Visual rehabilitation by using corneal wavefront-guided transepithelial photorefractive keratectomy for corneal opacities after epidemic keratoconjunctivitis

SummaryA large nosocomial outbreak of keratoconjunctivitis due to adenovirus type 8 is described. Two hundred cases were identified, 123 by isolation of the virus and 77 by detecting HI antibodies in convalescent sera. Infection usually presented as a severe keratoconjunctivitis, and 107 (54%) of infected patients developed sub-epithelial corneal opacities. The majority (66%) of infections were acquired at the accident and emergency department attached to a large urban eye hospital when patients attended for other reasons; trauma to the eye, especially corneal foreign bodies, was the most frequent cause for the initial attendance. Transmission of virus within the family occurred in 13% of cases, but there was little spread outside family or hospital environments. The outbreak lasted from May to September, 1982, but it was not confirmed by isolation of the virus until the end of June when control measures were instituted. Delay in applying control measures was probably the major factor accounting for this large, prolonged outbreak of epidemic keratoconjunctivitis.

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Case study: Use of contact lenses to manage complications following combined corneal cross-linking and topography-guided photorefractive keratectomy for pellucid marginal degeneration

Canadian Journal of Optometry ◽

10.15353/cjo.78.449 ◽

2016 ◽

Vol 78 (4) ◽

pp. 13

Author(s):

D Yeung ◽

Luigina Sorbara

Keyword(s):

Case Report ◽

Dry Eye ◽

Contact Lenses ◽

Photorefractive Keratectomy ◽

Cross Linking ◽

Visual Rehabilitation ◽

Collagen Cross Linking ◽

Corneal Collagen

This case report describes two significant long-term complications experienced by a patient following treatment for pellucid marginal degeneration (PMD). Two years after undergoing a combination of topography-guided photorefractive keratectomy (T-PRK) and corneal collagen cross-linking (CXL) procedures, the patient continued to experience glare and dryness associated with persistent stromal haze and dry eye. These procedures resulted in dissatisfaction with the final outcome, which led the patient to seek contact lens correction. Management of the symptomatic ocular sequelae with specialty soft toric contact lenses designed for irregular corneas supported her visual rehabilitation.

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Transepithelial Photorefractive Keratectomy with Crosslinking for Keratoconus

The Open Ophthalmology Journal ◽

10.2174/1874364101307010063 ◽

2013 ◽

Vol 7 (1) ◽

pp. 63-68 ◽

Cited By ~ 8

Author(s):

Achyut N Mukherjee ◽

Vasilis Selimis ◽

Ioannis Aslanides

Keyword(s):

Contact Lens ◽

Contact Lenses ◽

Corneal Thickness ◽

Single Step ◽

Photorefractive Keratectomy ◽

Spherical Equivalent ◽

Visual Rehabilitation ◽

Postoperative Assessment ◽

Ethical Approval

Purpose: To analyse visual, refractive and topographic outcomes of combining transepithelial photorefractive keratectomy (tPRK) with simultaneous corneal crosslinking for the visual rehabilitation of contact lens intolerant keratoconus patients. Methods: Patients with topographically significant keratoconus, limited corrected vision and intolerant of contact lenses were prospectively recruited, subject to ethical approval and consent. All patients underwent single step aspheric tPRK and sequential crosslinking. Preoperative vision, refraction, corneal topography and wavefront were assessed, with postoperative assessment at 1, 3, 6, and 12 months. Results: 22 eyes of 14 patients were included in the pilot study. Mean age was 32 years (SD 6.8, range 24 to 43). Mean preoperative unaided vision was 1.39 LogMAR (SD 0.5) best corrected 0.31 LogMAR (SD 0.2). Mean preoperative spherical equivalent was -2.74 Diopters (D) (SD 4.1 range -12.25 to +7.75), and mean cylinder -2.9 D (SD 1.2, range 0 to -5.5). Mean central corneal thickness was 461um (SD 29, range 411 to 516). Vision improved postoperatively; unaided 0.32 LogMAR (SD 0.4), best corrected 0.11 (SD 0.13) (P=<0.005). Mean postoperative cylinder was -1.4D (SD1.2), significantly reduced (p<0.005). Maximum keratometry (Kmax) was stable throughout postoperative follow up. (p<0.05). Conclusions: Non topographic transepithelial PRK with simultaneous crosslinking improves vision, and may offer an alternative to keratoplasty in contact lens intolerant keratoconus. Further comparative studies to topographic PRK techniques are indicated.

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Photorefractive Keratectomy for Visual Rehabilitation of Anisometropia Induced by Retinal Detachment Surgery

Journal of Refractive Surgery ◽

10.3928/1081-597x-20000101-10 ◽

2000 ◽

Vol 16 (1) ◽

pp. 75-78

Author(s):

Kamil Bilgihan ◽

Sengul C Özdek ◽

Gökhan Gürelik ◽

Ufuk Adigüzel ◽

Merih Önol ◽

...

Keyword(s):

Retinal Detachment ◽

Photorefractive Keratectomy ◽

Visual Rehabilitation ◽

Retinal Detachment Surgery

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CAUSES OF VISUAL HANDICAP AMONGST PATIENTS ATTENDING OUTPATIENT DEPARTMENT OF A TERTIARY CARE CENTER FOR VISUAL HANDICAP CERTIFICATE

10.36106/gjra/2304798 ◽

2020 ◽

pp. 62-64

Author(s):

Bhavika Patel ◽

Wilhemina Asari ◽

Chandni Sinojia

Keyword(s):

Care Center ◽

Tertiary Care ◽

Visual Outcome ◽

Outpatient Department ◽

Tertiary Care Center ◽

Visual Disability ◽

Visual Rehabilitation ◽

Phthisis Bulbi ◽

Corneal Opacities ◽

One Year

PURPOSE- To analyse various ocular diseases leading to permanent visual handicap in a district based on visual handicap certification issued by ophthalmologist at tertiary care center after verification of the domicile of the person. METHOD – This is a retrospective analysis of patients attending outpatient department of tertiary care center for visual handicap certification. It was done over the period of one year with total recruitment of 311 patients. All patients were examined for best corrected visual acuity according to Snellen’s chart, anterior and posterior segment examination. Ultrasonography and/or Optical Coherence Tomography and/or electroretinography / visual evoked potential was done in selected cases. After diagnosis, percentage of blindness was determined according to the categories of visual disability and blindness certificate was issued. RESULT- Maximum of the certified visually disabled individuals are of 21- 30 years (73 patients, 23.47%). 212 patients were males and 99 were females. Visual disability of 100% was seen in 258 cases. Retinitis Pigmentosa was the most common cause seen in 67(21.54%) cases. Other major causes include congenital ocular malformation(16.40%) optic atrophy(13.83%), phthisis bulbi (8.68%), corneal opacities(8.36%), glaucoma(6.75%). CONCLUSION- The burden of the blindness can be decreased by public educationand genetic counselling regarding common and preventable causes of blindness, as early diagnosis, treatment and visual rehabilitation can help to improve visual outcome and ultimately visual handicap in the society for the better future.

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