1,721,065 research outputs found
Consultation section: refractive surgical problem
No full textA 39-year-old man had bilateral LASIK 3 years previously. The patient states that during surgery, an epithelial defect occurred in both eyes that took almost 2 weeks to heal completely. The patient was treated with steroids, antibiotic eyedrops, and artificial tears. A 7.5 mm diameter scar in the anterior third of the stroma remained. Six months later, he was placed on low-dose steroids, after which he was fitted with an RGP contact lens in both eyes. Current slitlamp examination shows corneal scars extending throughout the resected flap in both eyes. The patient has difficulties tolerating RGP lenses in both eyes and severe symptoms of photophobia, star burst, night blindness, and difficulty in reading
Anterior lamellar keratoplasty in keratoconus
Full text linkKeratoconus (KC) is a progressive, bilateral, but usually asymmetrical ecstatic corneal disease, characterized by progressive corneal protrusion and thinning, that leads to corneal surface distortion. The reported incidence in the general population varies from 1.3 to 25 per 100,000 per year across different populations, with a prevalence of 8.8–229 per 100,000. Onset typically is at puberty with progression of the disease for 10–20 years after which it tends to stabilize. It occurs in all racial groups and equally affects males and females
Customized excimer laser lamellar transplantations: follow-up at one year
No full textObjectives: To assess the refractive and visual acuity results of customized excimer laser lamellar transplantations as an alternative to penetrating keratoplasties for treatment of keratoconus. Methods: This retrospective review of 15 eyes of 15 patients with mild to moderate keratoconus underwent customized excimer laser lamellar transplantations utilizing a CLAT procedure. Results: The mean preoperative uncorrected visual acuity (UCVA) was 20/200 (0.11±0.11 SD) and the mean preoperative best spectacle corrected visual acuity (BSCVA) was 20/50 (0.48±0.23 SD), with a mean manifest refraction spherical equivalent (MRSE) refraction of )4.75 D (±5.27). The mean preoperative corneal thickness was 411.7 lm (±29.6 lm) (range from 382 to 484 lm); the mean preoperative keratometric astigmatism was 4.86 D (±2.52 D) range from (1.65 to 7.47 D) and the mean refractive corneal power of 51.94 D (±5.22 SD). At 12 months follow-up, the mean UCVA was 20/30 (0.65±0.19 SD) and mean BSCVA was 20/22 (0.85±0.23 SD) with a mean MRSE of -1.12 D (±0.26 SD). The mean corneal thickness was 620.6 lm (±45.73 SD) (range from 514 to 671); the mean keratometric astigmatism was 2.78 D (±0.75 SD) (range from 2.25 to 3.31 D) and mean refractive corneal power of 48.01 D (±2.38). Conclusions: Customized excimer laser lamellar transplantation restores normal corneal shape and thickness in keratoconus patients with a unique advantage of customizing both the recipient bed and the donor lamella. This procedure is safe and effective for treatment of mild to moderate keratoconus as an alternative to PK
Corneal collagen cross-linking with riboflavin and UVA irradiation in pellucid marginal degeneration
No full textPURPOSE:
To report the results of corneal collagen cross-linking (CXL) with riboflavin and ultraviolet A irradiation in a patient affected by pellucid marginal degeneration (PMD).
METHODS:
A 43-year-old man with bilateral PMD underwent CXL in the left eye. The treatment was performed in standard fashion with the exception of slightly inferior decentration of the 9 mm-diameter irradiated area preserving an untreated surface area 1 mm from the limbus.
RESULTS:
Epithelial regrowth was complete after 4 days' use of a bandage soft contact lens. No side effects or damage to the limbal region were observed during re-epithelialization or during follow-up. Corrected distance visual acuity improved from 20/200 to 20/63 at 3 months and was stable through the 12-month interval. Keratometric astigmatism showed a 1.40-diopter (D) reduction and the power of ectasia apex decreased from 82.00 D to 78.00 D.
CONCLUSIONS:
Corneal collagen CXL was a safe tool in the management of PMD, improving some parameters in advanced stages of the disease
Collagen crosslinking for ectasia following PRK performed in excimer laser-assisted keratoplasty for keratoconus
No full textPURPOSE. To report the results of corneal collagen crosslinking (CXL) in a patient with corneal ectasia developed after excimer laser-assisted lamellar keratoplasty for keratoconus and a secondary photorefractive keratectomy (PRK) for residual refractive error.
METHODS. A 33-year-old woman, who had originally been treated for keratoconus in the right eye by excimer laser-assisted lamellar keratoplasty, subsequently had her residual ametropia treated by topographically guided, transepithelial excimer laser PRK. Five years after PRK, the patient developed corneal ectasia showing concomitant visual changes of best spectacle-corrected visual acuity (BSCVA) reduced to 20/33 with a refraction of -6.00 +6.00 x 30. The minimum corneal thickness at the ectasia apex was 406 pm. A treatment of riboflavin-UVA-induced corneal CXL was performed on the right eye.
RESULTS. Two years after the CXL treatment, the right eye improved to 20/20 BSCVA with a refraction of plano +1.00 x 50 while exhibiting a clear lamellar graft.
CONCLUSIONS. Corneal CXL provided safe and effective management of ectasia developed after excimer laser-assisted lamellar keratoplasty and PRK
- …
