Long-Term Comparison of Simultaneous Topography-Guided Photorefractive Keratectomy Followed by Corneal Cross-linking versus Corneal Cross-linking Alone.

To compare the results of corneal collagen cross-linking (CXL) alone with combined simultaneous topography-guided photorefractive keratectomy plus CXL (tPRK-CXL) for progressive keratoconus for a 3-year interval. Prospective, comparative interventional case series. Forty-eight patients (60 eyes) with progressive keratoconus. Thirty eyes underwent combined tPRK with a solid-state laser (maximum ablation depth, 50 μm) followed by CXL, and 30 eyes underwent CXL alone. Groups were matched in terms of age and keratoconus stage. Corrected distance visual acuity (CDVA), uncorrected distance visual acuity (UDVA), keratometry, and corneal confocal microscopy. Mean follow up was 39±11 months. Mean age at operation was 28±5.82 years. Before surgery, average CDVA in the tPRK-CXL group was 0.26±0.17 logarithm of the minimum angle of resolution (logMAR), and in the CXL group was 0.24±0.18 logMAR (P = 0.58). At last follow-up, CDVA was 0.09±0.10 logMAR in the tPRK-CXL group and 0.15±0.12 logMAR in the CXL group (P < 0.05). In both groups, no patient lost more than 2 lines of Snellen visual acuity, whereas 19 eyes and 8 eyes in the tPRK-CXL group and in the CXL group, respectively, gained 2 or more lines of CDVA. Before surgery, average UDVA was 0.83±0.54 logMAR in the tPRK-CXL group and 0.86±0.62 logMAR in the CXL group (P = 0.79). At last follow-up, UDVA was 0.27±0.25 logMAR in the tPRK-CXL group and 0.69±0.58 logMAR in the CXL group (P < 0.001). Before surgery, steep and flat keratometry had no significant differences between groups, and at last follow-up, both steep and flat keratometry readings were significantly flatter in the tPRK-CXL group compared with the CXL group. Depth of CXL treatment, as evaluated by confocal microscopy, was 269.8±31.8 μm in the CXL group and 299.7±29.8 μm in the tPRK-CXL group (P < 0.001). No differences were found in endothelial cell density. Simultaneous tPRK followed by CXL in this series of keratoconus patients offered significantly improved vision to treated patients in comparison with CXL alone, and similar results regarding postoperative stability. Safety concerns regarding corneal thickness were taken into account in treatment planning

Surgical management of post-Descemet stripping automated endothelial keratoplasty interface haze associated with interface deposits.

We describe an effective technique for the management of graft-host interface haze associated with interface deposits after Descemet-stripping automated endothelial keratoplasty (DSAEK) with bimanual irrigation/aspiration. A Tan marginal dissector was used to separate the graft from the stroma in the nasal two-thirds of the graft-host interface. The aspiration handpiece was inserted in the interface through the nasal side-port corneal incision and a separate irrigation tip was placed in the anterior chamber (AC) through the temporal corneal paracentesis. Meticulous rinsing of the two-thirds of the interface area and the AC was performed. At the end of the procedure, air was injected into the AC to float the donor graft against the host stromal bed and facilitate graft adherence. Postoperative anterior segment optical coherence tomography and slit-lamp examination confirmed elimination of the interface haze-deposits and a well-attached graft. An improvement in visual acuity was noted

Treatment of myopic choroidal neovascularization with intravitreal ranibizumab injections: The role of age

Purpose: The aim of this study was to explore the role of age as a prognostic factor for the outcome of myopic choroidal neovascularization (CNV) treatment with intravitreal ranibizumab injections. Methods: A retrospective review of charts of patients treated with intravitreal injections of ranibizumab for the treatment of myopic CNV was done. Patients with other ophthalmic disease were excluded. Patients were followed for at least 2 years. The correlation between age and the change in visual acuity and the number of injections during treatment was investigated. Results: Age of the patients was significantly correlated with the number of injections that the patients received (Pearson’s r=0.585, P=0.005). Also, it was significantly correlated with improvement in corrected distance visual acuity, defined as the difference between final and initial LogMAR corrected distance visual acuity (Pearson’s r=0.614, P=0.003). Conclusion: Age significantly affects the visual outcome of myopic CNV treatment with ranibizumab. Younger patients in our study needed fewer intravitreal injections and achieved a more significant improvement in vision. © 2017 Karagiannis et al

In vivo evaluation of blue-light attenuation with tinted and untinted intraocular lenses

In this paper we present a method for mapping streaming applications, with real-time requirements, onto a reconfigurable MPSoC. In this method, the performance of the hardware architecture (the reconfigurable Processing Element, the Network Interface and the Network-on-Chip) is integrated in the performance models of the applications. In this way the performance of the mapped application can be determined at run-time. A predictable NoC (guaranteed bandwidth and bounded latency), a predictable Network Interface and a predictable Processing Element are key requirements for our approach