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Dr. Albert Daxer

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

During his residency in ophthalmology at the Medical University in Innsbruck in 1992, Dr. Daxer was one of the first specialists to perform laser treatment for vision correction in Austria. Since the beginning of his specialisation in ophthalmology, he was engaged in all scientific, practical and surgical aspects of keratoconus and has more than 25 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. Since 2003, he runs one of the country's largest laser-vision centres in cooperation with 6 colleagues.

Dr. Daxer's scientific background 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 difficult cases of myopia. Dr. Daxer developed the MyoRing technology, currently the most effective treatment of keratoconus, as well as KERALUX Crosslinking, the latest technology to prevent early stages of keratoconus with still good visual acuity from vision loss. All these technologies are protected by international patents.

In 2014, Dr. Daxer founded the International Keratoconus Centre in Wels, Austria, in order to offer keratoconus patients the latest and most effective therapy for their disease.

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


Selected contributions to ophthalmology by Dr. Daxer:

1. Transparency of the Cornea.

The eye is one of the most vital sensory organs in humans. The cornea is the most important optical element of the eye and its transparency is a prerequisite for vision. Diseases associated with a loss of corneal transparancy are major causes for legal blindness. Many theories and hypotheses have been presented in the past to explain the mechanism of transparency of that particular tissue. Maurice (1957) was the first to propose 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 transparency. The transparency of the cornea is the result of a short-range ordered, liquid-crystal-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 of 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 these 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 crucial for the optical function of the cornea. In diseases such as keratoconus, which affect this functional ultrastructure and the biomechanics, 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 Euclidian 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 frequent 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 System (CISIS), the MyoRing intra-corneal implant, the PocketMaker Ultrakeratome, the PocketMaker corneal transplant technology as well as the pocket crosslinking technology. The minimally invasive and reversible treatment by means of Corneal IntraStromal Implantation System (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.

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. 2017;10:123-129. Daxer A. MyoRing Treatment of Myopia. J Optom. 2017;10:194-198.

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 utmost 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 itself depends 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. This 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.

6. Multifocal Cornea

Beyond the age of 40, age-related farsightedness affects the near vision of humans. Current treatment options include reading glasses, progressive glasses and multi-focal contact lenses. We have developed a new and very promising technology where the world's smallest inlay of only 0.3 mm in diameter is inserted into the cornea to create multi-focal imaging and to restore near-vision. www.multi-focal.vision

7. KERALUX Corneal Crosslinking

Conventional crosslinking cannot provide a homogeneous UV-A intensity distribution to the cornea. The reason is that the amount of UV-A energy transferred to the cornea by means of conventional crosslinking depends on the local steepness of the cornea. The steeper the cornea in a certain area, the lower the therapeutic energy transferred. This is a problem because keratoconus is characterized by an irregular shape of the cornea where the steepness varies from point to point within in every cornea and from patient to patient. Unfortunately, the steepest areas are in the most affected areas. We have developed a new technology which allows us to transfer the right amount of energy to every single point of the cornea - independent from the local steepness. www.dioptex.com/applications/keratoconus-keralux-cxl.html

8. Artificial cornea transplantation

In corneas damaged by alkali burns and other serious traumata, the performance of corneal transplantation based on donor corneas is a high-risk procedure with an almost 100% risk of tissue rejection. Artificial corneas are possible options in such cases. A sufficient preparation of the tissue in cases where the cornea is highly intransparent is usually not possible. We have developed surgical technologies based on the PocketMaker Ultarkeratome which allow extremely precise tissue preparation even in highly intransparent, turbid and scarred corneas. www.youtube.com/watch;


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.

 

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Salzburger Strasse 65

A - 4600 Wels/Linz


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