Corneal densitometry in patients with keratoconus undergoing intrastromal Ferrara ring implantation

2021 ◽  
pp. 112067212110206
Author(s):  
Pablo Felipe Rodrigues ◽  
Bernardo Kaplan Moscovici ◽  
Guilherme Ferrara ◽  
Luciano Lamazales ◽  
Marcela Mara Silva Freitas ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Medical Records ◽  
Spherical Equivalent ◽  
Interventional Study ◽  
Data Comparison ◽  
Corneal Densitometry ◽  
Corrected Visual Acuity ◽  
Ring Segment ◽  
The Mean

Objective: Evaluation of central corneal densitometry changes following Ferrara corneal ring segment implantation in patients with keratoconus, especially the correlation between corneal densitometry and keratometry. Methods: Retrospective, non-comparative, interventional study based on the review of medical records of patients diagnosed with keratoconus who underwent Ferrara corneal ring segment implantation. Pre and post-operative corneal densitometry measurements obtained with Pentacam HR (Oculus, Wetzlar, Germany) were analyzed. The follow-up time was 3 months, and data comparison was made, using specific statistical analysis, with the data of 3 months postoperatively. Results: The study sample consisted of 43 eyes of 36 patients. The mean corrected visual acuity improved from 0.82 LogMAR preoperatively (SD ± 0.33) to 0.19 LogMAR (SD ± 0.13) postoperatively. The mean spherical equivalent varied from −4.63 (SD ± 3.94) preoperatively to −2.16 (SD ± 2.63) postoperatively. Asphericity varied from −0.69 (SD ± 0.32) preoperatively to −0.27 (SD ± 0.31) postoperatively. The mean maximum K was 54.01D (SD ± 3.38) preoperatively and 51.50D (SD ± 2.90) postoperatively. The mean anterior densitometric value was 18.26 (SD ± 2.03) preoperatively and 17.66 (SD ± 1.84) postoperatively. Conclusion: Corneal densitometry is an interesting technology that should be studied in keratoconus patients. Our results suggest that the corneal densitometry in the cornea’s anterior layer reduces after ICRS implantation and correlates with corneal keratometry. Further studies should be performed to increase the knowledge in this field.

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

2018 ◽  
Vol 30 (1) ◽  
pp. 139-146 ◽  
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.

scholarly journals The effect of amblyopia on clinical outcomes of children with astigmatism

2021 ◽  
Vol 13 ◽  
pp. 251584142110408
Author(s):  
Burçin Çakır ◽  
Nilgün Özkan Aksoy ◽  
Sedat Özmen ◽  
Özlem Bursalı
Keyword(s):  
Visual Acuity ◽  
Clinical Outcomes ◽  
Medical Records ◽  
Convergence Insufficiency ◽  
Corrected Visual Acuity ◽  
Ocular Deviation ◽  
The Mean ◽  
The Difference ◽  
Best Corrected Visual Acuity

Background: Amblyopia is more common in children with high astigmatism, but factors contributing to development of amblyopia and visual outcomes are not fully understood. Objective: To evaluate the effect of amblyopia on the clinical outcomes in children with ⩾1.75 diopter (D) astigmatism. Methods: We reviewed the medical records of children with ⩾1.75 D astigmatism with and without amblyopia (amblyopes group and non-amblyopes group). The mean age, gender, amount and type of ocular deviation, presence of convergence insufficiency (CI), stereopsis, time of initial spectacle use and follow-up time, differences in best-corrected visual acuity (VoD) and spherical equivalent (SE) between eyes were assessed and compared between the groups. Best-corrected visual acuity (BCVA), mean SE, astigmatism measurements were assessed and compared between amblyopic, fellow, and non-amblyopic eyes. Results: The records included 68 eyes of 34 children with amblyopia and 56 eyes of 28 children without amblyopia. The mean age, gender, amount and type of ocular deviation, presence of CI, stereopsis, time of initial spectacle use, follow-up time, and the difference in SE did not differ between groups. In amblyopes, exodeviation was more common and statistically greater in near (33 cm) than at distance (6 m) (p = 0.005). The mean BCVA and astigmatism values were statistically different between amblyopic, fellow, and non-amblyopic eyes. Conclusion: A greater near than distance exodeviation and higher mean astigmatism value were found in amblyopic children with astigmatism.

scholarly journals Preliminary results of a new intrastromal corneal ring segment as a tissue saving procedure in photorefractive keratectomy to correct moderate to high myopia

2020 ◽  
Vol 13 (12) ◽  
pp. 1955-1960
Author(s):  
Sandro Coscarelli ◽  
Guilherme Rocha ◽  
Leonardo Torquetti
Keyword(s):  
Visual Acuity ◽  
High Myopia ◽  
Clinical Results ◽  
Repeated Measurements ◽  
Photorefractive Keratectomy ◽  
Spherical Equivalent ◽  
Intrastromal Corneal Ring ◽  
Ring Segment ◽  
The Mean

AIM: To evaluate the clinical results after implantation of a new intrastromal corneal ring segment (ICRS) associated with photorefractive keratectomy (PRK) to correct high myopia (HM) patients with thin corneas. METHODS: We evaluated 42 eyes of 23 HM patients that had ICRS implantation followed by PRK. The mean age of patients was 29.1±7.12y (range 18 to 40 years old). Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), keratometry, spherical equivalent, pachymetry, and aberrometry were compared using ANOVA with repeated measurements evaluated preoperatively and at last follow-up visit after the procedures. The refractive predictability and simulated/real corneal ablation were also assessed. RESULTS: The mean follow-up time after PRK was 6.8±1.6mo. The mean preoperative UCVA improved from 20/800 preoperative to 20/100 after ICRS and 20/35 after PRK. The mean preoperative BCVA was 20/25 (range from 20/30 to 20/20) and remained unchanged after ICRS implantation. Following the PRK the mean BCVA was 20/25 (range from 20/30 to 20/20). The mean spherical equivalent decreased from -7.25±1.12 (range -5.00 to -9.00) preoperatively to -3.32±1.0 (range -2.00 to -5.00) postoperatively (P<0.001) after ICRS implantation and decreased from -2.44±1.51 preoperatively to 0.32±0.45 (range -0.625 to 0.875) postoperatively (P<0.001) after PRK. The change in BCVA and topographic astigmatism was statistically significant (P<0.0001). CONCLUSION: ICRS in HM associated with PRK can be a tissue saving procedure and an alternative surgical option for correction of moderate to high myopia.

scholarly journals Safety and Efficacy of Myopic LASIK performed on Thin Corneas

2020 ◽  
Vol 14 (1) ◽  
pp. 33-38
Author(s):  
Jorge E. Valdez-García ◽  
Julio C. Hernandez-Camarena ◽  
Denise Loya-García ◽  
Paloma Lopez-Montemayor ◽  
Gustavo Ortiz-Morales ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Corneal Thickness ◽  
Practice Setting ◽  
Spherical Equivalent ◽  
Visual Outcomes ◽  
Corrected Visual Acuity ◽  
Uncorrected Distance Visual Acuity ◽  
Hispanic Patients ◽  
The Mean

Purpose: The aim was to report on the visual outcomes and safety of myopic LASIK performed in patients with corneas of central thickness below average(<540μm) and normal topography. Methods: This is a retrospective cohort study conducted at a private practice setting on Mexican Hispanic patients who underwent myopic LASIK between January 2014 and January 2015. An analysis of records of patients >18 years-old with previous normal topography, stable refraction, corrected visual acuity ≥ 20/20 (Snellen), Central Corneal Thickness (CCT) < 540μm and at least 12 months follow up after surgery was conducted. The main outcome measures were standard visual outcomes (efficacy, safety, refractive stability) and Percent Tissue Altered (PTA) analysis was conducted. Results: A total of 51 patients (102 eyes) were included; 56% (n=57) were female. The mean age was 26.52 ± 8.06 (range 18-55 years) with a mean follow up of 13.9 ± 1.2 months. Preoperative CCT was 515.44 ± 17.87μm (range 452- 540μm), with a mean refractive spherical equivalent (SEQ): -4.08 ± 2.17 D (range -0.75 to -9.75 D), and mean refractive cylinder: -1.44 ± 1.29 D (range 0.00 to -6.00 D). Mean predictability of postoperative SEQ was -0.20 ± 0.40 D (range -1.25 to +1.25). Postoperative SEQ was ±0.50 D in 71%, ±1.00 D in 93% of the eyes. Postoperative uncorrected distance visual acuity was ≥20/20 in 78% and ≥20/25 in 95%. One line of CDVA was lost in 3% of the eyes, no eyes lost ≥2 lines. No ectasia cases were observed during follow-up. Conclusion: LASIK surgery in Mexican Hispanic patients with thinner than “normal” corneas (<540 μm) is safe, efficient and predictable at 1 year follow up for myopic refractive corrections with no evidence of postoperative keratectasia.

scholarly journals Outcome of Trabeculectomy with Intraoperative Subtenon Injection of Mitomycin C

2021 ◽  
Author(s):  
Pir Salim Mahar ◽  
Asma Rahman
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Medical Records ◽  
P Value ◽  
Operative Outcomes ◽  
Corrected Visual Acuity ◽  
Subtenon Injection ◽  
The Mean ◽  
Best Corrected Visual Acuity

Abstract Purpose: To evaluate the efficacy of trabeculectomy with intraoperative subtenon injection of Mitomycin C (MMC) in terms of control of Intraocular pressure post-operatively.Study design: Observational studyMethods: A total of 49 patient’s medical records who underwent trabeculectomy with intraoperative subtenon injection of MMC with diagnosis of Primary Open Angle Glaucoma (POAG) from January 2017 to December 2018 were evaluated to see the post-operative outcomes in terms of control of intraocular pressure (IOP) with 12 months follow-up. The medical records were retrieved using the hospital information system. Age, gender, pre-operative IOP, Best-Corrected Visual Acuity (BCVA), co-morbids, previous surgery, Central Corneal Thickness (CCT), fundus findings, number of glaucoma medications and postoperative complications were obtained by using a proforma.Results: Total 72 eyes of 49 patient records were evaluated to see post operative outcomes at three, six and twelve months follow up. The mean IOP preoperatively was 24.68±13.66 mm Hg with maximum anti-glaucoma treatment. After the surgery the mean IOP was 13.69±6.68 mmHg at 3 months follow-up, and 12.68±4.04 and 13.33±4.8 mmHg at 6 and 12 months respectively (P-value 0.001). Preoperatively mean CCT was 529.81±28.75 and at 12 months follow-up after surgery was 530.45±29.43 with P-value 0.245. Best Corrected Visual Acuity outcomes were seen at each follow-up and results were found to be statistically significant (P value ≤ 0.05).Conclusions: Twelve months follow-up of trabeculectomy show that intraoperative subtenon injection of MMC is effective in terms of control of IOP postoperatively with minimal complications in patients with POAG.

scholarly journals Effect of phacoemulsification with intraocular lens implantation in eyes with cataract and functioning filtering blebs

2013 ◽  
Vol 13 (2) ◽  
pp. 33-41
Author(s):  
Devendra Maheshwari ◽  
Rengappa Ramakrishanan ◽  
Mohideen Abdul Kader ◽  
Neelam Pawar ◽  
Ankit Gupta
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Intraocular Lens ◽  
Intraocular Lens Implantation ◽  
Corrected Visual Acuity ◽  
Lens Implantation ◽  
The Mean ◽  
One Year ◽  
Best Corrected Visual Acuity

Aim: To evaluate the effect of phacoemulsification with intraocular lens implantation in eyes with pre-existing trabeculectomy.Methods: This prospective single-center clinical study evaluated intraocular pressure in 60 eyes of 60 patients who underwent phacoemulsification and implantation of a foldable intraocular lens after a previous successful trabeculectomy. Patients who had a trabeculectomy more than one year prior to the study were included. Intraocular pressure, number of antiglaucoma medications, bleb appearance, and visual acuity were recorded preoperatively, and at each follow-up examination and 12 months after phacoemulsification.Results: The mean intraocular pressure before phacoemulsification was 12.42 mmHg (SD, 4.60 mmHg), which increased to 14.98 mmHg (SD, 4.18 mmHg), 14.47 mmHg (SD, 3.58 mmHg), 15.44 mmHg (SD, 3.60 mmHg), and 15.71 mmHg (SD, 3.47 mmHg) after one, three, six, and 12 months, respectively. At each follow-up visit, the mean IOP was significantly higher than the preoperative value (p < 0.001, p = 0.015, p ≤ 0.001, and p = 0.001 at month one, three, six, and 12, respectively). The mean preoperative best-corrected visual acuity was 0.98 logMAR (SD, 0.44 logMAR) and the mean postoperative best-corrected visual acuity at 12 months was 0.20 logMAR (SD, 0.21 logMAR) [p = 0.0001]. The mean preoperative number of antiglaucoma medications used was 0.57 (SD, 0.63), which increased to 0.65 (SD, 0.63 ), 0.70 (SD, 0.72 ) 0.68, (SD, 0.70), and 0.67 (SD, 0.77 ) at one, three, six, and 12 months, respectively, but there were no statistically significant differences. Bleb size decreased clinically after phacoemulsification. Nineteen of 60 eyes (32%) developed fibrosis of bleb with decreased bleb size.Conclusion: Phacoemulsification with intraocular lens implantation significantly increased intraocular pressure and increased the number of antiglaucoma medications in eyes with pre-existing functioning filtering blebs.

Success of Intravitreal Ranibizumab for Myopic Choroidal Neovascularization After 2 Years of Treatment

2017 ◽  
Vol 1 (2) ◽  
pp. 122-125 ◽  
Author(s):  
Beatriz Abadia ◽  
Pilar Calvo ◽  
Antonio Ferreras ◽  
Gloria Lopez ◽  
Jesús Leciñena ◽  
...  
Keyword(s):  
Choroidal Neovascularization ◽  
Medical Records ◽  
Functional Outcomes ◽  
Retinal Thickness ◽  
Pathological Myopia ◽  
Intravitreal Ranibizumab ◽  
Corrected Visual Acuity ◽  
The Mean ◽  
Pro Re Nata

Purpose: To analyze the anatomical and functional outcomes in patients with choroidal neovascularization (CNV) secondary to pathological myopia (PM). Methods: Retrospective review of the medical records of 40 patients with CNV secondary to PM treated exclusively with intravitreal ranibizumab 0.5 mg and at least 24 months of follow-up. The initial dose comprised 1 or 3 monthly injections followed by a pro re nata regimen. Best-corrected visual acuity (BCVA), central retinal thickness (CRT) measured with spectral domain optical coherence tomography (OCT), and ocular and systemic adverse event were recorded. Results: Mean patient age was 62.5 ± 12.5 years. The mean spherical equivalent refractive error was −12.3 ± 6.9 diopters, and a single intravitreal injection was initially performed in 72.5% of cases. Mean baseline BCVA was 0.33 ± 0.20 logMAR (Snellen equivalent, 20/60), and mean CRT by OCT was 340.65 ± 80 µm. Both BCVA and OCT revealed significant improvement compared to baseline at all established cutoff points ( P < .001). Final BCVA was 0.50 ± 0.3 logMAR (Snellen, 20/40), and final CRT was 255.69 ± 47.7 µm ( P < .001). The mean number of ranibizumab injections was 2.75 ± 1.97. No cases of endophthalmitis or retinal detachments were reported, and no serious adverse systemic events were identified. Conclusion: Excellent anatomical and functional outcomes were obtained after treatment with intravitreal ranibizumab for CNV secondary to PM.

scholarly journals Outcomes of a Single-Segment Intrastromal Corneal Ring in Early Keratoconus Versus Early Pellucid Marginal Degeneration

2021 ◽  
Author(s):  
Seyed Javad Hashemian ◽  
Parya Abdolalizadeh ◽  
Leila Ghiasian ◽  
Hossein Aghaei ◽  
Ali Hadavandkhani ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Femtosecond Laser ◽  
Early Stage ◽  
Interventional Study ◽  
Short Term ◽  
Single Segment ◽  
Corrected Visual Acuity ◽  
Intrastromal Corneal Ring ◽  
Ring Segment ◽  
Outpatient Center

Abstract Purpose: To determine the effect of a single-segment intrastromal corneal ring segment (ICRS;Intacs-SK) on early keratoconus (KCN) or pellucid marginal degeneration (PMD).Methods: It is a prospective interventional study. One-hundred-twenty-four eyes (99 patients) with KCN and 36 eyes (26 patients) with PMD at early stage (the maximum keratometric reading less than 55 diopters) were included to ICRS implantation using femtosecond laser at a tertiary university-based hospital and a private outpatient center. The uncorrected distance and spectacle-corrected visual acuity (UDVA and SCDVA), manifest spherical and cylindrical refractions, and keratometry indices were measured preoperatively and postoperatively, 1 week, 2 and 6 months.Results: One week after surgery, significant improvements were observed in UDVA, SCDVA, cylinder and keratometry readings of both KCN and PMD groups (all P<0.05) with no significant changes afterwards. No significant change occurred in the sphere refraction of PMD group (P=0.10) in contrast to KCN group (P<0.001). Corneal irregularity of KCN group in central 3 and 5 mm zones increased at 1 week (both P<0.001) and then continued to decrease up to 6 months. However, the corneal irregularity of PMD group had significant reduction only at 1 week in 5-mm zone (P=0.02) and 2 months in 3-mm zone (P=0.01) postoperatively. The final efficacy indexes were 1.44±0.71 and 0.87±0.40 in KCN and PMD groups, respectively. Conclusion: Visual acuity and keratometry values reached stability at 1 week, after one-segment Intacs-SK implantation in KCN and PMD groups. The short-term efficacy of the procedure was more in early KCN compared to early PMD.

scholarly journals Visual and Refractive Outcomes of Small-Incision Lenticule Extraction in High Myopia: 5-Year Results

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Alper Ağca ◽  
İhsan Çakır ◽  
Beril Tülü Aygün ◽  
Dilek Yaşa ◽  
Yusuf Yıldırım ◽  
...  
Keyword(s):  
Visual Acuity ◽  
High Myopia ◽  
Spherical Equivalent ◽  
Small Incision Lenticule Extraction ◽  
Distance Visual Acuity ◽  
Small Incision ◽  
Refractive Outcomes ◽  
Lenticule Extraction ◽  
The Mean

Purpose. To report long-term visual and refractive results of small-incision lenticule extraction (SMILE) in treatment of high myopia. Materials and Methods. Medical records of patients who underwent SMILE for surgical correction of myopia or myopic astigmatism were retrospectively reviewed. Only patients with a preoperative spherical equivalent of subjective manifest refraction (SE) ≥ 6 D and a postoperative follow-up of 5 years were included in the study. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and SE were analyzed preoperatively and at 1-, 3-, and 5-year postoperative periods. Results. Thirty-seven eyes of 37 patients were included in the study. The mean attempted SE was −7.47 ± 1.10 D (range −6.00 to −10.00 D). At the 5-year visit, the mean difference between achieved and attempted SE was −0.43 ± 0.47 (0.50 to −1.25 D). Mean postoperative UDVA and CDVA were 0.20 ± 0.18 and 0.06 ± 0.08 logMAR, respectively. At the 1-year visit, 70% and 97% of the eyes were within ±0.50 D and ±1.00 D of the intended correction. At the 5-year follow-up, 59% and 92% percent of the eyes were within ±0.50 D and ±1.00 D of the intended SE, respectively. At the 5-year visit, the efficacy index was 0.89 ± 0.26 and the safety index was 1.16 ± 0.20. Fifty-four percent of the eyes gained one or more lines of CDVA. Conclusion. SMILE with an intended correction of up to a spherical equivalent of 10 D is safe and effective. However, there is regression of the refractive effect over extended follow-up.

Use of new-generation hybrid contact lenses for managing challenging corneas

2020 ◽  
pp. 112067212094275
Author(s):  
Ibrahim Inan Harbiyeli ◽  
Elif Erdem ◽  
Puren Isik ◽  
Meltem Yagmur ◽  
Reha Ersoz
Keyword(s):  
Visual Acuity ◽  
Medical Records ◽  
Contact Lenses ◽  
Corrected Visual Acuity ◽  
Manifest Refraction ◽  
Uncorrected Visual Acuity ◽  
The Mean ◽  
New Generation ◽  
Generation Hybrid ◽  
Irregular Astigmatism

Introduction: To evaluate the safety and efficacy of new-generation hybrid contact lenses (HCL) among patients with irregular astigmatism. Methods: Medical records of 25 patients fit with new-generation HCL (Eyebrid® and AirFlex®) were retrospectively reviewed. The data collected included etiology of irregular astigmatism, uncorrected visual acuity, manifest refraction, spectacle-corrected visual acuity (S-CDVA), steep / flat keratometric values, corneal astigmatism, records of rigid / soft CL fitted before HCL, all parameters of the trial lenses, and the final prescribed HCL parameters and HCL-CDVA. Results: The study included 34 eyes from 25 patients (nine females and 16 males) with an average age of 29 ± 13 (ranging from 8–56) years. In total, 25 eyes with keratoconus, four with post - keratoplasty astigmatism, three with irregular astigmatism due to corneal trauma and two with residual astigmatism after radial keratotomy were fit with HCL. The mean S-CDVA (logMAR) improved significantly from 0.76 ± 0.41 to 0.14 ± 0.15 with HCL ( p < 0.01). The most common indication for HCL was inability to fit with rigid gas permeable (RGP) lenses (22 eyes). The average number of lenses to successful fit was 1.4 (mode, 1; median, 1) and ideal fit was achieved with the first trial lens in 25 eyes (73%). Seven patients (nine eyes, 36%) discontinued lens use within the first 6 months because of discomfort (six eyes, 24%), ocular allergy (two eyes, 8%) and tearing of contact lens (one eye, 4%). Discussion: New-generation HCL may be a suitable option for fitting challenging corneas with irregular astigmatism that cannot be rehabilitated efficiently with rigid lenses.

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