Marie-Claude Robert

• MD
• Ophthalmologist at Université de Montréal

Purpose: Corneal blindness is mainly treated by cornea transplantation. However, there is a shortage of cornea donors for surgeries in many countries. Even with accessible donors, patients suffering from severe pathologies causing inflammation may not benefit as they are at high risk for graft rejection. The Griffith laboratory is the first to use...

Purpose: Corneal blindness is mainly treated by cornea transplantation. However, there is a shortage of cornea donors for surgeries in many countries. Even with accessible donors, patients suffering from severe pathologies causing inflammation may not benefit as they are at high risk for graft rejection. The Griffith laboratory is the first to use...

Introduction: Moderate corneal alkali burns such as those sustained from accidental exposure to household chemicals are treated with topical corticosteroids. Side effects include increased intraocular pressure and slowing of wound healing. Here, we compare the effects of a cannabinoid receptor 2 (CB2r) agonist, TA-A001, that is involved in wound he...

Purpose To evaluate preferred diagnostic tools and treatment decision-making factors in cases suspicious of mucous membrane pemphigoid (MMP) amongst ophthalmologists and cornea specialists. Methods Web-based survey, consisting of 14 multiple choice questions, posted to the Cornea Society Listserv Keranet, the Canadian Ophthalmological Society Corn...

PURPOSE Automated machine learning (AutoML) allows clinicians without coding experience to build their own deep learning (DL) models. This study assesses the performance of AutoML in diagnosing trachoma from field-collected conjunctival images and compares it to expert-designed DL models. METHODS Two ophthalmology trainees without coding experienc...

Purpose: Pterygium and ocular surface squamous neoplasia (OSSN) have been recognized as likely related conditions and share similar risk factors such as ultraviolet and chronic inflammation. The purpose of this study is to review the incidence of OSSN in pathology specimens sent as pterygium at a single tertiary centre between 2010 and 2022. Meth...

PURPOSE: Automated machine learning (AutoML) allows clinicians without coding experience to build their own deep learning (DL) models. This study assesses the performance of AutoML in diagnosing trachoma from field-collected conjunctival images and compares it to expert-designed DL models. METHODS: Two ophthalmology trainees without coding exper...

The objective of this experimental study was to investigate the stability of functional proteins in human serum eye drops, which are used for the treatment of ocular surface disorders, after prolonged storage of 6 months at -20°C. After obtaining whole blood from 3 volunteers and preparing 100% (S100), 50% (S50), and 20% (S20) serum eye drops, fibr...

This review assesses different clinical aspects of the various known drug-induced corneal deposits, based on the corneal layer involved (epithelium, stroma and/or endothelium), and based on the drug class. The most well-known condition caused by drug deposits is vortex keratopathy, or corneal verticillata, which is a whorl-like opacity in the corne...

Corneal blindness accounts for 5.1% of visual deficiency and is the fourth leading cause of blindness globally. An additional 1.5–2 million people develop corneal blindness each year, including many children born with or who later develop corneal infections. Over 90% of corneal blind people globally live in low- and middle-income regions (LMIRs), w...

The long-term survival of biomaterial implants is often hampered by surgery-induced inflammation that can lead to graft failure. Considering that most corneas receiving grafts are either pathological or inflamed before implantation, the risk of rejection is heightened. Here, we show that bioengineered, fully synthetic, and robust corneal implants c...

In this manuscript, we report the second case of keratitis from Metarhizium anisopliae in Canada. M. anisopliae is an entomopathogenic fungus used commercially as an agricultural biocontrol agent and rarely reported as pathogenic to humans.

Animal models of the Boston keratoprosthesis type 1 (KPro) are needed to study glaucoma damage after KPro implantation to control confounding comorbidities common in human KPro recipients. The purpose of this study was to determine the feasibility of establishing a reproducible mouse model of glaucoma after KPro surgery, specifically that of a mini...

Objective Pterygium surgery requires the removal of pterygium tissue and repair of the conjunctiva with either sutures or fibrin glue. The literature suggests that the cost of fibrin glue could be compensated by reducing procedure time and be more cost-effective. However, to our knowledge, no formal studies have examined this hypothesis. Method Re...

Objective To compare 10-year clinical outcomes of frozen versus fresh corneal graft carriers for the Boston Keratoprosthesis type 1 (KPro). Design Prospective, nonmasked randomized controlled trial. Participants Nineteen eyes of 19 patients having undergone Boston KPro type 1 implantation using a fresh or frozen graft carrier. Methods All patien...

PRéCIS:: Ocular surface disease (OSD) in glaucoma is an area for improvement in the management of patients with glaucoma. This study explores the knowledge of glaucoma subspecialists toward OSD in glaucoma, then provides a suggested treatment algorithm. Purpose: To assess the attitudes, knowledge, and level of comfort of Canadian glaucoma special...

Aim: To examine the mid-term visual and anatomical prognosis of patients who require reimplantation of a second Boston keratoprosthesis type 1 (B-KPro). Methods: Retrospective observational case series of 122 patients (141 eyes) who received a B-KPro at a single institution were reviewed. Eyes that underwent a second B-KPro were included in the st...

Purpose: To propose a modified treatment paradigm for chemical burns to the eye – in the acute and chronic phases – in particular aiming at preventing post-burn glaucoma. Methods: Recent laboratory and clinical data on the biology and treatment of severe chemical burns have been analyzed and organized for the cornea clinician. Results: Corneal blin...

Purpose: To evaluate the outcomes of transscleral cyclophotocoagulation (CPC) in the control of glaucoma in eyes with a Boston keratoprosthesis (KPro) type 1. Methods: This study is a retrospective case series of patients who have undergone at least 1 CPC treatment after KPro implantation. Eighteen eyes of 17 patients were included. Intraocular...

Purpose: To describe the incidence, presentation, and clinical course of vitritis occurring after Boston keratoprosthesis type 1 implantation. Design: Retrospective chart review. Participants: Medical records of all patients undergoing type 1 Boston keratoprosthesis implantation over a 4-year period were reviewed. Methods: Cases of vitreous...

Epidermolysis Bullosa (EB) is a heterogynous group of skin disorders characterized by the formation of blisters, and erosion of the skin, in response to minor trauma. Subtypes include EB simplex (EBS), junctional EB (JEB), dystrophic EB (DEB), and Kindler syndrome (KS). The severity and incidence of ocular involvement are highest in the recessive D...

Purpose: To propose a new treatment paradigm for chemical burns to the eye - in the acute and chronic phases. Methods: Recent laboratory and clinical data on the biology and treatment of chemical burns are analyzed. Results: Corneal blindness from chemical burns can now be successfully treated with a keratoprosthesis, on immediate and intermed...

Alkali burns to the eye constitute a leading cause of worldwide blindness. In recent case series, corneal transplantation revealed unexpected damage to the retina and optic nerve in chemically burned eyes. We investigated the physical, biochemical, and immunological components of retinal injury after alkali burn and explored a novel neuroprotective...

Purpose: To investigate the levels of neutrophil elastase (NE), matrix metalloproteinases (MMPs) and myeloperoxidase (MPO) in tear washes of patients with ocular graft-versus-host disease (oGVHD). Design: Case-control study. Methods: Based on established criteria, oGVHD patients (n = 14; 28 eyes) and age/sex-matched healthy controls (n = 14; 2...

Purpose Tumor necrosis factor (TNF)-α is upregulated in eyes following corneal alkali injury and contributes to corneal and also retinal damage. Prompt TNF-α inhibition by systemic infliximab ameliorates retinal damage and improves corneal wound healing. However, systemic administration of TNF-α inhibitors carries risk of significant complications,...

Purpose: To investigate the tear levels of matrix metalloproteinases (MMPs), myeloperoxidase (MPO), and tissue inhibitor of metalloproteinase-1 in eyes after Boston keratoprosthesis type I (B-KPro) implantation and to correlate these markers with the established B-KPro prognostic categories. Methods: Tear washes were collected from 40 patients (...

Purpose: To report our experience using intravenous infliximab for the treatment of tissue melt after Boston keratoprosthesis (B-KPro) types I and II in patients with autoimmune disease. Methods: Case series. Results: We identified four patients who were treated with intravenous infliximab in the context of tissue melt after B-KPro. Stevens-Jo...

Purpose: To describe the fabrication, evaluation, and preliminary in vivo safety of a new drug delivery system (DDS) for topical anti-TNF-α antibody administration. Methods: A DDS was fabricated using inverse template fabrication of a hydrophobic three-dimensional porous scaffold (100-300 μm in diameter porosity) loaded with 10% polyvinyl alcoho...

Abstract Use of the Boston Keratoprosthesis (B-KPro) has grown significantly, both in the United States and overseas over the course of the last decade. It is the most frequently employed keratoprosthesis for the management of complex corneal blindness. Improving outcomes and reductions in devastating complications such as corneal melting and infec...

Objective: To examine the clinical relevance and pathophysiology of Boston keratoprosthesis (B-KPro)-related corneal keratolysis (cornea melt) and to describe a novel method of preventing corneal melt using ex vivo crosslinked cornea tissue carrier. Methods: A review of B-KPro literature was performed to highlight cases of corneal melt. Studies...

Purpose: The aim of this study was to develop a modified ex vivo corneal cross-linking method that increases stromal resistance to enzymatic degradation for use as a carrier for the Boston keratoprosthesis. Methods: Ex vivo cross-linking of human corneas was performed using Barron artificial anterior chambers. The corneas were deepithelialized,...

To describe the long-term ophthalmologic outcomes of patients with methylmalonic aciduria and homocystinuria, cobalamin C type (cblC). Retrospective case series. All patients with cblC referred to the Department of Ophthalmology of the Centre Hospitalier Universitaire Sainte-Justine from 1984 through 2012 were studied. Twelve such patients were ide...

To describe the technique of endocanalicular laser dacryocystorhinostomy with mucosal flap creation and to report the outcomes of this technique. Prospective noncomparative case series of 7 patients with primary acquired nasolacrimal duct obstruction undergoing endocanalicular laser dacryocystorhinostomy with mucosal flap. The mucosal flap was crea...

The authors describe two patients with proliferative diabetic retinopathy bilaterally who were treated with transconjunctival 25-gauge pars plana vitrectomy (PPV) for dense vitreous hemorrhage (VH). After 4 and 10 months, respectively, both developed recurrent VH. They were initially managed with in-office gas-fluid exchange and anti-VEGF intravitr...

Purpose: To characterize the bacterial and fungal flora colonizing the ocular surface of eyes with Boston type 1 keratoprosthesis (KPro) and to determine the prevalence of resistance to antibiotics. Culture positivity and antibiotic resistance rates in eyes with KPro are compared with those of eyes after penetrating keratoplasty (PKP) as well as c...

Purposes: To describe a case of hemorrhagic Descemet membrane detachment following canaloplasty and to discuss its management using neodymium:yttrium-aluminum-garnet (Nd:YAG) laser Descemet membranotomy. Methods: Interventional case report. Results: A 71-year-old woman with chronic open-angle glaucoma developed a hemorrhagic Descemet detachmen...

Background/aims: To compare the complications leading to best-corrected visual acuity (BCVA) loss in patients with Boston keratoprosthesis type 1 (KPro) and glaucoma drainage device (GDD) and those with KPro alone. Methods: Retrospective case series of all patients who underwent KPro surgery at the Centre Hospitalier de l'Université de Montréal...

Background and objective: To report the position of the single-piece and three-piece intraocular lenses (IOLs) following in-the-bag implantation. Patients and methods: Forty patients with bilateral age-related cataracts were recruited from both tertiary hospital and private practice in Montréal, Canada. Patients received the single-piece IOL in...

Purpose: To present 4 cases of persistent leak attributed to subconjunctival fistula formation after glaucoma aqueous shunt implantation. Our preferred method for management is also described. Methods: Retrospective noncomparative case series. Results: Four cases of persistent leak after glaucoma aqueous shunt surgery are described. Three pati...

Endophthalmitis remains one of the most damaging and challenging complications following Boston keratoprosthesis type 1 (KPro) surgery. The authors reviewed the literature from 2001 onward to identify cases of endophthalmitis following KPro surgery and present an additional case of endophthalmitis in a patient with Stevens Johnson syndrome. The pre...

This study aims to determine whether frozen corneas can be successfully used as carriers of the Boston keratoprosthesis (KPro). Prospective study of 37 patients undergoing KPro surgery with fresh or frozen corneas as carriers. Patients were randomized to receive either a fresh corneal graft or a frozen corneal graft during implantation of the Bosto...

To describe the characteristics, indications, complications, and outcomes of the patients who underwent Boston type 1 keratoprosthesis (KPro) surgery at the Université de Montréal affiliated Notre-Dame Hospital. Retrospective case series. Forty-seven eyes of 43 patients who underwent KPro surgery. The charts of all patients who underwent KPro surge...