Irregular Astigmatism Management Using SPOT Scleral Lenses in the Treatment of Corneal Ectasia and Penetrating Keratoplasty

Keratoconus is a bilateral and progressive corneal disease characterized by a significant increase in irregular astigmatism and corneal thinning. Numerous treatments—including penetrating keratoplasty (PK), deep anterior lamellar keratoplasty (DALK), ultraviolet-crosslinking (UV-CXL), and intracorneal ring segments—are available for halting progression and/or obtaining (partial) visual rehabilitation. Recently, midstromal Bowman layer transplantation has been introduced as a new treatment option for advanced keratoconus. This technique has shown significant promise in halting disease progression and postponing riskier procedures such as PK or DALK.

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Penetrating keratoplasty versus intrastromal corneal ring segments to correct bilateral corneal ectasia: Preliminary study

Journal of Cataract & Refractive Surgery ◽

10.1016/j.jcrs.2006.09.048 ◽

2007 ◽

Vol 33 (3) ◽

pp. 488-496 ◽

Cited By ~ 15

Author(s):

Luis A. Rodríguez ◽

Pamela B. Guillén ◽

María A. Benavides ◽

Licette Garcia ◽

Dianela Porras ◽

...

Keyword(s):

Penetrating Keratoplasty ◽

Corneal Ectasia ◽

Intrastromal Corneal Ring ◽

Preliminary Study

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Simultaneous transepithelial topographic-guided laser and cross-linking to correct irregular astigmatism in a pediatric patient

European Journal of Ophthalmology ◽

10.1177/11206721211046476 ◽

2021 ◽

pp. 112067212110464

Author(s):

Luca Buzzonetti ◽

Gianni Petrocelli ◽

Sergio Petroni ◽

Paola Valente ◽

Giancarlo Iarossi

Keyword(s):

Pediatric Patient ◽

Penetrating Trauma ◽

Cross Linking ◽

Corneal Ectasia ◽

Irregularity Index ◽

Quality Of Vision ◽

Corrected Distance Visual Acuity ◽

Post Traumatic ◽

Irregular Astigmatism

Purpose: To evaluate an original approach for treating corneal ectasia and irregular astigmatism secondary to penetrating trauma in a pediatric patient. Case report: An 11 year old patient had a penetrating trauma in right eye when he was two and the refractive error was +1.50 diopters sphere −6.00 diopters cylinder axis 95°. To correct irregular astigmatism, the patient underwent simultaneous transepithelial topographic-guided laser Central Corneal Remodeling (CCR) and Corneal Cross-linking (CXL) in the attempt to regularize corneal ectasia and to improve the quality of vision. Uncorrected and Corrected Distance Visual Acuity were measured using Efficacy and Safety indexes; objective and subjective qualities of vision were evaluated using respectively corneal morphological irregularity index and National Eye Institute Visual Function questionnaires. Conclusions: Twelve month follow up suggests that simultaneous CCR and CXL could be effective to improve the quality of vision and to halt the progression of post-traumatic ectasia in pediatric patients.

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Customized Photorefractive Keratectomy for the Correction of Regular and Irregular Astigmatism After Penetrating Keratoplasty

Cornea ◽

10.1097/ico.0b013e318228174b ◽

2011 ◽

Vol 30 ◽

pp. S41-S44 ◽

Cited By ~ 10

Author(s):

Kenji Ohno

Keyword(s):

Penetrating Keratoplasty ◽

Photorefractive Keratectomy ◽

Irregular Astigmatism

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Corneal cross-linking in a 10-year-old child with stage III keratoconus

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v8i2.17015 ◽

2017 ◽

Vol 8 (2) ◽

pp. 174-177

Author(s):

Marco Abbondanza ◽

Valentina De Felice ◽

Gabriele Abbondanza

Keyword(s):

Penetrating Keratoplasty ◽

Young Patients ◽

Corneal Dystrophy ◽

Effective Procedure ◽

Stage Iii ◽

Cross Linking ◽

Rapid Progression ◽

Collagen Cross Linking ◽

Irregular Astigmatism ◽

Corneal Collagen

Background: Keratoconus is a corneal dystrophy characterized by progressive thinning, conical shape of the cornea and irregular astigmatism. It is particularly insidious when it occurs in very young patients. Case: We report the case of a 10-year-old child with an aggressive stage III keratoconus, who was suggested to undergo a Penetrating Keratoplasty. We performed Corneal Collagen Cross-linking with epithelium removal instead, which was successful in arresting the rapid progression of keratoconus. Observations: Eighteen months later, Kmax had decreased by 1.3 D, astigmatism by 0.8 D, thinnest pachimetry had improved by 69 μm and CDVA was 20/32. Conclusion: This case confirms that Corneal Collagen Cross-linking is a safe and effective procedure for the treatment of keratoconus even in its aggressive forms. We encourage ophthalmic surgeons to favor conservative treatments when dealing with very young patients.

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