scholarly journals Case Report: Phototherapeutic Keratectomy for Band Keratopathy Secondary to Chemo-Laser-Cryotherapy for Retinoblastoma

2021 ◽  
Vol 8 ◽  
Author(s):  
Ruoyan Wei ◽  
Meiyan Li ◽  
Weiming Yang ◽  
Haipeng Xu ◽  
Joanne Choi ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Corneal Thickness ◽  
Phototherapeutic Keratectomy ◽  
White Band ◽  
Corrected Distance Visual Acuity ◽  
Band Keratopathy ◽  
History Of ◽  
Distant Visual Acuity ◽  
The Right

Purpose: To report the clinical outcomes of phototherapeutic keratectomy (PTK) for pediatric band keratopathy after treatment for retinoblastoma.Methods: A 5-year-old boy presented with a 2-year history of poor visual acuity and a horizontal gray-white band across the central cornea in the right eye. He was diagnosed with band keratopathy after chemo-laser-cryotherapy for retinoblastoma. The band keratopathy was treated via PTK using the Mel-90 excimer laser with an optical treatment zone of 7.0 mm and ablation depth of 120 μm. The patient was followed at 1 week and 3 months postoperatively.Results: Surgery and postoperative follow-up were uneventful. At the 3-month follow-up, the uncorrected distant visual acuity of the right eye improved to 20/125, and the corrected distance visual acuity improved to 20/70 with a refraction of +10.00 D/−2.50 DC × 15. The clarity of the ablated area was evidently improved. The central corneal thickness decreases from 612 to 584 μm. The optical coherence tomography showed the thin band of hyperreflectivity in the ablated area disappeared, corneal transparency improved and the corneal surface smoothened.Conclusions: PTK is a safe and effective procedure to treat band keratopathy following treatment of retinoblastoma in children. Early intervention can reduce the risk of developing deprivation amblyopia.

Evolution of corneal flattening after repeated corneal cross-linking during a 6-year follow-up

2020 ◽  
pp. 112067212094566
Author(s):  
Michael A Grentzelos ◽  
Nafsika Voulgari ◽  
Clarice Giacuzzo ◽  
Konstantinos Droutsas ◽  
George D Kymionis
Keyword(s):  
Endothelial Cells ◽  
Visual Acuity ◽  
Case Report ◽  
Corneal Thickness ◽  
Cross Linking ◽  
Distance Visual Acuity ◽  
Corneal Opacification ◽  
Corrected Distance Visual Acuity ◽  
Corneal Flattening

Purpose: To report the evolution of corneal flattening after repeated corneal cross-linking (CXL) in a patient with progressive keratoconus during a 6-year follow-up. Methods: Case report. Results: A 27-year-old female underwent CXL for progressive keratoconus. Postoperatively, corneal topography revealed keratoconus progression with an increase of 1.20 diopters (D) in maximum keratometry (Kmax) and CXL was repeated. After the second treatment, a continuing significant corneal flattening (up to 16.00 D in Kmax) was observed during the first 5 years followed by stabilization during the last sixth year of follow-up. Both uncorrected and corrected distance visual acuity were improved while corneal thickness was decreased. There were no complications such as corneal opacification or endothelial cells decrease during the follow-up period. Conclusion: Repeated CXL can induce an excessive corneal flattening more pronounced during the first years of follow-up followed by stabilization thereafter.

scholarly journals Clinical Outcomes of Small Incision Lenticule Extraction with Accelerated Cross-Linking (ReLEx SMILE Xtra) in Patients with Thin Corneas and Borderline Topography

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Sri Ganesh ◽  
Sheetal Brar
Keyword(s):  
Visual Acuity ◽  
Clinical Outcomes ◽  
Corneal Thickness ◽  
Cross Linking ◽  
Small Incision Lenticule Extraction ◽  
Uncorrected Visual Acuity ◽  
Distant Visual Acuity ◽  
Lenticule Extraction ◽  
The Mean

Purpose. To study the safety and clinical outcomes of ReLEx SMILE with accelerated cross-linking in individuals with thinner corneas, borderline topography, and higher refractive errors.Methods. Eligible patients first underwent SMILE procedure for correction of myopic refractive error. Following the removal of lenticule, 0.25% riboflavin in saline was injected into the interface and allowed to diffuse for 60 seconds. Finally, eye was exposed to UV-A radiation of 45 mW/cm2for 75 seconds through the cap. Total energy delivered was 3.4 J/cm2.Results. 40 eyes of 20 patients with mean age of 26.75 ± 5.99 years were treated. Mean follow-up was 12 months ± 28.12 days. Mean spherical equivalent (SE) was −5.02 ± 2.06 D preoperatively and −0.24 ± 0.18 D postoperatively. The mean central corneal thickness (CCT) and keratometry changed from 501 ± 25.90 µm to 415 ± 42.26 µm and 45.40 ± 1.40 D to 41.2 ± 2.75 D, respectively. Mean uncorrected visual acuity (UCVA) was 20/25 or better in all eyes. No eyes lost lines of corrected distant visual acuity (CDVA). There were no complications like haze, keratitis, ectasia, or regression.Conclusion. Based on the initial clinical outcome it appears that SMILE Xtra may be a safe and feasible modality to prevent corneal ectasia in susceptible individuals.

Long-term visual, anterior and posterior corneal changes after crosslinking for progressive keratoconus

2021 ◽  
pp. 112067212110528
Author(s):  
Abdelrahman Salman ◽  
Ali Ali ◽  
Shaaban Rafea ◽  
Rana Omran ◽  
Buraa Kubaisi ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Statistical Significance ◽  
Corneal Thickness ◽  
Cross Linking ◽  
Long Term Outcomes ◽  
Corrected Distance Visual Acuity ◽  
Hyperopic Shift ◽  
The Mean

Aim To evaluate the long-term outcomes of corneal cross-linking (CXL) in patients with progressive keratoconus. Method In this retrospective non-comparative study, forty-five eyes of 31 patients with progressive keratoconus were treated with 30 min “epi-off” corneal cross-linking. The visual, refractive, topographic and tomographic outcomes were evaluated preoperatively and at least 10 years after cross-linking. Results Ten years post-corneal cross-linking, the mean anterior maximum keratometry decreased (−2.10 ± 3.25 D, P = 0.0001). Conversely, the posterior maximum keratometry increased (6.38 ± 9.79 D, P = 0.065). Both uncorrected and corrected distance visual acuity improved (LogMAR −0.08 ± 0.30) and (LogMAR −0.05 ± 0.21), respectively (P > 0.05, both). A statistically significant hyperopic shift was observed postoperatively (0.70 ± 1.31 D, P = 0.0009). The anterior topographic cylinder values revealed no change (−0.17 ± 1.31 D, P = 0.3), whereas the mean posterior cylinder values decreased (absolute value increased) significantly compared to baseline from −1.31 ± 0.97 D to −1.82 ± 1.78 D, (P < 0.05). The minimum corneal thickness values decreased significantly (−35.11 ± 48.63 µm, P = 0.0001). Four eyes (8.8%) showed more than 1 D increase in the anterior maximum keratometry. Conclusion This protocol and duration of Epi-off corneal cross-linking was found to be effective in halting keratoconus progression over the follow up period (10 years). Anterior corneal flattening and a hyperopic shift were observed. A statistically significant increase in the posterior corneal cylinder was observed. Although, not reaching statistical significance, the logMAR uncorrected and corrected visual acuity were improved.

scholarly journals Corneal collagen cross-linking in pediatric patients with keratoconus

2020 ◽  
Vol 148 (1-2) ◽  
pp. 70-75 ◽  
Author(s):  
Svetlana Stanojlovic ◽  
Vedrana Pejin ◽  
Tanja Kalezic ◽  
Jelica Pantelic ◽  
Borivoje Savic
Keyword(s):  
Visual Acuity ◽  
Pediatric Patients ◽  
Corneal Thickness ◽  
Cross Linking ◽  
Rubbing Behavior ◽  
Distant Visual Acuity ◽  
One Year ◽  
Collagen Cross Linking ◽  
Corneal Collagen

Introduction/Objective. The aim of this study was to report visual, refractive, and tomographic outcomes of corneal collagen cross-linking (CXL) in pediatric keratoconus. Methods. This retrospective study included 17 eyes of 12 patients with progressive keratoconus who underwent epithelium-off CXL at the age ? 18 years. Following data were analyzed at baseline and postoperatively at one, three, six, nine, 12 months for all the patients, and annually where available: uncorrected distant visual acuity (UDVA) and best spectacle-corrected distant visual acuity (CDVA), refraction and corneal tomography. Results. Mean UDVA improved significantly from 0.52 ? 0.38 at baseline to 0.24 ? 0.29 logarithm of minimum angle resolution (log MAR) at one year (p = 0.011) and remained stable at two-year follow-up (0.21 ? 0.34 log MAR). Mean CDVA was 0.15 ? 0.21 at baseline and 0.06 ? 0.13 log MAR at one year (p = 0.248). Maximum keratometry showed a significant flattening of 1.30 ? 1.99 D (p = 0.011) after a year and remained stable two years after CXL. Minimum keratometry significantly decreased with a mean change of 1.34 ? 1.37 (p = 0.001). Mean reduction of corneal thickness after CXL was 55.35 ? 64.42 ?m (P=0.003). After a year, seven (42%) eyes showed Kmax regression, nine (53%) stabilization, and one (5%) progression. Conclusion. In our study CXL effectively prevented progression of keratoconus in 95% of pediatric patients after a year, while improving UDVA and keratometry values. One patient with eye rubbing behavior showed signs of keratoconus progression after CXL treatment.

Management of cataract in a case of retinitis pigmentosa with bilateral pseudoexfoliation syndrome

2021 ◽  
Vol 14 (2) ◽  
pp. e238936
Author(s):  
Sucheta Parija ◽  
Koyel Chakraborty
Keyword(s):  
Visual Acuity ◽  
Retinitis Pigmentosa ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Visual Outcome ◽  
Pseudoexfoliation Syndrome ◽  
Corrected Distance Visual Acuity ◽  
History Of ◽  
Hypertensive Woman ◽  
The Right

Retinitis pigmentosa (RP) patients are at higher risk for macular oedema, anterior capsular phimosis and spontaneous dislocation of the implanted lens after cataract surgery. A 70-year-old hypertensive woman presented with diminution of vision in her left eye since 2 years. She had history of cataract surgery in the right eye 1 year ago. Her visual acuity was 20/200 in right eye and hand movements in left eye. Slit-lamp examination showed anterior capsular phimosis with intraocular lens in the right eye and pseudoexfoliation in both the eyes. Fundus examination revealed features of RP in both the eyes. Optical coherence tomography showed bilateral foveal atrophy. The patient underwent phacoemulsification cataract surgery with intraocular lens implantation in left eye and Nd:YAG laser capsulotomy in right eye. Postoperative best corrected distance visual acuity was 20/125 in right eye and 20/80 in left eye. This case highlights a rare coincidence of pseudoexfoliation syndrome in a patient with RP and the precautions undertaken during cataract surgery for an optimal visual outcome.

scholarly journals Corneal crosslinking in a case with Axenfeld–Rieger syndrome and unilateral pellucid marginal degeneration

2019 ◽  
Vol 11 ◽  
pp. 251584141882228 ◽  
Author(s):  
Mustafa Koc ◽  
Pinar Kosekahya ◽  
Merve Inanc ◽  
Kemal Tekin
Keyword(s):  
Visual Acuity ◽  
Male Patient ◽  
Vision Loss ◽  
Slit Lamp ◽  
Slit Lamp Examination ◽  
Corneal Crosslinking ◽  
Rieger Syndrome ◽  
Corrected Distance Visual Acuity ◽  
The Right

A 31-year-old male patient presented with the complaint of progressive vision loss in his left eye. Slit-lamp examination showed posterior embryotoxon, iris hypoplasia, and iridocorneal adhesion in both eyes, corectopia in the right, and peripheral inferior thinning and ectasia in the left eye. Corneal topography showed slightly asymmetric bowtie pattern in the right eye and crab-claw pattern in the left eye. Topographic examination was compared with his previous topography. The comparison showed 1.6-D steepening of maximum keratometry ( Kmax) and 22-µm decrease of thinnest corneal pachymetry. Corneal crosslinking treatment was performed on the left eye. At the postoperative 28-month follow-up visit, Kmax decreased from 54.1 to 53.0 D and corrected distance visual acuity improved to 20/20 with scleral lens. This is the first reported a case with Axenfeld–Rieger syndrome and pellucid marginal degeneration association. We suggest that corneal crosslinking can be useful for management of pellucid marginal degeneration and longer follow-up might be needed in order to corroborate the effectiveness of the corneal crosslinking procedure.

scholarly journals Three-year follow-up of accelerated transepithelial corneal cross-linking for progressive paediatric keratoconus

2020 ◽  
pp. bjophthalmol-2019-315260 ◽  
Author(s):  
Mi Tian ◽  
Weijun Jian ◽  
Xiaoyu Zhang ◽  
Ling Sun ◽  
Xingtao Zhou
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Corneal Thickness ◽  
Cross Linking ◽  
Safety And Efficacy ◽  
Manifest Refraction ◽  
Corrected Distance Visual Acuity ◽  
Minimum Angle

PurposeTo investigate the long-term safety and efficacy of accelerated transepithelial corneal cross-linking (ATE-CXL) in children with progressive keratoconus.MethodsFifty-three eyes of 41 paediatric patients (34 boys, 7 girls; mean age 14.81±1.96 years) undergoing ATE-CXL were enrolled in the study. Corrected distance visual acuity (CDVA) and manifest refraction were assessed preoperatively and 36 months postoperatively. Corneal keratometry, corneal thickness and posterior elevation were measured using Pentacam preoperatively and 1, 6, 12 and 36 months postoperatively. Pachymetry and epithelial thicknesses were measured using optical coherence tomography preoperatively and 6, 12, and 36 months postoperatively.ResultsThirty-six months postoperatively, CDVA improved from 0.32±0.28 to 0.26±0.25 in logarithm of the minimum angle resolution (p=0.025). Maximum keratometry was 58.73±9.70 D preoperatively and 59.20±10.24, 58.28±9.33, 57.88±9.99 and 58.98±10.79 D at 1, 6, 12 and 36 months postoperatively throughout the 36-month follow-up period (p>0.05). Similarly, corneal central thickness, which was 492.42±33.83 µm postoperatively, also remained stable during the 36-month follow-up (p>0.05). Both posterior central elevation and posterior highest elevation were stable at 12 months after ATE-CXL (p>0.05), but increased at 36 months postprocedure (p<0.05). Corneal pachymetry and epithelial thicknesses remained stable throughout the follow-up period (p>0.05).ConclusionsATE-CXL is a safe and effective treatment in paediatric progressive keratoconus patients, leading to stable keratometry and corneal thickness throughout the 36-month follow-up.

scholarly journals Long-Term Outcomes of Corneal Collagen Cross-Linking: Results of 6-Years Follow-Up

2020 ◽  
Author(s):  
Anita Csorba ◽  
Huba Kiss ◽  
Kinga Kránitz ◽  
Zoltán Zsolt Nagy
Keyword(s):  
Visual Acuity ◽  
Corneal Thickness ◽  
Cross Linking ◽  
Spherical Equivalent ◽  
Long Term Effects ◽  
Long Term Outcomes ◽  
Corrected Distance Visual Acuity ◽  
Long Term Follow Up

Abstract Background: Our aim was to evaluate the long-term effects of conventional epithelium-off corneal cross-linking performed on patients with progressive keratoconus. Methods: A retrospective analysis was performed on 34 eyes of 34 patients with progressive keratoconus underwent conventional cross-linking using Pentacam HR Scheimpflug camera. Visual acuity, spherical equivalent, keratometry, pachymetry and corneal topographic indices were analysed preoperatively and at 1, 3, and 6 years after the surgery. Results: Statistically significant decrease was detected at 1 year in spherical equivalent (p = 0.022), with no significant changes afterward (p =0.616). Uncorrected and best corrected distance visual acuity improved significantly in the first postoperative year (p =0.017 and p= 0.003, respectively), and remained stable with no significant changes at further visits (p = 0.203 and p = 0.336, respectively). Significant decrease of central corneal thickness and thinnest corneal thickness was observed at 1 year (both p <0.001), with additional thinning of thinnest corneal pachymetry up to 3 years (p = 0.01). Maximum keratometry and mean keratometry showed significant, continuous improvement between all consecutive visits over the whole follow-up period (all p-values <0.05). Significant improvement was found in the following 5 topographic indices at 1 year: ISV (p = 0.001), IVA (p = 0.028), KI (p = 0.002), CKI (p <0.001 and Rmin (p <0.001), with further improvement up to 3 years in ISV (p = 0.007), in CKI (p = 0.019) and in Rmin (p = 0.015). Rmin showed more improvement up to the end of follow-up (p <0.001).Conclusions: Conventional epithelium-off corneal cross-linking is effective in halting the progression of keratoconus and in regularization of the anterior corneal surface over a long-term follow-up period up to 6 years.

scholarly journals Clinical Outcomes of Micropulse Transscleral Cyclophotocoagulation in Patients with a History of Keratoplasty

2020 ◽  
Vol 2020 ◽  
pp. 1-6 ◽  
Author(s):  
Jun Hui Lee ◽  
Vivian Vu ◽  
Gabriel Lazcano-Gomez ◽  
Katherine Han ◽  
Pukkapol Suvannachart ◽  
...  
Keyword(s):  
Visual Acuity ◽  
San Francisco ◽  
Corneal Thickness ◽  
Rank Test ◽  
Corneal Transplant ◽  
Success Rates ◽  
History Of ◽  
Transscleral Cyclophotocoagulation ◽  
Definition Of Success

Purpose. To examine the surgical outcomes and graft conditions in patients receiving micropulse transscleral cyclophotocoagulation (MP-TSCPC) to treat post-keratoplasty ocular hypertension. Methods. This retrospective observational study included 30 eyes of 28 consecutive glaucoma patients with a history of penetrating keratoplasty (PKP) or Descemet’s stripping automated endothelial keratoplasty (DSAEK) who underwent MP-TSCPC at the University of California, San Francisco from 09/2015 to 08/2018. Using the Wilcoxon signed-rank test, we compared preoperative and postoperative intraocular pressure (IOP), number of glaucoma medications, visual acuity, and central corneal thickness at 1, 3, 6, and 12 months. Postoperative complications, additional surgeries, and graft failures were also recorded at these follow-up times. Linear regression model was used to study whether PKP vs. DSAEK affects the effectiveness of MP-TSCPC. Results. Thirty eyes from 28 patients were followed for 12 months. IOP was significantly decreased from preop at all follow-up points (P<0.001). There was no significant change in the number of glaucoma drops, visual acuity, or CCT. At 12 months, 21 of the 30 eyes met the definition of success, and only one underwent repeat PKP due to graft rejection. The type of corneal transplant was not a significant factor for IOP reduction at the last follow-up. Conclusions. MP-TSCPC achieved desirable IOP control and success rates for postkeratoplasty patients while resulting in minimal complications and graft failure. It appears to be a safe and effective procedure in patients who received corneal transplant with one-year follow-up.

Oral mucous membrane grafts for total symblepharon and lid margin keratinisation post Stevens-Johnson syndrome

2020 ◽  
Vol 13 (10) ◽  
pp. e239383 ◽  
Author(s):  
Priyanka Sudana ◽  
Sayan Basu ◽  
Swapna S Shanbhag
Keyword(s):  
Visual Acuity ◽  
Mucous Membrane ◽  
Surface Damage ◽  
Stevens Johnson Syndrome ◽  
Oral Ulcers ◽  
Johnson Syndrome ◽  
History Of ◽  
Limbal Stem Cell ◽  
The Right

A female patient in her late 40s presented with severe visual impairment and a history of oral ulcers, necrolysis of skin and hospitalisation after using gabapentin for neck pain 10 months ago. She was a diagnosed case of Stevens-Johnson syndrome (SJS) with chronic ocular sequelae—with total symblepharon and keratinised lid margins in the left eye and limbal stem cell deficiency and severe dryness in the right eye. Her visual acuity was perception of light in both eyes. She underwent left eye symblepharon release with autologous labial mucous membrane grafts (MMGs) for surface reconstruction and subsequent lid margin MMG for lid margin keratinisation. Best-corrected visual acuity improved to 20/25 with scleral lens in the left eye, which was sustained over 1 year of follow-up. Labial mucosa acts as a useful and easily accessible alternative to conjunctiva in eyes with bilateral severe ocular surface damage and total symblepharon secondary to SJS.

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