{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T08:34:16Z","timestamp":1740126856420,"version":"3.37.3"},"reference-count":30,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Klin Monbl Augenheilkd"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background Favorable functional outcomes have been reported after excimer laser-assisted penetrating keratoplasty (EXL PKP). But this technique has not been widely adopted, and there\n\t\t\t\t\tare reports on EXL PKP from only a very limited number of institutions. Some of these results refer to operations carried out with laser systems that are not commercially available. In this\n\t\t\t\t\tretrospective case series, we report the long-term outcome of EXL PKP using the Schwind Amaris 500E laser system.<\/jats:p><jats:p>\n          Material and Methods This retrospective consecutive case series included 30 eyes of 29 patients who had undergone EXL PKP between 2010 and 2013. Primary outcome measures were\n\t\t\t\t\ttopographic astigmatism and visual acuity. Secondary outcome measures were the rates of graft rejection and graft failure, and the rate of grafts with an endothelial cell density below 500\n\t\t\t\t\t\tcells\/mm2. Survival analyses were carried out for the following endpoints: visual acuity, rate of graft rejection, and rate of grafts with endothelial cell densities higher than\n\t\t\t\t\t500 cells\/mm2.<\/jats:p><jats:p>\n          Results The median interquartile range (IQR) duration of follow-up was 45 (36) months. The indications for PKP were keratoconus (n\u2009=\u200921), corneal scarring (n\u2009=\u20096), Fuchs endothelial\n\t\t\t\t\tdystrophy (n\u2009=\u20091), and corneal dystrophy other than Fuchs endothelial dystrophy (n\u2009=\u20092). The median (IQR) topographic astigmatism at the end of the follow-up period was 5.3 (2.9) D.\n\t\t\t\t\tForty-five months after surgery, 73% of all eyes had a visual acuity better than 0.3 LogMAR. The rate of graft rejection after 45 months of follow-up was 32%. All eyes maintained endothelial\n\t\t\t\t\tcell densities higher than 500 cells\/mm2. There was no graft failure.<\/jats:p><jats:p>\n          Conclusions EXL PKP is a safe and effective surgical procedure. No general conclusions can be drawn on the refractive outcome of EXL PKP. Potential advantages, such as a higher\n\t\t\t\t\tdegree of graft-host congruity, that could possibly improve the refractive outcome should be weighed against the higher costs of EXL PKP.<\/jats:p>","DOI":"10.1055\/a-1770-4474","type":"journal-article","created":{"date-parts":[[2022,4,15]],"date-time":"2022-04-15T00:41:35Z","timestamp":1649983295000},"page":"80-85","source":"Crossref","is-referenced-by-count":0,"title":["Long-Term Outcomes of Excimer Laser-Assisted Penetrating Keratoplasty Using a Commercially Available Laser System \u2013 A Retrospective Case Series"],"prefix":"10.1055","volume":"240","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2024-542X","authenticated-orcid":false,"given":"Moritz Claudius","family":"Daniel","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Augenheilkunde, Universit\u00e4tsklinikum Freiburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jana","family":"Jiang","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Augenheilkunde, Universit\u00e4tsklinikum Freiburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5324-7002","authenticated-orcid":false,"given":"Stefan J.","family":"Lang","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Augenheilkunde, Universit\u00e4tsklinikum Freiburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thabo","family":"Lapp","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Augenheilkunde, Universit\u00e4tsklinikum Freiburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikolai","family":"Gross","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Augenheilkunde, Universit\u00e4tsklinikum Freiburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katrin","family":"Wacker","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Augenheilkunde, Universit\u00e4tsklinikum Freiburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"B\u00f6hringer","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Augenheilkunde, Universit\u00e4tsklinikum Freiburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip","family":"Maier","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Augenheilkunde, Universit\u00e4tsklinikum Freiburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Reinhard","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Augenheilkunde, Universit\u00e4tsklinikum Freiburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,4,14]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"666","DOI":"10.1016\/s0002-9394(99)00036-7","article-title":"Three-year clinical outcome after penetrating keratoplasty for keratoconus with the guided trephine system","volume":"127","author":"I Ruhswurm","year":"1999","journal-title":"Am J Ophthalmol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"807","DOI":"10.1007\/s00347-011-2334-9","article-title":"[Perspectives of femtosecond laser-assisted keratoplasty]","volume":"108","author":"F Birnbaum","year":"2011","journal-title":"Ophthalmologe"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"225","DOI":"10.2174\/1874364101711010225","article-title":"Penetrating Keratoplasty for Keratoconus \u2013 Excimer Versus Femtosecond Laser Trephination","volume":"11","author":"B Seitz","year":"2017","journal-title":"Open Ophthalmol J"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1097\/ICO.0000000000000739","article-title":"Comparison of Long-Term Outcomes of Femtosecond Laser-Assisted Keratoplasty with Conventional Keratoplasty","volume":"35","author":"M C Daniel","year":"2016","journal-title":"Cornea"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"953","DOI":"10.1080\/02713680701689781","article-title":"Long-term refractive results of elliptical excimer laser penetrating keratoplasty (EELPK)","volume":"32","author":"N Szentm\u00e1ry","year":"2007","journal-title":"Curr Eye Res"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"478","DOI":"10.1007\/s00347-003-0900-5","article-title":"[Results of the first 1000 consecutive elective nonmechanical keratoplasties using the excimer laser. A prospective study over more than 12 years]","volume":"101","author":"B Seitz","year":"2004","journal-title":"Ophthalmologe"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"804","DOI":"10.3928\/1081-597X-20061001-11","article-title":"Intra-individual variability of penetrating keratoplasty outcome after excimer laser versus motorized corneal trephination","volume":"22","author":"N Szentm\u00e1ry","year":"2006","journal-title":"J Refract Surg"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"3471","DOI":"10.1007\/s12325-019-01120-3","article-title":"Comparison of Excimer Laser Versus Femtosecond Laser Assisted Trephination in Penetrating Keratoplasty: A Retrospective Study","volume":"36","author":"G T\u00f3th","year":"2019","journal-title":"Adv Ther"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"710","DOI":"10.1055\/s-2001-18662","article-title":"[Immunological graft reactions after penetrating keratoplasty \u2013 A prospective randomized trial comparing corneal excimer laser and motor trephination]","volume":"218","author":"B Seitz","year":"2001","journal-title":"Klin Monbl Augenheilkd"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2015\/645830","article-title":"Excimer versus Femtosecond Laser Assisted Penetrating Keratoplasty in Keratoconus and Fuchs Dystrophy: Intraoperative Pitfalls","volume":"2015","author":"M El-Husseiny","year":"2015","journal-title":"J Ophthalmol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"911","DOI":"10.1055\/s-0042-120539","article-title":"Funktionelle Ergebnisse und Transplantatversagen nach Re-Keratoplastik","volume":"234","author":"S Blug","year":"2017","journal-title":"Klin Monbl Augenheilkd"},{"volume-title":"R: A Language and Environment for Statistical Computing","year":"2020","author":"R Core Team","key":"ref12"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1007\/s00417-012-2054-0","article-title":"Clinical results of 123 femtosecond laser-assisted penetrating keratoplasties","volume":"251","author":"F Birnbaum","year":"2013","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1186\/s40662-016-0033-y","article-title":"Corneal surgery in keratoconus: which type, which technique, which outcomes?","volume":"3","author":"F Arnalich-Montiel","year":"2016","journal-title":"Eye Vis (Lond)"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"528","DOI":"10.1097\/ICO.0b013e3181c29705","article-title":"Extended long-term results of penetrating keratoplasty for keratoconus","volume":"29","author":"S Fukuoka","year":"2010","journal-title":"Cornea"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1156","DOI":"10.1016\/S0161-6420(99)90265-8","article-title":"Nonmechanical corneal trephination with the excimer laser improves outcome after penetrating keratoplasty","volume":"106","author":"B Seitz","year":"1999","journal-title":"Ophthalmology"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"563","DOI":"10.1007\/s00347-009-1931-3","article-title":"[Keratoplasty: laminate or penetrate? Part 1: penetrating keratoplasty]","volume":"106","author":"P Maier","year":"2009","journal-title":"Ophthalmologe"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"250","DOI":"10.3928\/1081-597X-19930701-05","article-title":"Astigmatism after penetrating keratoplasty using the Krumeich guided trephine system","volume":"9","author":"S C Belmont","year":"1993","journal-title":"Refract Corneal Surg"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1016\/j.ophtha.2007.04.051","article-title":"Outcomes of same-sizing versus oversizing donor trephines in keratoconic patients undergoing first penetrating keratoplasty","volume":"115","author":"P D Jaycock","year":"2008","journal-title":"Ophthalmology"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1807","DOI":"10.1001\/archopht.1985.01050120041016","article-title":"Oversized donor grafts in penetrating keratoplasty. A randomized trial","volume":"103","author":"D G Heidemann","year":"1985","journal-title":"Arch Ophthalmol"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1097\/00003226-199309000-00006","article-title":"A comparison between donor-recipient corneal size and its effect on the ultimate refractive error induced in keratoconus","volume":"12","author":"M A Javadi","year":"1993","journal-title":"Cornea"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"774","DOI":"10.1016\/s0161-6420(81)34953-7","article-title":"Disparate diameter grafting. Astigmatism, intraocular pressure, and visual acuity","volume":"88","author":"T Perl","year":"1981","journal-title":"Ophthalmology"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1016\/j.survophthal.2007.04.008","article-title":"Corneal graft rejection","volume":"52","author":"A Panda","year":"2007","journal-title":"Surv Ophthalmol"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"1024","DOI":"10.1016\/j.ajo.2011.01.007","article-title":"Graft rejection and graft failure after anterior lamellar versus penetrating keratoplasty","volume":"151","author":"V M Borderie","year":"2011","journal-title":"Am J Ophthalmol"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1097\/ICO.0b013e3181b6489e","article-title":"Large-diameter penetrating keratoplasty: indications and outcomes","volume":"29","author":"H M Skeens","year":"2010","journal-title":"Cornea"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"1005","DOI":"10.1097\/01.ico.0000240098.01468.4c","article-title":"Risk factors for the first episode of corneal graft rejection in keratoconus","volume":"25","author":"A J Epstein","year":"2006","journal-title":"Cornea"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1016\/j.ajo.2012.08.001","article-title":"Long-term outcomes in patients who received a corneal graft for keratoconus between 1980 and 1986","volume":"155","author":"L M Niziol","year":"2013","journal-title":"Am J Ophthalmol"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"607","DOI":"10.1007\/s003470050323","article-title":"[Immunologic graft reactions after nonmechanical corneal trephination using the excimer laser]","volume":"95","author":"B Seitz","year":"1998","journal-title":"Ophthalmologe"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1055\/s-2000-10586","article-title":"[Regression analysis of corneal endothelium after nonmechanical penetrating keratoplasty]","volume":"216","author":"A Langenbucher","year":"2000","journal-title":"Klin Monbl Augenheilkd"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1007\/s004170000225","article-title":"Graft endothelium and thickness after penetrating keratoplasty, comparing mechanical and excimer laser trephination: a prospective randomised study","volume":"239","author":"B Seitz","year":"2001","journal-title":"Graefes Arch Clin Exp Ophthalmol"}],"container-title":["Klinische Monatsbl\u00e4tter f\u00fcr Augenheilkunde"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1770-4474.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,10]],"date-time":"2023-02-10T09:14:08Z","timestamp":1676020448000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1770-4474"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,14]]},"references-count":30,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2023,1,27]]},"published-print":{"date-parts":[[2023,1]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1770-4474","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0023-2165","1439-3999"],"issn-type":[{"type":"print","value":"0023-2165"},{"type":"electronic","value":"1439-3999"}],"subject":[],"published":{"date-parts":[[2022,4,14]]}}}