Julia Talajic
Université de Montréal
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American Journal of Ophthalmology | 2012
Julia Talajic; Younes Agoumi; Sébastien Gagné; Krystel Moussally; Mona Harissi-Dagher
PURPOSE To report glaucoma outcomes after Boston type 1 keratoprosthesis (KPro) surgery, in particular, glaucoma prevalence, progression, and treatment. DESIGN Consecutive, retrospective, interventional case series. METHODS setting: Tertiary care institution. study population: Thirty-eight eyes in 38 patients. intervention: KPro surgery. main outcome measures: Visual acuity (VA), intraocular pressure, visual fields, optic nerve status, and glaucoma treatment. RESULTS Glaucoma diagnosis was known before surgery in 29 patients (76%; 14 had undergone previous surgery) and was diagnosed after surgery in 34 patients (89%) after a mean ± standard deviation of 16.5 ± 4.7 months of follow-up. The number of patients taking intraocular pressure-lowering medications increased from 19 (50%) before surgery to 28 (76%) after surgery (P = .017). Twenty-four patients (63%) were taking at least 1 additional glaucoma medication at their most recent postoperative visit. Eight patients (21%) had glaucoma progression (visual field progression, need for surgery, or both). Fifteen patients (40%) had a cup-to-disc ratio of 0.85 or more. Five patients required glaucoma surgery. VA was limited by glaucoma in 14 patients (37%), 11 of whom had a VA of 20/200 or worse. Five such patients (13%) had a dramatic improvement in VA, then progressed to end-stage glaucoma with fixation loss. Visual fields were limited by glaucoma in 25 patients (66%; mean Swedish Interactive Threshold Algorithm Fast mean defect, -20.3 ± 8.8 decibels; n = 18). CONCLUSIONS Most KPro candidates have glaucoma, which may deteriorate in a subset of patients after surgery. Dramatic VA improvement after KPro surgery does not preclude the need for rigorous monitoring for glaucoma progression. A low threshold should be used to treat suspicion of even slightly elevated intraocular pressure.
American Journal of Ophthalmology | 2014
Salima Hassanaly; Julia Talajic; Mona Harissi-Dagher
PURPOSE To describe outcomes after Boston Type 1 Keratoprosthesis (KPro) surgery in aniridic eyes. DESIGN Retrospective, interventional case series. METHODS SETTING University-based tertiary care institution. PATIENT POPULATION Twenty-six aniridic eyes of 19 patients who underwent KPro implantation by a single experienced surgeon (M.H.-D.) between October 27, 2008 and January 16, 2012. MAIN OUTCOME MEASURES Preoperative and postoperative best-corrected visual acuity (BCVA), intraoperative and postoperative complications, and keratoprosthesis retention. RESULTS Mean age was 56 years (range, 28-72); 10 patients were male. Seven patients had bilateral procedures. No intraoperative complications were encountered. Preoperatively, BCVA was 20/300 or worse in all eyes. After a mean follow-up time of 28.7±13.5 months (range 4-50), the most recent BCVA was 20/200 or better in 14 eyes. Visual potential was limited by preexisting terminal glaucoma (n=2), phthisis after retinal detachment (n=4), and suprachoroidal hemorrhage (n=2). Other postoperative complications included retroprosthetic membrane formation (n=15), infectious keratitis (n=1), extrusion (n=2), and corneal melt (n=4). Uncomplicated vitritis was reported in 6 eyes. No endophthalmitis occurred in this series. Most eyes have glaucoma and are on medical treatment. The overall retention rate of the initial prosthesis was 77%. CONCLUSIONS The prognosis in aniridic patients after KPro is variable. Meticulous follow-up and a subspecialty team approach are of utmost importance.
International Ophthalmology Clinics | 2013
Julia Talajic; Michael D. Straiko; Mark A. Terry
The first successful human EK dates back to 1956, when Tillet sutured a posterior stromal graft to the overlying recipient stroma after creating an anterior flap. However, this and other early EK techniques were wrought with the disadvantages associated with graft suturing. It was not until Melles et al used air to hold a posterior lamellar graft in place in 1998 that modern-day EK was born. This procedure, named posterior lamellar keratoplasty, performed through a 9-mm limbal incision, had the advantages of rapid visual recovery, conservation of the cornea’s anterior topography, and better tectonic strength than PK. Terry modified posterior lamellar keratoplasty with the introduction of new instruments, an artificial anterior chamber (AC), and cohesive viscoelastic. He debuted deep lamellar endothelial keratoplasty (DLEK) in a prospective clinical trial in the United States in 2000. Melles et al introduced his ‘‘descemetorhexis’’ in 2004, eliminating the challenging step of manual dissection and excision of the recipient posterior stroma before graft insertion. Price and Price’s ensuing modified procedure was called Descemet’s stripping endothelial keratoplasty (DSEK). In
Archive | 2015
Julia Talajic; Michael D. Straiko; Mark A. Terry
Investigative Ophthalmology & Visual Science | 2014
Julia Talajic; Cor van Zyl; Michael D. Straiko; Zachary M. Mayko; Mark A. Terry
Investigative Ophthalmology & Visual Science | 2013
David Davis-Boozer; Mark A. Terry; Michael D. Straiko; Julia Talajic; Asem A. Alqudah; Mark A. Greiner
Graefes Archive for Clinical and Experimental Ophthalmology | 2018
Milad Modabber; Julia Talajic; Michèle Mabon; Mathieu Mercier; Samir Jabbour; Johanna Choremis
Investigative Ophthalmology & Visual Science | 2013
Michael D. Straiko; Mark A. Terry; Julia Talajic; David Davis-Boozer
Investigative Ophthalmology & Visual Science | 2013
Julia Talajic; Mark A. Terry; Michael D. Straiko; Asem A. Alqudah; David Davis-Boozer
Investigative Ophthalmology & Visual Science | 2013
Jeffrey D. Holiman; Julia Talajic; David Davis-Boozer; Mark A. Terry