PhD students

Current PhD projects


Indre Vasiliauskaite
In her PhD thesis, Indre focuses on assessing clinical outcomes and graft survival after Descemet membrane endothelial keratoplasty (DMEK). Indre is especially looking into the long-term (10 years) graft survival after DMEK and how graft survival is affected by early endothelial cell density decrease after DMEK. Furthermore, Indre is also evaluating the effect of donor parameters such as donor sepsis and post-DMEK ocular procedures such as phacoemulsification after phakic DMEK on endothelial cell densities outcomes after DMEK. Another thesis aspect is the impact of early graft detachment on DMEK outcomes.
Click here for the published articles of Indre.

PhD promotor: Prof. Dr. Martine Jager (Leiden University)
PhD supervisors: Dr. Silke Oellerich, Dr. Viridiana Kocaba and Dr. Gerrit Melles


Alina Miron
In her PhD work, Alina focuses on the in vivo and in vitro behaviour of corneal endothelial cells before and after endothelial keratoplasty. The first part of the project concentrates on the postoperative endothelial cell density (ECD) decrease after Descemet membrane endothelial keratoplasty (DMEK) and DMEK graft viability prior to transplantation. The second part focusses on regenerative strategies for the treatment of Fuchs endothelial corneal dystrophy by developing and applying in vitro cell migration assays. In vitro cell migration from DMEK grafts of various sizes and shapes are investigated in a 3D cell culture system aiming to identify critical parameters for the successful clinical application of corneal endothelial therapy.
Click here for the published articles of Alina.

PhD promotor: Prof. Dr. Martine Jager (Leiden University)
PhD supervisors: Dr. Silke Oellerich, Dr. Sorcha Ni Dhubhghaill and Dr. Gerrit Melles


Lamis Baydoun
In her PhD thesis, Lamis investigates two complications after Descemet membrane endothelial keratoplasty (DMEK) that are closely linked to survival of a graft: 1. graft failure and 2. allograft rejection. By identifying eyes with primary and secondary graft failure, she evaluates the long-term DMEK survival rates and assesses indications and outcomes of repeat DMEK. Concerning allograft rejection which may potentially lead to graft failure, her research aims at detecting subclinical and `invisible´ inflammation after DMEK by laser flare photometry and at identifying eyes at risk of rejection by different diagnostic tools such as Scheimpflug imaging, pachymetry and specular microscopy to allow timely treatment and possibly prevent rejection beforehand.
Click here for the published articles of Lamis. 

PhD promotor: Prof. Dr. Martine Jager (Leiden University)
PhD supervisor: Dr. Gerrit Melles


Finalized PhD projects

 

Daniele Spinozzi
Transplantation of cultured corneal endothelial cells: towards clinical application
Corneal transplantation still represents the elected method for the treatment of corneal endothelial pathologies. However, the worldwide shortage of donor corneas induced the exploration of approaches to use the donor tissue more efficiently or to be more independent from donor tissue. In his thesis, Daniele illustrated the improvements of new strategies for cell-based corneal endothelial regeneration, alternative to corneal endothelial surgical transplantation, by bridging the gap between in vitro experiments and clinical models. In the studies described, he addressed the establishment of a GMP-compliant protocol for in vitro hCEC culture for clinical application and then focused on endothelial cell sheet transplantation, describing both in vitro and in vivo applications of expanded CEC-carriers constructs made by biocompatible materials. This PhD project was part of the Horizon 2020 EU Consortium ARREST BLINDNESS.
Click here to read the complete thesis.

PhD promotor: Prof. Dr. Martine Jager (Leiden University)
Co-promotors: Dr. Silke Oellerich and Dr. Gerrit Melles
Date of PhD defence: November 17, 2020


Rénuka Birbal
Advances in endothelial keratoplasty
Corneal diseases are among the leading causes of reversible blindness worldwide. When conservative treatment options fail, many eyes can be treated with corneal transplantation. Historically, full thickness corneal transplantation, in which all corneal layers are replaced, has been the mainstay of care in the treatment of corneal endothelial disorders. In the past two decades, however, there has been a trend towards the selective, less invasive replacement of only the diseased, rather than all corneal layers. These partial thickness corneal transplantations are known as lamellar keratoplasties. Lamellar keratoplasty has significantly improved the clinical outcomes, such as visual acuity, after transplantation. Since its introduction in 1998, lamellar keratoplasty has evolved from Deep lamellar endothelial keratoplasty to Descemet membrane endothelial keratoplasty (DMEK). Globally, however, there is only one donor cornea available for 70 people in need. This shortage inspired further refinement of conventional DMEK and led to the development of adapted DMEK-techniques, which may increase the availability of endothelial donor grafts. This thesis focused on donor tissue preparation for DMEK and evaluates the feasibility and clinical outcomes of DMEK, DMET, Hemi-DMEK and Quarter-DMEK in the management of corneal endothelial disorders.
Click here to read the complete thesis.

PhD promotor: Prof. Dr. Martine Jager (Leiden University)
Co-promotor: Dr. Gerrit Melles
Date of PhD defence: November 17, 2020


Korine van Dijk
Clinical outcomes of modern lamellar keratoplasty techniques
After penetrating keratoplasty had been the preferred method for the treatment of corneal disorders for almost a century, the introduction of lamellar keratoplasty techniques has changed the field of corneal transplantation substantially over the last two decades. These lamellar keratoplasty techniques provide several advantages over penetrating keratoplasty: anterior lamellar keratoplasty may potentially improve graft survival by preserving the healthy recipient endothelium in the management of corneal stromal diseases, and endothelial keratoplasty has improved the predictability and speed of visual rehabilitation for treating endothelial disorders, mainly by leaving the anterior corneal surface intact. The latest innovation in the field of endothelial keratoplasty is Descemet membrane endothelial keratoplasty (DMEK), in which only the Descemet membrane and endothelium are replaced by donor tissue. The trend towards more selective and minimally invasive transplantation techniques has also led to the development of new treatment options for patients with (advanced) keratoconus, including the mid-stromal implantation of an isolated donor Bowman layer, referred to as Bowman layer-transplantation. This thesis focused on the feasibility and clinical outcomes of these two modern lamellar keratoplasty techniques, i.e. DMEK for endothelial disorders, and Bowman layer-transplantation for advanced keratoconus.
Click here to read the complete thesis.

PhD promotor: Prof. Dr. Martine Jager (Leiden University)
Co-promotor: Dr. Gerrit Melles
Date of PhD defence: January 16, 2018


Jack Parker
Recent innovations in minimally invasive anterior and posterior lamellar keratoplasty
For nearly a century, the definitive treatment of many corneal dystrophies and ectactic disorders were limited to penetrating keratoplasty, but over the past two decades, a surge of surgical innovation has propelled the treatment of many corneal diseases to more targeted approaches with significantly better visual outcomes. This thesis focused on the clinical outcomes of the rapid innovations for surgical treatment of corneal diseases, spanning from endothelial keratoplasty Bowman layer transplantation, highlighting key steps which may be moving us closer to a “post-keratoplasty” world.
Click here to read the complete thesis.

PhD promotor: Prof. Dr. Martine Jager (Leiden University)
Co-promotor: Dr. Gerrit Melles
Date of PhD defence: July 4, 2017


Lisanne Ham
Descement membrane endothelial keratoplasty – Donor tissue preparation and clinical outcomes
The first DMEK surgery was performed in 2006. The focus of this thesis was on the donor graft preparation technique and the postoperative outcomes of this new corneal transplantation technique. Clinical outcomes after DMEK were analyzed in terms of visual rehabilitation, endothelial cell density, refractive change and stability, and postoperative complications. New perspectives offered by DMEK were compared to the earlier corneal transplantation techniques.


Click here for the published articles of Lisanne.

PhD promotor: Prof. Dr. Jorge Alío
Co-promotor: Dr. Gerrit Melles
Date of PhD defence: May 14, 2012


Isabel Dapena
Descement membrane endothelial keratoplasty – Surgical technique, results and complications
Descemet membrane endothelial keratoplasty (DMEK) was the latest refinement of the endothelial keratoplasty techniques. The focus of this thesis was to describe the standardization of the surgical technique and to assess and evaluate the postoperative results of the standardized ‘no-touch’ DMEK technique. In addition the association of surgical-related aspects, including the surgeon’s learning curve, with postoperative outcomes was evaluated.

 

Click here for the published articles of Isabel.

PhD promotor: Prof. Dr. Jorge Alío
Co-promotor: Dr. Gerrit Melles
Date of PhD defence: May 14, 2012