Bowman layer transplantation in eyes with progressive advanced keratoconus

Purpose: to study the efficiency of Bowman layer transplantation (BLT) in corneal stroma for the treatment of progressive keratoconus (KC).Material and methods. 30 patients (30 eyes) with progressive KC stages III to IV (according to Amsler — Krumeich classification), underwent BLT into a mid-stromal pocket. At the time of surgery, the patients were 14 to 37 (averagely 26.6 ± 6.2 years). Before and after the surgery, the maximum keratometry index (Kmax) and the corneal thinnest point (CTP) values were determined. Also, we evaluated visual acuity before and after surgery in scleral contact lenses, endothelial cells density (ECD) and the depth of graft location. The indication for surgery was the refusal of corneal transplantation, progression of KC, contraindications for ultraviolet crosslinking or implantation of intracorneal ring segments based on the CTP and Kmax values. The follow-up continued 6 to 36 months (averagely, 26.6 ± 6.0 months).Results. Throughout the observation period, no intra or postoperative complications associated with BLT or deterioration of CTP, Kmax or best corrected visual acuity (BCVA) in scleral lenses were noted.Conclusions. Kmax, CTP and ECD values remaining stable during the follow-up is the evidence of a stabilizing BLT effect on the KC progression. The absence of BCVA decrease in scleral lenses indicates a functional safety of BLT.

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Correction of refractive disorders in the surgical treatment of keratoconus by MyoRing implantation

Modern technologies in ophtalmology ◽

10.25276/2312-4911-2021-5-188-191 ◽

2021 ◽

pp. 188-191

Author(s):

S.V. Milova ◽

◽

A. Daxer ◽

Keyword(s):

Visual Acuity ◽

Surgical Treatment ◽

Key Words ◽

Corneal Stroma ◽

Degenerative Disease ◽

Corrected Visual Acuity ◽

Corneal Deformation ◽

Biomechanical Strength ◽

Observation Period

Keratoconus is a progressive degenerative disease in which, due to the weakening of the biomechanical strength of the cornea, its cone-shaped deformation occurs, leading to the development of induced myopia and astigmatism, as well as to a decrease in corrected visual acuity. Treatment of this disease consists in achieving stabilization of the process by strengthening the structure of the cornea, as well as in correcting refractive disorders caused by corneal deformation. Purpose. The purpose is to evaluate the effectiveness of correction of refractive disorders by implanting a closed MyoRing ring in the corneal stroma of patients with keratoconus. Material and methods. The data of 98 MyoRing implantation operations using CISIS technology using the PoketMaker ultraceratom for stage 3-4 keratoconus were analyzed. The observation period is up to 9 years. The initial myopia averaged -9.23 D ±3.82, astigmatism-6.13 ±2.51. Results. Stabilization of the refractive effect occurred usually within 3-6 months after surgery. On average, the following correction of refractive disorders was achieved: myopia-8.14 D ± 2.67 and astigmatism-4.28 D ± 2.12. Keratometry indicators also in most cases stabilized within 3-6 months after surgery and remained unchanged throughout the entire follow-up period. Conclusions. Implantation of a closed MyoRing ring in keratoconus makes it possible to significantly correct refractive disorders and prevents further progression of the disease. Key words: keratoconus, MyoRing, SISI, ring implantation in keratoconus.

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Visual Acuity, Contrast Sensitivity Function, and Twilight Vision of Soft and Rigid Gas-Permeable Contact Lens Wearers

10.21203/rs.3.rs-133490/v1 ◽

2020 ◽

Author(s):

Iva Krolo ◽

Aida Kasumović ◽

Ivana Radman ◽

Ivan Sabol ◽

Maja Malenica Ravlić ◽

...

Keyword(s):

Visual Acuity ◽

Prospective Study ◽

Contrast Sensitivity ◽

Contact Lens ◽

Contact Lenses ◽

Sensitivity Function ◽

Visual Performance ◽

Corrected Visual Acuity ◽

Before And After ◽

Spectacle Correction

Abstract Aim of study was to assess the visual acuity (VA) before and after correction with soft and rigid gas permeable contact lenses (CLs) in healthy subjects, as well as their visual perfomance, including contrast sensitivity function (CSF), and twilight vision (TV). 60 eyes corrected with soft contact lenses (SCLs) and 38 eyes with rigid gas permeable contact lenses (RGPCLs) were enrolled in this prospective study. The following measurements were obtained: best spectacle–corrected visual acuity (BSCVA), best contact lens-corrected visual acuity (BCLCVA), TV, and CSF. Parameters were evaluated before and after CLs fitting and 2 months after the baseline. Exclusion criteria included anterior and posterior segment pathology, amblyopia, prior CLs wear, and ocular surgery. When analyzing TV, results showed superiority of CLs to the spectacle correction, with no statistical difference regarding the CL type. As for the CSF, RGPCLs were superior to both SCLs and spectacle correction. Visual performance was better in group fitted with RGPCLs oppose to SCLs group. CL wear improved visual performance compared to spectacles. This is the first prospective study to simultaneously investigate changes in VA, CS, and TV in SCL and RGCL wear, suggesting RGPCLs as the correction of choice for achieving optimal visual performance.

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The effectiveness of subtenon triamcinolone injection for the treatment of macular edema in children with retinitis pigmentosa

Russian Pediatric Ophthalmology ◽

10.17816/rpo2021-16-1-5-12 ◽

2021 ◽

Vol 16 (1) ◽

pp. 5-12

Author(s):

Lyudmila A. Katargina ◽

Ekaterina V. Denisova ◽

Maria A. Khrabrova ◽

Natalia A. Osipova

Keyword(s):

Visual Acuity ◽

Carbonic Anhydrase ◽

Retinitis Pigmentosa ◽

Macular Edema ◽

Repeated Injection ◽

Carbonic Anhydrase Inhibitors ◽

Before And After ◽

Subtenon Injection ◽

Observation Period

Aim: This study aimed to assess the functional and anatomical results of subtenon triamcinolone injections in children with retinitis pigmentosa (PR) and cystic macular edema (CME), refractory to local carbonic anhydrase inhibitors. Material and methods: We examined 11 children (9 girls, 2 boys) aged 9 to 17 years who underwent subtenon injections of triamcinolone (22 eyes). The follow-up period ranged from 1.6 to 33.1 months (average 9.711.6 months), the number of triamcinalone injections ranged from 1 to 11, averaging 3. Before and after injection, best corrected visual acuity (BCVA), the thickness and structure of the retina in the macular zone (optical coherence tomography [OCT] was performed by using the NIDEK RS-3000, Japan or the Spectralis, Heidelberg Engineering, Germany), and intraocular pressure (IOP) were assessed. Results: The CME height at the end of the observation period decreased in 10 cases (45.5%), and the average central retinal thickness decreased from 70 to 594 m (on average, 219.1183.4 m). In 12 eyes (54.5%), the CME height at the end of the observation period did not change significantly. BCVA improved in two eyes (9.1%) and did not change in the other cases. Two children (18%) developed ophthalmic hypertension in both eyes after two injections of triamcinalone. In one child, IOP returned to normal on the background of hypothetical therapy. In another child, due to non-compensation of IOP at the maximum hypotensive mode, sinus trabeculectomy was performed in both eyes, and IOP normalization was achieved. Conclusion: Subtenon injection of triamcinolone in children with CME against a background of PR is in most cases is an effective and safe method of treatment and can be recommended if carbonic anhydrase inhibitors are ineffective at reducing/ resorbing edema and maintaining or improving visual function. Considering that the action of triamcinolone is short lived, and its repeated injection is required, and the resorption of CME and an increase in visual acuity are not always achievable, it is necessary to continue the search for more effective treatment methods.

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Treatment of Punctate Inner Choroidopathy with Choroidal Neovascularization Using Corticosteroid and Intravitreal Ranibizumab

BioMed Research International ◽

10.1155/2018/1585803 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Wei Wu ◽

Shiying Li ◽

Haiwei Xu ◽

Yong Liu ◽

Yi Wang ◽

...

Keyword(s):

Visual Acuity ◽

Choroidal Neovascularization ◽

Oral Corticosteroid ◽

Fundus Autofluorescence ◽

Intravitreal Ranibizumab ◽

Punctate Inner Choroidopathy ◽

Corrected Visual Acuity ◽

Before And After ◽

Ranibizumab Treatment

Background. To evaluate the treatment outcomes of patients with punctate inner choroidopathy (PIC) and secondary choroidal neovascularization (CNV). Methods. This is a retrospective study of 24 eyes in 22 patients suffering from PIC with CNV. Patients were treated with intravitreal ranibizumab monotherapy (14 eyes) or combined oral corticosteroid and intravitreal ranibizumab therapy (corticosteroid-ranibizumab group, 10 eyes). Mean follow-up duration was 24.0 months. We evaluated best-corrected visual acuity (BCVA), fundus autofluorescence, fluorescein angiography, indocyanine green angiography, and optical coherence tomography, before and after treatment. The following variables were compared between groups: number of intravitreal ranibizumab injections, BCVA, recurrence of CNV, and change in PIC lesions. Results. The ranibizumab monotherapy group received an average of 3 intravitreal ranibizumab injections; mean logMAR visual acuity improvement was 0.34, and 8 eyes developed recurrent CNV during follow-up. The corticosteroid-ranibizumab group received an average of 1.9 intravitreal ranibizumab injections; mean logMAR visual acuity improvement was 0.61, and there was no recurrence of CNV. Combined corticosteroid-ranibizumab therapy also resulted in better resolution of PIC lesions and fewer new PIC lesions. Conclusion. Both corticosteroid-ranibizumab treatment and ranibizumab monotherapy could significantly improve the vision of PIC patients with CNV. Combined corticosteroid and intravitreal ranibizumab treatment appeared to reduce CNV recurrence and development of new PIC lesions compared with ranibizumab monotherapy.

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Long-term follow-up of school-age children on the effectiveness of myopia correction with contact lenses

Journal of Education, Health and Sport ◽

10.12775/jehs.2021.11.03.026 ◽

2021 ◽

Vol 11 (3) ◽

pp. 266-282

Author(s):

Nataliia Aleieva ◽

Sergiy Rykov ◽

Iryna Shargorodska ◽

Mykola Petrovsky

Keyword(s):

Visual Acuity ◽

Contact Lenses ◽

Corneal Thickness ◽

School Age Children ◽

School Age ◽

Corrected Visual Acuity ◽

Long Term Follow Up ◽

Myopic Astigmatism

Introduction and purpose. Early use of contact correction for congenital myopia and astigmatism in children and adolescents contributes to their social rehabilitation. The myopia correction with contact lenses provides sustainability of correction and absence of periods of blurred retinal images, which are experienced with the use of glasses. The purpose of the study was to determine, through long-term follow-up, the extent to which contact lens correction improves uncorrected and maximally corrected visual acuity in school-age children with myopia and myopic astigmatism. Material and methods. We followed up for three years 84 children (168 eyes) aged 6–16 years with myopic manifest refraction and astigmatism, who used soft silicone hydrogel aspherical contact lenses to correct ametropia. In the early and late follow-up, these patients were examined for visual acuity, objective and subjective clinical refraction, axial eye length, corneal thickness and diameter, keratometry, and phorometric data (accommodation, vergence, disparate areas, and oculomotor apparatus and their interaction). Results.In course of long-term monitoring of myopia and myopic astigmatism correction with contact lenses in school-age children, the statistically significant results were recorded after three years of observation, namely: an increase in uncorrected visual acuity by 47% (t=5.2; p<0.01), corrected acuity vision by 8% (t=9.3; p<0.01), the spheroequivalent by 17% (t=3.7; p<0.01), anteroposterior segment of the eye by 4% (t=7,1; p<0.01), amplitude of accommodation by 27% (t=14.6; p<0.01), negative part of relative accommodation by 17% (t=7.3; p<0.01), positive part of relative accommodation by 32% (t=7.1; p<0.01), flexibility of accommodation by 35% (t=14.2; p<0.01), the ratio of accommodation convergence to accommodation by 19% (t=3.4, p<0.01), stereovision acuity by 56% (t=4.1; p<0.01), as well as a decrease in keratometry index in the strong meridian by 2% (t=5.2; p<0.01), delays in accommodative responses by 33% (t=14.2; p <0.01), distance phoria by 16% (t=10.1; p<0.01), near phoria by 16% (t=11.3, p<0.01). Conclusions. The study has shown that the use of contact lenses by school-aged children with myopia and myopic astigmatism can increase uncorrected and maximum corrected visual acuity. The increase of the spheroequivalent and anteroposterior axis (APA) of the eye indicates progression of myopia, but the use of soft contact lenses (SCL) leads to changes of the anterior corneal surface: an increase of the thickness in the central zone, and its flattening. Improvement of accommodation, vergence, disparate parts of the oculomotor apparatus, and their interaction was also observed. The results obtained indicate deceleration of myopia progression.

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Deep anterior lamellar keratoplasty in keratoconus

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1102088n ◽

2011 ◽

Vol 139 (1-2) ◽

pp. 88-91

Author(s):

Ljubisa Nikolic ◽

Vesna Jovanovic

Keyword(s):

Visual Acuity ◽

Contact Lenses ◽

Young Patients ◽

Lamellar Keratoplasty ◽

Deep Anterior Lamellar Keratoplasty ◽

Corrected Visual Acuity ◽

Anterior Lamellar Keratoplasty ◽

One Year ◽

Peeling Off

Introduction. Deep anterior lamellar keratoplasty (DALK) is intended for the surgical treatment of corneal pathology without the involvement of the endothelium. Sparing of the healthy host endothelium for lifetime is of utmost importance in young patients. Therefore, keratoconus is among the main indications for DALK. Outline of Cases. Two men, 22 and 28 years of age, underwent DALK for the treatment of progressive keratoconus, with low visual acuity, impossible to be corrected with gas-permeable contact lenses, due to the extreme conical protrusion of the cornea. Baring of Descemet?s membrane was achieved with lamellar dissection and peeling off the stroma. An 8.5 mm graft without the endothelium was sutured into an 8.0 mm bed. Both grafts remained clear and attached, without either ocular surface pathology or problems arising from sutures. The best corrected visual acuity was 20/25 and 20/40, with the astigmatism of 2.5 and 3.0 diopters, respectively. The follow-up was one year. Conclusion. This is the first presentation of DALK in our literature. The restoration of corneal transparency and stability, with sparing of the host endothelium, has put DALK among successful corneal tranplantation procedures. Together with Descemet stripping endothelial keratoplasty, which already accounts for almost a half of all our keratoplasties, it offers an alternative to penetrating keratoplasty.

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

BMJ Open Ophthalmology ◽

10.1136/bmjophth-2020-000677 ◽

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.

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Ophthalmic Screening in Patients with Coronavirus Disease 2019: A Prospective Cohort Study

Journal of Clinical Medicine ◽

10.3390/jcm10050896 ◽

2021 ◽

Vol 10 (5) ◽

pp. 896

Author(s):

Anthia Papazoglou ◽

Anna Conen ◽

Sebastian Haubitz ◽

Markus Tschopp ◽

Viviane J. Guignard ◽

...

Keyword(s):

Animal Studies ◽

Clinical Course ◽

Intraocular Inflammation ◽

Ocular Motility ◽

Corrected Visual Acuity ◽

Published Evidence ◽

Laboratory Results ◽

Minimum Angle ◽

Observation Period

Postmortem pathological examinations, animal studies, and anecdotal reports suggest that coronavirus disease 2019 (COVID-19) could potentially affect intraocular tissue. However, published evidence is scarce and conflicting. In our study, we screened 100 eyes of 50 patients hospitalized for COVID-19. Relevant medical and ophthalmological history was assessed as well as symptoms, laboratory results, specific treatments, clinical course, and outcome. Ophthalmic exams including assessment of best corrected visual acuity (BCVA), intraocular pressure (IOP), color perception, ocular motility, ophthalmoscopy as well as optical coherence tomography (OCT) of the macula and the optic disc was performed at hospital admission and 29 to 192 days later. Of the 50 patients included, 14 (28%) were female. Median age was 64.5 (range 29–90) years. COVID-19 severity was mild in 15 (30%), severe in 30 (60%), and critical in five cases (10%). At baseline, median BCVA was 0.1 (0–1.8) Logarithm of the Minimum Angle of Resolution (LogMAR) and median IOP was 16 (8–22) mmHg. At follow-up, no relevant changes in BCVA and IOP were documented. No signs of active intraocular inflammation or optic nerve affection were found and OCT findings were widely stable during the observation period. Our findings suggest that COVID-19 does not regularly affect intraocular tissue.

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Morphological Changes in Lamellar Macular Holes According to SD-OCT Examination over a Long Observation Period

Diagnostics ◽

10.3390/diagnostics11071145 ◽

2021 ◽

Vol 11 (7) ◽

pp. 1145

Author(s):

Magdalena Kal ◽

Izabela Chojnowska-Ćwiąkała ◽

Mateusz Winiarczyk ◽

Monika Jasielska ◽

Jerzy Mackiewicz

Keyword(s):

Retinal Thickness ◽

Morphological Changes ◽

Outer Diameter ◽

Corrected Visual Acuity ◽

Macular Holes ◽

Kolmogorov Smirnov ◽

Inner Diameter ◽

Observation Period ◽

Sd Oct

Background: The aim of this study was to evaluate the quantitative morphological changes in lamellar macular holes (LMHs) based on SD-OCT examinations and to assess the correlations among minimal retinal thickness (MRT), reading vision (RV), and best corrected visual acuity (BCVA) over a 36-month follow-up period. Methods: A group of 40 patients (44 eyes) with LMH was evaluated, with an average age of 69.87 (SD = 10.14). The quantitative parameters monitored in the follow-up period (at 0, 3, 6, 12, 18, 24, 30, and 36 months) were tested for normality of distribution by Shapiro–Wilk and Kolmogorov–Smirnov tests. Results: The RV and BCVA values were stable, and no significant changes were found at any of the check-ups during the 36-month follow-up period (BCVA p = 0.435 and RV p = 0.0999). The analysis of individual quantitative LMH parameters during the 36-month follow-up period did not demonstrate statistically significant differences: MRT (p = 0.461), Max RT temporal (p = 0.051), Max RT nasal (p = 0.364), inner diameter (ID) (p = 0.089), and outer diameter (OD) (p = 0.985). Conclusions: The observations at 0, 6, 12, 18, 24, 30, and 36 months revealed moderate and significant correlations between RV and MRT. No significant correlation between BCVA and MRT was observed.

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Corneal densitometry in patients with keratoconus undergoing intrastromal Ferrara ring implantation

European Journal of Ophthalmology ◽

10.1177/11206721211020631 ◽

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.

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