scholarly journals Three-dimensional locations of ruptured retinal arterial macroaneurysms and their associations with the visual prognosis

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Saori Sakaguchi ◽  
Yuki Muraoka ◽  
Shin Kadomoto ◽  
Sotaro Ooto ◽  
Tomoaki Murakami ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Three Dimensional ◽  
University Hospital ◽  
Fundus Photography ◽  
Final Visit ◽  
Subretinal Hemorrhage ◽  
Initial Visit ◽  
Visual Prognosis ◽  
Department Of Ophthalmology ◽  
Retinal Artery

AbstractThe aim of this retrospective, observational study was to examine the intraretinal locations of ruptured retinal arterial macroaneurysms (RMAs) and investigate the associations with the visual prognosis. Fifty patients (50 eyes) with untreated RMA rupture who visited the Department of Ophthalmology at Kyoto University Hospital (April 2014–July 2019) were included. The intraretinal position of the ruptured RMAs relative to the affected retinal artery was examined using optical coherence tomography (OCT) and color fundus photography (CFP). The relative RMA positions were anterior to (anterior type, 44%), at the same level as (lateral type, 20%), or posterior to (posterior type, 34%) the affected artery. At the initial visit, the posterior type showed greater subretinal hemorrhage thickness than did the lateral and anterior types (P = 0.016 and 0.006, respectively), and poorer visual acuity (VA) than did the anterior type (P = 0.005). At the final visit, the length of the foveal ellipsoid zone band defect was longer (P = 0.005) and VA was poorer (P < 0.001) for the posterior type than for the anterior type. The intraretinal positions of ruptured RMAs vary, affect the thickness of foveal subretinal hemorrhage and predict future damage to the foveal photoreceptors. The visual prognosis may be poor for posteriorly ruptured RMAs.

scholarly journals Aflibercept for Vascularised Serous Pigment Epithelial Detachment: One-Year Anatomical and Functional Results

2020 ◽  
Vol 76 (2) ◽  
pp. 88-93
Author(s):  
Jaroslav Románek ◽  
Hana Palyzová ◽  
Jan Grygar ◽  
Jan Ernest
Keyword(s):  
Visual Acuity ◽  
Functional Results ◽  
University Hospital ◽  
Pigment Epithelial Detachment ◽  
Intravitreal Therapy ◽  
Pigment Epithelial ◽  
Department Of Ophthalmology ◽  
Treatment Naïve ◽  
One Year ◽  
The Military

Purpose: To assess the effect of intravitreal aflibercept on pigment epithelial detachment (PED) secondary to occult choroidal neovascularization (CNV) in treatment-naive patients. Patients and methods: Retrospective analysis of thirty-six patients (thirty-eight eyes) with mean age 77 (SD ± 7), who were treated with aflibercept 2.0 mg (Eylea, Bayer) at the Department of Ophthalmology of 1st Faculty of Medicine of the Charles University and the Military University Hospital Prague. All patients were treated in fixed regimen, which means 3 loading doases 1 month apart, followed by further 2-monthly doses over total 12-month period. Best corrected visual acuity (BCVA) was evaluated on Early Treatment Diabetic Retinopathy Study (ETDRS) charts. Diameters as PED height, width and central retinal thickness (CRT) were assesed using spectral-domain optical coherence tomography. All previously mentioned were analyzed et the baseline and than at every visit. Therapy complications were also evaluated. Results: Borderline significant improvement in the mean of BCVA score of 3.2 letters (SD ± 11.6, p = 0.05) at the end of follow-up period was observed. Mean PED height at 12 months significantly decreased by 140 µm (SD ± 238, p < 0.01). Reductions in PED height were correlated with reductions in central macular thickness (R = 0.94, p < 0.001) simultaneously with PED width (R = 0.45, p < 0.01). There was no significant correlation between PED height decrease and visual acuity. PED rupture was observed in 3 eyes (8 %). Conclusion: Aflibercept intravitreal therapy in fixed regimen in patients with PED secondary to occult CNV shows great anatomical effect. However, correlation between PED diameters and visual acuity was not observed.

scholarly journals AB1019 THERAPEUTIC PROFILE OF PATIENTS WITH VOGT KOYANAGI HARADA DISEASE FOLLOWED AT THE HOSPITAL DE CLÍNICAS. SAN LORENZO PARAGUAY.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1802.3-1802
Author(s):  
N. Colman ◽  
J. Losanto ◽  
S. Riquelme ◽  
M. Melo
Keyword(s):  
Visual Acuity ◽  
Immunosuppressive Treatment ◽  
Average Dose ◽  
Management Options ◽  
Visual Prognosis ◽  
San Lorenzo ◽  
Department Of Ophthalmology ◽  
Timely Treatment ◽  
Therapeutic Profile ◽  
Good Vision

Background:Vogt-Koyanagi-Harada Disease (VKHD) is an autoimmune eye disease that causes chronic vision complications in young people. The treatment is based on corticosteroids and immunosuppressants, to which biological drugs are currently added. The visual prognosis depends on the stage in which it is diagnosed and the effective and timely treatment.1,2Objectives:Describe the evolution and the therapeutic profile of patients with VKHD who go to the Rheumatology Department of the Hospital de Clínicas. San Lorenzo Paraguay until November 2019Methods:Descriptive cross-sectional study conducted at the Hospital de Clínicas, San Lorenzo Paraguay, where clinical histories of patients with this disease and who have regular follow-up were reviewed.Results:21 patients were included, 17 (81%) women, average age of 35 years. The diagnosis and treatment were made 15 (71%) in acute phase, 4 (19%) convalescent phase and 2 (10%) in chronic phase.Corticosteroids: All received corticosteroids at diagnosis. Methylprednisolone IV 1g /day for 3 consecutive days in 8 (44%) cases and for 5 days in 10 (55.5%) cases. The first month everyone received prednisone orally at 1mg / kg / d on average (60-75 mg/d), at 3 months the average dose of prednisone was 37 mg / d, at 6 months of 23 mg/d and at 12 months 10 mg / d months.Immunosuppressive treatment: They received 20 (95%) patients. Induction with monthly intravenous cyclophosphamide was performed in 8 (40%) cases and with Azathioprine in 12 (60%) cases. Of the patients treated with Azathioprine initially, in 5 (23%) patients it was necessary to switch to Cyclophosphamide IV due to failure or intolerance. The maintenance treatment was azathioprine in 13 (62%) of the patients, MTX in 4 (19%) and the association of both drugs was indicated in 3 (14%) patients. One case was refractory and received infliximab and subsequently Rituximab, which resulted in remission.The best final Visual Acuity (AV) was recorded with the Snellen chart in 40 eyes (20 patients), 27 (67.5%) patients with good vision (20/20 to 20/50), 8 (20%) patients with decreased VA (20 / 50-20 / 200), and 5 (12.5%) with legal blindness (<20/200) and of these only 3 patients had unilateral involvement and one patient with bilateral blindness. Sequelae / complications: 6 (28.5%) patients presented cataracts and finally 3 (14%) glaucoma, 5 (24%) anterior / posterior synechiae.Conclusion:The majority of patients in this series presented a good vision when the inflammatory process was resolved (AV 20 / 20-20 / 50), this probably related to early diagnosis and initial aggressive treatment with intravenous corticosteroid pulses and its association with immunosuppressants of entry as mentioned in the literature. The worst vision, (visual acuity <20/200) occurred in 5 of 40 eyes, corresponding to 4 patients, two of them diagnosed and treated in the chronic stage. Timely treatment improves visual prognosis.References:[1]Lodhi SAK, Lokabhi Reddy JM, Peram V. Clinical spectrum and management options in Vogt–Koyanagi–Harada disease. Clin Ophthalmol. 2017;11:1399–406.[2]Concha-del Río LE, Gómez L, Arellanes-García L. Corticotherapy vs. Corticotherapy Plus Immunosuppressive Therapy in Acute Vogt-Koyanagi-Harada Disease. Arch Soc Esp Oftalmol [Internet]. 2018;93(5):225–30. Available from:https://doi.org/10.1016/j.oftal.2017.09.010Acknowledgments:Department of RheumatologyDepartment of OphthalmologyDisclosure of Interests:None declared

scholarly journals Visual outcomes and choroidal thickness associated with human leukocyte antigen DRB1*04 in unclassifiable uveitis in Japanese patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Norihiko Misawa ◽  
Mizuki Tagami ◽  
Atsushi Sakai ◽  
Takeya Kohno ◽  
Shigeru Honda
Keyword(s):  
Visual Acuity ◽  
Human Leukocyte Antigen ◽  
Choroidal Thickness ◽  
Case Series ◽  
Human Leukocyte ◽  
Final Visit ◽  
Visual Prognosis ◽  
Leukocyte Antigen ◽  
Significant Difference ◽  
Vkh Disease

Abstract Purpose Human leukocyte antigen (HLA) and immunity are related. Uveitis is also closely related to immunity. For example, the common presence of human leukocyte antigen (HLA)-DRB1*04 in the immune response is well known. The aim of this study was to investigate the relationship between visual prognosis and various HLA alleles before and after therapy in patients with unclassifiable uveitis, excluding those with Vogt-Koyanagi-Harada (VKH) disease. Methods This retrospective case series included 42 eyes from 22 consecutive patients with unclassifiable uveitis, excluding those with VKH disease. Visual acuity (VA), sex, refractive error, central retinal thickness (CRT), central choroidal thickness (CCT), and duration from onset to treatment were measured at initial and 6-month visits. Mean values of parameters were compared at each visit. Genotyping was performed by polymerase chain reaction amplification with sequence-specific primers. Results DRB1*04 showed a dominant change. No significant difference was observed in the other alleles. In DRB1*04, The mean differences in initial CCT, 6-month CCT, and 6-month VA showed statistically significant difference was found in best-corrected visual acuity (BCVA) between DRB1*04+ and DRB1*04− at the first visit. BCVA values at baseline and at the final visit were 0.13 ± 0.29 and 0.20 ± 0.36 in the DRB1*04+ and 0.00045 ± 0.20 and − 0.058 ± 0.11 in the DRB1*04− groups(p = 0.00465). Central Choroidal Thickness (CCT) values pretreatment and at the final visit after treatment were (pretreatment:361.00 ± 361.0 μm,after treatment: 286.00 ± 106.53 μm, p = 0.0174) in the DRB1*04+ group, and (pretreatment:281.3 ± 139.68 μm,after treatment:223.85 ± 99.034 μm, p = 0.0426) in the DRB1*04− group, respectively, indicating changes between baseline and the final visit. CCT was significantly greater in the DRB1*04+ group at both the initial visit and at 6 months. Multivariate analysis showed a significant difference between the presence or absence of DRB1*04 and sex. Conclusion HLA-DRB1*04 allele may affect visual prognosis and CCT in unclassifiable uveitis.

scholarly journals Macular Hole Surgery Using Gas Tamponade—An Outcome from the Oslo Retrospective Cross-Sectional Study

2019 ◽  
Vol 8 (5) ◽  
pp. 704
Author(s):  
Ingar Stene-Johansen ◽  
Ragnheiður Bragadóttir ◽  
Beáta Éva Petrovski ◽  
Goran Petrovski
Keyword(s):  
Visual Acuity ◽  
Large Diameter ◽  
Cross Sectional Study ◽  
Interquartile Range ◽  
University Hospital ◽  
Sectional Study ◽  
Ilm Peeling ◽  
Cross Sectional ◽  
Gas Tamponade ◽  
Department Of Ophthalmology

Purpose: The study aims to determine the anatomical success and functional outcome of pars plana vitrectomy (PPV) for macular holes (MH) performed at a single study center using a consistent procedure of internal limiting membrane (ILM) peeling, SF6 tamponade and 3 days face-down positioning. Methods: A retrospective cross-sectional study involving eyes with MHs which underwent 23- or 25-gauge PPV with or without phacoemulsification and all undergoing a 20% SF6 gas tamponade, follow-up to 6 months postoperatively were included at the Department of Ophthalmology, Oslo University Hospital and University of Oslo, Oslo, Norway (12-month study period between 1 January and 31 December 2015) Pre- and post-operative Best-Corrected Visual Acuity (BCVA) assessment, comprehensive eye examination and intraocular pressure (IOP) measurement. as well as Optical Coherence Tomography to determine the diameter of the MH and its closure were all carried out. Results: 198 consecutive eyes operated for MH (age: 69.4 ± 7.6 years; 1.6:1 female:male ratio) were included; 35.7%/48.6% had symptoms from 3–6/6–48 months; 5.1% had high-grade myopia, 21.5% focal VMT <1500 µm with or without epiretinal membrane (ERM), and 74.0%/26.0% had phakic/pseudophakic status. Primary closure of the MH occurred in 93.3% of the patients. Lens status and length of symptoms showed no significant correlation with closure of the MH. The pre-operative logMAR visual acuity: 0.8 ± 0.3 (median: 0.7; interquartile range (IQR): 0.5–0.8; range: 0.3–1.7), improved significantly post-operatively: 0.4 ± 0.3 (median: 0.3; interquartile range (IQR): 0.1–0.5; range: −0.02–1.2). BCVA improvement of <0.2, 0.2–0.4 and >0.4 was present in 28.3%, 27.3% and 44.4% of the treated patients. No significant median differences could be detected between the duration of the pre-operative symptoms and the pre-/post-operative visual acuity. Increased IOP was measured in 2.6% of the cases day after surgery. Conclusions: Our study found visual outcome not to be dependent upon the length of symptoms in MH patients treated by PPV all undergoing ILM peeling, SF6 tamponade and face-down positioning. The large diameter MH was not a limiting factor to achieve improved post-operative BCVA.

Retinal Vascular Occlusive Disorders - Risk Factors

2018 ◽  
Vol 3 (02) ◽  
Author(s):  
Shivcharan Lal Chandravanshi, Sunil Kumar Shrivastava, Priyanka Agnihotri, Smriti Gupta
Keyword(s):  
Risk Factors ◽  
Retinal Vein Occlusion ◽  
Central Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Vein Occlusion ◽  
Department Of Ophthalmology ◽  
Retinal Artery ◽  
Central Retinal Vein

Aims and Objective - The aim of the present study is to identify risk factors associated with different retinal vascular occlusive diseases (RVOD), such as central retinal artery occlusion (CRAO), hemi-retinal artery occlusion (HRAO), branch retinal artery occlusion (BRAO), cilioretinal artery occlusion (Cilio-RAO), central retinal vein occlusion (CRVO), branch retinal vein occlusion (BRVO), and hemi-retinal vein occlusion (HRVO). Patients and Method - A cross-sectional study on 114 consecutive subjects, aged 24-96 years who have attended at the outpatient department of ophthalmology at Shyam Shah Medical College, Rewa, MP, were included in the study. The Duration of study was January 2016 to December 2017. Only patients with CRAO, BRAO, HRAO, Cilio-RAO, CRVO, BRVO, and HRVO were included in the study. Other retinal vascular disorders such as diabetic vaso-occlusive disease, anterior and posterior ischemic and non-ischemic neuropathy, hypertensive retinopathy, sickle cell retinopathy, retinal telangiectasia, retinopathy of prematurity, were excluded from study. Results - We have included 114 patients, 64 cases (56.14%) males, 50 (43.85%) females, aged 56+/-8 years (range 24-96 years).  Bilateral retinal vascular occlusive disorders were seen in only 4 cases (3.5%). Two patients have bilateral CRVO followed by one case of bilateral BRVO and one case of bilateral CRAO.  Out of 114 patients, branch retinal vein occlusion was seen in 62 cases (54.38%), followed by central retinal vein occlusion in 36 cases (31.57%), CRAO in 8 cases (7.01%), and hemi- retinal vein occlusion in 4 cases (3.50%). Hypertension was the most common, (40 cases, 35.08%) risk factor identified for retinal vascular occlusive disorders followed by diabetes 24 cases (21.05%), combined diabetes and hypertension in 22 cases (19.29%), and atherosclerosis in 18 cases (15.78%). Conclusions - Retinal vascular occlusive diseases have systemic as well as ocular risk factors. Understanding of these risk factors is essential for proper treatment of RVOD. Timely identification of risk factors for RVOD may helpful in decreasing ocular and systemic morbidity in these patients.

scholarly journals Ophthalmological findings in children with non-syndromic craniosynostosis: preoperatively and postoperatively up to 12 months after surgery

2021 ◽  
Vol 6 (1) ◽  
pp. e000677
Author(s):  
Evangelia Ntoula ◽  
Daniel Nowinski ◽  
Gerd Holmstrom ◽  
Eva Larsson
Keyword(s):  
Visual Acuity ◽  
University Hospital ◽  
Cranial Sutures ◽  
Sagittal Craniosynostosis ◽  
Syndromic Craniosynostosis ◽  
Disc Oedema ◽  
Before And After ◽  
Congenital Condition ◽  
Skull Deformity

AimsCraniosynostosis is a congenital condition characterised by premature fusion of one or more cranial sutures. The aim of this study was to analyse ophthalmic function before and after cranial surgery, in children with various types of non-syndromic craniosynostosis.MethodsChildren referred to Uppsala University Hospital for surgery of non-syndromic craniosynostosis were examined preoperatively. Visual acuity was measured with Preferential Looking tests or observation of fixation and following. Strabismus and eye motility were noted. Refraction was measured in cycloplegia and funduscopy was performed. Follow-up examinations were performed 6–12 months postoperatively at the children’s local hospitals.ResultsOne hundred twenty-two children with mean age 6.2 months were examined preoperatively. Refractive values were similar between the different subtypes of craniosynostosis, except for astigmatism anisometropia which was more common in unicoronal craniosynostosis. Strabismus was found in seven children, of which four had unicoronal craniosynostosis.Postoperatively, 113 children were examined, at mean age 15.9 months. The refractive values decreased, except for astigmatism and anisometropia in unicoronal craniosynostosis. Strabismus remained in unicoronal craniosynostosis. Two new cases with strabismus developed in unicoronal craniosynostosis and one in metopic, all operated with fronto-orbital techniques. No child had disc oedema or pale discs preoperatively or postoperatively.ConclusionOphthalmic dysfunctions were not frequent in children with sagittal craniosynostosis and preoperative ophthalmological evaluation may not be imperative. Children with unicoronal craniosynostosis had the highest prevalence of strabismus and anisometropia. Fronto-orbital techniques used to address skull deformity may be related to a higher prevalence of strabismus postoperatively.

Transepithelial photorefractive keratectomy on the same day of the initial consultation for the correction of myopia

2021 ◽  
pp. 112067212110334
Author(s):  
Olga Reitblat ◽  
Assaf Gershoni ◽  
Michael Mimouni ◽  
Eitan Livny ◽  
Yoav Nahum ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Clinical Outcomes ◽  
Photorefractive Keratectomy ◽  
Spherical Equivalent ◽  
Initial Visit ◽  
Safety Outcome ◽  
Uncorrected Visual Acuity ◽  
Safety Indices

Purpose: To examine the clinical outcomes, efficacy, safety, and predictability of transepithelial photorefractive keratectomy (Trans-PRK) operations performed on the day of the first screening visit in comparison with operations scheduled at a following appointment. Methods: Data of consecutive patients with myopia of various degrees, who underwent Trans-PRK, were retrospectively analyzed. Findings were compared between patients who underwent Trans-PRK on the same day of first consultation to patients that underwent surgery at subsequent visits, following initial consultation on a different day. Results: The study included 599 eyes treated on the initial visit day and 1936 eyes treated on a subsequent visit. Mean final spherical equivalent was close to emmetropia in both groups ( p = 0.183). Efficacy indices were 0.928 ± 0.192 in the initial-visit group and 0.945 ± 0.163 in the second-visit group ( p = 0.152). Safety indices were 0.954 ± 0.156 and 0.955 ± 0.151 ( p = 0.707), respectively. No differences between the groups were seen in uncorrected visual acuity (UDVA) of ⩾20/20, ⩾20/25, and ⩾20/32. Only the sub-analysis of patients reaching UDVA of 20/40 or better was slightly lower in the first-visit (95.5%) compared with the second-visit group (97.9%, p = 0.001). Results of attempted correction within ±0.50 D were: 63.3% and 69.0%, respectively ( p = 0.009). Complications profiles in the two groups were comparable. Conclusions: Trans-PRK completed on the day of the first screening appointment demonstrated a similar safety outcome compared with subsequent-visits procedures, and slightly lower, yet comparable, results regarding efficacy and predictability.

scholarly journals Retinal vascular findings in patients with COVID-19

2021 ◽  
Vol 13 ◽  
pp. 251584142110304
Author(s):  
Emre Aydemir ◽  
Alper Halil Bayat ◽  
Burak Ören ◽  
Halil Ibrahim Atesoglu ◽  
Yasin Şakir Göker ◽  
...  
Keyword(s):  
Healthy Subjects ◽  
Fundus Photography ◽  
Control Group ◽  
Fundus Fluorescein Angiography ◽  
University Of Wisconsin ◽  
Retinal Vascular Caliber ◽  
Retinal Artery ◽  
The Mean ◽  
And Gender ◽  
College Of Engineering

Purpose: The purpose of this study was to compare the retinal vascular caliber of COVID-19 patients with that of healthy subjects. Methods: This was a prospective case–control study. Forty-six patients who had COVID-19 were successfully treated, and 38 age- and gender-matched healthy subjects were enrolled in this study. Fundus photography was taken using fundus fluorescein angiography (FA; Visucam 500; Carl Zeiss Meditec, Jena, Germany). Retinal vascular caliber was analyzed with IVAN, a semi-automated retinal vascular analyzer (Nicole J. Ferrier, College of Engineering, Fundus Photography Reading Center, University of Wisconsin, Madison, WI, USA). Central retinal artery equivalent (CRAE), central retinal vein equivalent (CRVE), and artery–vein ratio (AVR) were compared between groups. Results: The mean age was 37.8 ± 9.5 years in the COVID-19 group ( n = 46) and 40 ± 8 years in the control group ( n = 38) ( p = 0.45). The mean CRAE was 181.56 ± 6.40 in the COVID-19 group and 171.29 ± 15.06 in the control group ( p = 0.006). The mean CRVE was 226.34 ± 23.83 in the COVID-19 group and 210.94 ± 22.22 in the control group ( p = 0.044). AVR was 0.81 ± 0.09 in the COVID-19 group and 0.82 ± 0.13 in the control group ( p = 0.712). Conclusion: Patients who had COVID-19 have vasodilation in the retinal vascular structure after recovery. As they may be at risk of retinal vascular disease, COVID-19 patients must be followed after recovery.

Long term results of accelerated corneal collagen cross-linking in pediatric keratoconus

2021 ◽  
pp. 112067212110183
Author(s):  
Yasin Cinar ◽  
Cagla Cilem Han ◽  
Alparslan Sahin ◽  
Zeba A Syed
Keyword(s):  
Visual Acuity ◽  
Corneal Thickness ◽  
University Hospital ◽  
Long Term Results ◽  
Cross Linking ◽  
Distance Visual Acuity ◽  
The Mean ◽  
Collagen Cross Linking ◽  
Corneal Collagen

Purpose: To evaluate the long term visual, refractive, and corneal tomographic outcomes of epithelium-off accelerated corneal collagen cross-linking (ACXL) in the management of pediatric keratoconus (KC). Methods: This retrospective study included patients under 18 years old with progressive KC who underwent ACXL between 2012 and 2019 at Dicle University Hospital. Complete ophthalmic examination was performed including uncorrected distance visual acuity (UDVA), best spectacle-corrected distance visual acuity (CDVA), manifest refraction, and corneal tomography. Evaluations were performed preoperatively and at 6 months intervals postoperatively. Results: Forty-nine eyes of 49 patients were included in the study. The mean age of patients at the time of ACXL was 14.2 ± 1.8 (range: 9.5–17.3) years. Mean follow up was 4.61 ± 1.90 (range: 2.0–8.1) years. The mean LogMAR UDVA improved from 0.94 ± 0.41 to 0.81 ± 0.43, 0.69 ± 0.41, and 0.67 ± 0.33 after 1, 3, and 5 years respectively ( p = 0.001). The mean LogMAR CDVA improved from 0.58 ± 0.36 to 0.46 ± 0.31, 0.34 ± 0.23, and 0.39 ± 0.27 after 1, 3, and 5 years respectively ( p = 0.015). The mean refractive cylinder improved significantly from 6.01 ± 2.07 diopters (D) to 5.46 ± 1.87, 5.38 ± 2.18, and 5.02 ± 2.31 D after 1, 3, and 5 years respectively ( p = 0.005). As compared to preoperative values, steep keratometry and maximum keratometry were not significantly different ( p = 0.805 and 0.448, respectively) following ACXL, while flat keratometry significantly improved after ACXL ( p = 0.012). Although central corneal thicknesses decreased significantly ( p = 0.029), the decrease in thinnest corneal thickness was not statistically significant ( p = 0.205). Conclusion: Epithelium-off ACXL seems to be effective for halting KC progression with long term clinical benefits in pediatric patients.

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