Transient anisocoria after corneal collagen cross-linking.

Purpose. To report a case with transient anisocoria after corneal collagen cross-linking (CXL). Methods. Case report. Results. A 24-year-old male underwent corneal collagen cross-linking (CXL) in his right eye for keratoconus. At the end of the procedure, the pupil of the treated eye was irregular and dilated, while the pupil of the fellow eye was round, regular, and reactive (anisocoria). The following day, pupils were round, regular, and reactive in both eyes. Conclusion. Anisocoria may be a transient and innocuous complication after CXL. A possible cause for this complication might be the anesthetic drops used before and during the surgical procedure or/and the ultraviolet A irradiation during the treatment

Non-Invasive Ocular Rigidity Measurement: A Differential Tonometry Approach.

Taking into account the fact that Goldmann applanation tonometry (GAT) geometrically deforms the corneal apex and displaces volume from the anterior segment whereas Dynamic Contour Tonometry (DCT) does not, we aimed at developing an algorithm for the calculation of ocular rigidity (OR) based on the differences in pressure and volume between deformed and non-deformed status according to the general Friedenwald principle of differential tonometry. To avoid deviations of GAT IOP from true IOP in eyes with corneas different from the "calibration cornea" we applied the previously described Orssengo-Pye algorithm to calculate an error coefficient "C/B". To test the feasibility of the proposed model, we calculated the OR coefficient (r) in 17 cataract surgery candidates (9 males and 8 females). The calculated r according to our model (mean ± SD, range) was 0.0174 ± 0.010 (0.0123-0.022) mmHg/μL. A negative statistically significant correlation between axial length and r was detected whereas correlations between r and other biometric parameters examined were statistically not significant. The proposed method may prove a valid non-invasive tool for the measurement method of OR, which could help in introducing OR in the decision-making of the routine clinical practice

Pterygium concomitant with other ocular surface lesions: Clinical implications and pathogenetic links.

In the present study, we aimed to evaluate the co-existence of ophthalmic pterygium with other ocular surface lesions in a cohort of patients from the Cretan population. This is a retrospective evaluation of all pterygia in patients examined and treated at the Department of Ophthalmology of the University Hospital of Heraklion, Greece during an 8-year period (from June 2006 to June 2014). A total of 158 cases was examined. Ocular surface images and medical history were evaluated in order to detect concomitant ocular surface pathological conditions. Concomitant lesions included conjunctival nevi (5 cases, 3.16%), iris nevi (4 cases, 2.53%), conjunctival papillomas (8 cases, 5.06%), conjunctival intraepithelial neoplasia (CIN; 4 cases, 2.53%) and 6 cases of hypertophy of the plica semilunaris (3.79%). Of note, pterygium was overlying the iris which was occupied by the iris nevus in 2 out of the 4 cases of iris nevus. Overall, our data indicate that ophthalmic pterygium may often co-exist with other clinically significant ocular surface lesions. The association of ophthalmic pterygium with conjunctival papillomas or CIN stresses the potential involvement of human papilloma virus in the pathogenesis of ophthalmic pterygium, whereas the topographical association of pterygium with iris nevus may offer support to the transcameral light pathway pathogenetic mechanism

Applanation tonometry versus dynamic contour tonometry in eyes treated with latanoprost.

To examine the differences between Goldmann Applanation Tonometry (GAT) and Dynamic Contour Tonometry (DCT) associated with latanoprost use. Twenty-four eyes (of 24 patients) treated with latanoprost monotherapy (latanoprost group, LG), 11 eyes (of 11 patients) not receiving prostaglandin analogs (nonlatanoprost group, NLG), and 20 eyes of 20 nonglaucomatous patients (control group, CG) were included. GAT, DCT, measurement of central corneal thickness and axial length of the eyeball were performed. The difference between GAT and DCT intraocular pressure (dIOP) was calculated. Differences in dIOP among LG, NLG, and CG and correlations of dIOP with other clinical parameters were examined. dIOP was significantly higher in LG, compared with NLG or CG. The correlations of dIOP with axial length of the eyeball were statistically significant in the LG but not in NLG or CG. The correlations of dIOP with central corneal thickness, patients' age, and duration of latanoprost use (LG) were statistically not significant. The fact that dIOP was significantly higher in LG, compared with NLG and CG implies that latanoprost may affect the biomechanical properties of the ocular walls

Clinical and imaging findings in multifocal orbital vascular lesions: a case series.

A variety vascular disorders can affect the orbit, often manifesting as solitary space-occupying lesions. This study presents a case series of 3 patients with multi-focal orbital vascular conditions emphasizing on the clinical and imaging findings which could assist in the diagnosis and treatment planning. Retrospective consecutive case series of 3 patients with multifocal orbital vascular conditions treated at the Department of Ophthalmology of the University Hospital of Heraklion, in Crete, Greece. Presenting symptoms included diplopia with compensatory head tilt (1 case) and eyelid protrusion enhanced by Valsalva maneuver (2 cases). MRI and CT studies showed multiple contrast-enhancing vascular lesions, associated with calcifications (1 case). Two lesions were surgically removed, proving to be orbital varices. Orbital vascular lesions may present multi-focally and displace adjacent structures. MRI and CT imaging may reveal their multi-focal presence as well as associated features, such as phleboliths

Optical Coherence Tomography Angiography (OCTA) of the eye: A review on basic principles, advantages, disadvantages and device specifications.

Optical Coherence Tomography Angiography (OCTA) is a relatively new imaging technique in ophthalmology for the visualization of the retinal microcirculation and other tissues of the human eye. This review paper aims to describe the basic definitions and principles of OCT and OCTA in the most straightforward possible language without complex mathematical and engineering analysis. This is done to help health professionals of various disciplines improve their understanding of OCTA and design further clinical research more efficiently. First, the basic technical principles of OCT and OCTA and related terminology are described. Then, a list of OCTA advantages and disadvantages, with a special reference to blood flow quantification limitations. Finally, an updated list of the basic hardware and software specifications of some of the commercially available OCTA devices is presented

Corneal Collagen Cross-Linking Mushroom Shape Demarcation Line Profile After Limited Bowman's Membrane Removal by Phototherapeutic Keratectomy.

To report a corneal collagen cross-linking (CXL) mushroom shape demarcation line profile after limited Bowman's membrane removal by phototherapeutic keratectomy (PTK). Case report. A twenty-one-year-old male with progressive keratoconus underwent mechanical epithelial debridement (at an 8.5 mm zone) followed by PTK (at a 5.0 mm zone and in a 10 μm depth) and CXL. No intra- or early postoperative complications were found. Evaluation of the corneal stromal demarcation line depth using anterior segment optical coherence tomography revealed a mushroom shape profile. It seems that removal of the Bowman's layer leads to greater depth of the corneal stromal demarcation line

Fifteen-year follow-up after anterior chamber phakic intraocular lens implantation in one and LASIK in the fellow eye.

To report a patient fifteen years after anterior chamber phakic intraocular lens (AC-PIOL) implantation in one and laser in situ keratomileusis (LASIK) in the fellow eye. Case report. A 56-year-old male underwent AC-PIOL implantation in one eye and LASIK in the fellow eye fifteen years ago. Preoperative uncorrected visual acuity (UCVA) was finger count in both eyes. Preoperative best spectacle-corrected visual acuity (BSCVA) was 20/25 (-16.75 -0.50 x 40) in the LASIK eye and 20/32 (-24.50 -0.50 x 90) in the AC-PIOL eye. Fifteen years postoperatively, UCVA was finger count in the LASIK eye and 20/200 in the AC-PIOL eye, while BSCVA was 20/32 and 20/25, respectively. Endothelial cell density (ECD) was 2020+/-47 in the LASIK eye and 945+/-22 in the AC-PIOL eye. Both procedures had similar visual outcomes. Furthermore, lower ECD was found in the AC-PIOL eye in comparison to the LASIK eye

Effect of the Regenerative Agent Poly(Carboxymethylglucose Sulfate) on Corneal Wound Healing After Corneal Cross-Linking for Keratoconus.

To evaluate the effect of a regenerative agent (RGTA) [Cacicol20-poly(carboxymethyl glucose sulfate); OTR3, Paris, France] on corneal reepithelialization and pain after corneal cross-linking (CXL) for keratoconus. In this prospective comparative (contralateral) clinical study, patients with bilateral progressive keratoconus underwent CXL treatment. The corneal epithelium during CXL was removed using transepithelial phototherapeutic keratectomy (Cretan protocol). One eye of each patient was randomly instilled with an RGTA (Cacicol20) once a day (study group), whereas the fellow eye was instilled with artificial tears (control group). Patients were examined daily until complete reepithelialization. Postoperative examinations included slit-lamp biomicroscopy to assess the epithelial defect size and subjective evaluation of pain. The study enrolled 18 patients (36 eyes). The mean epithelial defect size for study and control groups was 19.6 ± 4.2 mm versus 21.5 ± 2.8 mm, respectively, at day 1 (P = 0.019) and 6.4 ± 3.4 mm versus 7.9 ± 4.3 mm, respectively, at day 2 (P = 0.014). At day 3 postoperatively, 61.1% of study eyes were fully reepithelialized, compared with 11.1% of control eyes (P = 0.002). RGTA (Cacicol20) instillation seems to result in faster corneal reepithelialization after CXL in this study. However, there was no significant effect in subjective pain/discomfort