Lamellar Keratoplasty Using Microkeratome-Assisted Anterior Lamellar Graft in the Management of Deep Limbal Dermoid: A Case Report

Limbal dermoid is a congenital benign tumor of the limbus which is often managed by surgery if necessary. In dermoid lesions involving the deep stroma, tumor excision and reconstruction of the anterior segment with amniotic membrane transplantation or keratoplasty may be required. Herein, we present a case of deep limbal dermoid treated with surgical resection and lamellar keratoplasty using microkeratome-assisted anterior lamellar graft

Evaluation of Intereye Corneal Asymmetry in Patients with Keratoconus. A Scheimpflug Imaging Study

Purpose: To assess the correlation between keratoconus severity and intereye asymmetry of pachymetric data and posterior elevation values and to evaluate their combined accuracy in discriminating normal corneas from those with keratoconus. Methods: This study included 97 patients: 65 subjects with bilateral normal corneas (NC) and 32 with keratoconus (KC). Central corneal thickness (CCT), thinnest corneal thickness (ThCT) and posterior elevation (PE) at the thinnest point of the cornea were measured in both eyes using Scheimpflug imaging. Intereye asymmetry and its correlation with keratoconus severity were calculated for each variable. The area under the receiver operating characteristic curve (AUROC) was used to compare predictive accuracy of different variables for keratoconus. Results: In normal eyes, intereye differences were significantly lower compared with the keratoconus eyes (p<0.001, for CCT, ThCT and PE). There was a significant exponential correlation between disease severity and intereye asymmetry of steep keratometry (r(2) = 0.55, p<0.001), CCT (r(2) = 0.39, p<0.001), ThCT (r(2) = 0.48, p<0.001) and PE (r(2) = 0.64, p<0.001). After adjustment for keratoconus severity, asymmetry in thinnest pachymetry proved to be the best parameter to characterize intereye corneal asymmetry in keratoconus. This variable had high accuracy and significantly better discriminating ability (AUROC: 0.99) for KC than posterior elevation (AUROC: 0.96), ThCT (AUROC: 0.94) or CCT (AUROC: 0.92) alone. Conclusions: There is an increased intereye asymmetry in keratometry, pachymetry and posterior corneal elevation values in keratoconic patients compared to subjects with normal corneas. Keratoconus patients with more severe disease are also more asymmetric in their disease status which should be taken into account during clinical care

Comparison of Efficacy of Two Different Topical 0.05% Cyclosporine A Formulations in the Treatment of Adenoviral Keratoconjunctivitis-Related Subepithelial Infiltrates

Subepithelial infiltrates secondary to adenoviral keratoconjunctivitis may persist for years and cause blurred vision, halos, glare, and photophobia. These infiltrates arise from immune reaction against the virus, and few studies have reported topical cyclosporine A to be effective in the treatment of subepithelial infiltrates. Herein, we describe a patient with adenoviral keratoconjunctivitis-related subepithelial infiltrates who did not respond to treatment with a new topical cyclosporine A emulsion prepared with castor oil (Depores 0.05%; Deva İlaç, Kocaeli, Turkey), while the FDA-approved nanoemulsion formulation provided improvement in symptoms and reduced the inflammatory reaction (Restasis 0.05%; Allergan, Irvine, Calif., USA)

Ocular Tuberculosis with Progressive Unilateral Corneal Melting

Objectives: In this case report, we present a patient with ocular tuberculosis presenting with progressive unilateral corneal melting. Patient: A 47-year-old female was admitted with melting at the inferior half of the peripheral cornea and inferior subconjunctival nodules. Biopsy material of the nodules was negative for tuberculosis bacillus. However, polymerase chain reaction of the biopsy sample revealed the DNA of the bacillus, and the diagnosis was confirmed. Conclusion: In endemic areas, ocular tuberculosis should be kept in mind in the differential diagnosis of patients with chronic and atypical corneal involvement

Endothelial alterations in 712 keratoconus patients

PurposeTo investigate the effect of the severity of keratoconus on the corneal endothelium using specular microscopy. MethodsSeven hundred and twelve eyes from the Homburg Keratoconus Center (HKC) database were included in this retrospective study. Corneal endothelium was evaluated using the Tomey EM-3000 specular microscope. Keratoconus-related topographic and tomographic data were obtained from Scheimpflug-based tomography (Oculus Pentacam® HR). Eyes were classified into stages 0 (healthy) to 4 (severe keratoconus) according to the Topographic Keratoconus Classification (TKC). Subgroups were analysed based on contact lens (CL) type (none/rigid/soft). ResultsThe frequencies of keratoconus stages 0/1/2/3/4 according to TKC were 169/94/206/166/77. The endothelial cell density (ECD) for the endothelial cell area for TKC 0/1/2/3/4 was 2611/2624/2557/2487/2401 cells per mm2 and the coefficient of variation (CV) was 40.9/40.0/41.6/46.2/49.0%, respectively. The more severe the keratoconus stage, the lower the endothelial cell count (p 2 and CV was 41.8/54.1/43.1%, respectively. A significant difference in CV was found between NoCL and RCL (p = 0.02), and no significant difference in CV was found between NoCL and SCL (p = 0.07). Endothelial cell density (ECD) did not differ significantly between NoCL and RCL or SCL. ConclusionEndothelial cell density (ECD) decreases and CV increases significantly with increasing tomographic severity of keratoconus. In patients with RCL compared to eyes without CL wear, we found a statistically significantly higher CV in the endothelial cell size.</br