One-Year Follow-up of Corneal Confocal Microscopy After Corneal Cross-Linking in Patients With Post Laser In Situ Keratosmileusis Ectasia and Keratoconus

2009 ◽  
Vol 147 (5) ◽  
pp. 774-778.e1 ◽  
Author(s):  
George D. Kymionis ◽  
Vasilios F. Diakonis ◽  
Maria Kalyvianaki ◽  
Dimitra Portaliou ◽  
Charalampos Siganos ◽  
...  
Keyword(s):  
Confocal Microscopy ◽  
Cross Linking ◽  
Corneal Confocal Microscopy ◽  
One Year

scholarly journals Epi-Off versus Epi-On Corneal Collagen Cross-Linking in Keratoconus Patients: A Comparative Study through 2-Year Follow-Up

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
F. Cifariello ◽  
M. Minicucci ◽  
F. Di Renzo ◽  
D. Di Taranto ◽  
G. Coclite ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Confocal Microscopy ◽  
Comparative Study ◽  
Corneal Thickness ◽  
Treatment Modalities ◽  
Cross Linking ◽  
Corneal Confocal Microscopy ◽  
Group 2 ◽  
Group 1

Aim. To evaluate two different techniques of cross-linking: standard epithelium-off (CXL epi-off) versus transepithelial (CXL epi-on) cross-linking in patient with progressive keratoconus.Methods. Forty eyes from 32 patients with progressive keratoconus were prospectively enrolled from June 2014 to June 2015 in this nonblinded, randomized comparative study. Twenty eyes were treated by CXL epi-off and 20 by CLX epi-on, randomly assigned, and followed for 2 years. All patients underwent a complete ophthalmologic testing that included uncorrected and best corrected visual acuity, central and peripheral corneal thickness, corneal astigmatism, simulated maximum, minimum, and average keratometry, corneal confocal microscopy, Schirmer I and break-up time (BUT) tests, and the Ocular Surface Disease Index. Intra- and postoperative complications were recorded. The solution used for CXL epi-off comprised riboflavin 0.1% and dextran 20.0% (Ricrolin), whereas the solution for CXL epi-on (Ricrolin TE) comprised riboflavin 0.1%, dextran 15.0%, trometamol (Tris), and ethylenediaminetetraacetic acid. Ultraviolet-A treatment was performed with a UV-X system at 3 mW/cm2.Results. In both groups, a significant improvement in visual function (Group 1: baseline 0.36 ± 0.16 logMAR, two-year follow-up 0.22 ± 0.17 logMAR,p=0.01; Group 2: baseline 0.32 ± 0.18 logMAR, 2-year follow-up 0.27 ± 0.19 logMAR,p=0.01) was recorded. Keratometry remained unchanged in both groups. The mean corneal thickness showed a significant reduction (mean difference of corneal thickness: −55 micron and −71 micron, resp.). One-month after treatment, OSDI©reached 13.56 ± 2.15 in Group 1 (p=0.03) and 11.26 ± 2.12 in Group 2 (p=0.04). At confocal microscopy, abnormal corneal nerve alterations were found in both groups. Fibrotic reaction (43.75%) and activated keratocyte (62.6%) were more commonly recorded in Group 1 than in Group 2 (25.0% and 18.75%), withp=0.668and 0.356, respectively.Conclusion. Our findings demonstrate that both procedures are able to slow keratoconus progression. Both treatment modalities are equivalent in terms of results and related complications. CXL epi-on technique is preferable to CXL epi-off since it preserves the corneal thickness and improves visual acuity, also reducing the postoperative ocular discomfort during the study period.

Corneal cross-linking for treatment of progressive keratoconus in a patient with Alport syndrome: A case report

2021 ◽  
pp. 112067212199767
Author(s):  
Iva Krolo ◽  
Aida Kasumović ◽  
Ivana Radman ◽  
Pavao Pavić
Keyword(s):  
Case Report ◽  
Alport Syndrome ◽  
Contact Lenses ◽  
Corneal Dystrophy ◽  
Clinical Findings ◽  
Cross Linking ◽  
Posterior Polymorphous Corneal Dystrophy ◽  
One Year ◽  
Corneal Tomography

Purpose: Ocular features of Alport syndrome include anterior lenticonus, posterior polymorphous corneal dystrophy, and fleck-and-dot retinopathy in most cases. Keratoconus in such patients has been rarely mentioned in previous studies. To our knowledge, this is the first report of corneal cross-linking for halting the progression of keratoconus in a patient with Alport syndrome. Case report: A 22-year-old male was referred for his initial corneal topography, after he was already prescribed with rigid gas-permeable contact lenses. Alport syndrome was diagnosed in his infancy and gene COL4A5 mutation was confirmed. Ophthalmological evaluation confirmed keratoconus. One-year follow-up showed a progression on his right eye and standard corneal cross-linking was performed. Stabilization of the disease marked by normalization in visual function and corneal tomography values was noticed 1 year after the procedure. Conclusions: When diagnosing ocular clinical findings of Alport syndrome, keratoconus should be considered. Standard corneal cross-linking protocol can halt its progression.

Carpal Tunnel Syndrome Associated with Bifid Median Nerve and Palmaris Profundus - Case Report and Literature Review

2019 ◽  
Vol 24 (02) ◽  
pp. 238-242
Author(s):  
Francesco Kostoris ◽  
Stefania Bassini ◽  
Emiliano Longo ◽  
Luigi Murena
Keyword(s):  
Median Nerve ◽  
Carpal Tunnel ◽  
Rare Case ◽  
Direct Compression ◽  
Transverse Carpal Ligament ◽  
Accidental Injury ◽  
Tunnel Syndrome ◽  
One Year

The anatomic variations of the median nerve and of the muscles of the wrist have been widely reported in literature. It is essential for the surgeon to be familiar with these variations in order to avoid accidental injury to the nerve during surgery. We report a rare case of bifid median nerve accompanied by an anomalous tendon of palmaris profundus discovered during the surgical release of carpal tunnel. The transverse carpal ligament was dissected and the anomalous tendon was left in situ because any direct compression over the median nerve was noticed intraoperatively. The patient was evaluated one year postoperatively clinically and radiologically (with MRI). At the follow up the resolution of symptoms was complete and the sleep disturbance was solved. The patient achieved a postoperative QuickDASH score of 9.1 and a Michigan Hand Questionnaire outcome score of 90 points.

Diffuse Sterile Corneal Infiltration: An Unusual Complication Post Collagen Cross-linkage

2015 ◽  
Vol 4 (3) ◽  
pp. 115-119 ◽  
Author(s):  
Ritu Arora ◽  
Sonal Dangda
Keyword(s):  
Visual Acuity ◽  
Rare Complication ◽  
Cross Linking ◽  
Unusual Complication ◽  
Topical Steroids ◽  
Poor Vision ◽  
Corneal Clouding ◽  
Cross Linkage

ABSTRACT Purpose Presenting the course of visually disabling corneal infiltration post uneventful collagen cross-linking (CXL) in a 23 years old male with bilateral keratoconus. Methods A 23 years old male with bilateral keratoconus underwent cross-linking of left eye with indigenous 0.1% riboflavin dye and 370 nm ultraviolet A irradiation. This patient had an uneventful successful cross-linking performed in right eye 6 months prior with good recovery of vision to LogMAR (6/9 Snellen). Results Patient developed diminution of vision, along with redness of eye, photophobia and watering on 3rd day after uneventful cross-linkage. Examination revealed very poor vision; diffuse corneal clouding with multiple superficial stromal infiltrates and incomplete corneal epithelization. A provisional diagnosis of infective keratitis was made, in situ bandage contact lens (BCL) removed and subjected to culture. Intensive fortified topical antibiotics were initiated and steroids withheld. After complete corneal re-epithelization on 6th day, the infiltrations did not decrease in either intensity or number. Response to antibiotics being inadequate, an immune etiology was suspected and full strength topical steroids reinstituted which resulted in slow resolution of infiltration over a 10 weeks period. Last follow-up at 9 months post-CXL, revealed a diffuse stromal haze with unaided visual acuity of LogMAR 0.8 6/36 and best-corrected visual acuity (BCVA) of 0.3 (6/12) with use of a rigid gas permeable lens. Conclusion Sterile infiltration post-CXL requiring intense topical steroids is a rare complication of CXL and needs to be differentiated from infective keratitis. How to cite this article Bhattacharyya M, Singh K, Mutreja A, Dangda S, Arora R. Diffuse Sterile Corneal Infiltration: An Unusual Complication Post Collagen Cross-linkage. Int J Kerat Ect Cor Dis 2015;4(3):115-119.

Sirolimus Combined with Dexamethasone for the Treatment of a Patient with Interferon Resistant Hydroa Vacciniform-Like Lymphoma

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 4992-4992
Author(s):  
Zhigang Liu ◽  
Yongqian Jia ◽  
Yuping Gong ◽  
Yong Guo ◽  
Jiazhuo Liu ◽  
...  
Keyword(s):  
T Cell ◽  
Conflicts Of Interest ◽  
Serum Biochemistry ◽  
Skin Lesions ◽  
Cytotoxic T Cell ◽  
Cell Phenotype ◽  
Ebv Dna ◽  
One Year

Abstract Abstract 4992 Hydroa vacciniform-like lymphoma is an unusual pediatric cutaneous T-cell lymphoma, which rarely involved with adults. Chemotherapy and/or radiotherapy had little or no benefit. Patients may have a response to α-interferon. We report here an adult case with interferon resistant hydroa vacciniform-like lymphoma that has been successfully treated with sirolimus, an mTOR pathway inhibitor. The patient is a thirty-five year old women,she begun with recurrent cutanous rash and small vesicule around her mouth and nose 3 years ago. One year before, the symptoms were exacerbated with obvious vesiculopapular eruption, edematous, blisters, ulcers, scarring and crusts in her face. Scattered vesiculopapular could be seen in her upper chest and extremities accompanied with fever and submandibular lymphadenopathy. Facial skin biopsy showed angiocentric infiltrates from the epidermis to the subjacent dermis. The infiltrate cells showed a cytotoxic T-cell phenotype, with positive TCR gene rearrangement and EBER expression in situ hybridization. EBV serum test showed EBV-IgA and IgG positive, but serum EBV-DNA was negative. Patient was given α-interferon 300 million units, intramuscularlly, two times a week, plus prednisone 30mg per day, orally. Patients' skin lesions were improved, but present recurrent episodes of papulovesicular eruptions. For the past 3 month patient had a recurrent high fever and exacerbated vesiculopapular eruptions and blisters. Laboratory test showed anemia and neutropenia, serum biochemistry and marrow examination confirmed that a lymphoma associated hematophagocytosis was complicated. Sirolimus was started at an initial dose of 1.5mg, orally, every 12 hours, combined with dexamethasone 10mg/day, intravenously. Three days later the fever begun to resolved and the skin lesion gradually subsided. Two weeks later the skin lesions disappeared and the dose of sirolinmus begun to tapered to 1.0mg, orally, every 12 hours, with prednisone 30mg/day, orally. By three month of follow-up the patient still on stable and be observed. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Cornea Confocal Microscopy: Utilities and Perspectives

2021 ◽  
Author(s):  
Eduardo Rojas Alvarez
Keyword(s):  
Confocal Microscopy ◽  
Corneal Transplantation ◽  
Infectious Keratitis ◽  
Corneal Dystrophies ◽  
Corneal Confocal Microscopy ◽  
Depth Study ◽  
High Resolution Images ◽  
Refractive Medium ◽  
High Standards

The cornea is the ocular refractive medium with the greatest refractive power of the eye. The study of it is of vital importance for the diagnosis and follow-up of ophthalmological diseases with the aim of achieving high standards of visual acuity in our patients. Confocal microscopy of the cornea allows in-depth study of it, quickly, safely, painlessly, obtaining high-resolution images of the corneal sublayers. This chapter summarizes the procedure for performing corneal confocal microscopy, the normal characteristics of the tissue with real images of our patients, as well as a brief explanation of the main applications of this technology in the study of corneal dystrophies (keratoconus), in refractive surgery, corneal transplantation, infectious keratitis, glaucoma filtration bulla, among other topics.

scholarly journals Outcomes of Wavefront-Optimized Laser-Assisted In-Situ Keratomileusis and Photorefractive Keratectomy for correction of Myopia and Myopic Astigmatism over One Year Follow-Up

2018 ◽  
Vol 12 (1) ◽  
pp. 256-263 ◽  
Author(s):  
Mohammad M. Shehadeh ◽  
Mohammad T. Akkawi ◽  
Ammar A. Aghbar ◽  
Muna T. Musmar ◽  
Malak N Khabbas ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Excimer Laser ◽  
Photorefractive Keratectomy ◽  
Distance Visual Acuity ◽  
Visual Outcomes ◽  
Corrected Distance Visual Acuity ◽  
One Year ◽  
Myopic Astigmatism

Background: Laser corneal refractive surgery suits, technology and nomograms are improving with time. This may improve the refractive and visual outcomes of the patients. Objectives: To evaluate the safety, efficacy, stability, and predictability of wavefront-optimized photorefractive keratectomy and Laser-assisted in-situ keratomileusis in patients with myopia and myopic astigmatism over 1-year using WaveLight® EX500 Excimer Laser machine. Methods: In this prospective cohort study, refractive and visual outcomes in 596 eyes (365 patients), either having myopia or myopic astigmatism were assessed. Patients were divided into Two groups: 1) Patients who underwent PRK (53 eyes have myopia and 217 eyes have myopic astigmatism), 2) Patients who underwent LASIK (53 eyes have myopia and 273 eyes have myopic astigmatism). Results: At 12 months postoperatively 94.3% of the myopic patients reached their preoperative best corrected distance visual acuity at the final one year follow up visit post PRK and LASIK. In patients with myopic astigmatism who underwent LASIK and PRK, 95.2%, and 96.3% of the patients reached their preoperative best corrected distance visual acuity at the final one year follow up visit post LASIK and PRK, respectively. The efficacy and safety indices were 1.00 or more for all groups with no eye lost any line of best corrected distance visual acuity. Conclusion: Our study results confirm the excellent efficacy, safety, good predictability and stability of myopia / myopic astigmatism correction by either wavefront- optimized LASIK or PRK over 1-year follow-up without significant differences between them using the WaveLight® EX500 excimer laser system.

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