Cornea
Progression of Pediatric Keratoconus After Corneal Cross-Linking: A Systematic Review and Pooled Analysis
Purpose:
Corneal collagen cross-linking (CXL) is an effective treatment to slow down keratoconus (KC) progression in adults. Several studies have also shown efficacious outcomes in pediatric populations, yet no systematic analysis has been performed and no accepted definition for progression is available in children after CXL. This study aimed to establish the most commonly used criteria for progression and to conduct a systematic review of the literature with pooled analysis to assess children’s keratoconus progression after CXL.
Methods:
A systemic literature review combined with pooled analysis was performed on full-length studies of KC after CXL treatment in a pediatric population and the methods used to report progression were analyzed.
Results:
Thirty-seven studies (2078 eyes) were identified on the rates of KC progression after CXL. The most common method to report progression was increased Kmax, Kmean, or Ksteep by ≥1.0 diopter (78.3% of studies). Using these criteria, the mean pooled progression rate after epithelium-off CXL was 9.9% (95% confidence interval: 6.1% –14.6%, total pooled sample size: 1508 eyes) with high heterogeneity between studies [I2 = 86.48% (95% confidence interval: 80.98 – 90.39), P
Cornea
Long-Term Outcomes of Big Bubble Deep Anterior Lamellar Keratoplasty in Mucopolysaccharidoses: A Retrospective Case Series and Review of the Literature
Purpose:
The purpose of this study was to report the long-term surgical and visual outcomes of patients with mucopolysaccharidoses (MPS) after big bubble deep anterior lamellar keratoplasty (BB-DALK).
Methods:
This was a retrospective case s…
Cornea
“Air-Assisted” Donor Lenticule Insertion in Descemet Stripping Endothelial Keratoplasty in Aphakia With Large Iris Defect and Without Posterior Capsular Support
Purpose:
The purpose of this study was to report a novel technique of donor lenticule insertion in Descemet stripping endothelial keratoplasty (DSEK) in aphakic corneal edema with large iris defect and without any posterior capsular support.
Met…
Cornea
Use of a Single Radial Incision to Improve Curvature Matching and Graft Adhesion in Descemet Membrane Endothelial Keratoplasty in a Patient With Keratoconus
Purpose:
The purpose of this study was to report a novel surgical technique for altering donor Descemet membrane endothelial keratoplasty (DMEK) curvature to match host posterior stroma in a patient with advanced keratoconus (KC) and endothelial de…
Cornea
Corneal Cellular and Neuroinflammatory Changes After SARS-CoV-2 Infection
Purpose:
The purpose of this study was to evaluate corneal cellular and ultrastructural changes and to quantify the neuroinflammatory process in patients after mild severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.
Methods:
Thirty patients after SARS-CoV-2 infection and 41 age-matched controls were examined. All subjects underwent in vivo confocal microscopy of the corneal cell layers and subbasal nerve fibers with the Heidelberg Retina Tomograph II. Semiautomated analysis of basal epithelial, anterior and posterior stromal keratocyte, and endothelial cell density was performed. Dendritic cell (DC) density and area were also calculated, and subbasal nerve plexus morphology was analyzed.
Results:
The posterior stromal keratocyte density was significantly lower in patients after SARS-CoV-2 infection (P = 0.0006). DC density in the central cornea was significantly higher in patients after SARS-CoV-2 infection (P = 0.0004). There was a significant difference in the DC area between the 2 groups (P
Cornea
High-Dose Oral Posaconazole for the Treatment of Recalcitrant Fungal Keratitis
Purpose:
To report the successful treatment of 3 cases of recalcitrant fungal keratitis (FK) with high-dose oral posaconazole.
Methods:
This is a series of 3 patients from a single academic center with a culture-positive FK who were treated …
Cornea
Changes in Corneal Biomechanical Properties After Small-Incision Lenticule Extraction and Photorefractive Keratectomy, Using a Noncontact Tonometer
Purpose:
The aim of this study was to evaluate and compare early corneal biomechanical changes after small-incision lenticule extraction (SMILE) and photorefractive keratectomy (PRK).
Methods:
The study comprised 74 patients eligible for refractive surgery, equally allocated to PRK (37 patients) and SMILE (37 patients). Corneal biomechanical properties were recorded and compared between the 2 groups at preoperatively and 3 months after surgery using a dynamic ultra-high-speed Scheimpflug camera equipped with a noncontact tonometer.
Results:
Both procedures significantly affected corneal biomechanical properties at 3 months after surgery. Patients in the PRK group showed significantly better results for deformation amplitude ratio (DA ratio) (P = 0.03), maximum inverse radius (InvRadMax) (P = 0.02), and A2 time (P = 0.03). The mean changes in DA ratio, HC radius, InvRadMax, and Ambrosio relational thickness were significantly higher in the SMILE group in comparison with those of the PRK group (all, P