Detecting subclinical keratoconus by biomechanical analysis in tomographically regular keratoconus fellow eyes

2021 ◽  
pp. 112067212110637
Author(s):  
Victor A Augustin ◽  
Hyeck-Soo Son ◽  
Isabella Baur ◽  
Ling Zhao ◽  
Gerd U Auffarth ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Case Series ◽  
Biomechanical Analysis ◽  
Corvis St ◽  
Corrected Visual Acuity ◽  
The Mean ◽  
Best Corrected Visual Acuity ◽  
Fellow Eyes

Purpose To analyze the tomographically non-affected second eyes of keratoconus patients using the Corvis ST to detect any biomechanical abnormalities or subclinical keratoconus. Methods In this retrospective, single-center, consecutive case series 244 eyes of 122 keratoconus patients were analyzed between November 2020 and February 2021. Fourteen fellow eyes fulfilled the inclusion criteria and showed no clinical or tomographic signs of keratoconus. Main outcome measures included best-corrected visual acuity, tomographic and biomechanical analyses using Scheimpflug imaging: Pentacam and Corvis ST (Oculus, Wetzlar, Germany). Tomographic analyses included anterior and posterior simulated keratometry, K-Max, central corneal thickness, thinnest corneal thickness, Belin/Ambrosio Ectasia Display, and the ABCD grading system. For biomechanical analyses, the corneal biomechanical index (CBI) and tomographic biomechanical index were used. Results The mean best-corrected visual acuity was 0.01 ± 0.10 logMAR. Mean K-Max was 43.79 ± 1.12 D, mean central corneal thickness 529 ± 25 µm, mean thinnest corneal thickness 524 ± 23 µm, and mean Belin/Ambrosio Ectasia Display 1.0 ± 0.32. The mean CBI was 0.30 ± 0.21. Regular CBI values were found in six of 14 patients. The mean tomographic biomechanical index was 0.47 ± 0.22 with regular values observed in only two of 14 patients. No signs of tomographic or biomechanical abnormalities were shown in only one of 14 keratoconus fellow eyes, with regular ABCD, Belin/Ambrosio Ectasia Display, CBI and tomographic biomechanical index values. Conclusions Tomographically normal fellow eyes of keratoconus patients are rare. In these cases, a biomechanical analysis of the cornea may help detect a subclinical keratoconus. The tomographic biomechanical index was the most sensitive index to verify a mild ectasia.

scholarly journals Comparative study of anatomic and functional changes of the corneal endothelium in cataract patients undergoing phacoemulsification and MSICS

2021 ◽  
Vol 7 (2) ◽  
pp. 358-362
Author(s):  
Gurvinder Khosa ◽  
Karanijit Singh ◽  
Prempal Kaur ◽  
Rajesh Kumar ◽  
Upasna Ajmani
Keyword(s):  
Visual Acuity ◽  
Endothelial Cell ◽  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Cell Loss ◽  
P Value ◽  
Corrected Visual Acuity ◽  
Group 2 ◽  
Best Corrected Visual Acuity ◽  
Group 1

The purpose of this study was to compare the effect of Phacoemulsification and Manual small incision cataract surgery (MSICS) on the corneal endothelium and to assess its impact on visual acuity and induced astigmatism. In this prospective randomized study, 100 cases were randomly selected with the help of lottery system. 50 cases underwent phacoemulsification (group 1) and 50 underwent MSICS (group 2) by a single surgeon. The endothelial cell count, central corneal thickness, best corrected visual acuity and induced astigmatism was measured preoperatively and postoperatively on day 1, 7, 28 and on day 42. Mean endothelial cell loss (cells/mm2) in group 1 at the end of six weeks was 538.64 (20.59%) and in group 2 was 485.66 (19.20%) which was statistically insignificant (p >0.05). The mean central corneal thickness was reduced in both the groups with a mean of 0.51±0.04 mm in group 1 and 0.50±0.03 mm in group 2 which was statistically insignificant. Postoperative best corrected visual acuity of more than 6/18 was found in 49 (98%) cases in each group at six weeks, and was statistically insignificant (p value > 0.05). Phacoemulsification group had statistically significant less mean postoperative astigmatism than MSICS group (p value < 0.05). Both groups gave similar statistically insignificant results in relation to endothelial cell loss, central corneal thickness and best corrected visual acuity at the end of six weeks, although the mean astigmatism was more in group 2 in comparison to group 1 with a statistically significant difference.

scholarly journals Navigation-Guided Endoscopy Combined with Deep Lateral Orbitotomy for Removal of Small Tumors at the Lateral Orbital Apex

2018 ◽  
Vol 2018 ◽  
pp. 1-8
Author(s):  
GuangMing Zhou ◽  
Xin Ju ◽  
Bo Yu ◽  
YunHai Tu ◽  
JieLiang Shi ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Vision Loss ◽  
Case Series ◽  
Pathological Examination ◽  
Orbital Apex ◽  
Corrected Visual Acuity ◽  
Lateral Orbitotomy ◽  
Before And After ◽  
The Mean ◽  
Best Corrected Visual Acuity

Purpose. To evaluate the efficacy, feasibility, and safety of the navigation-guided endoscopy combined with deep lateral orbitotomy for removal of small tumors at the lateral orbital apex.Design. A retrospective, noncomparative case series.Methods. Retrospective analysis of ten patients (10 eyes) with small tumors at the lateral orbital apex comprised navigation-guided endoscopy combined with deep lateral orbitotomy at the Eye Hospital of Wenzhou Medical University from November 2015 to November 2017. In each case, the indication of surgery was existing or imminent visual impairment due to the tumor. The removal was believed to be complete if the mass was removed intactly during the surgery. The tumor character was confirmed by pathological examination after surgery. Patients were followed up to 3 months after surgery. Best corrected visual acuity before and after surgery was compared.Results. All tumors were completely removed by the navigation-guided endoscopic approach. The mean preoperative best corrected visual acuity was 6/15 (95% confidence interval (95% CI) 6/40–6/8.5), and the mean postoperative best corrected visual acuity was 6/10 (95% CI 6/15–6/7.5). 5 of 7 (71%) patients with vision loss gained visual improvement in different degrees after surgery, and the rest of the patients had preoperative best corrected visual acuity. Visual field of all patients also improved. 8 cavernous hemangiomas and 2 schwannomas were confirmed postoperatively by pathology. 4 patients accompanied with limitation of eye abduction, which recovered spontaneously in an average of 4 weeks. No other serious complications occurred.Conclusions. Navigation-guided endoscopy combined with deep lateral orbitotomy seems to be a feasible, efficient, and safe approach for removing small tumors at the lateral orbital apex. This trial is registered withChiCTR1800019244.

Comparative study on corneal cross-linking with isotonic and hypotonic riboflavin: can hypotonic riboflavin be applied in thinner corneas?

2021 ◽  
Vol 2 (1) ◽  
pp. 14-19
Author(s):  
Ana Sofia Lopes ◽  
◽  
Susana Henriques ◽  
Peter Pêgo ◽  
Cristina Vendrell ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retrospective Study ◽  
Comparative Study ◽  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Cross Linking ◽  
Corrected Visual Acuity ◽  
The Difference ◽  
Best Corrected Visual Acuity

AIM: To compare the results of corneal cross-linking (CXL) with isotonic (IR) and hypotonic riboflavin (HR) in patients with keratoconus and to verify the efficacy of keratoconus in thinner corneas. METHODS: Retrospective study of 29 eyes/keratoconus patients submitted to CXL, 15 eyes with application of IR (IR group) and 14 eyes with application of HR (HR group). The parameters analysed included (1-year follow-up): best corrected visual acuity (BCVA), sphere and cylinder, central and finer pachymetry, mean and maximum keratometry (Km and Kmax respectively), complications and progression. RESULTS: An increase on the BCVA scale (logMAR, logarithm of the minimal angle of resolution) was observed in the two groups: 0.26±0.57 (IR) and 0.47±0.72 (HR) before treatment, and 0.13±0.79 (IR) and 0.29±1.52 (HR) at the 1y. Only at 1y, the difference was statistically significant (P=0.018, group IR with higher BCVA). The central pachymetry (μm) decreased at 1mo in both groups, and increased in the following months: 497±28 μm (IR) and 432±14 μm (HR) before treatment, and 480±31 μm (IR) and 424±15 μm (HR) to the 1y. The thinner pachymetry (μm) presented the same evolution: 487±29 μm (IR) and 410±20 μm (HR) before treatment, and 468±33 μm (IR) and 413±13μm (HR) at 1y. Km and Kmax decreased in both groups (P>0.05). Six eyes from each group presented transitory haze. No eye progressed to the 1y. CONCLUSION: The use of hypotonic riboflavin seems to be a valid alternative for performing the traditional corneal cross-linking technique in eyes with a central corneal thickness of <400 μm.

scholarly journals Evaluation of Donor and Recipient Characteristics Involved in Descemet Stripping Automated Endothelial Keratoplasty Outcomes

2021 ◽  
Vol 8 ◽  
Author(s):  
Michele Lanza ◽  
Rosa Boccia ◽  
Adriano Ruggiero ◽  
Paolo Melillo ◽  
Mario Bifani Sconocchia ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Visual Acuity ◽  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Bullous Keratopathy ◽  
Endothelial Keratoplasty ◽  
Eye Bank ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity

Aims: To evaluate both donor and recipient features involved in visual acuity restoring and complication insurgence in eyes that have undergone Descemet stripping automated endothelial keratoplasty (DSAEK).Methods: In this retrospective study, charts of 111 eyes of 96 patients (mean age 70.25 ± 8.58 years) that underwent DSAEK were evaluated. Only Fuch's Distrophy (FD) or Bullous Keratopathy (BK) due to cataract surgery eyes were included. A complete ophthalmic check with endothelial cell density (ECD) and central corneal thickness (CCT) measurement was performed before surgery and at 1, 3, 6, and 12 months follow-up. Each DSAEK was performed by the same well-trained surgeon; only pre-cut lenticules, provided by same Eye Bank, were implanted.Results: A total of 48 (43%) complications have been observed (most of them were 22 partial graft detachments and 17 IOP spikes). At the last follow-up (mean: 8.58 ± 4.09 months), a significant increase (p &lt; 0.05) of best corrected visual acuity (BCVA) was detected. Overall mean BCVA of the eyes evaluated was 0.40 ± 0.43 LogMAR with BK eyes showing a significantly higher improvement (p &lt; 0.05) compared to FD eyes. The only factor showing a significant correlation (p &lt; 0.05) with visual acuity enhancement was the implant of a lenticule thinner than 100 μm. Recipient features significantly (p &lt; 0.05) associated with complications observed after surgery were glaucoma and diabetes mellitus.Conclusion: The use of a graft thinner than 100 μm can provide better visual acuity recovery while recipients affected by glaucoma or diabetes mellitus are more prone to develop complications after surgery.

Comparison of the Effectiveness of Intravitreal Ranibizumab for Diabetic Macular Edema in Vitrectomized and Nonvitrectomized Eyes

2016 ◽  
Vol 236 (2) ◽  
pp. 67-73 ◽  
Author(s):  
Yoshito Koyanagi ◽  
Shigeo Yoshida ◽  
Yoshiyuki Kobayashi ◽  
Yuki Kubo ◽  
Muneo Yamaguchi ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Treatment Option ◽  
Central Macular Thickness ◽  
Intravitreal Ranibizumab ◽  
Corrected Visual Acuity ◽  
The Mean ◽  
The Difference ◽  
Best Corrected Visual Acuity

Purpose: To compare the effectiveness of intravitreal ranibizumab (IVR) for diabetic macular edema (DME) between eyes with and without previous vitrectomy. Procedures: We prospectively assessed the best-corrected visual acuity (BCVA) and central macular thickness (CMT) after IVR for 6 months. Results: There were no significant differences in the baseline BCVA and CMT between both groups. In the nonvitrectomized group (n = 15), the mean changes of BCVA and CMT from baseline to month 6 were significant (p < 0.01). In the vitrectomized group (n = 10), the improvement appeared to be slower, and the mean BCVA improvement was not significant (p = 0.5), although the mean CMT decrease was significant (p < 0.05). There were no significant differences in the mean changes of BCVA and CMT between both groups at 6 months. Conclusions: The difference in the effectiveness of IVR between both groups was not significant. IVR can be a treatment option even for vitrectomized DME eyes.

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.

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 Real-world outcomes of two-year Conbercept therapy for diabetic macular edema

2021 ◽  
Vol 14 (3) ◽  
pp. 416-422
Author(s):  
Yong Cheng ◽  
◽  
Ming-Wei Zhao ◽  
Tong Qian ◽  
◽  
...  
Keyword(s):  
Visual Acuity ◽  
Adverse Events ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Vision Loss ◽  
Retinal Thickness ◽  
Corrected Visual Acuity ◽  
The Mean ◽  
Number Of Injections ◽  
Best Corrected Visual Acuity

AIM: To evaluate the two-year outcomes of patients treated for diabetic macular edema (DME) with intravitreal Conbercept (IVC). METHODS: The clinical data of 30 DME patients (36 eyes) were retrospectively reviewed. The patients were treated with IVC for 3mo. Additional IVC was given at subsequent monthly visits, if needed (3+PRN). The patients were followed up for 24mo. RESULTS: The best-corrected visual acuity (BCVA) at 24mo significantly increased (66.7±15.3 letters) in comparison with the baseline (54.4±15.4 letters, P<0.0001). The mean improvement in BCVA was 11.0±2.9 letters. At 24mo, 44.1% of the eyes surveyed gained ≥15 letters, 52.9% of the eyes gained ≥10 letters, and 70.6% of the eyes gained ≥5 letters. No vision loss was noted in 96.8% of the eyes, and 5.9% of the eyes lost ≥5 letters, but ≤10 letters. The central retinal thickness (CRT) at 24mo was significantly reduced (277.1±122.9 μm) in comparison with the baseline (510.9±186.1 μm, P<0.0001). At 24mo, 43.3% of the patients had a CRT ≤250 μm. The mean number of injections over 24mo was 10.6±2.0. No severe eye or systemic adverse events related to either the drug or injection were noted. CONCLUSION: IVC is safe and effective for the treatment of DME.

scholarly journals Association of foveal avascular zone with the metamorphopsia in epiretinal membrane

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Hideki Shiihara ◽  
Hiroto Terasaki ◽  
Shozo Sonoda ◽  
Naoko Kakiuchi ◽  
Hidetaka Yamaji ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Superficial Layer ◽  
University Hospital ◽  
Foveal Avascular Zone ◽  
Service Unit ◽  
Corrected Visual Acuity ◽  
Avascular Zone ◽  
The Mean ◽  
The Relationship ◽  
Best Corrected Visual Acuity

Abstract This study was to investigate the relationship between the metamorphopsia and foveal avascular zone (FAZ) parameter in eyes with epiratinal membrane (ERM). We studied patients with an ERM visited retinal service unit at the Kagoshima University Hospital or Shirai Hospital. The best-corrected visual acuity (BCVA), and the degree of metamorphopsia by M -CHARTS™ were evaluated. The 3 × 3 mm optical coherence tomography angiography (OCTA) images of the superficial layer were obtained. Area (mm2), the circularity, eigen value were calculated using ImageJ software. The relationship between visual function, such as best corrected visual acuity (BCVA) and metamorphopsia, and FAZ parameters were studied by Pearson’s correlational coefficient. Fifty-four eyes of 51 patients (24 men and 27 women) with an ERM were studied. The mean age of the patients was 69.6 ± 8.20 years. The mean BCVA and metamorphopsia score was 0.31 ± 0.29 logMAR units and 0.49 ± 0.42. There was no significant relationship between BCVA and FAZ parameters. While, metamorphopsia score was significantly and negatively correlated with all of FAZ parameters (area R = − 0.491, P < 0.001; circularity R = − 0.385, P = 0.004; eigenvalue ratio R = − 0.341; P = 0.012). Multiple regression analysis showed the FAZ area was solely and significantly correlated with metamorphopsia score (β − 0.479, P < 0.001). The size but not the shape of the FAZ was significantly correlated with the degree of metamorphopsia suggesting that it could be an objective parameter of metamorphopsia in ERM patients.

Outcomes of corneal neurotisation using processed nerve allografts: a multicentre case series

2020 ◽  
pp. bjophthalmol-2020-317361
Author(s):  
Adam R Sweeney ◽  
Margaret Wang ◽  
Christopher L Weller ◽  
Cat Burkat ◽  
Andrea L. Kossler ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Ocular Trauma ◽  
Surgical Techniques ◽  
Case Series ◽  
Retrospective Case ◽  
Corneal Sensation ◽  
Corrected Visual Acuity ◽  
The Mean ◽  
Maximal Gain ◽  
Prior Infection

BackgroundCorneal neurotisation is a rapidly evolving procedure treating neurotrophic keratopathy. The variety of surgical techniques used and corresponding outcomes after corneal neurotisation are not well understood. This study describes the techniques and outcomes in the largest case series of corneal neurotisation using processed nerve allografts to date.MethodsThis is a retrospective case series of patients who underwent corneal neurotisation with human cadaveric processed nerve allografts. All patients had preoperative and postoperative description of best corrected visual acuity and measurement of corneal sensation. Comparative studies after stratification of techniques were performed.ResultsA total of 17 patients were identified. The cause of corneal anaesthesia was prior infection in eight cases, trigeminal nerve palsy in eight cases and ocular trauma in one case. There were no intraoperative or postoperative complications. Following neurotisation surgery, the time to first gain of corneal sensation and maximal gain of sensation occurred at a mean of 3.7 months (range 1–8 months) and 6.6 months (range 3–15 months), respectively. The mean preoperative and postoperative corneal sensation as measured by Cochet-Bonnet aesthesiometry was 0.36 cm (range 0–3.2 cm) and 4.42 cm (range 0–6 cm), respectively (p<0.01). Visual acuity was unchanged after neurotisation. There were no statistical differences in outcomes based on end-to-end versus end-to-side coaptations, donor nerve selection or laterality of donor nerve.ConclusionCorneal neurotisation with processed nerve allografts is a safe and effective procedure. This study provides further evidence for the use of processed nerve allografts for corneal neurotisation.

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