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Comparative corneal topography and refractive variables in monozygotic and dizygotic twins.

PURPOSE: To investigate the role of heredity in determining corneal shape, axial length, and overall refractive error. METHODS: Twenty monozygotic and 19 dizygotic twin pairs, age 12 to 73 years, were enrolled in the study. Zygosity was determined by physical similarity and by responses to questions adapted from surveys. Two twin pairs were excluded because of undetermined zygosity and one pair because of keratoconus (both siblings). Refractive error was determined by an automated refractor. Manifest refraction was also recorded, as well as cycloplegic refraction in subjects under age 18 year…

Health care concerns and guidelines for adults with Down syndrome.

Down syndrome (DS) is the most common cause of mental retardation in North America, yet little information is available on the natural histo … including loss of vision due to early onset of adult cataracts (50%), recurrent keratitis (21%) or keratoconus (15.8%), and significant hearing loss (25%). Behavioral problems (50%), loss of cognitive abilities, and onset of symptoms of Alzheimer disease (group 1: 5.5%; group 2: 75%) pose ongoing challenges for care. In conclusion, the quality of life for ad …

Repeatability and agreement of total corneal astigmatism measured in keratoconic eyes using four current devices.

BACKGROUND: To evaluate repeatability and agreement in measurements of total corneal astigmatism (TCA) in keratoconic eyes, using four optical coherence tomography (OCT)-based devices: Anterion, Casia SS-1000, IOLMaster 700, and MS-39. METHODS: Three consecutive measurements were taken with each device in 136 eyes. TCA values were converted into components J0 and J45. The Anterion and the IOLMaster 700 also provided axial length (AL) measurements. The repeatability was calculated using pooled within-subject standard deviation (Sw). The agreement among the four devices was assessed by pairwise

Results of intrastromal corneal ring segment implanted alone or combined with same-day corneal crosslinking and their correlation with preoperative corneal biomechanical strain from finite element analysis.

PURPOSE: To compare the results of intrastromal corneal ring segment (ICRS) alone or combined with same-day corneal crosslinking (CXL) and investigate the relationship of preoperative corneal biomechanics data on the outcomes. SETTING: Department of Ophthalmology of Federal University of Parana. DESIGN: Prospective nonrandomized interventional comparative study. METHODS: Forty-nine eyes of 44 keratoconus patients underwent ICRS only (n = 27, Group 1) or same day ICRS+CXL (n = 22, Group 2) and were followed up for at least 24 months. Visual acuity and preoperative and postoperative tomograph…

Comparison of Wavefront-guided and Best Conventional Scleral Lenses after Habituation in Eyes with Corneal Ectasia.

SIGNIFICANCE: Visual performance with wavefront-guided (WFG) contact lenses has only been reported immediately after manufacture without time for habituation, and comparison has only been made with clinically unrefined predicate conventional lenses. We present comparisons of habitual corrections, best conventional scleral lenses, and WFG scleral lenses after habituation to all corrections. PURPOSE: The purpose of this study was to compare, in a crossover design, optical and visual performance of eyes with corneal ectasias wearing dispensed best conventional scleral lens corrections and dispen

Stromal Rejection After SMILE for the Correction of Astigmatism After Graft.

PURPOSE: To describe a case of stromal rejection in a 46-year-old man after small incision lenticule extraction (SMILE) for the correction of residual astigmatism following deep anterior lamellar keratoplasty (DALK). METHODS: Case report. RESULTS: Nine years after an uneventful DALK in the left eye, the patient (uncorrected distance visual acuity [UDVA] = 20/200, corrected distance visual acuity [CDVA] = 20/32, and refraction = -3.25 -4.25 × 165°) underwent SMILE using the VisuMax femtosecond laser platform (Carl Zeiss Meditec, Jena, Germany). The next day, the UDVA, CDVA, and refraction wer

Visual outcomes of the second eye in keratoconic patients who have a corneal graft in the first eye: analysis at 12 years.

PURPOSE: To analyze demographic, clinical, and keratometric outcomes of the second eye in keratoconic patients when the first eye has alread … eratoplasty. New therapeutic treatments have been made available, allowing for stabilization of the keratoconus decreasing the impact of transplantation.

Accelerated versus conventional corneal crosslinking for refractive instability: an update.

PURPOSE OF REVIEW: Corneal crosslinking (CXL) is a relatively new treatment modality offering refractive stability in patients with ectatic disorders. The procedure as initially described (Dresden protocol) is time consuming; accelerated protocols have been lately developed. The purpose of this review is to present the recent findings regarding the comparison of accelerated CXL with the conventional Dresden protocol. RECENT FINDINGS: A variety of accelerated protocols are described in the literature. Safety and efficacy of the procedures with regard to stability seem to be equivalent in initi

Long-Term Biomechanical and Histologic Results of WST-D/NIR Corneal Stiffening in Rabbits, Up to 8 Months Follow-up.

PURPOSE: To determine the long-term safety and efficacy of WST-D/near-infrared (NIR) corneal stiffening. METHODS: One eye of 23 New Zealand White rabbits was de-epithelialized mechanically followed by topical application of 2.5 mg/mL WST11, combined with dextran-500 (WST-D) for 20 minutes. Subsequently, samples were irradiated with a NIR (755 nm) laser at 10 mW/cm2 for 30 minutes. Untreated fellow eyes served as controls. One week (n = 4), 1 month (n = 6), 4 months (n = 9), or 8 months (n = 4) after treatment rabbits were euthanized. Corneal strips were cut in superior-inferior direction for

Accelerated Corneal Cross-Linking With a Hypoosmolar Riboflavin Solution in Keratoconic Thin Corneas: Short-Term Results.

PURPOSE: The aim of this study was to evaluate the early term topographic and aberration results of accelerated (9 mW/cm) corneal cross-linking (CXL) treatment in keratoconic thin corneas. METHODS: Forty-nine eyes from 43 patients (mean age of 21.2 ± 7.1) with progressive keratoconic thin corneas (<400 μm without epithelium) who had accelerated corneal CXL with hypoosmolar riboflavin solution throughout the procedure were enrolled. We measured the uncorrected and corrected distance visual acuity, refraction, slit-lamp examination, topographic values, and corneal higher-order aberrations (Pent

A study comparing standard and transepithelial collagen cross-linking riboflavin solutions: epithelial findings and pain scores.

PURPOSE: To evaluate epithelial signs and pain after epithelial-on corneal collagen cross-linking (Epi-on CCL) with new transepithelial riboflavin formulation and epithelial-off corneal collagen cross-linking (Epi-off CCL) with standard riboflavin formulation and to compare pain and duration of epithelial healing between both techniques. METHODS: Thirty-nine eyes of 39 patients undergoing Epi-on CCL and 39 eyes of 39 patients undergoing Epi-off CCL were evaluated. Corneal epithelial signs and durations of corneal epithelial healing and subjective pain scores after the procedures were recorded

Comparative analysis of corneal measurements obtained from a Scheimpflug camera and an integrated Placido-optical coherence tomography device in normal and keratoconic eyes.

PURPOSE: To assess the agreement between a Scheimpflug camera (Pentacam) and a combined Placido-optical coherence tomography device (Visante OMNI) in measuring corneal curvature, thickness and elevation values in normal and keratoconic eyes. METHODS: Corneal measurements of 110 normal eyes (one eye per subject) and 70 keratoconic eyes were obtained from both devices and compared. Agreement was determined using the Bland-Altman analysis 95% limits of agreement (LoA). RESULTS: The Pentacam measured significantly greater keratometry readings in the flattest (K1) and steepest meridians (K2) in n

Intraoperative pachymetric measurements during corneal collagen cross-linking with riboflavin and ultraviolet A irradiation.

OBJECTIVE: To study central corneal pachymetric variations during corneal collagen cross-linking (CXL) treatment with the use of riboflavin and ultraviolet A irradiation (UVA). DESIGN: Prospective, noncomparative, interventional clinical study. PARTICIPANTS: Fifteen keratoconic patients (19 eyes) were enrolled. METHODS: All patients underwent riboflavin-UVA-induced corneal CXL. Intraoperative central corneal thickness (CCT) measurements using ultrasound pachymetry were performed during the procedure. Measurements were obtained after epithelial removal, after riboflavin drop instillation, an

Clinical applications of wavefront aberrometry - a review.

One of the most powerful clinical applications of aberrometry is wavefront-guided refractive surgery. This concept led to a paradigm shift in refractive error correction, and the same ideas were applied to design the power and shape of intraocular and contact lenses. Other applications are the diagnosis of irregular astigmatism and the assessments of the optical quality of the eye. Because the higher-order aberrations of the eye are expressed as the total root mean square errors, a set of coefficients for the Zernike terms, Strehl ratio, point spread functions, modulation transfer functions, a

Fourier analysis of single running suture adjustment in penetrating and deep lamellar keratoplasty.

PURPOSE: To prospectively evaluate clinical and visual results of running suture adjustment after keratoplasty. METHODS: Thirty-seven eyes of 33 patients received running suture adjustment after keratoplasty. Changes in uncorrected visual acuity, distance best spectacle-corrected visual acuity (BSCVA), refraction, and Fourier analysis constituents were assessed before and after suture adjustment. RESULTS: Thirty eyes, which had improvement of distance BSCVA soon after suture adjustment, maintained improvement at 1 year, whereas 7 eyes with decreased distance BSCVA soon after suture adjustmen

A review of selected inherited corneal dystrophies associated with systemic diseases.

The normal transparency of the cornea permits detailed in vivo study of several human pathologic conditions. Many systemic diseases are associated with corneal dystrophies which are manifested by haziness, opacification, crystalline deposition, or discoloration. Although these abnormal states can sometimes be seen grossly, biomicroscopy with slit lamp illumination is necessary for an exact morphologic description. Only precise delineation can lead to an accurate diagnosis of the corneal disorder and thus provide clues for an associatkd systemic disease.

The Role of the Ubiquitin System in Eye Diseases.

The ubiquitin-proteasome system (UPS) is a fundamental process that regulates various biological functions, including immune response, cell cycle, oxidative stress, migration, and cellular proliferation. This system is responsible for the degradation of proteins, while proteasomes play a significant role in mechanisms involved in health and human diseases. The participation of the UPS in immune response is particularly relevant, leading to the involvement of immunoproteasomes. This specialized proteasome is involved in the processing and presentation of antigenic peptides, making it crucial fo

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… Keratoconus Keratoconus (KC) is a degenerative disease of the cornea characterized by cone-like steepening and irregular stromal thinning, which distorts vision. … In ocular surface diseases, including dry eye and keratoconus, effective management is crucial for enhancing visual quality. …

Culture-Proven Endophthalmitis Associated With Penetrating Keratoplasty: Clinical Features, Microbiologic Aspects, and Outcomes.

PURPOSE: The objective of this study was to report the clinical features, microbiologic profile, treatments, and outcomes of culture-proven … 70% were female. Indications for PKP were diverse, including 5 optical grafts for Fuchs dystrophy, keratoconus, and corneal edema and 4 therapeutic grafts. Initial visual acuity was hand motion on average. Hypopyon was present in 60%, vitritis in 80%, and suture abscesses in 30%. Initial management was intravitreal aspiration, with intravitreal injection of …