Within the past two decades, full thickness penetrating keratoplasty (PK) has been largely supplanted by lamellar endothelial keratoplasty (EK) procedures that have revolutionized the treatment of... Show moreWithin the past two decades, full thickness penetrating keratoplasty (PK) has been largely supplanted by lamellar endothelial keratoplasty (EK) procedures that have revolutionized the treatment of corneal endothelial diseases such as Fuchs endothelial dystrophy. Since the introduction of EK in 1998, these techniques have undergone continuous transition, from Deep lamellar endothelial keratoplasty (DLEK) to Descemet stripping (automated) endothelial keratoplasty (DSEK/DSAEK) and eventually to Descemet membrane endothelial keratoplasty (DMEK). While the graft in DLEK and DSEK/DSAEK consists of endothelium, Descemet membrane and stroma, in DMEK only an isolated Descemet membrane with its endothelium, devoid of stroma, is transplanted. Notably, the thinner graft used in DMEK may have three main advantages over earlier techniques: Faster and better visual rehabilitation, predictable small refractive change, and a reduced risk of immunologic reactions. This thesis will investigate the clinical outcomes after DMEK, the latest refinement of lamellar endothelial keratoplasty techniques. The focus will be on DMEK graft survival and on allograft rejection (and its prediction), a complication that may potentially lead to graft failure and hereby reduce the overall survival probability. Show less
The main aim of this thesis is to evaluate the clinical risk factors and imaging techniques for the diagnosis and to analyze the treatment outcomes of Ruthenium-106 plaque brachytherapy for iris... Show moreThe main aim of this thesis is to evaluate the clinical risk factors and imaging techniques for the diagnosis and to analyze the treatment outcomes of Ruthenium-106 plaque brachytherapy for iris and iridociliary melanomas in terms of tumor regression and its complications, survival and development of metastasis. This thesis also focuses on the differential diagnosis of iris melanomas. Understanding of these subjects can assist ophthalmologists in the diagnosis and evidence-based management of iris melanomas, therefore avoiding unnecessary treatment of an iris naevus. Show less
