Ophthalmologists
21 years of experience

Accepting new patients
Northwest Dallas
5323 Harry Hines Blvd
Dallas, TX 75390
214-648-3837
Locations and availability (3)

Education ?

Medical School Score
Louisiana State University at New Orleans (1989)
  • Currently 2 of 4 apples

Awards & Distinctions ?

Awards  
Luis Perez Memorial Award in Ophthalmology
Best Doctors in America (2005)
Luis Perez Memorial Award in Ophthalmology (1989)
Best Doctors in America (2002)
Associations
American Board of Ophthalmology
American Academy of Ophthalmology

Affiliations ?

Dr. Verity is affiliated with 8 hospitals.

Hospital Affilations

Score

Rankings

  • Children's Medical Center of Dallas
    1935 Motor St, Dallas, TX 75235
    • Currently 4 of 4 crosses
    Top 25%
  • UT Southwestern University Hospital - Zale Lipshy
    5151 Harry Hines Blvd, Dallas, TX 75235
    • Currently 4 of 4 crosses
    Top 25%
  • UT Southwestern University Hospital - St. Paul
    5909 Harry Hines Blvd, Dallas, TX 75235
    • Currently 4 of 4 crosses
    Top 25%
  • Parkland Health & Hospital System
    5201 Harry Hines Blvd, Dallas, TX 75235
    • Currently 1 of 4 crosses
  • Cardinal Glennon Childrens Hospital
  • St Louis University Hospital
  • UT Southwestern St Paul Hospital
  • UT Southwestern Zale Lipshy Hospital
  • Publications & Research

    Dr. Verity has contributed to 25 publications.
    Title Apodized Diffractive Intraocular Lens Implantation After Laser in Situ Keratomileusis with or Without Subsequent Excimer Laser Enhancement.
    Date December 2010
    Journal Journal of Cataract and Refractive Surgery
    Excerpt

    To evaluate the long-term refractive and visual outcomes of apodized diffractive multifocal intraocular lens (IOL) implantation after myopic laser in situ keratomileusis (LASIK) with or without subsequent excimer laser enhancement.

    Title Ophthalmic Manifestations of Stevens-johnson Syndrome and Toxic Epidermal Necrolysis and Relation to Scorten.
    Date October 2010
    Journal American Journal of Ophthalmology
    Excerpt

    To evaluate the severity of ocular involvement of patients with Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and SJS/TEN overlap, and to investigate the relationship of the SCORTEN (a severity-of-illness score for SJS and TEN based on a minimal set of well-defined variables calculated within 24 hours of admission) with eye disease in this patient population.

    Title Laser in Situ Keratomileusis for Residual Refractive Errors After Apodized Diffractive Multifocal Intraocular Lens Implantation.
    Date August 2009
    Journal Journal of Cataract and Refractive Surgery
    Excerpt

    To evaluate the visual and refractive outcomes of laser in situ keratomileusis (LASIK) to correct residual refractive error after apodized diffractive multifocal intraocular lens (IOL) implantation.

    Title Outcomes of Permavision Intracorneal Implants for the Correction of Hyperopia.
    Date June 2009
    Journal American Journal of Ophthalmology
    Excerpt

    To report the clinical and visual outcomes of a series of patients implanted with the PermaVision intracorneal lens (ReVision Optics Inc, Lake Forest, California, USA) for correction of hyperopia.

    Title Assessment of Keratocyte Activation Following Lasik with Flap Creation Using the Intralase Fs60 Laser.
    Date October 2008
    Journal Journal of Refractive Surgery (thorofare, N.j. : 1995)
    Excerpt

    To assess the response of corneal keratocytes to the IntraLase FS60 femtosecond laser using attenuated steroids.

    Title Intraocular Lens Power Calculation After Radial Keratotomy: Estimating the Refractive Corneal Power.
    Date July 2007
    Journal Journal of Cataract and Refractive Surgery
    Excerpt

    PURPOSE: To evaluate the most accurate method for corneal power determination in patients with previous radial keratotomy (RK). SETTING: University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA. METHODS: A retrospective review of data for 16 eyes of 14 patients with a history of RK and subsequent phacoemulsification and posterior chamber intraocular lens (IOL) implantation was performed. Outcome measures included axial length, postoperative topography, type and power of IOL implanted, and postoperative spherical equivalent (SE) refraction at 3 to 6 months. Average central corneal power (ACCP) was defined as the average of the mean powers of the central Placido rings. For each eye, simulated K-readings and different values of ACCP computed corresponding to different central corneal diameters were used in each case, along with the implanted IOL power, to back-calculate the SE refraction (Ref) via the double-K adjusted Holladay 1 IOL formula. The predicted refractive error was hence computed as (Ref - SE), both in algebraic and absolute values. RESULTS: The ACCP over the central 3.0 mm (ACCP(3mm)) yielded the lowest absolute predicted refractive error (0.25 +/- 0.38 diopters [D]), which was statistically lower than the error for ACCP(1mm) (P<.001) and for the simulated K-value (P = .033). It also resulted in 87.5% of eyes being within +/-0.50 D and 100% within +/-1.00 D of the actual postoperative refraction. CONCLUSIONS: Corneal refractive power after RK was best described by averaging the topographic data of the central 3.0 mm area. Applying this method, together with a double-K IOL formula, achieved excellent IOL power predictability.

    Title Comparison of the Corneal Response to Laser in Situ Keratomileusis with Flap Creation Using the Fs15 and Fs30 Femtosecond Lasers: Clinical and Confocal Microscopy Findings.
    Date June 2007
    Journal Journal of Cataract and Refractive Surgery
    Excerpt

    PURPOSE: To compare the response of the cornea to laser in situ keratomileusis (LASIK) with flap creation using the IntraLase FS15 or FS30 femtosecond laser (IntraLase Corp.). SETTING: Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, Texas, USA. METHODS: Twenty-three patients (31 eyes) who had LASIK with flap creation using the FS15 or FS30 laser were assessed by clinical examination and confocal microscopy in a nonrandomized parallel treatment group comparative trial. Eight FS15 patients (15 eyes) were examined preoperatively and 3 months postoperatively, and 14 FS30 patients (15 eyes) were examined 3 months postoperatively. RESULTS: No patient in either group had clinically significant flap interface haze. One FS15 eye and 1 FS30 eye had significant keratocyte activation at the flap interface. The mean difference between the actual flap thickness and intended flap thickness was 16.8 microm +/- 11.1 (SD) and 13.9 +/- 7.1 microm in the FS15 group and FS30 group, respectively (P = .49). The mean measured interface reflectivity was 156.4 +/- 88.6 confocal backscatter units (CBU) and 104.8 +/- 91.2 CBU, respectively (P = .15). The mean density of interface particles was 21.4 +/- 14.8 particles/mm(2) in the FS15 group and 11.0 +/- 7.1 particles/mm(2) in the FS30 group (P<.05). CONCLUSIONS: Both the FS15 and FS30 lasers provided more reproducible flap thickness and fewer interface particles than previously observed using microkeratomes. The response of corneal keratocytes to intra-LASIK was reduced compared with previous results in which higher raster energies were used. Compared with the FS15, there was an apparent reduction in overall interface reflectivity and fewer interface particles with the FS30 laser.

    Title Prospective Evaluation of Permavision Intracorneal Implants Using in Vivo Confocal Microscopy.
    Date June 2007
    Journal Journal of Refractive Surgery (thorofare, N.j. : 1995)
    Excerpt

    PURPOSE: To report effects of the PermaVision intracorneal lens at the cellular level using in vivo confocal microscopy. METHODS: Four eyes implanted with intracorneal lenses beneath an IntraLase flap for correction of hyperopia were evaluated preoperatively and 1 to 6 months postoperatively. RESULTS: Intracorneal lenses were tolerated in three eyes with little or no haze observed clinically and good visual results. Minimal keratocyte activation was detected by confocal microscopy, and cell density was decreased posterior to the implants. Epithelial thinning was observed 1 month after implantation. Thickness stabilized by 6 months but remained thinner than baseline (33 +/- 2 microm vs 48 +/- 8 microm, P < .01). The fourth eye had a complicated course with early flap displacement followed by diffuse lamellar keratitis. Confocal microscopy revealed activated keratocytes throughout the anterior stroma. The implant was removed, and recovery was promising. CONCLUSIONS: Implantation of intracorneal lenses can induce side effects of epithelial thinning, keratocyte loss, and keratocyte activation.

    Title Evaluation of Intrastromal Lipid Deposits After Intacs Implantation Using in Vivo Confocal Microscopy.
    Date September 2006
    Journal Eye & Contact Lens
    Excerpt

    PURPOSE: To assess the structure and location of intrastromal lipid deposits after implantation of Intacs by using in vivo confocal microscopy. METHODS: Seven eyes of six patients were examined by in vivo confocal microscopy 5 years (n = 6) or 2 months (n = 1) after uncomplicated implantation of Intacs for the correction of mild myopia. Selected images from all corneal layers were qualitatively evaluated for structural changes, with special attention paid to areas surrounding the Intacs implants. RESULTS: In the peripheral cornea of eyes examined 5 years after surgery, epithelial and endothelial cell layers appeared normal. Tandem scanning confocal microscopy showed stromal haze surrounding the implants in all eyes examined, but no keratocyte activation was seen. Reflective amorphous or crystalline structures consistent with lipid deposition were detected in all eyes with long-term implantation of Intacs. Deposits were localized to the inner and outer edges of Intacs segments and to the region anterior to the implant. Confocal microscopy did not show any deposits in the eye examined 2 months after surgery, although the region anterior to the implant appeared hazy and edematous. Areas central to the implant appeared normal in all eyes. CONCLUSIONS: The mechanical and physiologic stresses introduced by the implantation of Intacs lead to the accumulation of lipid deposits in the extracellular matrix. By using in vivo confocal microscopy, the location and structure of these deposits can be determined.

    Title Confocal Assessment of the Corneal Response to Intracorneal Lens Insertion and Laser in Situ Keratomileusis with Flap Creation Using Intralase.
    Date August 2006
    Journal Journal of Cataract and Refractive Surgery
    Excerpt

    PURPOSE: To assess the response of the cornea to hydrogel intracorneal lens (ICL) insertion or laser in situ keratomileusis (LASIK) with IntraLase (IntraLase Corp.) at the cellular level. SETTING: Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, Texas, USA. METHODS: Twenty patients (29 eyes) were evaluated by in vivo confocal microscopy 1 to 6 months postoperatively: 20 eyes had LASIK with flap creation by IntraLase, and 9 eyes had ICL insertion (8 following IntraLase). RESULTS: For LASIK with IntraLase, keratocyte activation and/or interface haze was detected in 8 of 20 eyes. The remaining eyes had interface particles but no cell activation. Keratocyte activation was generally limited to a few cell layers adjacent to the interface. However, 2 patients exhibited multiple layers of activation and increased extracellular matrix (ECM) reflectivity (haze) surrounding the interface by confocal microscopy. Both patients also had clinical haze and photophobia. For ICLs, following insertion, 5 of 9 eyes had activated keratocytes adjacent to the implant surfaces. The largest amount of cell activation and ECM haze detected by confocal microscopy was in 2 patients with significant clinical haze. Structures with an epithelioid morphology were detected on some implant surfaces. Epithelial thickness was 33.3 microm +/- 2.3 (SD) in the ICL eyes and 49.2 +/- 6.5 microm in the LASIK with IntraLase eyes. CONCLUSIONS: Both LASIK with IntraLase and ICL insertion following IntraLase induced keratocyte activation, which may underlie clinical observations of haze in some patients. Intracorneal lens implant also induced thinning of the overlying corneal epithelium.

    Title Two-year Outcomes of Intrastromal Corneal Ring Segments for the Correction of Myopia.
    Date September 2001
    Journal Ophthalmology
    Excerpt

    OBJECTIVE: To evaluate the safety and efficacy of Intrastromal Corneal Ring Segments (ICRS) for the correction of myopia. DESIGN: Nonrandomized, comparative trial. PARTICIPANTS: Patients enrolled in the United States Food and Drug Administration phase II and phase III clinical trials of the ICRS had best spectacle-corrected visual acuity (BSCVA) of 20/20 or better, myopia of -1.00 to -3.50 diopters (D), and a cylindrical correction of 1.00 D or less as measured by manifest refraction. INTERVENTION: Surgical correction of myopia with an ICRS. MAIN OUTCOME MEASURES: Efficacy was assessed by predictability of refractive outcome (deviation from predicted cycloplegic refraction spherical equivalent), stability of refractive effect, and postoperative uncorrected visual acuity. Safety was assessed by adverse events, maintenance or loss of preoperative BSCVA, and induced manifest refraction cylinder. RESULTS: Four hundred fifty-two patients were enrolled at 11 investigational sites in both studies. Of the 454 surgical attempts, 449 received an ICRS in one eye (0.25, 0.30, and 0.35 mm in 148, 151, and 150 eyes, respectively). First surgeries were attempted in 452 patients. An ICRS was successfully implanted in 447 initial eyes, and 5 surgeries were discontinued. Of the five discontinued surgeries, three patients subsequently exited from the study, and two patients went on to have the ICRS implanted in the second eye, bringing the total number of successful implants to 449 patient eyes. Month 24 postoperative follow-up was completed on 358 patients (80%). At month 24, 328 of 354 eyes (93%) were within +/-1.00 D of predicted refractive outcome. Refraction changed by 1 D or less in 97% of eyes (421/435) between 3 and 6 months after implantation and in 99% (343/348) between months 18 and 24. Before surgery, 87% of eyes (390/448) saw worse than 20/40 uncorrected; 24 months after surgery, 55% of eyes (196/358) saw 20/16 or better, 76% (271/358) saw 20/20 or better, and 97% (346/358) saw 20/40 or better. Although two eyes (2/358; 0.5%) lost two or more lines of BSCVA at 24 months; visual acuity in both was 20/20 or better. Intraoperative complications included anterior corneal surface perforation (three eyes) and anterior chamber perforations (two eyes, one during an attempted exchange procedure); all healed spontaneously without suturing and without loss of BSCVA. The ICRS was repositioned in five eyes to increase correction. Postoperative complications in one eye each were infectious keratitis, shallow segment placement, and loss of two lines of BSCVA at two or more consecutive examinations (subsequently regained). CONCLUSIONS: The ICRS safely, predictably, and effectively reduced or eliminated myopia of -1.00 to -3.50 D. The refractive effect was stable over time.

    Title Intrastomal Corneal Ring Segments: Reversibility of Refractive Effect.
    Date March 2001
    Journal Journal of Refractive Surgery (thorofare, N.j. : 1995)
    Excerpt

    PURPOSE: To evaluate the reversibility of refractive effect following removal of the ICRS (intrastromal corneal ring segments; Intacs). METHODS: Data from 34 eyes from which ICRS were removed during United States FDA Phase II and III clinical trials were evaluated with regard to segment size, loss or change of best spectacle-corrected visual acuity (BSCVA), any change of uncorrected visual acuity (UCVA), manifest spherical equivalent refraction, manifest cylinder refraction, stability of manifest cylinder refraction, and subjective visual symptoms. RESULTS: Out of 725 initial or contralateral eyes placed with the ICRS during Phase II and III clinical trials, segments were removed from 34 eyes (4.7%). Other than one (1/725, 0.1%) safety related ICRS removal, 30/725 (4.1%) were due to visual symptoms. ICRS removal was accomplished under topical anesthesia without complications in all eyes. The mean length of time the segments remained in the cornea after initial surgery was 10.3 +/- 5.4 months. At 3 months after ICRS removal, 21 eyes had monitored data available and were within +/-1 line or 10 letters of their preoperative BSCVA. Twenty eyes (20/21, 95%) returned to within +/-1.00 D of their preoperative manifest spherical equivalent refraction. All eyes had a stable refraction at the 3-month examination after removal, and a manifest spherical equivalent refraction within +/-1.00 D of their 1-month examination after removal. Nineteen eyes (19/21, 90%) returned to within +/-2 lines and 16 eyes (16/21, 76%) returned to within +/-1 line of preoperative UCVA. CONCLUSION: The ICRS (Intacs) was easily and safely removed, and eyes returned to preoperative refractive status within 3 months.

    Title Two-incision Radial Keratotomy for Low Myopia with Astigmatism.
    Date September 1997
    Journal Journal of Cataract and Refractive Surgery
    Excerpt

    PURPOSE: To evaluate the effectiveness of two-incision radial keratotomy (RK) in correcting low-magnitude refractive myopic astigmatism. SETTING: Two clinical study sites, one in St. Louis, Missouri, USA, the other in Caracas, Venezuela. METHODS: Fifty-seven eyes of 43 patients with low-magnitude myopic astigmatism had two-incision RK at one of two clinical study sites. In the initial phase of this series, 10 eyes with amblyopia at the 20/30 level had surgery at one center. Refractive keratotomy was performed with the radial incision placed in the plus cylinder axis of refraction. This axis was verified as the meridian of greatest corneal curvature by standard keratometry and computer-assisted corneal topographic analysis. Two eyes received a second operation (enhancement). RESULTS: Mean follow-up was 11.1 months (range 6 to 12 months). Mean preoperative and postoperative myopic spherical equivalent measured -1.42 diopters (D) +/- 0.51 (SD) and -0.14 +/- 0.39 D, respectively; the mean reduction was 1.28 +/- 0.59 D (P = .0001). Mean preoperative and postoperative refractive astigmatism was 1.41 +/- 0.45 D and 0.48 +/- 0.33 D, respectively (P = .0001). Mean preoperative and postoperative keratometric astigmatism was 1.26 +/- 0.54 D and 0.31 +/- 0.35 D, respectively, a mean reduction of 0.95 D (P = .0001). The surgical meridian was flattened by an average of 2.06 D by keratometry and the orthogonal meridian, by an average of 1.10 D. Preoperative uncorrected visual acuity (UCVA) was 20/40 or better in five (9%) eyes (range counting fingers to 20/40). Postoperative UCVA acuity was 20/40 or better in all eyes (mean acuity 20/25). In the nonamblyopic subgroup mean postoperative UCVA was 20/24. CONCLUSIONS: A limited number of radial incisions placed in the topographically confirmed axis of greatest curvature are effective in the treatment of low-magnitude myopic astigmatism.

    Title Macular Corneal Dystrophy Type Ii: Multiple Studies on a Cornea with Low Levels of Sulphated Keratan Sulphate.
    Date August 1997
    Journal Eye (london, England)
    Excerpt

    We investigated an individual macular corneal dystrophy (MCD) type II cornea from a 42-year-old woman with markedly reduced antigenic keratan sulphate levels. A characteristic 4.6 A X-ray reflection was evident, and the mid-stroma contained 30% less sulphur than normal. Close packing of collagen was restricted to the superficial stroma. Abnormally large proteoglycan filaments were noted throughout the extracellular matrix and Descemet's membrane's posterior non-banded zone, but not its anterior banded zone. Small, collagen-associated stromal proteoglycans were susceptible to digestion with chondroitinase ABC, but not keratanase I or N-glycanase. On occasion, collagen fibrils ranged in size from 20 nm to 58 nm, with preferential diameters of 34 nm and 42 nm. Corneal guttae were evident, as were numerous endothelial inclusions, most probably due to intracellular fibrillogranular vacuoles similar to those found in the stroma. The endothelium expressed reduced anti-keratan sulphate labelling.

    Title Organization of Collagen in the Lyophilized Cornea.
    Date June 1997
    Journal Journal of Refractive Surgery (thorofare, N.j. : 1995)
    Excerpt

    PURPOSE: To investigate the organization of collagen fibrils in the lyophilized cornea. METHODS: Freshly harvested porcine corneas (n = 10) were lyophilized and examined by synchrotron x-ray diffraction and transmission electron microscopy. RESULTS: Collagen fibrils are highly compacted in lyophilized corneas. They become more widely spaced when the tissue is rehydrated, however, the distribution of imbibed water throughout the stroma is not necessarily homogeneous within an individual cornea, nor is it always similar in specimens that have been rehydrated to similar levels. In lyophilized corneas, the mean center-to-center interfibrilar spacing of the regularly arranged collagen reaches levels found in freshly thawed porcine corneas (between 74% and 78% water by weight) when between 74.3% and 81.6% of the rehydrated lyophilized cornea's weight is water. CONCLUSION: Regularly arranged collagen fibrils are able to reapproximate their original spacings if lyophilized corneal tissue is rehydrated, although the manner in which imbibed water is distributed is somewhat unpredictable.

    Title The Combined (genesis) Technique of Radial Keratotomy. A Prospective, Multicenter Study. Refractive Keratoplasty Study Group.
    Date May 1997
    Journal Ophthalmology
    Excerpt

    PURPOSE: A prospective, multicenter, clinical study to evaluate a standardized surgical (Genesis) protocol which includes combined-technique radial incisions in patients seeking reduction of their physiologic myopia. The combined incisions were designed to incorporate the safety of the centrifugal incision technique with the efficacy of the centripetal incision technique. METHODS: A total of 375 eyes undergoing radial keratotomy procedures performed in six different clinical centers were analyzed. All procedures were performed in accordance with the Genesis nomograms. The Genesis protocol called for using preoperative screening pachymetry to guide central clear zone size selection, incising the thinnest corneal quadrant first, suturing corneal perforations, and discouraged more than one enhancement procedure, when indicated. Globe fixation technique served as a study variable. RESULTS: Mean follow-up was 6.2 months (range, 1.5-12 months). Mean residual cycloplegic refraction was -0.48 +/- 0.61 diopters (D) (range, -2.50 to +1.50 D); 92% of eyes were within 1 D of the planned goal of -0.50 D and 85% were within 1 D of emmetropia; 14% were myopic; and 1% was hyperopic by more than 1 D. Uncorrected visual acuity was 20/40 or better in 95% of eyes; the remaining 5% retaining myopic refractive errors. A single procedure was performed in 73% of eyes, and 99% received less than two enhancements. Of eyes with no enhancements, 97% had uncorrected visual acuity of 20/40 or better. One study eye (0.3%) had a two-line loss of spectacle visual acuity. There were no invasions of the central clear zone. Globe fixation was a significant predictor for enhancement incidence (P < 0.001) but not for perforation incidence (P = 0.06). Incision sequence was predictive for perforation incidence (P < 0.0002). CONCLUSION: The combined-technique of radial keratotomy, coupled with the Genesis surgical protocol, affords centrifugal incision safety with centripetal incision efficacy. The Genesis nomograms, with a built in refractive outcome goal of -0.50 D provide an acceptable degree of accuracy and predictability while guarding against hyperopic overcorrection.

    Title Onlay Lamellar Refractive Keratoplasty.
    Date November 1994
    Journal Seminars in Ophthalmology
    Title Accuracy and Precision of the Corneal Analysis System and the Topographic Modeling System.
    Date May 1992
    Journal Cornea
    Excerpt

    Two computer-assisted topographic analysis systems were evaluated with calibrated spherical surfaces and normal human corneas. The Topographic Modeling System-1 (TMS-1) was found to be statistically more accurate in determining the power of calibrated spheres near the apex and at 1 mm from the apex than the Corneal Analysis System (CAS). The CAS, however, was statistically more accurate at 3 mm from the apex with each calibrated sphere. The small differences in accuracy between the two instruments, however, are unlikely to be of clinical significance. The topographic patterns on color-coded maps from 22 normal corneas of 11 subjects were similar with the two instruments. Simulated keratometry values with the CAS more accurately identified the keratometer-determined major cylinder axis compared with the TMS-1. Conversely, the TMS-1 was more accurate than the CAS at determining the level of corneal astigmatism.

    Title Fate of Lyophilized Xenogeneic Corneal Lenticules in Intrastromal Implantation and Epikeratophakia.
    Date April 1987
    Journal Investigative Ophthalmology & Visual Science
    Excerpt

    The antigenicity of intrastromal and epikeratophakia xenografts of lyophilized corneal tissue was evaluated in nonimmune and immune recipients. Lyophilized feline lenticules were implanted into intrastromal pockets in unsensitized rabbits and rabbits sensitized to the donor cat. In both cases, the grafts remained clear. Sensitized rabbits with clear intrastromal grafts received fresh tissue penetrating keratoplasty grafts from the same donor cat, placed adjacent to the intrastromal grafts. The fresh tissue penetrating keratoplasty grafts were rapidly rejected, while the lyophilized intrastromal grafts remained clear. Cats sensitized to rabbits received lyophilized and rehydrated epikeratophakia grafts shaped from rabbit cornea; these lyophilized grafts also remained clear for the 3-month period of the study. The results indicate that lyophilized and rehydrated corneal stroma, which is devoid of living cells, is not antigenic and is not subjected to immunologic attack, even in cases where the donor and host are of different species and the host has been previously immunized to the donor.

    Title Peripheral Corneal Disorders.
    Date October 1986
    Journal Survey of Ophthalmology
    Excerpt

    The peripheral cornea is anatomically and physiologically distinct from its central counterpart. The major differences relate to the gradual transition of corneal tissues to those of the conjunctiva, episclera, and sclera; furthermore, the vascular structures, lymphatics, and inflammatory cells from these neighboring structures are intimately associated with the limbus and periphery of the cornea. The peripheral cornea is thereby predisposed to three main classes of disorders which do not normally involve the central cornea. First, local conditions affecting the sclera and conjunctiva may secondarily spread to involve the limbus and peripheral cornea. These include several infectious diseases, as well as hypersensitivity conditions, mass lesions, and degenerations. Second, due to the associated blood vessels and lymphatics, the peripheral cornea may be involved in a variety of systemic diseases, including vasculitides, autoimmune disorders, and abnormal metabolic conditions. Finally, there are several conditions, such as the noninflammatory peripheral degenerations, which primarily affect the peripheral cornea without associated ocular or systemic changes. In this review, we present a classification and discussion of the various disorders which may involve the peripheral cornea.

    Title Five Year Follow-up of Epikeratophakia in Children.
    Date June 1986
    Journal Ophthalmology
    Excerpt

    Epikeratophakia alters the anterior curvature of the cornea by the addition of a machine-carved donor lenticule. Since March 1980, 88 patients under eight years of age have had epikeratophakia, with at least six months of follow-up. Eighty percent of the original surgeries were successful; some failed grafts were replaced successfully, so that in all, 89% of the patients had successful grafts. The average increase in curvature of the cornea was 14.7 diopters, and the average spectacle overcorrection was +0.56 diopters. In these growing eyes, we documented a myopic shift of 1.5 diopters per year. Visual acuity results varied with the timing of refractive surgery, density of the amblyopia, and the parents' ability to maintain the patching schedule. The largest group of children were those who had unilateral traumatic cataracts. In this group, 7 of 15 patients who had surgery under 4 years of age had final verbal acuities of 20/40 or better. Long-term follow-up has demonstrated that epikeratophakia safely and successfully corrects refractive errors in aphakic children either as a primary procedure, or as a secondary procedure after cataract extraction.

    Title Antibody Response Following Implantation of Xenogenic Lenticules.
    Date September 1985
    Journal Cornea
    Excerpt

    Rabbits underwent implantation of either lyophilized or fresh porcine lenticules into the central or peripheral cornea. All animals were followed for up to four months by slit-lamp examination and macrophotography to determine implant rejection. Serum antibody levels to soluble porcine cornea extract were determined by an enzyme-linked immunosorbant assay. Only those animals receiving lenticules into the peripheral cornea experienced a rejection and developed an antibody response to the porcine cornea extract. The production of antibody preceded the appearance of vascularization of the implanted lenticules. Thus, the site of lenticule implantation, not the type of tissue preparation, determined the outcome of the graft.

    Title Myopic Extended Wear Contact Lenses in 100 Patients: a Retrospective Study.
    Date February 1985
    Journal The Clao Journal : Official Publication of the Contact Lens Association of Ophthalmologists, Inc
    Title Keratophakia with Lyophilized Cornea Lathed at Room Temperature: New Techniques and Experimental Surgical Results.
    Date January 1984
    Journal Ophthalmic Surgery
    Excerpt

    A modified method of prelathing lyophilized corneal tissue at room temperature for refractive keratoplasty is described. This method allows perfect centration of a lyophilized corneal button on the plastic base and thus more accurate lathing. Keratophakia was performed with lenticules prepared in this fashion on a series of eight cats which were followed for 30 weeks postoperatively. All lenticules were clear ten weeks following surgery and the final optical correction obtained varied +/- 2.5 D from the intended correction.

    Title Comparative Study of Descemet Stripping Automated Endothelial Keratoplasty Donor Preparation by Moria Cbm Microkeratome, Horizon Microkeratome, and Intralase Fs60.
    Date
    Journal Cornea
    Excerpt

    PURPOSE:: To evaluate the quality of stromal bed and the safety on endothelium in preparation of donor tissue for Descemet stripping automated endothelial keratoplasty in a masked fashion using 2 mechanical microkeratomes and a femtosecond laser. METHODS:: Deep anterior lamellar dissection was performed on 15 donor corneas. Central endothelial cell density was calculated using specular microscopy before and after the dissection. One cornea from each of 5 donor pairs was cut with the Moria ALTK system with the CBm microkeratome using the 300-μm head and the mate cut with the Horizon disposable 300-μm microkeratome. Five additional donor corneas were cut with the Intralase 60-kHz FS laser. The donor corneas were then bisected with half of the cornea used for Live/Dead assay to study central endothelial viability. The other halves were sent for scanning electron microscopy of the stromal bed. Qualitative surface roughness of the scanning electron microscopy images was graded by 2 masked observers, and quantitative surface roughness was assessed using roughness evaluation software. RESULTS:: The Horizon group showed a smoother stromal bed compared with the Moria or Intralase groups by 2 masked observers. However, the Moria group had the smoothest quantitative score of all the groups when assessed by roughness evaluation software. There was no statistically significant difference among the 3 groups in the percentage change in the central endothelial cell density or percentage of viable central endothelium by Live/Dead assay after the dissection. CONCLUSIONS:: Both mechanical microkeratomes created smoother stromal bed dissections than the femtosecond laser. All systems provided good endothelial cell viability.


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