Nine-Year Follow-Up of Intacs Implantation for Keratoconus

To present a case of nine- year bilateral Intacs (Addition Technology, Inc, Fremont, California, USA) implantation for early stage keratoconus. A 25-year-old male underwent bilateral Intacs implantation for the management of keratoconus and hardcontact-lens intolerance (stage 1) in 1999. Nine years postoperatively, spherical equivalent refraction changed from preoperative -0.75 and -2.25 to +0.75 and -1.25 for the right and the left eye, respectively. UCVA was improved from 20/50 to 20/25 in the right and from 20/200 to 20/32 in the left eye. BSCVA of 20/20 in the right eye maintained stable in comparison with the Pre-Intacs BSCVA, while BSCVA was improved from 20/25 to 20/20 in the fellow eye. No early or late complications were observed. Nine years after bilateral Intacs implantation for the management of early stage keratoconus, there was a significant improvement and postoperative stability in patient's visual acuity. No long-term, sight-threatening complications were identified during follow-up

Transepithelial Phototherapeutic Keratectomy Using a 213-nm Solid-State Laser System Followed by Corneal Collagen Cross-Linking with Riboflavin and UVA Irradiation

Purpose. To present a case of a keratoconic patient who underwent epithelial removal with transepithelial phototherapeutic keratectomy (t-PTK) using a 213-nm solid-state laser system followed by corneal collagen cross-linking (CXL) with riboflavin and ultraviolet-A (UVA) irradiation. Methods. Case report. Results. A twenty-four-year-old male with keratoconus underwent CXL treatment after epithelial removal with t-PTK using a solid-state laser system. No intra- or early postoperative complications were found. One month postoperatively, uncorrected visual acuity (UCVA) improved from 20/63 to 20/32 while best spectacle- corrected visual acuity (BSCVA) improved from 20/40 to 20/25. Corneal topography revealed a significant improvement which remained stable during the six-month followup period. Conclusions. Epithelial removal with t-PTK before CXL could improve patient's visual outcome

Customized pachymetric guided epithelial debridement for corneal collagen cross linking

<p>Abstract</p> <p>Backround</p> <p>We describe a modified method for deepitheliazation prior to corneal cross linking (CXL). The technique may overcome the current corneal pachymetric limitation parameter (over 400 microns) that is necessary for the safety of the procedure without affecting the overall benefits.</p> <p>Methods</p> <p>In a series of two patients, with inferior topographic steepening and regional thinning (less than 400 microns corresponding to the area of corneal steepening), CXL after customized epithelial removal was performed.</p> <p>Results</p> <p>There were no intra- or postoperative adverse events seen by the nine month follow up examination. Stabilization of the corneal ectasia was observed up to nine months post-costumized pachymetric-guided epithelial removal.</p> <p>Conclusion</p> <p>The technique of customized pachymetric-guided epithelial removal is easy to perform and may overcome the limitations of the preoperative corneal pachymetry expanding the application of the procedure in patients with regional corneal thinning.</p

Clinical Study Long Term Followup of Photorefractive Keratectomy with Adjuvant Use of Mitomycin C

properly cited. Purpose. To study the long term refractive and visual outcomes of photorefractive keratectomy (PRK) with intraoperative application of mitomycin C (MMC). Methods. This study included 37 eyes who received myopic PRK; after photoablation, a sponge soaked in 0.02% MMC solution was applied in all corneas for 2 minutes. Efficacy, safety, predictability, and stability of PRK MMC were evaluated. Endothelial cell density was evaluated at the last postoperative interval. Results. Mean preoperative spherical equivalent (SEQ) was −6.03 ± 1.87 D (diopters) and reduced to −0.09 ± 0.53 D at the last postoperative examination. Mean followup was 44.73 ± 18.24 months. All the eyes were in the ±1.00 D of attempted versus achieved SEQ at the one-year follow-up interval. Furthermore, 95% of the eyes did not lose lines or gained 1 to 2 lines of CDVA, while 5% lost 1 line. At the third postoperative month, 89% of the eyes either were clear or had trace haze, while 4 eyes had mild haze; by the 12-month postoperative interval, none of the eyes demonstrated haze. Mean endothelial cell density (ECD) at the last postoperative interval was 2658 ± 153 cells/mm 2 . Conclusions. PRK, with intraoperative use of MMC, demonstrates stable refractive and visual outcomes up to 44 months after surgery

Central Corneal Thickness in Patients With Neovascular Age-Related Macular Degeneration

Purpose: To compare the central corneal thickness (CCT) measurements of patients with neovascular age-related macular degeneration (AMD) and control subjects. Methods: The CCT value (measured with ultrasound corneal pachymetry) of 130 eyes (130 patients, 1 eye from each patient) with neovascular AMD (AMD group) and 98 eyes (98 patients, 1 eye from each patient) of similar age, sex, and eye&apos;s axial length healthy control subjects (normal group) was compared. Results: The mean age (AMD group: 69.1 years vs. control group: 69.5 years, P = 0.81), sex (AMD group: 77 women, 59% vs. control group: 59 women, 60%, P = 0.77), and eye&apos;s axial length (AMD group: 25.05-mm vs. control group: 24.61-mm, P = 0.38) of patients with neovascular AMD and healthy control subjects were comparable. There were no statistically significant differences in the mean CCT measurements in the neovascular AMD group in comparison with the control group (549.44 vs. 544.35 mm, P = 0.11). Conclusions: CCT measurements do not differ in patients with neovascular AMD compared with healthy control subjects

Corneal stroma demarcation line after standard and high-intensity collagen crosslinking determined with anterior segment optical coherence tomography

PURPOSE: To use anterior segment optical coherence tomography (AS-OCT) to compare corneal stroma demarcation line depth after corneal collagen crosslinking (CXL) with 2 treatment protocols. SETTING

Follow up of intraocular lens subluxation with a combined topographer/aberrometer

Purpose: To report a 36-year-old patient with intraocular lens (IOL) subluxation that was followed for IOL stability with evaluation of images captured with the iTrace combined aberrometer/topographer. Methods: The patient had undergone phacoemulsification with IOL implantation for congenital cataract 15 years before. He presented with bilateral IOL subluxation, more severe in his right eye. Right eye was operated for IOL exchange and left eye was followed with the iTrace images. The images were captured with an infrared camera, and the pupil, the pupil center and the corneal vertex could be detected. The subluxated IOLs edge was visible through infrared light retroillumination. IOL position was evaluated with respect to the pupil, the pupil center and the corneal vertex. Results: The patient's left eye was followed for 7 months, and IOL position was noted to be stable. Thus no intervention was planned. Conclusion: Evaluation of iTrace images is a reliable method to follow eyes with IOL subluxation