cisis

Dr. Albert Daxer

Dr. Daxer is an internationally leading specialist in keratoconus and refractive & corneal surgery.

He was one of the first specialists to introduce laser treatment for vision correction in Austria in 1992. Together with 6 colleagues, he runs one of the country's leading laser centres. He has more than 20 years of experience in keratoconus treatment.

Dr. Daxer holds a degree in electronic engineering. He earned his university diploma (Dipl.-Ing.) in physics at the Vienna University of Technology before completing his doctoral studies in medicine at the University of Vienna (Dr.med.univ.). During his medical studies, he also worked with various industrial companies and research institutes. He performed his specialist studies of ophthalmology and optometry at the Department of Ophthalmology of the University of Innsbruck (PhD), where he is an associate professor. Since 2000, he has been running an ophthalmology practice in Ybbs/Danube which accepts all health insurance providers and since 2003 a laser-vision center (www.augen-laser.center).

Dr. Daxer's scientific oeuvre comprises all areas related to ophthalmology with special focus on the cornea and keratoconus. In 2003, he founded the research and development company DIOPTEX - a spin-off of his scientific activities at the University Hospital of Innsbruck - with the intention to provide effective and safe therapeutic options for keratoconus and high-grade myopia. As of 2005, DIOPTEX was granted funds from the Austrian federal development and financing bank Austria Wirtschaftsservice (AWS) for a scientific project supervised by Dr. Daxer to support the development of MyoRing and PocketMaker ultrakeratome. Financial support from the Austrian Research Promotion Agency (FFG) proved useful in the performance of international studies for the treatment of patients.

MyoRing/CISIS is the most advanced, most effective and safest method available for the treatment of keratoconus and certain forms of myopia. This treatment method has been tried and tested for many years, with follow-up periods of meanwhile over eight years in regular clinical use. Since 2007, CISIS has been approved as a medicinal product for the treatment of keratoconus and myopia in Europe as well as in 20 countries outside of Europe. Several thousand therapy sessions have already been performed with great success and without any noteworthy complications.

Dr. Daxer boasts numerous publications in internationally reputed ophthalmology journals and is also invited to perform peer reviews on a regular basis.


Selected scientific literature on the subject (Dr. Daxer):

Basic sciences (peer reviewed)

Fratzl P and Daxer A. Structural transformation of collagen fibrils in the corneal stroma during drying. An x-ray scattering study. Biophys J 1993;64:1210-1214.

Daxer A and Fratzl P. Collagen fibril orientation in the human corneal stroma and its implications in keratoconus. Invest Ophthalmol Vis Sci 1997;38:121-129.

Daxer A et al. Collagen fibrils in the human corneal stroma: structure and ageing. Invest Ophthalmol Vis Sci 1998;39:644-647.

Daxer A. Biomechanics of the cornea. International Journal of Keratoconus and Ectatic Corneal Diseases 2014;3:57-62.

Daxer A. Biomechanics of Corneal Ring Implants. Cornea 2015;34:1493–1498.

Clinical sciences (peer reviewed)

Daxer A. Corneal intrastromal implantation surgery for the treatment of moderate and high myopia. J Cataract Refract Surg 2008;34:194-198

Daxer A, Mahmood H and Venkateswaran RS. Intracorneal continous ring implantation for keratoconus: one year follow-up. J Cataract Refract Surg 2010;36:1296-1302.

Daxer A. Adustable Intracorneal Ring in a Corneal Pocket for Keratoconus. J Refract Surg 2010;26:217-221.

Daxer A, Mahmoud H and Venkateswaran RS. Corneal Crosslinking and Visual Rehabilitation in Keratoconus in One Session without epithelial debridement: New Technique. Cornea 2010;29:1176-1179.

Alio JL, Pinero DP and Daxer A. Clinical outcomes after complete ring implantation in corneal ectasia using the femtosecond laser technology. A pilot study. Ophthalmology 2011;118:1282-1290.

Mahmood H, Venkateswaran RS and Daxer A. Implantation of a complete corneal ring in an intrastromal pocket for keratoconus. J Refract Surg 2011;27:63-68.

Daxer A. MyoRing for central and noncentral keratoconus. International Journal of Keratoconus and Ectatic Corneal Diseases 2012;1:117-119.

Bikbova G, Bikbov M and Daxer A. Descemet Stripping PocketMaker Endothelial Keratoplasty. International Journal of Keratoconus and Ectatic Corneal Diseases 2012;1:125-127.

Daxer B, Mahmoud H and Daxer A. MyoRing Treatment for Keratoconus: DIOPTEX PocketMaker vs. Ziemer LDV for corneal pocket creation. International Journal of Keratoconus and Ectatic Corneal Diseases 2012;1:151-152.

Daxer A. Corneal thickness after MyoRing implantation for keratoconus. International Journal of Keratoconus and Ectatic Corneal Diseases 2014;3:15-19.

Daxer A. MyoRing Treatment for Cases of Myopia not eligible for Laser Vision Correction. International Journal of Keratoconus and Ectatic Corneal Diseases 2014;3:20-22.

Daxer A. MyoRing treatment of keratoconus. International Journal of Keratokonus and Ectatic Corneal Diseases 2015;4:76-83.

Daxer A, Ettl A and Hörantner R. Long-Term Results of MyoRing Treatment of Keratoconus. J Optom. 2016 Feb 25. pii: S1888-4296(16)00004-2. doi: 10.1016/j.optom.2016.01.002. [Epub ahead of print]

Daxer A. MyoRing Treatment of Myopia. J Optom. 2016 Jul 23. pii: S1888-4296(16)30035-8. doi: 10.1016/j.optom.2016.06.003. [Epub ahead of print]

Prangl-Grötzl A, Ettl A, Hörantner R and Daxer A. Individual Long-Term Visual Stability after MyoRing Treatment of Keratoconus. International Journal of Keratoconus and Ectatic Corneal Diseases 2016;5(2):53-56.

General:

Daxer A. Intracorneal ring: A good alternative to LASIK? Ophthalmology Times Europe. Oct 2007, p 40-41.

Daxer A. Corneal intrastromal implantation surgery. Cataract and Refractive Surgery Today Europe. Oct 2008, p 63-64. 

Daxer A. Intracorneal ring in a pocket shows promise for treatment of Keratoconus. ESCRS Eurotimes Feb 2009. P17.


Five selected contributions to ophthalmology by Dr. Daxer:

1. Transparency of the Cornea:

The eye is one of the most important sense organs in human. The cornea is the most important optical element of the eye and its transparency is a prerequisite for vision. Diseases associated with loss of corneal transparancy are major causes of legal blindness. Many theories and hypothesis have been presented in the past to explain the mechanism of transparancy of that particular tissue. Maurice, 1957 was the first who proposed a relation between the arrangement of collagen fibrils inside the corneal stroma and the transparency of the tissue. It was in 1993 when we were able to present the right physical theory including experimental proof of the origin and mechanism of corneal transparancy: The transparency of the cornea is the result of a short-range ordered, liquid-crystall-like arrangement of  fractal-proteoglycan-coated collagen-fibrils inside the corneal lamellae.

Fratzl P and Daxer A.  Structural transformation of collagen fibrils in corneal stroma during drying. An x-ray scattering study. Biophysical Journal 1993;64:1210-1214.

 2. Ultrastructure of the Cornea:

The cornea is the most important optical element of the eye and contributes to more than two-third to its dioptic (refractive) power. The ultrastructural properties of the cornea on every level are most important for the optical funcion of the eye. We have investigated and defined the corneal ultrastructure on every level such as a. the molecular arrangement inside the collagen fibrils, b. the properties of the collagen fibrils themselves, c. the arrangement of the collagen fibrils inside the collagen lamellae and d. the arrangement of the collagen lamellae inside the cornea. We found that the regularity of that properties inside the cornea are a prerequisite for the normal optical function of the eye. In particular a very specific anisotropy of the collagen lamellae inside the cornea defined by a particular mixture of orthogonal and random orientation of the collagen lamellae is most important for the optical function of the cornea. In diseases which affect that functional ultrastructure, like in Keratoconus for instance, the visual function of the eye is dramatically impaired and often the reason for legal blindness.

Daxer A and Fratzl P. Collagen fibril orientation in the human corneal stroma and its implication in keratoconus. Investigative Ophthalmology and Visual Science 1997;38:121-129. 

Daxer A et al. Collagen fibrils in the human corneal stroma: structure and aging. Investigative Ophthalmology and Visual Science 1998;39:644-648.

3. The diagnosis of diabetic retinopathy by means of fractal geometry.

Simple three-dimensional euklidian geometry is not sufficient to characterize the retinal vasculature. The retinal vasculature follows the more complex concept of fractal geometry. Many systemic diseases, such as Diabetes Mellitus, significantly affect the retinal vessels in the human eye. In particular, the formation of new retinal vessels in diabetes mellitus (proliferative diabetic retinopathy) is a high risk factor for blindness and, in addition to kidney failure, blindness is the second most complication in Diabetes Mellitus. Strategies for detection and quantification of proliferative diabetic retinopathy are therefore of great importance. We have investigated the fractal geometry of normal and abnormal retinal vasculature and developed a new and most effective method for the early diagnosis of proliferative diabetic retinopathy.

Daxer A. Fractals and retinal vessels. Lancet 1992;39:618.

Daxer A. The fractal geometry of proliferative diabetic retinopathy: implications for the diagnosis and the process of retinal vasculogenesis. Current Eye Research 1993; 12:1103-1109.

4. The Corneal Pocket Concept (CPC) for the treatment of Myopia and Keratoconus.

Our development and establishment of the Corneal Pocket Concept (CPC) as a new surgical principle is a milestone in modern corneal surgery. It includes the deveopment of Corneal Intrastromal Implantation Surgery (CISIS), the MyoRing intra-corneal implant, the PocketMaker Ultrakeratome, the PocketMaker corneal transplant technology as well as the pocket crosslinking technology (see www.dioptex.com and www.cisis.com/en). The minimally invasive and reversible treatment by means of Corneal Intrastromal implantation surgery (CISIS) using the MyoRing is currently by far the most effective and safest treatment method for myopia, keratoconus and many other diseases and disorders.

Daxer A. Corneal intrastromal implantation surgery for the treatament of moderate and high myopia. Journal of Cataract and Refractive Surgery 2008;34:194-198.

Daxer A. Adjustable intracorneal ring in a lamellar pocket for keratoconus. Journal of Refractive Surgery 2010;26:217-221.

Daxer A, Mahmoud H, Venkateswaran RS. Intracorneal continous ring implantation for keratoconus: One-year follow-up. Journal of Cataract and refractive Surgery 2010;36:1296-1302.

Bikbova G, Bikbov M and Daxer A. Descemet stripping PocketMaker endothelial keratoplasty. International Journal of Keratoconus and ectatic Corneal Diseases 2012;1:125-127.

Daxer A, Mahmoud H and Venkateswaran RS. Corneal crosslinking and visual rehabilitation in keratoconus in one session without epithelial debridement: new technique. Cornea 2010;29:1176-1179.

Daxer A. MyoRing treatment of keratoconus. International Journal of Keratoconus and ectatic Corneal Diseases 2015;4:76-83.

Daxer A, Ettl A and Hörantner R. Long-Term Results of MyoRing Treatment of Keratoconus. J Optom. 2016 Feb 25. pii: S1888-4296(16)00004-2. doi: 10.1016/j.optom.2016.01.002. [Epub ahead of print]

Daxer A. MyoRing Treatment of Myopia. J Optom. 2016 Jul 23. pii: S1888-4296(16)30035-8. doi: 10.1016/j.optom.2016.06.003. [Epub ahead of print]

Prangl-Grötzl A, Ettl A, Hörantner R and Daxer A. Individual Long-Term Visual Stability after MyoRing Treatment of Keratoconus. International Journal of Keratoconus and Ectatic Corneal Diseases 2016;5(2):53-56.

5. Biomechanics of the Cornea.

Two corneal properties are of outmost importance to the optical function of the eye: The transparency and biomechanics of the cornea. The dioptres of the eye as well as the quality of vision depend on the shape and regularity of the corneal surface. An irregularily shaped cornea results in corneal blindness. The shape of the cornea depends itself on the biomechanical equilibrium between the forces inside (tension) and outside (air pressure and intra-ocular pressure) the cornea. I was able to provide an easy to use model (Spherical dome model) which relates the forces and tension inside the cornea to the fundamental anatomical and structural characteristics of the tissue. That model allows ophthalmologists, optometrists and vision scientists to estimate and calculate the effect of surgical procedures on the stability of the cornea.

Daxer A. Biomechanics of the cornea. International Journal of Keratoconus and Ectatic Corneal Diseases 2015;4:76-83.

Daxer A. Biomechanics of Corneal Ring Implants. Cornea 2015;34:1493–1498.

 

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