Straylight before and after phacoemulsification in eyes with preoperative corrected distance visual acuity better than 0.1 logMAR

ABSTRACT Purpose The purpose of this study is to evaluate the topographic, topometric and visual changes after implantation of Ferrara intrastromal corneal ring segments (ICRS) in grades I and II keratoconus patients. Materials and methods The chart records of 50 consecutively operated keratoconus patients were reviewed. The patients were operated on by the same surgeon, with the manual technique. All patients were preoperatively and postoperatively evaluated with the Pentacam (OCULUS Optikgeräte, Wetzlar, Germany). The studied parameters were: uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), keratometry, corneal asphericity and corneal volume. Results Fifty eyes of 42 patients (26 males and 16 females) were analyzed. The mean preoperative UDVA was 0.91 ranging from LogMAR 0.10 to 1.30. The mean postoperative CDVA was 0.19 ranging from 0.00 to 0.54 LogMAR. The postoperative CDVA was equal or better than 0.18 in 37 cases (74%). The mean K1 decreased from 45.80D (±2.52) preoperatively to 44.27D (± 2.10) postoperatively and the mean K2 value, from 49.06D (± 2.09) to 46.22D (±1.89). The mean asphericity increased from −0.71 preoperatively to −0.29 postoperatively. The average preoperative corneal volume was 56.89 ± 3.11 mm3 while the average postoperative corneal volume was 57.64 ± 3.05 mm3. Conclusion The study supports the early indication of implantation of Ferrara ICRS in mild to moderate keratoconus cases in order to achieve good visual, keratometric and ashpericity outcomes. How to cite this article Rodrigues PF, Ferrara G, Ferrara P, Dias WG, Torquetti L. Intrastromal Corneal Ring Segments Implantation in Patients with Mild Keratoconus. Int J Kerat Ect Cor Dis 2014;3(3):122-126.

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Customized versus Standard Epithelium Profiles in Transepithelial Photorefractive Keratectomy

Optics ◽

10.3390/opt2040025 ◽

2021 ◽

Vol 2 (4) ◽

pp. 266-275

Author(s):

Diego de Ortueta ◽

Dennis von Rüden ◽

Samuel Arba-Mosquera

Keyword(s):

Visual Acuity ◽

Anterior Segment ◽

Photorefractive Keratectomy ◽

Refractive Errors ◽

Optical Coherence ◽

Distance Visual Acuity ◽

Ablation Technique ◽

Corrected Distance Visual Acuity ◽

Epithelium Thickness ◽

Better Than

Transepithelial photorefractive keratectomy (TransPRK) is an established surface ablation technique used to correct refractive errors. Using anterior segment optical coherence (AS-OCT), it is now possible to measure the epithelium thickness and input these data into the laser platform. In this study, we explore whether better results were obtained in this way. To this end, we retrospectively analyze the results from a low-myopia group treated with a customized epithelium thickness, as measured using AS-OCT, and compare them with the results from a group treated with an optimized standard epithelium thickness. The customized epithelium profile group contains more eyes with vision better than 20/20, and more eyes in this group gain one line of corrected distance visual acuity (CDVA). In conclusion, with the customized epithelium thickness, we obtain superior results using TransPRK in low-myopia corrections.

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Outcomes of a 320-degree intrastromal corneal ring segment implantation for keratoconus: Results of a 6-month follow-up

European Journal of Ophthalmology ◽

10.1177/1120672118818018 ◽

2018 ◽

Vol 30 (1) ◽

pp. 139-146 ◽

Cited By ~ 3

Author(s):

Guilherme Andrade do Nascimento Rocha ◽

Paulo Ferrara de Almeida Cunha ◽

Leonardo Torquetti Costa ◽

Luciene Barbosa de Sousa

Keyword(s):

Visual Acuity ◽

Spherical Equivalent ◽

Distance Visual Acuity ◽

Uncorrected Distance Visual Acuity ◽

Intrastromal Corneal Ring ◽

Corrected Distance Visual Acuity ◽

Ring Segment ◽

The Mean ◽

Corneal Tomography

Importance: This study shows that a newer long-arc length intrastromal corneal ring segment is efficient and safe for keratoconus treatment. Background: To evaluate visual, tomographic results and complications of a 320-degree intrastromal corneal ring segment implantation with the femtosecond laser for keratoconus treatment. Design: A prospective, nonrandomized, and interventional study. Participants: A total of 34 eyes of 31 patients diagnosed with keratoconus were enrolled. Methods: Patients were divided into two groups based on the strategy used for 320-degree intrastromal corneal ring segment thickness selection. In one group, this selection was based on spherical equivalent (SE group) and in the other on the mean asphericity (Q group). The uncorrected and corrected distance visual acuities, spherical equivalent, K1, K2, Km, Kmax, and mean asphericity ( Q) on corneal tomography were evaluated preoperatively and at 3 and 6 months postoperatively. For astigmatism improvement, we analyzed the corneal tomographic vectorial astigmatism change preoperatively and at 6 months postoperatively. The mean follow-up period was 6.63 ± 0.96 months. Results: The mean uncorrected distance visual acuity and corrected distance visual acuity improved with a significant spherical equivalent improvement ( p < 0.05), with no differences between the 320-degree intrastromal corneal ring segment groups. All corneal tomographic parameters improved significantly ( p < 0.05) between the preoperative and postoperative intervals, with a significant better performance when we used spherical equivalent for the 320-degree intrastromal corneal ring segment thickness selection. Finally, the mean vectorial corneal tomographic astigmatism significantly improved after 6 months, again with no differences between groups. Conclusion: This study suggests that implanting a 320-degree intrastromal corneal ring segment is a safe and effective procedure for treating patients with keratoconus. It also suggests that for thickness selection spherical equivalent is the better strategy.

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Long-term Stability of Ectasia in a Young Patient with Asymmetric Keratoconus

International Journal of Keratoconus and Ectatic Corneal Diseases ◽

10.5005/jp-journals-10025-1102 ◽

2015 ◽

Vol 4 (2) ◽

pp. 66-68

Author(s):

Rosane de Oliveira Corrêa ◽

Ana Laura Caiado Canedo ◽

Rozalia Beildeck ◽

Marcella Quaresma Salomão ◽

Penelope Burle de Politis

Keyword(s):

Visual Acuity ◽

Young Patient ◽

Distance Visual Acuity ◽

Long Term Stability ◽

Uncorrected Distance Visual Acuity ◽

Manifest Refraction ◽

Corrected Distance Visual Acuity ◽

Ring Segment ◽

Intracorneal Ring Segment ◽

The Right

ABSTRACT Purpose To report the clinical course of a typical young patient presenting with asymmetric keratoconus (KC), that demonstrates that stabilization of the ectatic process is possible without cross-linking (CXL) procedure. Methods Case report and review of the literature. Results A 17-year-old male patient was referred due to the diagnosis of keratoconus. Patient complained of loss of vision in the left eye (OS). Uncorrected distance visual acuity (UDVA) was 20/25+ in the right eye (OD) and 20/80 in the left eye; wavefront-assisted manifest refraction gave best corrected distance visual acuity (CDVA) of 20/20 in OD and 20/40 in OS. The diagnosis of keratoconus was confirmed with Placido disk-based topography (Oculus Keratograph 4), and Pentacam HR corneal tomography (Oculus Optikgeräte GmbH, Wetzlar, Germany). Femtosecond laser-assisted intracorneal ring segment (ICRS) implantation was performed in the left eye and treatment for allergy was prescribed for both eyes, along with patient education and advice not to rub the eyes. After 3 months, significant improvement was observed on UDVA (20/30) and CDVA (20/20) in the left eye. Topometric and tomographic stability of ectasia was observed in the right eye in a 4-year follow-up. Conclusion Intracorneal ring segment caused significant regularization of the corneal shape and improvement on visual acuity. Ectasia stability was achieved with no need for CXL, despite the patient's young age. This case raises the point that the indication of CXL for every keratoconic patient should be reconsidered. How to cite this article de Oliveira Corrêa R, Canedo ALC, Beildeck R, Salomão MQ, de Politis PB, Ambrósio R Jr. Longterm Stability of Ectasia in a Young Patient with Asymmetric Keratoconus. Int J Kerat Ect Cor Dis 2015;4(2):66-68.

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Corneal Cross-linking in Combination with Intracorneal Ring Segments

International Journal of Keratoconus and Ectatic Corneal Diseases ◽

10.5005/jp-journals-10025-1149 ◽

2017 ◽

Vol 6 (2) ◽

pp. 92-96

Author(s):

Aylin Kiliç

Keyword(s):

Visual Acuity ◽

Cross Linking ◽

Corneal Crosslinking ◽

Distance Visual Acuity ◽

Corrected Distance Visual Acuity ◽

Ring Segment

ABSTRACT The goal of ring segment surgery is to reduce the degree of myopia and astigmatism, improving uncorrected and corrected distance visual acuity. The crosslinking is a procedure used for stabilizing the cornea in patients with progressive keratoconus. Corneal crosslinking surgery and combination of an intracorneal ring segments seems to be as effective for corneal stability and refractive improvement in keratoconic eyes. How to cite this article Kiliç A. Corneal Cross-linking in Combination with Intracorneal Ring Segments. Int J Kerat Ect Cor Dis 2017;6(2):92-96.

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Implantable collamer lens for the correction of post-keratoplasty myopia and astigmatism

International Eye Research ◽

10.18240/ier.2020.02.09 ◽

2020 ◽

Vol 1 (2) ◽

pp. 113-116

Author(s):

Nasser A Alsabaani ◽

◽

Salem Almalki ◽

Keyword(s):

Visual Acuity ◽

Contact Lenses ◽

Posterior Chamber ◽

Implantable Collamer Lens ◽

Distance Visual Acuity ◽

Refractive Outcomes ◽

Uncorrected Distance Visual Acuity ◽

Single Center Study ◽

Corrected Distance Visual Acuity ◽

Corneal Refractive Surgery

AIM: To evaluate the safety, refractive outcomes and vision after phakic posterior chamber implantable collamer lens (ICL) after keratoplasty (KP). METHODS: This retrospective single center study evaluated 32 (35 eyes) patients who received an ICL for myopia and/or astigmatism after keratoplasty. Patients underwent ICL surgery if they were unable to wear glasses or contact lenses and excimer laser surgery was contraindicated. Data were collected on uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), refraction and complications. Data were analyzed for the preoperative and last postoperative visits (16.7±13mo) (P<0.05). RESULTS: Preoperatively, spherical equivalent (SE) ranged from -4.00 to -20.00 D and cylinder from -2.00 to -9.00 D. The mean SE decreased statistically significantly from -11.41±3.62 D preoperatively to -1.95±1.78 D postoperatively (P<0.0001). Mean UDVA increased statistically significantly from 20/400 preoperatively to 20/25 postoperatively (P<0.0001). There was a mean improvement in postoperative CDVA of 1.5 lines compared to preoperatively, 37% of eyes had an increase of 2 or more lines. One eye (2.8%) lost ≥1 line of CDVA. There were no intraoperative or postoperative complications. CONCLUSION: Posterior chamber phakic intraocular lens implantation is a safe and effective treatment for post-keratoplasty myopia and astigmatism in patients unable to wear spectacles or contact lenses and where corneal refractive surgery is contraindicated.

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Clinical outcomes of small incision lenticule extraction versus advanced surface ablation in low myopia

European Journal of Ophthalmology ◽

10.1177/1120672119865699 ◽

2019 ◽

Vol 30 (6) ◽

pp. 1278-1286 ◽

Cited By ~ 1

Author(s):

Suphi Taneri ◽

Saskia Kießler ◽

Anika Rost ◽

Tim Schultz ◽

H Burkhard Dick

Keyword(s):

Visual Acuity ◽

Spherical Equivalent ◽

Small Incision Lenticule Extraction ◽

Distance Visual Acuity ◽

Small Incision ◽

Surface Ablation ◽

Uncorrected Distance Visual Acuity ◽

Corrected Distance Visual Acuity ◽

Spherical Equivalent Refraction ◽

Lenticule Extraction

Purpose: To compare the visual and refractive outcomes of small incision lenticule extraction and advanced surface ablation for low myopia or myopic astigmatism. Methods: Retrospective, observational case series of our first 50 consecutive small incision lenticule extraction patients compared to refraction-matched 50 advanced surface ablation treatments with attempted spherical equivalent correction ⩽−3.5 D, astigmatism ⩽−1.5 D, and corrected distance visual acuity of 1.0 (decimal scale) or better. Only one eye per patient was included. Results: Small incision lenticule extraction: mean attempted spherical equivalent correction was −2.80 ± 0.63 D. Uncorrected distance visual acuity was 0.85 and 1.0 at days 1 and 5, respectively. At 3 months, mean spherical equivalent refraction was 0.02 ± 0.32 D (range: −0.5 to +0.75 D), mean cylinder was −0.24 ± 0.21 D (range: 0 to −0.75 D), mean uncorrected distance visual acuity was 1.27, mean efficacy index was 0.96, and mean safety index was 1.05. Uncorrected distance visual acuity was same or better than corrected distance visual acuity in 96%, astigmatism ⩽0.5 D in 98% and ⩽1 D in 100% of eyes, respectively. Advanced surface ablation: mean attempted spherical equivalent correction was −2.75 ± 0.5 D. Uncorrected distance visual acuity was 0.72 and 0.61 at days 1 and 5, respectively. At 3 months, mean spherical equivalent refraction was 0.22 ± 0.32 D, mean cylinder was −0.27 ± 0.27 D, mean uncorrected distance visual acuity was 1.21, mean efficacy index was 1.03, and mean safety index was 1.08. Conclusion: Small incision lenticule extraction for low myopia was found to be safe and effective with outcomes at 3 months similar to those obtained with advanced surface ablation while offering a quicker visual recovery.

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Photorefraktive Keratektomie bei Keratokonus

Karger Kompass Ophthalmologie ◽

10.1159/000443487 ◽

2016 ◽

Vol 2 (1) ◽

pp. 36-43

Author(s):

Deepali Sandeep Tambe ◽

Anders Ivarsen ◽

Jesper Hjortdal

Keyword(s):

Visual Acuity ◽

Postoperative Komplikationen ◽

Distance Visual Acuity ◽

Photorefraktive Keratektomie ◽

Corrected Distance Visual Acuity

Zielsetzung: Beurteilung der Wirksamkeit und Sicherheit der topografiegeführten photorefraktiven Keratektomie (PRK) bei Keratokonus und Einschätzung des Risikos einer nachfolgenden Progression. Methoden: Hierbei handelt es sich um eine retrospektive Nachbeobachtungsstudie. Zwischen 1998 und 2013 wurden 28 Augen von 23 Patienten (Alter 17-60 Jahre) mit Keratokonus im Stadium 1-3 mit einer topografiegeführten PRK behandelt. Vor dem Eingriff, 3 Monate danach und bei einer Langzeit-Nachuntersuchung im Median 7 Jahre nach dem Eingriff wurden jeweils eine Messung des korrigierten Fernvisus (corrected distance visual acuity; CDVA), Keratometrie, Pachymetrie und Hornhaut-Topografie durchgeführt. Postoperative Komplikationen einschließlich späterer Keratoplastik wurden dokumentiert. Ergebnisse: Bis zur Langzeit-Nachuntersuchung im Median 7 Jahre (Bereich 3-10 Jahre) nach der PRK war bei 5 der 28 Augen (18%) eine Hornhaut-Transplantation vorgenommen worden. Vier Augen standen für die Nachuntersuchung nicht zur Verfügung. Bei den verbleibenden 19 Augen war der CDVA in 16 Augen (84,3%) verbessert, in 2 Augen (10,5%) verschlechtert und in 1 Auge (5,2%) unverändert. Damit hatte sich der durchschnittliche CDVA von 0,49 logMAR vor der PRK auf 0,27 logMAR nach 3 Monaten und 0,24 logMAR bei der Langzeit-Nachuntersuchung verbessert. Das mittlere sphärische Äquivalent ging von -6,2 auf -3,7 dpt nach 3 Monaten und -2,1 dpt bei der Langzeit-Nachuntersuchung zurück. Ebenso verringerte sich der mittlere Zylinderwert von -4,2 auf -3,0 dpt nach 3 Monaten und bei der Langzeit-Nachuntersuchung. Schlussfolgerung: Die topografiegeführte PRK stellt bei Keratokonus potenziell eine wirksame Option zur Reduktion von Myopie und Astigmatismus sowie eine vorläufige oder dauerhafte Alternative zur Keratoplastik bei Patienten mit Keratokonus und Kontaktlinsen-Unverträglichkeit dar. In der hier vorgestellten Studie wurde ein geringes Risiko für eine Progression des Keratokonus nach einer PRK festgestellt.

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Evolution of corneal flattening after repeated corneal cross-linking during a 6-year follow-up

European Journal of Ophthalmology ◽

10.1177/1120672120945662 ◽

2020 ◽

pp. 112067212094566

Author(s):

Michael A Grentzelos ◽

Nafsika Voulgari ◽

Clarice Giacuzzo ◽

Konstantinos Droutsas ◽

George D Kymionis

Keyword(s):

Endothelial Cells ◽

Visual Acuity ◽

Case Report ◽

Corneal Thickness ◽

Cross Linking ◽

Distance Visual Acuity ◽

Corneal Opacification ◽

Corrected Distance Visual Acuity ◽

Corneal Flattening

Purpose: To report the evolution of corneal flattening after repeated corneal cross-linking (CXL) in a patient with progressive keratoconus during a 6-year follow-up. Methods: Case report. Results: A 27-year-old female underwent CXL for progressive keratoconus. Postoperatively, corneal topography revealed keratoconus progression with an increase of 1.20 diopters (D) in maximum keratometry (Kmax) and CXL was repeated. After the second treatment, a continuing significant corneal flattening (up to 16.00 D in Kmax) was observed during the first 5 years followed by stabilization during the last sixth year of follow-up. Both uncorrected and corrected distance visual acuity were improved while corneal thickness was decreased. There were no complications such as corneal opacification or endothelial cells decrease during the follow-up period. Conclusion: Repeated CXL can induce an excessive corneal flattening more pronounced during the first years of follow-up followed by stabilization thereafter.

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Optimal Keratoplasty for the Correction of Presbyopia and Hypermetropia

Journal of Ophthalmology ◽

10.1155/2017/7545687 ◽

2017 ◽

Vol 2017 ◽

pp. 1-6

Author(s):

Daniele Veritti ◽

Valentina Sarao ◽

Paolo Lanzetta

Keyword(s):

Visual Acuity ◽

Patient Satisfaction ◽

Postoperative Complications ◽

Safety And Efficacy ◽

Distance Visual Acuity ◽

Uncorrected Distance Visual Acuity ◽

Ophthalmologic Examination ◽

Near Visual Acuity ◽

Better Than

Purpose.To evaluate prospectively the safety and efficacy of optimal keratoplasty for the correction of hyperopia and presbyopia.Methods. Consecutive patients undergoing bilateral optimal keratoplasty for refractive presbyopic and hypermetropic corrections were enrolled. Each patient received a complete ophthalmologic examination at baseline, 1 hour, 1 day, 1 week, 1 month, 3 months, and 6 months after treatment.Results. The study included 40 consecutive eyes of 20 patients. All patients reached the 6-month follow-up. No serious intra- or postoperative complications were recorded. Monocular and binocular uncorrected near visual acuities improved significantly during the follow-up (p<0.001). Binocular uncorrected distance visual acuity in presbyopic patients improved from 0.28 logMAR to a maximum of 0.04 logMAR (from 20/38 to 20/22 Snellen equivalent) the day after the treatment and remained significantly better than baseline until the end of the follow-up. A significant improvement of patient satisfaction for near (p<0.001) and distance (p=0.007) activities was seen the day after treatment and was maintained throughout the follow-up.Conclusions.Optimal keratoplasty is a safe, noninvasive, rapid, pain-free, office-based procedure. It offers low to moderate hyperopes and presbyopes an improvement in uncorrected near visual acuity while maintaining or improving their distance visual acuity.

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