis on donor tissue-associated infections. RESULTS: A total of 3414 keratoplasty cases were included in the statistical analysis. Seventy-one cases (2.1%) were associated with a fungal culture-positive donor rim. Candida species were cultured in 40 cases (56.3%). There was a higher incidence of positive rim cultures over the last 5 years of the analytic period compared with the first 15 years (P = 0.018). Fungal keratitis developed in 4 cases (5.6%), and all patients required further surgical intervention to achieve cure. There were no cases of fungal endophthalmitis. Empiric antimycotic prophylaxis initiated at the time of positive culture result reduced the incidence of keratitis from 15.8% in untreated cases to 1.9% in treated cases (P = 0.056). CONCLUSIONS: Positive donor rim fungal cultures are uncommon, but carry an unacceptably high risk of postoperative fungal infection. This risk may be reduced with prophylactic antimycotic therapy when culture-positive donor rims are identified.

6 Article Postoperative hemorrhagic occlusive retinal vasculitis associated with intracameral vancomycin prophylaxis during cataract surgery. 2016

Miller, Matthew A / Lenci, Lucas T / Reddy, Chittaranjan V / Russell, Stephen R. ·From the Department of Ophthalmology and Visual Sciences (Miller, Lenci, Russell), University of Iowa Hospitals and Clinics, Iowa City, Iowa, and the Retina Consultants of Central Illinois (Reddy), Peoria, Illinois, USA. Electronic address: matthew-a-miller@uiowa.edu. · From the Department of Ophthalmology and Visual Sciences (Miller, Lenci, Russell), University of Iowa Hospitals and Clinics, Iowa City, Iowa, and the Retina Consultants of Central Illinois (Reddy), Peoria, Illinois, USA. ·J Cataract Refract Surg · Pubmed #27956296.

ABSTRACT: We present the case of a 75-year-old man who had uneventful cataract surgery and administration of intracameral vancomycin for endophthalmitis prophylaxis, followed by the same procedure in the fellow eye 1 week later. The patient subsequently developed bilateral hemorrhagic occlusive retinal vasculitis, resulting in profound vision loss in both eyes. A second case of hemorrhagic occlusive retinal vasculitis previously reported from our institution is summarized. That case was characterized by a far milder course, with rapid resolution of vision loss. The 2 cases illustrate the broad range of toxicity potentially associated with intracameral vancomycin, suggest that bilateral administration results in a worse prognosis, and indicate that this disorder may be underrecognized due to the potential for a mild course. We recommend that intracameral vancomycin not be used for endophthalmitis prophylaxis. FINANCIAL DISCLOSURE: None of the authors has a financial or proprietary interest in any material or method mentioned.

7 Article Residual astigmatism after toric intraocular lens implantation: Analysis of data from an online toric intraocular lens back-calculator. 2016

Kramer, Brent A / Berdahl, John P / Hardten, David R / Potvin, Richard. ·From the University of Iowa Carver College of Medicine (Kramer), Iowa City, Iowa, Vance Thompson Vision (Berdahl), Sioux Falls, South Dakota, Minnesota Eye Consultants (Hardten), Minnetonka, Minnesota, and Science in Vision (Potvin), Akron, New York, USA. · From the University of Iowa Carver College of Medicine (Kramer), Iowa City, Iowa, Vance Thompson Vision (Berdahl), Sioux Falls, South Dakota, Minnesota Eye Consultants (Hardten), Minnetonka, Minnesota, and Science in Vision (Potvin), Akron, New York, USA. Electronic address: rick@scienceinvision.com. ·J Cataract Refract Surg · Pubmed #27956286.

ABSTRACT: PURPOSE: To evaluate some possible causes for residual astigmatism after toric intraocular lens (IOL) implantation based on an analysis of data from an online toric IOL back-calculator. DESIGN: Retrospective data review. METHODS: An online toric back-calculator was designed to allow users to input preoperative toric planning information along with postoperative IOL orientation and refractive results. These were then used to determine the optimum orientation of the IOL to reduce refractive astigmatism. The collected aggregate data were extracted from this calculator to investigate the associated reasons for residual astigmatic refractive error with toric IOLs. RESULTS: The study analyzed 12 812 records with a mean postoperative refractive astigmatism of 1.89 diopters (D). Refractive astigmatism was significantly higher with higher IOL cylinder power (P < .01) but was not different by IOL manufacturer. Ninety percent of IOLs were not at the ideal orientation, despite 30% being at the preoperative calculated orientation. Misalignment showed a directional bias for some IOLs but not for others. The mean calculated percentage reduction in residual cylinder after reorientation was 50% ± 31% (SD), with the magnitude of residual astigmatism after IOL reorientation expected to be 0.50 D or less in 37% of eyes (4835/12 812). Expected outcomes were significantly different by IOL type. CONCLUSIONS: Analysis of data from the online toric back-calculator provided insights into the nature of residual astigmatism after toric IOL implantation. The reasons for residual astigmatism in this data set varied by IOL type. FINANCIAL DISCLOSURE: Proprietary or commercial disclosures are listed after the references.

8 Article Descemet membrane adhesion strength is greater in diabetics with advanced disease compared to healthy donor corneas. 2016

Schwarz, Chaid / Aldrich, Benjamin T / Burckart, Kimberlee A / Schmidt, Gregory A / Zimmerman, M Bridget / Reed, Cynthia R / Greiner, Mark A / Sander, Edward A. ·Department of Biomedical Engineering, University of Iowa, Iowa City, IA, USA. · Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, Iowa City, IA, USA; Iowa Lions Eye Bank, Coralville, IA, USA. · Iowa Lions Eye Bank, Coralville, IA, USA. · College of Public Health, Department of Biostatistics, University of Iowa, Iowa City, IA, USA. · Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, Iowa City, IA, USA; Iowa Lions Eye Bank, Coralville, IA, USA; Cornea Research Center, Stephen A. Wynn Institute for Vision Research, Iowa City, IA, USA. Electronic address: mark-greiner@uiowa.edu. · Department of Biomedical Engineering, University of Iowa, Iowa City, IA, USA. Electronic address: edward-sander@uiowa.edu. ·Exp Eye Res · Pubmed #27777123.

ABSTRACT: Descemet membrane endothelial keratoplasty (DMEK) is an increasingly popular surgical procedure for treating ocular diseases that require a corneal transplant. Previous studies have found that tissue tearing during surgical preparation is more likely elevated in eyes from donors with a history of diabetes mellitus. To quantify these potential differences, we established an experimental technique for quantifying the force required to separate the endothelium-Descemet membrane complex (EDM) from stroma in human donor corneal tissue, and we assessed differences in adhesion strength between diabetic and non-diabetic donor corneas. Transplant suitable corneas were obtained from 23 donors 50-75 years old with an average preservation to assay time of 11.5 days. Corneas were classified from a medical records review as non-diabetic (ND, n = 9), diabetic without evidence of advanced disease (NAD, n = 8), or diabetic with evidence of advanced disease (AD, n = 10). Corneas were sectioned into 3 mm wide strips and the EDM peeled from the stroma. Using the force-extension data obtained from mechanical peel testing, EDM elastic peel tension (T

9 Article Incidence of Cystoid Macular Edema After Descemet Membrane Endothelial Keratoplasty as a Staged and Solitary Procedure. 2016

Flanary, William E / Vislisel, Jesse M / Wagoner, Michael D / Raecker, Matthew E / Aldrich, Benjamin T / Zimmerman, M Bridget / Goins, Kenneth M / Greiner, Mark A. ·*Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, Iowa City, IA; †Cornea Research Center, Stephen A. Wynn Institute for Vision Research, Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, Iowa City, IA; and ‡Department of Biostatistics, University of Iowa College of Public Health, Iowa City, IA. ·Cornea · Pubmed #27158809.

ABSTRACT: PURPOSE: To compare the incidence of visually significant postoperative cystoid macular edema (CME) in pseudophakic eyes after Descemet membrane endothelial keratoplasty (DMEK) performed after recent versus remote cataract surgery. METHODS: A retrospective chart review was performed of all consecutive eyes that underwent DMEK without concurrent cataract surgery at the University of Iowa between October 2012 and December 2014. The DMEK procedures were classified as staged if performed between 2 weeks and 6 months after cataract surgery and solitary if performed more than 6 months after cataract surgery. Possible confounders, including a history of diabetes in the recipient, were tracked. Macular optical coherence tomography was performed to detect CME 1 month after DMEK if the best-corrected visual acuity was ≤20/30 with a clear cornea with no other reason for visual compromise. RESULTS: A total of 173 eyes from 140 patients were included in the statistical analysis. Staged DMEK was performed in 88 eyes (50.8%) and solitary DMEK in 85 eyes (49.2%). The incidence of CME was 8.0% (7 of 88 eyes) in the staged DMEK group and 7.1% (6 of 85 eyes) in the solitary DMEK group (P = 0.823). The incidence of CME did not differ significantly between the staged and solitary DMEK groups regardless of the recipient diabetic status. All cases of CME resolved within 6 months on topical therapy. CONCLUSIONS: The incidence of postoperative CME after DMEK is similar in the setting of recent or remote cataract surgery.

10 Article Small-incision 4-point scleral suture fixation of a foldable hydrophilic acrylic intraocular lens in the absence of capsule support. 2016

Terveen, Daniel C / Fram, Nicole R / Ayres, Brandon / Berdahl, John P. ·From the University of South Dakota Sanford School of Medicine (Terveen, Berdahl), and Vance Thompson Vision (Berdahl), Sioux Falls, South Dakota, the University of Iowa Hospitals and Clinics (Terveen), Iowa City, Iowa, Advanced Vision Care and Jules Stein Eye Institute (Fram), David Geffen School of Medicine, University of California, Los Angeles, California, the Cornea Service (Ayres), and Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania, USA. Electronic address: dcterveen@gmail.com. · From the University of South Dakota Sanford School of Medicine (Terveen, Berdahl), and Vance Thompson Vision (Berdahl), Sioux Falls, South Dakota, the University of Iowa Hospitals and Clinics (Terveen), Iowa City, Iowa, Advanced Vision Care and Jules Stein Eye Institute (Fram), David Geffen School of Medicine, University of California, Los Angeles, California, the Cornea Service (Ayres), and Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania, USA. ·J Cataract Refract Surg · Pubmed #27026444.

ABSTRACT: PURPOSE: To determine the visual outcomes and complications of a new small-incision technique for 4-point fixation of a hydrophilic acrylic posterior chamber intraocular lens (IOL) in the absence of capsule support. SETTING: Three North American tertiary referral centers and a private practice. DESIGN: Retrospective case series. METHODS: Secondary IOL placement was performed from 2011 to 2014. Indications for surgery, clinical results, and complications were analyzed. Primary outcomes included postoperative corrected distance visual acuity (CDVA) and surgical complications. RESULTS: Charts of 35 patients (37 eyes) were reviewed. The mean age at surgery was 56 years, and the mean follow-up was 6 months (range 3 to 24 months). Clinical indications included a dislocated IOL (30%), ocular trauma (19%), crystalline lens subluxation (19%), uveitis-glaucoma-hyphema syndrome (5%), post-complicated cataract (8%), congenital cataract (8%), and decompensated cornea (3%). The mean CDVA improved from 20/80 preoperatively to 20/40 postoperatively (P < .01). Thirty-six eyes (97%) had an improved or unchanged CDVA, and 1 eye (3%) had a reduced CDVA because of worsening glaucoma. Postoperative complications included ocular hypertension (24%), iritis (5%), wound leakage (3%), transient corneal edema (3%), glaucoma requiring a tube shunt (3%), and IOL dislocation (3%). CONCLUSION: Small-incision 4-point scleral fixation of the Akreos AO60 hydrophilic acrylic IOL in the absence of capsule support appears to be a safe and effective technique for secondary IOL placement. FINANCIAL DISCLOSURES: Drs. Berdahl and Ayres are consultants to Bausch & Lomb, Inc. Drs. Ayres and Fram have received speaker fees from Bausch & Lomb. Dr. Terveen does not have a financial or proprietary interest in any material or methods mentioned.

11 Article Cataract Surgery Visual Outcomes and Associated Risk Factors in Secondary Level Eye Care Centers of L V Prasad Eye Institute, India. 2016

Matta, Sumathi / Park, Jiwon / Palamaner Subash Shantha, Ghanshyam / Khanna, Rohit C / Rao, Gullapalli N. ·Andhra Pradesh Right to Sight Society, Hyderabad, India. · Massachusetts Institute of Technology, Cambridge, United States of America. · Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa city, IA, United States of America. · Allen Foster Research Centre for Community Eye Health, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India. · Brien Holden Eye Research Centre, L.V. Prasad Eye Institute, Banjara Hills, Hyderabad, India. ·PLoS One · Pubmed #26741363.

ABSTRACT: PURPOSE: To evaluate cataract surgery visual outcomes and associated risk factors in rural secondary level eye care centers of L V Prasad Eye Institute (LVPEI), India. METHODS: The Eye Health pyramid of LVPEI has a network of rural secondary care centres (SCs) and attached vision centres (VCs) that provide high quality comprehensive eye care with permanent infrastructure to the most disadvantaged sections of society. The most common procedure performed at SCs is cataract surgery. We audited the outcome of a random sample of 2,049 cataract surgeries done from October 2009-March 2010 at eight rural SCs. All patients received a comprehensive ophthalmic examination, both before and after surgery. The World Health Organization recommended cataract surgical record was used for data entry. Visual outcomes were measured at discharge, 1-3 weeks and 4-11 weeks follow up visits. Poor outcome was defined as best corrected visual acuity <6/18. RESULTS: Mean age was 61.8 years (SD: 8.9 years) and 1,133 (55.3%) surgeries were performed on female patients. Pre-existing ocular co-morbidity was present in 165 patients (8.1%). The most common procedure was small incision cataract surgery (SICS) with intraocular lens (IOL) implantation (91.8%). Intraoperative complications were seen in 29 eyes (1.4%). At the 4-11 weeks follow-up visit, based on presenting visual acuity (PVA), 61.8% had a good outcome and based on best-corrected visual acuity (BCVA), 91.7% had a good outcome. Based on PVA and BCVA, those with less than 6/60 were only 2.9% and 1.6% respectively. Using multivariable analysis, poor visual outcomes were significantly higher in patients aged ≥70 (OR 4.63; 95% CI 1.61, 13.30), in females (OR 1.58; 95% CI 1.04, 2.41), those with preoperative comorbidities (odds ratio 4.68; 95% CI 2.90, 7.57), with intraoperative complications (OR 8.01; 95% CI 2.91, 22.04), eyes that underwent no IOL or anterior chamber-IOL (OR 12.63; 95% CI 2.65, 60.25) and those undergoing extracapsular cataract extraction (OR 9.39; 95% CI 1.18, 74.78). CONCLUSIONS: This study demonstrates that quality cataract surgeries can be achieved at rural SCs. The concept of the LVPEI SCs can be applied to other developing countries, allowing rural patients to attain better vision through cataract surgery. Despite improvements in quality of cataract surgery, gender discrimination in terms of outcome continues to be an issue and needs further investigation.

12 Article Recurrent Vitreous Hemorrhage Despite Pars Plana Vitrectomy, Laser, and Injections. 2016

Chung, Anthony / Chin, Eric K / Almeida, David R P. ·Department of Ophthalmology and Visual Sciences, The University of Iowa, Iowa City. ·JAMA Ophthalmol · Pubmed #26633845.

ABSTRACT: -- No abstract --

13 Article Retinal detachment postphacoemulsification in Bichon Frises: a retrospective study of 54 dogs. 2016

Pryor, Silvia G / Bentley, Ellison / McLellan, Gillian J / Giuliano, Elizabeth A / Allbaugh, Rachel A / Rankin, Amy J / Labelle, Amber L / Buhr, Kevin A. ·Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin, 2015 Linden Dr., Madison, WI, 53706, USA. · Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin, 2015 Linden Dr., Madison, WI, 53706, USA. bentleye@vetmed.wisc.edu. · Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, 900 East Campus Drive, Columbia, MO, 65211, USA. · Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, 1600 S. 16th St., Ames, IA, 50011, USA. · Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, 1800 Dennison Ave, Manhattan, KS, 66506, USA. · Veterinary Clinical Medicine, University of Illinois Urbana-Champaign, 1008 W. Hazelwood Drive, Urbana, IL, 61802, USA. · Department of Biostatistics and Medical Informatics, University of Wisconsin, 600 Highland Avenue, Madison, WI, 53792, USA. ·Vet Ophthalmol · Pubmed #26429670.

ABSTRACT: OBJECTIVE: To compare rates of retinal detachment (RD) postphacoemulsification in American Bichon Frises with and without prophylactic retinopexy. PROCEDURES: Medical records of 54 Bichon Frises undergoing phacoemulsification with or without prophylactic retinopexy between 2003 and 2013 in one or both eyes were reviewed from five Midwestern university veterinary teaching hospitals. Inclusion criteria were preoperative ERG, at least 6 months of follow-up postphacoemulsification, and the absence of preexisting RD as determined by ophthalmic examination and/or ultrasound. Statistical analyses were performed using chi-squared test, and Wilcoxon rank-sum tests and Wilson confidence intervals with the P-value <0.05 were considered significant. RESULTS: Phacoemulsification was performed without retinopexy in 79 eyes (42 dogs, non-PR group) and with prophylactic retinopexy in 23 eyes (12 dogs, PR group). Incidence of diabetes mellitus was 10/42 and 3/12 in the non-PR and the PR groups, respectively (P = 0.93). Intraocular lens implantation was performed in 40/42 non-PR dogs and 11/12 PR dogs (P = 0.63, 73/79 vs. 21/23 eyes). At final re-examination, RD occurred in 4/79 eyes without retinopexy, compared to 0/23 RD in the retinopexy group. There was no statistically significant difference in RD rates between the two groups (P = 0.27). CONCLUSIONS: These data provide no statistical evidence to support prophylactic retinopexy in Bichon Frises. Due to the low rate of retinal detachment following phacoemulsification without prophylactic retinopexy, the procedure appears to offer limited benefit to offset cost, procedural risk, and risk of extended or repeated anesthesia in Bichon Frises.

14 Article Boston type 1 keratoprosthesis for failed keratoplasty. 2016

Hager, Jonathan L / Phillips, David L / Goins, Kenneth M / Kitzmann, Anna S / Greiner, Mark A / Cohen, Alex W / Welder, Jeffrey D / Wagoner, Michael D. ·Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, 200 Hawkins Drive, Iowa City, IA, 52242-1091, USA. · Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA, 52242-1091, USA. · Cornea Research Center, Stephen A Wynn Institute for Vision Research, 375 Newton Road, Iowa City, IA, 52242-1091, USA. · Department of Ophthalmology and Visual Sciences, Dean McGee Eye Institute, University of Oklahoma School of Medicine, Oklahoma City, OK, USA. · Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, 200 Hawkins Drive, Iowa City, IA, 52242-1091, USA. michael-wagoner@uiowa.edu. · Cornea Research Center, Stephen A Wynn Institute for Vision Research, 375 Newton Road, Iowa City, IA, 52242-1091, USA. michael-wagoner@uiowa.edu. · Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA, 52242-1091, USA. michael-wagoner@uiowa.edu. ·Int Ophthalmol · Pubmed #25975459.

ABSTRACT: The purpose of this study was to evaluate the outcomes of the Boston type 1 keratoprosthesis (Kpro-1) in eyes with failed keratoplasty. A retrospective review was performed of every patient treated with a Kpro-1 at a tertiary eye care center between January 1, 2008 and July 1, 2013. Eyes with a failed keratoplasty originally performed for corneal edema, trauma, or keratoconus were included in the statistical analysis. The main outcome measures were visual outcome, prosthesis retention, and postoperative complications. Twenty-four eyes met the inclusion criteria, including 13 eyes with corneal edema, 8 eyes with trauma, and 3 eyes with keratoconus. After a mean follow-up period of 28.9 months (range 7-63 months), the median best corrected visual acuity (BCVA) was 20/125. The BCVA was ≥ 20/40 in 4 (16.7 %) eyes, ≥ 20/70 in 9 (37.5 %) eyes, and ≥ 20/200 in 14 (58.3 %) eyes. Overall, the postoperative BCVA improved in 17 (70.9 %) eyes, was unchanged in 3 (12.5 %) eyes, and was worse in 4 (16.7 %) eyes. The initial Kpro-1 was retained in 22 (91.7 %) eyes, and was successfully repeated in the other 2 eyes. One or more serious prosthesis- or sight-threatening complications occurred in 8 (33.3 %) eyes. These included 1 case of wound dehiscence leading to prosthesis extrusion, 1 case of fungal keratitis leading to prosthesis extrusion, 4 cases of endophthalmitis, and 5 retinal detachments. The Boston Kpro-1 is associated with an excellent prognosis for prosthesis retention and satisfactory visual improvement in eyes with previous failed keratoplasty.

15 Article Crossed versus conventional pseudophakic monovision: Patient satisfaction, visual function, and spectacle independence. 2015

Zhang, Fuxiang / Sugar, Alan / Arbisser, Lisa / Jacobsen, Gordon / Artico, Jessica. ·From the Department of Ophthalmology (Zhang, Artico), Henry Ford Health System, Taylor, the Kellogg Eye Center (Sugar), University of Michigan, Ann Arbor, the Department of Biostatistics and Research Epidemiology (Jacobsen), Henry Ford Health System, Detroit, Michigan · Eye Surgeons Associates PC (Arbisser), Bettendorf, Iowa. ·J Cataract Refract Surg · Pubmed #26603393.

ABSTRACT: PURPOSE: To compare patient satisfaction, visual function, and spectacle independence in patients with crossed or conventional pseudophakic monovision. SETTING: Department of Ophthalmology, Henry Ford Health System, Taylor, Michigan, USA. DESIGN: Retrospective comparative cohort study. METHODS: Cataract surgery patient records from June 1999 to December 2013 were reviewed. Crossed monovision patients were identified. Control conventional monovision cases were matched for age, sex, general health, personal lifestyle/main hobbies, preoperative refractive status, postoperative refractive status, uncorrected distance visual acuity, uncorrected near visual acuity, astigmatism level, and anisometropia level. A survey was mailed to participants, and results were independently analyzed. RESULTS: The review comprised 7311 patient records. Forty-four crossed monovision patients were identified, and 30 of them were enrolled. Thirty matched pairs were surveyed. The mean anisometropia was 1.19 diopters (D) in the conventional and 1.12 D in the crossed monovision groups. No significant difference was identified for eye-hand coordination, eye-foot coordination, or sport-related depth perception, but satisfaction was slightly better in the crossed monovision group (P = .028). No significant difference was identified for 6 of 8 spectacle independence measures, but nighttime driving was a little easier for the crossed monovision group (P = .025). Seventy-seven percent of crossed and 50% of conventional monovision patients did not use glasses for intermediate distance activities (P = .037). CONCLUSION: Crossed pseudophakic monovision appears to work as well as conventional pseudophakic monovision in terms of patient satisfaction and spectacle independence in patients with a mild degree of anisometropic pseudophakia. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.

16 Article Boston Type 1 Keratoprosthesis for Iridocorneal Endothelial Syndromes. 2015

Phillips, David L / Goins, Kenneth M / Greiner, Mark A / Alward, Wallace L M / Kwon, Young H / Wagoner, Michael D. ·*Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, Iowa City, IA; and †Cornea Research Center, Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, Stephen A. Wynn Institute for Vision Research, Iowa City, IA. ·Cornea · Pubmed #26398156.

ABSTRACT: PURPOSE: To evaluate the outcome of the Boston type 1 keratoprosthesis (KPro-1) in eyes with iridocorneal endothelial syndromes and failed keratoplasties. METHODS: A retrospective review was performed of every eye with a history of iridocorneal endothelial syndrome and a failed corneal transplant that was treated with a KPro-1 at a tertiary eye care center between January 1, 2008, and July 1, 2014. The main outcome measures were visual outcome, prosthesis retention, and postoperative complications. RESULTS: Four eyes met the inclusion criteria. Two eyes had essential iris atrophy and 2 eyes had Chandler syndrome. All 4 eyes had failed corneal transplants and successful glaucoma drainage devices. The mean patient age at the time of KPro-1 surgery was 68.3 years (range, 60-80 years). The mean postoperative follow-up duration was 47 months (range, 27-69 months). Preoperatively, the best-corrected visual acuity (BCVA) was worse than 20/200 in all 4 eyes, including 2 eyes that had hand motions vision. After KPro-1, all 4 eyes initially obtained a BCVA of ≥20/70. At the most recent examination, the BCVA was still ≥20/100 in 3 eyes. The KPro-1 device was retained in all 4 eyes. Postoperative complications included glaucoma progression (1 eye), a retroprosthetic membrane (1 eye), and sterile vitritis (1 eye). CONCLUSIONS: The Boston KPro-1 may offer a better prognosis than repeat traditional keratoplasty in reestablishing corneal clarity in eyes with iridocorneal endothelial syndromes. Despite anatomic success, visual rehabilitation may be compromised by preexisting glaucomatous optic neuropathy and its postoperative progression.

17 Article Stability and safety of MA50 intraocular lens placed in the sulcus. 2015

Kemp, P S / Oetting, T A. ·Department of Ophthalmology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA. · Department of Ophthalmology, Veterans Administration Medical Center, Coralville, IA, USA. ·Eye (Lond) · Pubmed #26139047.

ABSTRACT: PURPOSE: To describe the safety and stability of sulcus placement of the MA50 intraocular lens (IOL). PATIENTS AND METHODS: Consecutive patients with MA50 IOLs placed in the sulcus at the University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA, from 1997 to 2012 were identified. Inclusion criteria included patients with over 4 weeks of follow-up data. AEL was compared with incidence of IOL decentration using at two-tailed Student's t-test. RESULTS: Fifty eyes of 49 patients meeting the inclusion criteria were identified. Four weeks post-operatively, the average best-corrected visual acuity was 20/30. IOL decentration occurred in 14% of patients; patients with decentered IOLs had a significantly longer average AEL (25.37 mm) than patients whose IOL remained centered (23.94 mm, P=0.017). Other complications included uveitis-glaucoma-hyphema syndrome (12%), iritis (8%), and glaucoma (6%). There were no cases of pigment dispersion syndrome or need for lens exchange. Twelve eyes (24%) had intra-operative optic capture by the anterior capsule, none of which had post-operative decentration. CONCLUSION: The MA50 IOL is a reasonable, stable option for placement in the sulcus, with a low-risk profile; however, in eyes with longer AEL and presumably larger anterior segment, surgeons should consider placing an IOL with longer haptic distance than the MA50 to maintain centration. Optic capture of the MA50 IOL by the anterior capsule should be considered for longer eyes, as it is protective against decentration.

18 Article May consultation #7. 2015

Arbisser, Lisa Brothers. ·Bettendorf, Iowa, USA. ·J Cataract Refract Surg · Pubmed #26049846.

ABSTRACT: -- No abstract --

19 Article Regional assessment of energy-producing metabolic activity in the endothelium of donor corneas. 2015

Greiner, Mark A / Burckart, Kimberlee A / Wagoner, Michael D / Schmidt, Gregory A / Reed, Cynthia R / Liaboe, Chase A / Flamme-Wiese, Miles J / Zimmerman, M Bridget / Mullins, Robert F / Kardon, Randy H / Goins, Kenneth M / Aldrich, Benjamin T. ·University of Iowa Carver College of Medicine, Department of Ophthalmology and Visual Sciences, Iowa City, Iowa, United States 2Iowa Lions Eye Bank, Coralville, Iowa, United States. · Iowa Lions Eye Bank, Coralville, Iowa, United States. · University of Iowa Carver College of Medicine, Department of Ophthalmology and Visual Sciences, Iowa City, Iowa, United States. · University of Iowa College of Public Health, Department of Biostatistics, Iowa City, Iowa, United States. · University of Iowa Carver College of Medicine, Department of Ophthalmology and Visual Sciences, Iowa City, Iowa, United States 4Iowa City Veterans Affairs Medical Center and Center of Excellence for the Prevention and Treatment of Visual Loss, Iowa City. ·Invest Ophthalmol Vis Sci · Pubmed #26024071.

ABSTRACT: PURPOSE: We characterized mitochondrial respiration and glycolysis activity of human corneal endothelium, and compared metabolic activity between central and peripheral regions. METHODS: Endothelial keratoplasty-suitable corneas were obtained from donors aged 50 to 75 years. The endothelium-Descemet membrane complex (EDM) was isolated, and 3-mm punches were obtained from central and peripheral regions. Endothelium-Descemet membrane punches were assayed for mitochondrial respiration (oxygen consumption) and glycolysis (extracellular acidification) using an extracellular flux analyzer. Enzymatic (citrate synthase, glucose hexokinase) and mitochondrial density (MitoTracker) assays also were performed. RESULTS: Ten corneas were analyzed per assay. Metabolic activity for mitochondrial respiration and glycolysis showed expected changes to assay compounds (P < 0.01, all pairwise comparisons). Basal mitochondrial respiration and glycolysis activity did not differ between regions (P > 0.99). Similarly, central versus peripheral activity after assay compound treatment showed no significant differences (P > 0.99, all time points). The intracorneal coefficient of variation for basal readings between two and four peripheral punches was 18.5% of the mean. Although peripheral samples displayed greater enzymatic activity than central samples (P < 0.05), similar to extracellular flux results, mitochondrial density did not differ between regions (P = 0.78). CONCLUSIONS: Extracellular flux analysis of oxygen and pH is a valid technique for characterizing metabolic activity of human corneal endothelium. This technique demonstrates high reproducibility, allows quantification of metabolic parameters using small quantities of live cells, and permits estimation of overall metabolic output. Neither oxygen consumption nor extracellular acidification differed between central and peripheral regions of transplant suitable corneas in this series. Our results show that endothelial cell health can be quantified biochemically in transplant suitable corneas.

20 Article Special Commentary: Food and Drug Administration and American Academy of Ophthalmology Sponsored: Developing Novel End Points for Premium Intraocular Lenses Workshop. 2015

Lum, Flora / Tarver, Michelle E / Kahook, Malik Y / Oetting, Thomas A / Rorer, Eva / Hilmantel, Gene / Calogero, Don / Kiang, Tina / Berdahl, John P / Coleman, Anne L / Eydelman, Malvina B. ·H. Dunbar Hoskins, Jr., MD Center for Quality Eye Care, American Academy of Ophthalmology, San Francisco, California (on behalf of the American Academy of Ophthalmology). · Office of Device Evaluation, Center for Devices and Radiological Health, Food and Drug Administration, Silver Spring, Maryland. · Department of Ophthalmology, University of Colorado School of Medicine, Aurora, Colorado (on behalf of the American Academy of Ophthalmology). · Department of Ophthalmology, University of Iowa, Iowa City, Iowa (on behalf of the American Academy of Ophthalmology). · University of South Dakota School of Medicine, Sioux Falls, South Dakota (on behalf of the American Academy of Ophthalmology). · Jules Stein Eye Institute, David Geffen School of Medicine and Fielding School of Public Health, University of California, Los Angeles, California (on behalf of the American Academy of Ophthalmology). · Office of Device Evaluation, Center for Devices and Radiological Health, Food and Drug Administration, Silver Spring, Maryland. Electronic address: malvina.eydelman@fda.hhs.gov. ·Ophthalmology · Pubmed #25896896.

ABSTRACT: -- No abstract --

21 Article Graft survival of diabetic versus nondiabetic donor tissue after initial keratoplasty. 2015

Vislisel, Jesse M / Liaboe, Chase A / Wagoner, Michael D / Goins, Kenneth M / Sutphin, John E / Schmidt, Gregory A / Zimmerman, M Bridget / Greiner, Mark A. ·*Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, Iowa City, IA; †Iowa Lions Eye Bank, Coralville, IA; ‡Department of Ophthalmology, Kansas University Medical Center, Kansas City, KS; and §Department of Biostatistics, University of Iowa College of Public Health, Iowa City, IA. ·Cornea · Pubmed #25642643.

ABSTRACT: PURPOSE: To compare corneal graft survival using tissue from diabetic and nondiabetic donors in patients undergoing initial Descemet stripping automated endothelial keratoplasty (DSAEK) or penetrating keratoplasty (PKP). METHODS: A retrospective chart review of pseudophakic eyes that underwent DSAEK or PKP was performed. The primary outcome measure was graft failure. Cox proportional hazard regression and Kaplan-Meier survival analyses were used to compare diabetic versus nondiabetic donor tissue for all keratoplasty cases. RESULTS: A total of 183 eyes (136 DSAEK, 47 PKP) were included in the statistical analysis. Among 24 procedures performed using diabetic donor tissue, there were 4 cases (16.7%) of graft failure (3 DSAEK, 1 PKP), and among 159 procedures performed using nondiabetic donor tissue, there were 18 cases (11.3%) of graft failure (12 DSAEK, 6 PKP). Cox proportional hazard ratio of graft failure for all cases comparing diabetic with nondiabetic donor tissue was 1.69, but this difference was not statistically significant (95% confidence interval, 0.56-5.06; P = 0.348). There were no significant differences in Kaplan-Meier curves comparing diabetic with nondiabetic donor tissue for all cases (P = 0.380). Statistical analysis of graft failure by donor diabetes status within each procedure type was not possible because of the small number of graft failure events involving diabetic tissue. CONCLUSIONS: We found similar rates of graft failure in all keratoplasty cases when comparing tissue from diabetic and nondiabetic donors, but further investigation is needed to determine whether diabetic donor tissue results in different graft failure rates after DSAEK compared with PKP.

22 Article Treatment of acanthamoeba keratitis with intravenous pentamidine before therapeutic keratoplasty. 2015

Sacher, Bradley A / Wagoner, Michael D / Goins, Kenneth M / Sutphin, John E / Greiner, Mark A / Kitzmann, Anna S. ·*Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, Iowa City, IA; and †Department of Ophthalmology, Kansas University Medical Center, Kansas City, KS. ·Cornea · Pubmed #25255139.

ABSTRACT: PURPOSE: The aim of this study was to evaluate the outcome of pretreatment of Acanthamoeba keratitis with intravenous pentamidine (IVP) before therapeutic keratoplasty (TKP). METHODS: A retrospective chart review was performed of the medical records of every patient treated with IVP before TKP for Acanthamoeba keratitis at a single, tertiary care eye center between January 1, 2002, and December 31, 2012. The main outcome measures were microbiological cure, graft survival, and visual outcome. RESULTS: Eight eyes of 7 patients met the inclusion criteria. Preoperatively, all 8 eyes had failed traditional antiamoebic therapy, including 5 eyes with recurrent infections after previous TKP. The patients were treated with IVP (190-400 mg/d) for a median of 14 days (range, 7-26 days). After 8 TKP, a microbiological cure was achieved, and a clear graft was maintained in 5 (62.5%) eyes during a mean follow-up interval of 31.2 months (range, 1.0-95.7 months). Repeat TKP in 3 eyes with recurrent Acanthamoeba keratitis resulted in 2 additional microbiological cures and 1 more clear graft. The final best-corrected visual acuity was ≥20/40 in 5 (62.5%) eyes and worse than 20/200 in 3 eyes. Overall, the final vision was improved in 6 (75.0%) eyes, remained the same in 1 (12.5%) eye, and was worse in 1 (12.5%) eye. CONCLUSIONS: The adjunctive use of IVP before TKP may assist with the achievement of microbiological cure, clear graft, and good visual outcome in a majority of eyes with Acanthamoeba keratitis.

23 Article Diabetes mellitus increases risk of unsuccessful graft preparation in Descemet membrane endothelial keratoplasty: a multicenter study. 2014

Greiner, Mark A / Rixen, Jordan J / Wagoner, Michael D / Schmidt, Gregory A / Stoeger, Christopher G / Straiko, Michael D / Zimmerman, M Bridget / Kitzmann, Anna S / Goins, Kenneth M. ·*Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, Iowa City, IA; †Iowa Lions Eye Bank, Coralville, IA; ‡Lions VisionGift, Portland, OR; and §Devers Eye Institute, Portland, OR. ·Cornea · Pubmed #25222000.

ABSTRACT: PURPOSE: The aim of this study was to evaluate preparation outcomes of tissue prepared for Descemet membrane endothelial keratoplasty (DMEK) from diabetic and nondiabetic donors. METHODS: In this nonrandomized, consecutive case series, DMEK grafts were prepared from diabetic and nondiabetic donors by experienced technicians in 2 eye banks using slightly different, modified submerged manual preparation techniques to achieve "prestripped" graft tissue. Graft preparation results were analyzed retrospectively. The main outcome measure was the rate of unsuccessful (failed) DMEK graft preparations, defined as tears through the graft area that prevent tissue use. RESULTS: A total of 359 corneas prepared from 290 donors (114 diabetic and 245 nondiabetic) were included in the statistical analysis of graft preparation failure. There were no significant differences between diabetic and nondiabetic donor tissue characteristics with respect to donor age, death to preservation time, death to preparation time, endothelial cell density, percent hexagonality, or coefficient of variation. DMEK tissue preparation was unsuccessful in 19 (5.3%) cases. There was a significant difference in the site-adjusted rate of DMEK preparation failure between diabetic [15.3%; 95% confidence interval (CI), 9.0-25.0] and nondiabetic donors (1.9%; 95% CI, 0.8-4.8), and the corresponding site-adjusted odds ratio of DMEK graft preparation failure in diabetic donor tissue versus nondiabetic donor tissue was 9.20 (95% CI, 2.89-29.32; P = 0.001). CONCLUSIONS: Diabetes may be a risk factor for unsuccessful preparation of donor tissue for DMEK. We recommend caution in the use of diabetic tissue for DMEK graft preparation. Further study is needed to identify what subset of diabetic donors is at risk for unsuccessful DMEK graft preparation.

24 Article August consultation #8. 2014

Oetting, Thomas A. ·Iowa City, Iowa, USA. ·J Cataract Refract Surg · Pubmed #25088647.

ABSTRACT: -- No abstract --

25 Article August consultation #2. 2014

Jones, Jason. ·Sioux City, Iowa, USA. ·J Cataract Refract Surg · Pubmed #25088641.

ABSTRACT: -- No abstract --

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