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14. Ab Externo Choroidal Fluid Drainage, Pars Plana Vitrectomy, and Endotamponade for the Management of Persistent Hypotony following Glaucoma Surgery.

Author

Koenig, Susanna Friederike, Vounotrypidis, Efstathios, Wertheimer, Christian Maximilian, Wolf, Armin, and Teus, Miguel

Subjects
GLAUCOMA surgery, INTRAOCULAR pressure, RETROSPECTIVE studies, EYE diseases, SURGICAL complications, LONGITUDINAL method, SURGICAL hemostasis, OPHTHALMIC surgery
Abstract

Background. Persistent severe serous choroidal detachment is a rare complication after glaucoma surgery. Surgical treatment with choroidal fluid drainage through a scleral incision is an option in these cases. Combining this procedure with pars plana vitrectomy and gas endotamponade has potential advantages. In the following, the perioperative course of this surgical option in a small cohort will be presented. Methods. This is a retrospective cohort study of the postoperative course of ab externo drainage of persistent serous choroidal detachment (≥4 weeks) in combination with pars plana vitrectomy and gas endotamponade in six eyes of six patients after exhausting all conservative treatment options. Inclusion criterion was persistent hypotony with severe serous choroidal detachment after intraocular pressure (IOP) lowering surgery due to medically uncontrolled glaucoma. Eyes were evaluated according to resolution of choroidal detachment, change in IOP and visual acuity (VA), postdrainage complications, and need for further surgeries. Results. Before surgery, all patients presented with flat anterior chamber, decreased vision, and persistent choroidal detachment. The surgery itself was uneventful, but due to the complexity of the cases, tailoring the procedure to each patient's needs was required. Complete resolution of choroidal effusion was achieved by one month in 5 eyes and in 1 eye by month 3. There was an increase in average IOP from 5 (±2.1) mmHg before surgery to 11.3 (±3.7) mmHg and in VA from 1.7 (±0.8) to 1.2 (±0.6) logMAR. Five out of six patients required additional surgery, mainly to further increase the IOP even though choroidal detachment had already resolved. Conclusion. Ab externo choroidal fluid drainage combined with pars plana vitrectomy and gas endotamponade seems to be an effective and safe treatment option in persistent ocular hypotony. Although repeated surgeries might be necessary, large‐scale prospective studies must be undertaken to provide corroborative evidence. [ABSTRACT FROM AUTHOR]

Published
2024
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19. New models of innovation through collaboration: the translation journey of novel concepts in corneal refractive surgery

Author

Buhl, Lara, primary, Dolling, Maron, additional, Wang, Ying, additional, Parshad, Badri, additional, Li, Xiaolei, additional, Wertheimer, Christian M., additional, Kassumeh, Stefan A., additional, Priglinger, Siegfried, additional, Bischoff, Mark, additional, Evans, Conor L., additional, Anderson, R. R., additional, Birngruber, Reginald, additional, and Apiou-Sbirlea, Gabriela, additional

Published
2023
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29. Influence of endotamponade on anterior chamber depth and refractive outcome after combined phacovitrectomy: case-control study.

Author

Chatzimichail, Eleftherios, Wertheimer, Christian, Kilani, Adnan, König, Susanna, Gatzioufas, Zisis, Wolf, Armin, and Vounotrypidis, Efstathios

Subjects
*PHYSIOLOGIC salines, *PHOTOREFRACTIVE keratectomy, *CATARACT surgery, *CASE-control method, *OPHTHALMIC surgery, *PHACOEMULSIFICATION, *SURGICAL complications
Abstract

In combined phacovitrectomy, the injected tamponade seems to affect the ACD differently only in the very early postoperative period; at 6 weeks postoperatively, no difference was observed. Purpose: To compare the changes in the anterior chamber depth (ACD) and in the refractive outcomes after combined phacovitrectomy with respect to the endotamponade (balanced salt solution, air, sulfur hexafluoride [SF6, gas]). Setting: Department of Ophthalmology, University Hospital Ulm, Ulm, Germany. Design: Retrospective, longitudinal case-control study. Methods: 160 eyes of 160 patients were included in the study. 120 eyes underwent phacoemulsification with in-the-bag implantation combined with vitrectomy and were divided into 3 groups according to tamponade (balanced salt solution, air, gas). 40 control eyes with cataract surgery only were included. Further inclusion criteria were uneventful surgery, no postoperative complications and absence of corneal pathology. Endpoints were ACD as measured by swept-source optical coherence tomography-based biometry (IOLMaster 700) preoperatively, 1 to 2 days and 6 weeks postoperatively and refractive prediction error (PE) using the Barrett and Haigis formulas. Results: Within the first 2 days after surgery the ACD was shallower in the eyes left with gas or air tamponade, when compared with balanced salt solution or cataract surgery alone (P <.001). This effect diminished 6 weeks later, and all eyes reached comparable ACD (P =.396). The refractive PE was slightly, but statistically significantly higher in the gas group when compared with cataract surgery alone (P =.012 for Barrett, P =.006 for Haigis). Conclusions: The resulting ACD after combined phacovitrectomy was independent of the tamponade used, but a gas-tamponade was associated with a higher refractive PE. [ABSTRACT FROM AUTHOR]

Published
2023
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33. Pharmacological drug screening to inhibit uveal melanoma metastatic cells either via EGF-R, MAPK, mTOR or PI3K

Author

Kassumeh, Stefan, Arrow, Sebastian, Kafka, André, Luft, Nikolaus, Priglinger, Siegfried G., Wolf, Armin, Eibl-Lindner, Kirsten, and Wertheimer, Christian M.

Subjects
Basic Research
Abstract

AIM: To screen five potential pharmacological substances specifically targeting EGF-R, MAPK, mTOR, or PI3K for their antiproliferative effects, possible impact on cell viability, as well as cell death rates on three different uveal melanoma metastasis cell lines in vitro. METHODS: Three different uveal melanoma metastasis cell lines (OMM2.5, OMM2.3, and OMM1), that originated from human hepatic and subcutaneous metastasis, were exposed to inhibitors of different targets: erlotinib (EGF-R), everolimus (mTOR), selumetinib (MAPK), trametinib (MAPK) or the alkylphosphocholine erufosine (PI3K). Cell viability was assessed with a 2,3-bis-(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide (XTT) dye reduction assay after 24h of treatment. Antiproliferative effects were evaluated separately after a 72-hour incubation of the cells with the pharmacological substance. Subsequently, the IC(50) was calculated. Tumor cell death was investigated using a double stain apoptosis detection assay. RESULTS: Selumetinib, trametinib, and erufosine significantly decreased cell viability of all OMM cell lines (P

Published
2022

40. Establishing an objective biomarker for corneal cystinosis using a threshold‐based Spectral domain optical coherence tomography imaging algorithm

Author

Keidel, Leonie, primary, Elhardt, Carolin, additional, Hohenfellner, Katharina, additional, Priglinger, Siegfried, additional, Schworm, Benedikt, additional, Wertheimer, Christian, additional, Priglinger, Claudia, additional, Luft, Nikolaus, additional, Bechtold Dalla Pozza, S, additional, Bergmann, C, additional, Buss, M, additional, Dosch, R, additional, Erler, J, additional, Getzinger, T, additional, Herzig, N, additional, Hohenfellner, K, additional, Holla, H, additional, Knerr, C, additional, Koeppl, C, additional, Ockert, C, additional, Passow, M, additional, Rohayem, J, additional, Steidle, G, additional, Thiele, A, additional, Treikauskas, U, additional, Vill, K, additional, Weber, R, additional, and Weitzel, D, additional

Published
2020
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