Jennifer Y Li

University of California, Davis, Davis, California, United States

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Publications (23)82.92 Total impact

  • Mazen Y Choulakian · Jennifer Y Li · Samuel Ramos · Mark J Mannis ·
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    ABSTRACT: Purpose: To evaluate the predictability and reproducibility of stromal bed thickness for single-pass donor Descemet stripping automated endothelial keratoplasty (DSAEK) tissue preparation, using the ML7 Microkeratome Donor Cornea System (Med-logics Inc, Athens, TX). Methods: In this retrospective chart review of 256 consecutive corneal tissue preparations for DSAEK surgery, from June 2013 to August 2014, tissue thicknesses were divided into 3 groups, depending on surgeon preference: <91 μm (group A), 90 to 120 μm (group B), and 120 to 160 μm (group C). Precut and postcut data were recorded. Results: Average postcut donor corneal thickness was 114 ± 30 μm (range 60-183 μm), whereas the average in group A was 97 ± 23 μm (range 60-128), in group B was 113 ± 21 μm (range 77-179), and in group C was 134 ± 43 (range 89-183). Average postcut endothelial cell density was very adequate at 3013 ± 250 cells per square millimeter. There were a total of 7 failed procedures from 256 attempts, which represents a rate of 2.7%. This rate decreases to 1.5% when analyzing the last 200 cuts. Conclusions: The ML7 Microkeratome Donor Cornea System allows for reliable and reproducible DSAEK tissue preparation. Ultrathin DSAEK tissues can be prepared with a single-pass. Aiming for a graft thickness between 90 and 120 μm seems to be most reliable.
    Cornea 11/2015; DOI:10.1097/ICO.0000000000000675 · 2.04 Impact Factor
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    ABSTRACT: To examine the clinical outcomes of scleral lenses for visual rehabilitation after penetrating keratoplasty (PK). A retrospective review was conducted for 34 patients (48 eyes) who had a history of prior PK and were fit with scleral lenses between October 2009 and December 2013 at the UC Davis Eye Center. The most common initial indication for PK was keratoconus in 27 eyes (56%). Thirty-three eyes (69%) had previously been fit with other types of contact lenses, with small-diameter rigid gas-permeable lenses being the most common. The improvement in best-corrected visual acuity with a scleral lens compared with prior spectacle refraction or other contact lens was a mean of two best-corrected visual acuity lines. Forty-four eyes (91.7%) achieved functional vision with best scleral lens-corrected visual acuities of 20/40 or better. Patients who continued wearing scleral lenses were significantly more likely to report "good" subjective vision compared with patients who abandoned scleral lens wear (P=0.009), although change in objective best-corrected visual acuity did not differ significantly. There were no cases of infectious keratitis. Six eyes (12.5%) developed graft rejection; 3 were able to resume scleral lens wear. Nineteen eyes (39.5%) discontinued scleral lens wear for various reasons, the most common reason for discontinuation of lens wear was difficulty with scleral lens insertion or removal (8 eyes, 42.1%). Scleral lenses are effective and safe in patients who have had PK. There was a mean gain in visual acuity, with the majority of patients achieving 20/40 vision or better. The patient's subjective perception of vision was a significant factor in determining whether scleral lens wear was continued or abandoned.
    Eye & contact lens 07/2015; DOI:10.1097/ICL.0000000000000163 · 1.47 Impact Factor
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    ABSTRACT: Ocular surface disorders, such as dry eye disease, ocular rosacea, and allergic conjunctivitis, are a heterogeneous group of diseases that require an interdisciplinary approach to establish underlying causes and develop effective therapeutic strategies. These diverse disorders share a common thread in that they involve direct changes in ocular surface chemistry as well as the rheological properties of the tear film and topographical attributes of the cellular elements of the ocular surface. Knowledge of these properties is crucial to understand the formation and stability of the preocular tear film. The study of interfacial phenomena of the ocular surface flourished during the 1970s and 1980s, but after a series of lively debates in the literature concerning distinctions between the epithelial and the glandular origin of ocular surface disorders during the 1990s, research into this important topic has declined. In the meantime, new tools and techniques for the characterization and functionalization of biological surfaces have been developed. This review summarizes the available literature regarding the physicochemical attributes of the ocular surface, analyzes the role of interfacial phenomena in the pathobiology of ocular surface disease, identifies critical knowledge gaps concerning interfacial phenomena of the ocular surface, and discusses the opportunities for the exploitation of these phenomena to develop improved therapeutics for the treatment of ocular surface disorders.
    The ocular surface 07/2014; 12(3). DOI:10.1016/j.jtos.2014.01.004 · 3.34 Impact Factor
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    ABSTRACT: To evaluate the microbial flora of eyes with a Boston Keratoprosthesis (K-Pro). A prospective study was performed for 17 eyes of 15 patients who underwent a K-Pro implantation between September 2005 and June 2011. Preoperative diagnoses included failed corneal grafts, limbal stem cell deficiency, chemical burns, and Stevens-Johnson Syndrome. The patients used topical antibiotics after their surgery including a fluoroquinolone, polymyxin-trimethoprim, vancomycin, or a combination of the 3. The conjunctiva in the study eye was swabbed and cultured. A separate culture was taken of the contralateral eye as well. If available, the bandage contact lens was removed, and half of it was placed in thioglycolate broth, and half in 5 mL of a sterile balanced salt solution. The contact lens in the balanced salt solution was sonicated using a QSonica Q125 sonicator (Newtown, CT) for 1 minute, at an amplitude of 20%. Ten microliters of fluid was subsequently cultured. Of the patients who underwent the K-Pro surgery during that time period, 15 patients with 17 eyes were able to participate in the data collection. Nine of the 17 eyes implanted with the K-Pro (53%) had positive cultures. Two of the 13 (15%) of the control swabs exhibited bacterial growth. Eight percent (1/12) of the sonicated lenses were positive on culture, whereas 4/12 (33%) of the lenses placed in thioglycolate broth were positive for organisms. Despite being on antibiotics, eyes implanted with the K-Pro were more likely to have a positive conjunctival culture in our cohort as compared with that of fellow eyes.
    Cornea 10/2013; 32(12). DOI:10.1097/ICO.0b013e3182a81992 · 2.04 Impact Factor
  • Jeffrey M Goshe · Mark A Terry · Jennifer Y Li ·
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    ABSTRACT: The aim of this study was to report the inadvertent insertion of a glaucoma tube into the graft-host interface in a patient with previous Descemet stripping automated endothelial keratoplasty (DSAEK). This is a retrospective case report. A 56-year-old aniridic woman with a history of multiple failed penetrating keratoplasties (PKPs) and glaucoma underwent DSAEK under failed PKP of her left eye at our institution. After undergoing a subsequent glaucoma tube placement by an outside glaucoma specialist, the tube was identified in the DSAEK-PKP interface. The tube was successfully repositioned at the time of repeat PKP with placement of a Boston type I keratoprosthesis. Inadvertent insertion of a glaucoma tube into the DSAEK interface may result in ocular morbidity in patients with previous DSAEK surgery.
    Journal of glaucoma 10/2013; 22(8):e21-e22. DOI:10.1097/01.ijg.0000435772.12655.47 · 2.11 Impact Factor
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    ABSTRACT: Purpose: To report the results of imaging using high-resolution, Fourier domain anterior segment optical coherence tomography (AS-OCT) to evaluate patients with a type 1 Boston Keratoprosthesis (KPro). Methods: We performed a retrospective comparative study of patients in whom we implanted the Boston KPro. A total of 26 eyes of 23 patients from the Cornea Service at the University of California Davis Eye Center were included. Subjects were evaluated with the Spectralis AS-OCT (Heidelberg Engineering GmbH). Results: Preoperative diagnoses for KPro surgery included failed corneal transplant (69%), chemical burn (23%), and aniridia (8%). The average age of patients was 63.2 years (range, 17-88 years). Fifty-four percent of the patients were female. The mean duration between the KPro surgery and the acquisition of high-resolution AS-OCT imaging was 35.8 months (range, 2-90 months). The most commonly observed finding was retroprosthetic membrane formation, which we found in 77% of KPro eyes. In 65% of KPro eyes, we identified epithelium behind the front plate, and in 54%, we identified an epithelial lip over the anterior surface of the KPro front plate. In 31% of KPro eyes, we identified periprosthetic cysts, gaps or spaces, and thinning in the corneal carrier graft. Conclusions: Fourier domain AS-OCT is a useful noninvasive imaging technique in patients with a KPro and provides the ability to identify changes that are sometimes difficult to appreciate by clinical evaluation. The higher resolution Fourier domain systems may aid in the clinical diagnosis and management of pathology that might not be imaged with instruments of lower resolution. AS-OCT has the potential for monitoring the anatomic stability of an implanted KPro and may also help to monitor for complications. Moreover, high-resolution imaging may enhance our understanding of periprosthetic anatomy.
    Cornea 04/2013; 32(7). DOI:10.1097/ICO.0b013e318285c8f4 · 2.04 Impact Factor
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    ABSTRACT: Purpose: To determine the immediate endothelial cell loss (ECL) resulting from insertion of a precut donor button using the Neusidl Corneal Inserter (NCI) and compare it with the previously published ECL resulting from insertion of a folded donor button using non-coapting forceps. Methods: Ten corneas were precut for Descemet stripping automated endothelial keratoplasty and trephinated to a diameter of 8.0 mm (n = 5) or 8.5 mm (n = 5). Each tissue was placed onto the platform of a new NCI spatula and inserted into a cadaveric whole globe through a 5.2 mm incision. The tissue was carefully removed and stained with trypan blue and alizarin red to detect damaged endothelium. ECL was estimated using Adobe Photoshop planimetry. Mean ECL was compared with previously reported studies of forceps insertion with a one-sample t test, using SPSS v. 19. Geographic patterns of ECL were also documented. Results: Mean ECL was 15.6% (95% confidence interval, 13.8-17.4). We were unable to detect a difference in ECL compared with previous insertion methods studied (P < 0.001). The pattern of damage from the NCI was different than that previously seen with forceps insertion. Conclusion: Immediate endothelial damage resulting from use of the NCI for insertion of Descemet stripping automated endothelial keratoplasty tissue is comparable with that seen with a standard forceps technique, but with a different damage pattern.
    Cornea 11/2012; 32(4). DOI:10.1097/ICO.0b013e318274a72b · 2.04 Impact Factor
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    ABSTRACT: To determine whether preoperative donor thickness has a relationship with postoperative visual acuity after Descemet's stripping automated endothelial keratoplasty (DSAEK). Retrospective correlation and comparative analysis of an interventional case series. A total of 418 eyes of 292 patients undergoing DSAEK surgery for Fuchs' endothelial dystrophy without visual loss from comorbidities. Descemet's stripping automated endothelial keratoplasty was performed in 548 eyes with Fuchs' dystrophy, and preoperative graft thickness (GT) was recorded. After exclusion of patients with confounding variables that would affect postoperative visual acuity, postoperative best spectacle-corrected visual acuity (BSCVA) was measured at 6 months in 418 eyes. Pearson's correlation analysis was performed between preoperative GT and BSCVA. Cases were split into deciles on the basis of GT and BSCVA and then compared with 1-way analysis of variance (ANOVA) and chi-square test. Best spectacle-corrected visual acuity at 6 months postoperatively. Mean GT of the series was 162.9±29.0 μm (range, 80-265 μm), and mean Snellen BSCVA was 20/28 with a range of 20/16 to 20/70. There was a weak correlation between GT and BSCVA that was significant (R = 0.236, P<0.001) but only accounted for 5% of the visual outcome (R(2) = 0.056). Visual outcome was best within the thinnest decile group of 45 donors (GT range, 80-124), with a mean Snellen BSCVA of 20/25 (range, 20/20-20/50), and worst within the thickest decile group of 41 donors (GT range, 200-265), with a mean Snellen BSCVA of 20/33 (range, 20/20-20/70). Post hoc comparison of BSCVA between the thickest and thinnest groups was significant (P = 0.006). Preoperative GT may have a small effect on visual outcome in the extremes of thickness, but not in the common range of 100 to 200 μm. Donor thickness has a tenuous relationship with visual outcome, accounting for only 5% of the variance in vision between patients, and should play a minimal role in surgical planning. Proprietary or commercial disclosure may be found after the references.
    Ophthalmology 07/2012; 119(10):1988-96. DOI:10.1016/j.ophtha.2012.05.021 · 6.14 Impact Factor
  • Jennifer Y Li · Mark A Terry · Jeffrey Goshe · David Davis-Boozer ·

    Ophthalmology 07/2012; 119(7):1499. DOI:10.1016/j.ophtha.2012.01.058 · 6.14 Impact Factor
  • Article: Reply.

    American Journal of Ophthalmology 07/2012; 154(1):208-9. DOI:10.1016/j.ajo.2012.02.030 · 3.87 Impact Factor
  • Jennifer Y. Li · Mark A. Terry · Jeffrey Goshe · David Davis-Boozer ·

    Ophthalmology 07/2012; 119(7):1499-1499. · 6.14 Impact Factor
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    ABSTRACT: To determine if patients with prior glaucoma surgery experience higher rates of postoperative graft dislocation after Descemet's stripping automated endothelial keratoplasty (DSAEK) and to determine if postoperative hypotony may be a risk factor in these patients. Retrospective, comparative analysis of an interventional case series. Eight hundred fifty-four eyes (67 eyes with prior glaucoma surgery and 787 controls) from 582 patients who underwent DSAEK at 1 institution between January 2005 and April 2011. Groups were compared with regard to preoperative, intraoperative, and postoperative parameters. Continuous variables were compared using the independent samples t test or Mann-Whitney U test. Categorical variables were compared using the chi-square test or Fisher exact test. Frequencies of postoperative graft dislocation and postoperative hypotony. Study eyes before surgery differed from control eyes with regard to corneal thickness (768 vs. 655 μm; P<0.001) and intraocular pressure (13 vs. 16 mmHg; P<0.001). Postoperative graft dislocation occurred significantly more frequently in study eyes compared with control eyes (9% vs. 2%; P = 0.008). Among eyes in which dislocation occurred, postoperative hypotony was present in 5 study eyes (83%) and 0 control eyes. Previous glaucoma surgery was associated with a significantly increased rate of graft dislocation compared with control eyes. Dislocation was related strongly to postoperative hypotony in eyes with prior glaucoma surgery. Proprietary or commercial disclosure may be found after the references.
    Ophthalmology 02/2012; 119(6):1130-3. DOI:10.1016/j.ophtha.2012.01.012 · 6.14 Impact Factor
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    ABSTRACT: To evaluate the long-term improvement of visual acuity after Descemet's stripping automated endothelial keratoplasty (DSAEK) surgery. Retrospective analysis of a noncomparative, interventional case series. One hundred eight patients undergoing DSAEK surgery for Fuchs' endothelial dystrophy and pseudophakic bullous keratopathy without other ocular comorbidities who completed a full 3-year follow-up period. Postoperative best spectacle-corrected visual acuity (BSCVA) was recorded at 6, 12, 24, and 36 months. Improvement in BSCVA between each time point was evaluated using paired-samples t tests. Subanalysis evaluating the percentage of eyes achieving a BSCVA of 20/20, 20/25, 20/30, and 20/40 at each time point was performed. Improvement in postoperative BSCVA. There was a statistically significant trend toward improvement in average BSCVA with time at postoperative month 6 and postoperative years 2 and 3. There were also increasing proportions of eyes reaching vision of 20/20, 20/25, and 20/30 from 6 months to 1 year, 1 year to 2 years, and 2 years to 3 years. The percentage of patients achieving 20/25 BSCVA improved from 36.1% at 6 months to 70.4% at 3 years after surgery. A similar increase in the percentage of patients reaching a BSCVA of 20/20 after DSAEK surgery also was observed from 11.1% at 6 months to approximately 47.2% at 3 years. There is gradual improvement of visual acuity over time after DSAEK surgery for Fuchs' endothelial dystrophy and pseudophakic bullous keratopathy in patients without other vision-limiting ocular comorbidities. Proprietary or commercial disclosure may be found after the references.
    Ophthalmology 02/2012; 119(6):1126-9. DOI:10.1016/j.ophtha.2011.12.037 · 6.14 Impact Factor
  • Jeffrey M Goshe · Jennifer Y Li · Mark A Terry ·

    International Ophthalmology 02/2012; 32(1):61-6. DOI:10.1007/s10792-011-9511-3 · 0.55 Impact Factor
  • Mark A Greiner · Jennifer Y Li · Mark J Mannis ·

    Ophthalmology 01/2012; 119(1):203. DOI:10.1016/j.ophtha.2011.09.035 · 6.14 Impact Factor
  • Article: Reply.

    American Journal of Ophthalmology 12/2011; 152(6):1079. · 3.87 Impact Factor
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    ABSTRACT: To evaluate the effects of graft rejection episodes after Descemet's stripping automated endothelial keratoplasty surgery (DSAEK) on long-term endothelial cell density (ECD) decline and graft survival. Retrospective, comparative analysis of an interventional case series. We included 615 eyes of 415 Fuchs' dystrophy patients at a single institution with ≥ 6 months follow-up and without comorbidities known to influence postoperative ECD. All patients were enrolled as part of an ongoing, institutional review board-approved clinical protocol for a long-term, prospective study of endothelial keratoplasty in patients with endothelial dysfunction. Preoperative specular microscopy of donor corneal tissue was performed. Postoperative specular microscopy measurements were recorded at 6 and 12 months, and yearly thereafter. The percentages of endothelial cell loss recorded at 1, 2, 3, and 4 years were compared with the Mann-Whitney U test. Percentage ECD declines were calculated at each time point from the results of the preoperative and postoperative specular microscopy. Patients with graft rejection episodes and late endothelial failure were identified. Graft rejection was defined as findings of keratic precipitates with or without corneal edema, or anterior chamber cell and flare with or without corneal edema after the initial resolution of perioperative inflammation. We identified 45 cases of graft rejection. The greatest number of rejections occurred between postoperative months 12 and 18. Eyes with a graft rejection episode had a higher median percentage decline in ECD at all time points compared with eyes without graft rejection episodes. This was statistically significant at 2 and 3 years postoperatively. There is a trend toward a greater percentage of ECD loss with time in eyes experiencing graft rejection after DSAEK surgery. Proprietary or commercial disclosure may be found after the references.
    Ophthalmology 11/2011; 119(1):90-4. DOI:10.1016/j.ophtha.2011.07.007 · 6.14 Impact Factor
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    American Journal of Ophthalmology 11/2011; 152(5):884-5. DOI:10.1016/j.ajo.2011.07.015 · 3.87 Impact Factor
  • Jennifer Y Li · Michele C Lim · Mark J Mannis ·
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    ABSTRACT: We report a case of a 30-year-old woman with aniridia who developed a traumatic cataract related to placement of an Ex-PRESS mini glaucoma shunt. To our knowledge, this potential complication of the device has not been reported.
    Journal of Cataract and Refractive Surgery 07/2011; 37(7):1360-2. DOI:10.1016/j.jcrs.2011.04.019 · 2.72 Impact Factor
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    ABSTRACT: To evaluate long-term complications related to glaucoma drainage devices in patients undergoing Boston type 1 keratoprosthesis surgery. Retrospective case series. All patients who underwent Boston type 1 keratoprosthesis surgery at the University of California, Davis, between 2004 and 2010 were included. Preoperative and postoperative data were reviewed. Twenty-five eyes with glaucoma drainage devices were highlighted. Visual acuity and postoperative complications were tracked at postoperative months 1, 3, 6, 9, and 12 and at annual intervals thereafter. Forty eyes of 35 patients were evaluated with an average follow-up of 33.6 months. Conjunctival breakdown occurred in association with 10 glaucoma drainage device implants in 9 eyes. Eleven eyes had glaucoma drainage devices placed before keratoprosthesis surgery, 3 eyes underwent glaucoma drainage device placement at the time of surgery, and 2 eyes had a glaucoma drainage device placed after surgery. All but one of the eroded glaucoma drainage devices were placed before surgery. Associated complications included endophthalmitis, hypotony, and keratoprosthesis extrusion, with 6 glaucoma drainage devices requiring removal. Long-term beset-corrected visual acuity was maintained better in eyes in which glaucoma drainage device erosions did not develop. One of the main challenges with keratoprosthesis surgery is treating concurrent glaucoma. Glaucoma drainage devices have been advocated as a way to address this long-term complication, but this series suggests that glaucoma drainage device-related complications can cause significant vision loss.
    American Journal of Ophthalmology 05/2011; 152(2):209-18. DOI:10.1016/j.ajo.2011.01.034 · 3.87 Impact Factor

Publication Stats

212 Citations
82.92 Total Impact Points


  • 2011-2014
    • University of California, Davis
      • • School of Medicine
      • • Department of Ophthalmology
      Davis, California, United States
  • 2011-2012
    • California State University, Sacramento
      Sacramento, California, United States