Localized flap melt after Nd-YAG laser treatment in recurrent post-LASIK epithelial ingrowth

ABSTRACTNeodymium: Yttrium-Aluminum-Garnet (Nd-YAG) laser treatment of epithelial ingrowth was found promising with high success rates in cases of primary post-LASIK epithelial ingrowth. However, the application range of this procedure is not well-known. For the first time, the authors report the outcome of a patient treated with Nd-YAG laser for multiple recurrences of post-laser in situ keratomileusis epithelial ingrowth

Effects of 1% cyclopentolate hydrochloride on anterior segment parameters obtained with Pentacam in young adults

Purpose: To investigate the effects of topically applied 1% cyclopentolate hydrochloride on anterior segment parameters obtained with a Pentacam rotating Scheimpflug camera in healthy young adults. Methods: Anterior segment analyses of 25 eyes from 25 young adults (Group 1), before and after 45 min of 1% cyclopentolate hydrochloride application, were performed. For a control group (cycloplegia-free, Group 2), 24 eyes of 24 age- and sex-matched healthy cases were evaluated twice at 45 min intervals. The results obtained from the groups were compared statistically. Results: The mean ages of the groups were 23.04 ± 3.42 (range, 18-29) and 22.4 ± 2.05 (range, 18-27) years for Groups 1 and 2, respectively (p=0.259). In Group 1, measurements between the two analyses were significantly different for the values of anterior chamber depth (ACD), anterior chamber angle (ACA), and anterior chamber volume (ACV) (p<0.05), whereas no statistical difference was found for the central corneal thickness (CCT) and keratometry (K1, K2) measurements. In Group 2, none of these parameters were statistically different between the two analyses. Conclusions: Topically applied 1% cyclopentolate hydrochloride caused an increase in the ACD and ACV values, and a decrease in the ACA value. However, it had no significant effect on the CCT and keratometry measurements. It is important to consider these effects when using the Pentacam device on young adults with cycloplegia and when applying it for various reasons

Ultrasound biomicroscopy confirmation of corneal overriding due to improper suturing of full-thickness corneal laceration

We herein present a case with corneal overriding due to improper suturing of a full-thickness corneal laceration. There was a 2.5-mm difference between horizontal and vertical white-to-white measurements in the cornea. However, slit lamp examination failed to demonstrate the exact architecture of the laceration. Ultrasound biomicroscopy defined the wound edges thoroughly and confirmed the presence of corneal overriding. Six weeks after suture enhancement, the abnormal oval appearance of the cornea was absent and correct apposition of the corneal edges was seen on ultrasound biomicroscopy. Ultrasound biomicroscopy can be used in preoperative surgical planning of cases with complicated corneal lacerations. It can be used to adjust and enhance wound architecture in eyes with penetrating injury

Air bubble in anterior chamber as indicator of full-thickness incisions in femtosecond-assisted astigmatic keratotomy

Femtosecond-assisted astigmatic keratotomy is predictable and precise but may occasionally lead to a full-thickness incision on the cornea and the attendant complications. The presence of an air bubble in the anterior chamber soon after creation of the keratotomy by the femtosecond laser may indicate a full-thickness incision. We present a case in which recognition of this clinical finding early in the procedure might have prevented undesirable complications, such as leakage of aqueous and the potential for intraocular infection

Optical coherence tomography in cornea and refractive surgery

Optical coherence tomography (OCT) is the most promising imaging technique used in ophthalmology today. Noninvasive, noncontact and having quick image acquisition makes OCT a requirement in ophthalmology practice. OCT can be used to gain cross-sectional images of the anterior and posterior segment of the eye. In cornea and refractive surgery anterior segment OCT (AS-OCT) is used in presurgical planning and postsurgical evaluation. AS-OCT is especially needed in phakic intraocular lens implantation, laser-assisted in situ keratomileusis enhancement and lamellar keratoplasty. There are also various promising advancements in AS-OCT imaging, such as intraoperative OCT and ultra-high-resolution OCT. These techniques offer new therapeutic and diagnostic options with increased resolution and improved scanning time

Corneal haze following disruption of epithelial basement membrane on ultra-high-resolution OCT following femtosecond LASIK

To analyze in vivo structural properties of a case with interface haze that developed after femtosecond laser-assisted LASIK. Case report. A 42-year-old man underwent uncomplicated LASIK. Four months after the surgery he developed regression of his refractive error and interface haze in both eyes. Flap thickness was calculated as 73 μm and 81 μm in the right and left eyes, respectively. A novel ultra-high-resolution spectral domain optical coherence tomography (OCT) system was used to demonstrate in vivo morphology of the cornea. On ultra-high-resolution OCT, haze was demonstrated as increased bright white reflectivity of the flap interface. Areas of focal disruption of the basement membrane and Bowman layer corresponded with the most significant areas of interface haze. Our results support the hypothesis that haze after femtosecond LASIK may be a result of damage to the basement membrane and Bowman layer of the cornea

An unusual complication of blunt ocular trauma: A horseshoe-shaped macular tear with spontaneous closure

A case of horseshoe-shaped macular tear after blunt trauma with the course of the tear and the relevant findings obtained by spectral-domain optical coherence tomography (SD-OCT) is described. A 21-year-old man who had suffered blunt trauma 5 days previously visited our clinic complaining of vision loss in his left eye. Ophthalmic examination and SD-OCT images revealed a horseshoe-shaped macular tear. A month later at the second visit, the macular tear was found to have spontaneously closed. There have been many cases reported previously of the spontaneous closure of traumatic macular holes. A horseshoe-shaped macular tear is an atypical clinical presentation. However, the mechanism of spontaneous closure is hypothetically as same as that for a macular hole. High-resolution images and three-dimensional maps taken with SD-OCT can provide more details on macular diseases and are more useful than time-domain OCT images

Effects of 1% cyclopentolate hydrochloride on anterior segment parameters obtained with Pentacam in young adults

Purpose: To investigate the effects of topically applied 1% cyclopentolate hydrochloride on anterior segment parameters obtained with a Pentacam rotating Scheimpflug camera in healthy young adults

In vivo structural characteristics of the femtosecond LASIK-induced opaque bubble layers with ultrahigh-resolution SD-OCT

The authors report in vivo morphology of opaque bubble layers with ultrahigh-resolution anterior-segment optical coherence tomography (UHR-OCT) in 3 patients. Two patients were operated on with a 30-kHz IntraLase femtosecond laser (Abbott Medical Optics, Abbott Park, IL) and one patient was operated on with a 500-kHz VisuMax femtosecond laser (Carl Zeiss Meditec, Jena, Germany). UHR-OCT images from the patient operated on with the 500-kHz femtosecond laser revealed that the opaque bubble layer extended anterior to the flap dissection plane up to Bowman's membrane. The lamellar flap dissection was incomplete in this patient. The opaque bubble layer in the patients operated on with the 30-kHz femtosecond laser extended posterior to the flap dissection plane and these patients experienced complete lamellar dissections with uncomplicated flap lifts. UHR-OCT imaging can be used to demonstrate the structural characteristics of OBL. It has the potential to be used to predict incomplete lamellar flap dissections in patients with opaque bubble layers