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

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.

scholarly journals Safety and Efficacy of Epithelium-On Corneal Collagen Cross-Linking Using a Multifactorial Approach to Achieve Proper Stromal Riboflavin Saturation

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Aleksandar Stojanovic ◽  
Xiangjun Chen ◽  
Nan Jin ◽  
Ting Zhang ◽  
Filip Stojanovic ◽  
...  
Keyword(s):  
Cross Linking ◽  
Slight Reduction ◽  
Irregularity Index ◽  
Uva Irradiation ◽  
Odd Order ◽  
Corrected Distance Visual Acuity ◽  
Superficial Epithelium ◽  
Multifactorial Approach ◽  
Collagen Cross Linking ◽  
Corneal Collagen

Purpose. To evaluate the efficacy and safety of epithelium-on corneal collagen cross-linking (CXL) using a multifactorial approach to achieve proper stromal riboflavin saturation.Methods. This non-randomized retrospective study comprised 61 eyes with progressive keratoconus treated with epithelium-on CXL. Chemical epithelial penetration enhancement (benzalkonium chloride-containing local medication and hypotonic riboflavin solution), mechanical disruption of the superficial epithelium, and prolongation of the riboflavin-induction time until verification of stromal saturation were used before the UVA irradiation. Uncorrected and corrected distance visual acuity (UDVA, CDVA), refraction, corneal topography, and aberrometry were evaluated at baseline and at 1, 3, 6, and 12 months postoperative.Results. At 12-month, UDVA and CDVA improved significantly. None of the eyes lost lines of CDVA, while 27.4% of the eyes gained 2 or more lines. Mean spherical equivalent decreased by 0.74 D, and mean cylindrical reduction was 1.15 D. Irregularity index and asymmetry from Scheimpflug-based topography and Max-Kat the location of cone from Placido-based topography showed a significant decrease. Higher-order-aberration data demonstrated a slight reduction in odd-order aberrationsS3, 5,7 (). Postoperative pain without other complications was recorded.Conclusion. Epithelium-on CXL with our novel protocol appeared to be safe and effective in the treatment of progressive keratoconus.

scholarly journals Clinical Outcomes at 1 Year following Corneal Ectasia Treatment with Accelerated Transepithelial Cross-linking

2016 ◽  
Vol 5 (3) ◽  
pp. 93-98 ◽  
Author(s):  
Rafael J Pérez-Cambrodí ◽  
Pedro Ruiz-Fortes ◽  
Alberto Artola
Keyword(s):  
Visual Acuity ◽  
Clinical Outcomes ◽  
Statistical Significance ◽  
Cross Linking ◽  
Corneal Ectasia ◽  
Significant Difference ◽  
Corrected Distance Visual Acuity ◽  
The Mean

ABSTRACT Objective To assess the clinical outcomes in ectatic corneas following accelerated transepithelial cross-linking (CXL) over 1 year of follow-up. Materials and methods Twenty-one eyes diagnosed with progressive corneal ectasia (19 keratoconus, 2 post-laser in situ keratomileusis ectasias) in 14 patients aged between 26 and 69 years were enrolled. All cases were treated with accelerated transepithelial CXL using the Avedro KXL® system (Waltham, MA, United States). Changes at visual, refractive, corneal topographic, and corneal aberrometric level were evaluated over a 12-month follow-up period. The demarcation was also determined using optical coherence tomography (OCT). Results The mean depth of the demarcation line measured by OCT was 202.72 µm, varying between 153 and 230 µm. One month postsurgery, a change was noted at the limit of statistical significance in sphere (p = 0.05) and in spherical equivalent (p = 0.05). Likewise, a statistically significant difference was observed in corrected distance visual acuity (CDVA) (p = 0.01). There were no significant changes in either visual acuity or refraction between 1 and 6 months (p ≥ 0.35). Although changes in trend were observed in corneal topographic and aberrometric parameters after surgery, none reached statistical significance (p ≥ 0.08). A significant change was observed only in astigmatism of the posterior surface between 1 and 12 months (p = 0.02). Conclusion Accelerated transepithelial CXL may be a useful technique for the management of progressive corneal ectasia, as it is able to maintain the topographic and aberrometric profile of the cornea with no significant changes. Longer-term studies are required to confirm this finding How to cite this article Piñero DP, Artola A, Ruiz-Fortes P, Soto-Negro R, Pérez-Cambrodi RJ. Clinical Outcomes at 1 Year following Corneal Ectasia Treatment with Accelerated Transepithelial Cross-linking. Int J Kerat Ect Cor Dis 2016;5(3):93-98.

scholarly journals Transepithelial versus epithelium-off corneal collagen cross-linking for corneal ectasia: protocol for a systematic review, meta-analysis and trial sequential analysis of randomised controlled trials

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e025728 ◽  
Author(s):  
Siddharth Nath ◽  
Carl Shen ◽  
Alex Koziarz ◽  
Laura Banfield ◽  
Mark A Fava ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomised Controlled Trials ◽  
Cross Linking ◽  
Published Data ◽  
Controlled Trials ◽  
Corneal Ectasia ◽  
Randomised Controlled ◽  
Collagen Cross Linking ◽  
Corneal Collagen

IntroductionCorneal ectasias are progressive, degenerative ocular diseases defined by abnormal structural changes in the cornea, leading to distortion of vision and substantial reduction in quality of life. Corneal collagen cross-linking (CXL) increases the biomechanical rigidity of the cornea and has been shown to halt ectatic processes. The established CXL protocol requires removal of the corneal epithelium. However, some surgeons have proposed transepithelial approaches to enhance patient recovery and minimise adverse events. Whether novel transepithelial approaches are as effective in arresting ectasia as the established epithelium-off protocol remains unclear. This study will systematically review the evidence on transepithelial CXL approaches and compare it to the epithelium-off protocol.Methods and analysisWe will include randomised controlled trials (RCTs) comparing transepithelial and epithelium-off CXL for any corneal ectasia. We will search 16 electronic databases including MEDLINE and Embase, as well as the grey literature. Two reviewers will independently screen search results to identify eligible studies, complete data abstraction and conduct quality assessment. We will assess the quality of individual RCTs using the Cochrane risk of bias assessment tool. Our primary outcome will be the change in maximal keratometry at 12 months after treatment, and we will examine 11 additional outcomes. We will summarise our analyses by measures of association (relative risk or odds ratio) and corresponding 95% confidence intervals (CIs) for dichotomous outcomes and weighted mean differences with 95% CIs for continuous outcomes. Prespecified subgroup analyses will be conducted to explore heterogeneity. The overall quality of evidence will be rated using the Grading of Recommendations Assessment, Development and Evaluation approach.Ethics and disseminationEthics approval is not required for this systematic review as it draws from previously published data. Results of the study will be submitted to a peer-reviewed journal for publication and discussed at conferences and seminars.PROSPERO registration numberCRD42018102069

scholarly journals Corneal Physiology and Responses to Cross-Linking and Intracorneal Rings in Keratoconus

2012 ◽  
Vol 1 (1) ◽  
pp. 1-6
Keyword(s):  
Progressive Disease ◽  
Cross Linking ◽  
Arc Length ◽  
Quality Of Vision ◽  
Long Time ◽  
Ring Segment ◽  
Corneal Opacities ◽  
New Treatment ◽  
Treatment Alternatives

ABSTRACT Keratoconus is a noninflammatory, usually, bilateral progressive disease. It is a pathology characterized by a progressive thinning and ectasia of the stroma that results in cone-shaped cornea. In advanced keratoconus with corneal opacities, keratoplasty, can be the only surgical alternative for a long time. Recently, new treatment alternatives were developed in keratoconus treatment, such as intracorneal ring segments and corneal cross- linking. Intracorneal ring segment acts as spacer elements between the bundles of corneal lamellae producing a shortening of the central arc length. Corneal cross-linking treatment increases the stiffness of the cornea. Several studies reported that collagen cross-linking can delay or stop keratoconus progression and produce better quality of vision. How to cite this article Kiliç A. Corneal Physiology and Responses to Cross-Linking and Intracorneal Rings in Keratoconus. Int J Keratoco Ectatic Corneal Dis 2012;1(1):1-6.

The Current Situation in Chemical Stabilization of Biological Materials

1972 ◽  
Vol 30 ◽  
pp. 132-133
Author(s):  
John H. Luft
Keyword(s):  
Electron Microscopy ◽  
Electron Microscope ◽  
Osmium Tetroxide ◽  
Molecular Level ◽  
Cross Linking ◽  
Chemical Stabilization ◽  
Specimen Preparation ◽  
Sufficient Condition ◽  
Radio Telescopes

With information processing devices such as radio telescopes, microscopes or hi-fi systems, the quality of the output often is limited by distortion or noise introduced at the input stage of the device. This analogy can be extended usefully to specimen preparation for the electron microscope; fixation, which initiates the processing sequence, is the single most important step and, unfortunately, is the least well understood. Although there is an abundance of fixation mixtures recommended in the light microscopy literature, osmium tetroxide and glutaraldehyde are favored for electron microscopy. These fixatives react vigorously with proteins at the molecular level. There is clear evidence for the cross-linking of proteins both by osmium tetroxide and glutaraldehyde and cross-linking may be a necessary if not sufficient condition to define fixatives as a class.

Results of osteopathic correction of patients with post-traumatic coccygodynia

2019 ◽  
pp. 19-27
Author(s):  
Yu. V. Antonova ◽  
A. M. Iskandarov ◽  
I. B. Mizonova
Keyword(s):  
Quality Of Life ◽  
Emotional State ◽  
Pain Syndrome ◽  
Control Group ◽  
Life Questionnaire ◽  
Treatment Area ◽  
Diffi Cult ◽  
Osteopathic Treatment ◽  
Post Traumatic

Introduction.Coccygodynia is a multidisciplinary disease which is diffi cult to treat. It seriously limits the ability to work and signifi cantly affects the quality of life of patients. The study of somatic dysfunctions in patients with coccygodynia and the analysis of the results of osteopathic treatment of such patients makes it possible to justify the necessity of osteopathic correction of coccygodynia.Goal of the study— to determine the structure of the leading somatic dysfunctions in patients with coccygodynia and to study the effectiveness of osteopathic treatment of this pathology.Materials and methods.The study involved 44 patients from 25 to 65 years old, randomly divided into two groups. The main group of 24 people (20 women and 4 men) received osteopathic treatment, in accordance with the identifi ed leading somatic dysfunctions. Patients of the control group (16 women and 4 men) were treated locally with soft manual techniques (the treatment area was limited by the pelvic region). In order to assess the results of the treatment, we examined the intensity of the pain syndrome and the psycho-emotional state of patients. The severity of the pain syndrome was assessed in accordance with the visual analogue scale (VAS). The psycho-emotional state (with physical and mental components) was assessed with the help of the SF-36 quality of life questionnaire.Results.Somatic dysfunctions typical for patients with coccygodynia have been identifi ed. Osteopathic treatment has proven to be more effective in comparison with local manual therapy of coccygodynia both in early periods and in 3 months after the end of the treatment course.Conclusion.Osteopathic treatment of post-traumatic coccygodynia is effective, and can be recommended for treatment of such patients.

The visualization and assessment of the anterior surface of the cornea using video keratotopography

The Eye ◽  
2020 ◽  
Vol 22 (130) ◽  
pp. 36-43
Author(s):  
Gulnara Andrienko
Keyword(s):  
Contact Lenses ◽  
Corneal Topography ◽  
Topographic Maps ◽  
Specific Situation ◽  
Main Method ◽  
Pathological Conditions ◽  
Quality Of Vision ◽  
Corneal Shape ◽  
Color Map

Corneal topography is the main method for assessing the regularity of the surface of the cornea. Corneal irregularity leads to a deterioration in its refractive properties and a decrease in the quality of vision. Learning the basics of corneal topography will help determine the choice of a color map for a specific situation, as well as understand and analyze the data associated with these maps. This article describes the main types of topographic maps, various patterns of corneal shape in normal and pathological conditions and how to use the data obtained to design and fit contact lenses. Despite the fact that images may vary depending on topographers used, the information presented in this article is universal.

The Effect of Post-Traumatic Growth, Resilience, and Optimism on Quality of Life among the Disaster Victims

2015 ◽  
Vol 33 (2) ◽  
pp. 1-14 ◽  
Author(s):  
Myoung-ran Yoo ◽  
Seon Young Choi ◽  
Hye Lee Han ◽  
Yu-mi Seo ◽  
Myoung In Noh
Keyword(s):  
Quality Of Life ◽  
Disaster Victims ◽  
Post Traumatic Growth ◽  
Post Traumatic
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