Cornea
Management of Keratoconus in Down Syndrome and Other Intellectual Disability
Purpose:
The purpose of this study was to assess an intellectual disability (ID) cohort with keratoconus (KC) regarding ophthalmic (visual acuity and corneal tomography) and systemic characteristics and to describe an appropriate clinical algorithm…
Cornea
Conjunctival Infiltration in a Child as a Rare Manifestation of IgG4-Related Disease
Purpose:
Ocular manifestations of immunoglobulin G4 (IgG4)-related disease are common in children although remain ill-defined because of the disease’s rarity. We describe a pediatric case of IgG4-related orbital disease (IgG4-ROD) who presented wit…
Cornea
Transepithelial Diluted Alcohol and Iontophoresis-Assisted Corneal Crosslinking for Progressive Keratoconus in Adults: 4-Year Clinical Results
Purpose:
The aim of this study was to compare the 4-year clinical outcomes of transepithelial diluted alcohol and iontophoresis-assisted corneal crosslinking (DAI-CXL) and standard corneal crosslinking (S-CXL) in adults with progressive keratoconus.
Methods:
This retrospective study included 36 eyes of 36 keratoconic patients who underwent DAI-CXL (n = 18) or S-CXL (n = 18). Best spectacle-corrected visual acuity (BSCVA) and corneal topography parameters were analyzed at baseline and at 1, 2, 3, and 4 years of follow-up. Corneal demarcation line depth (DLD) at 1 month was measured, and the relation of DLD with corneal thickness (DL%) was assessed.
Results:
BSCVA improved significantly only in S-CXL (P = 0.01). A significant decrease in maximum keratometry and mean keratometry occurred at 4 years in both groups (all P 0.05). There was a significant reduction in the thinnest corneal thickness in S-CXL (P = 0.01); however, the mean thinnest corneal thickness in DAI-CXL remained stable (P = 0.094). Higher-order aberrations and coma aberration decreased significantly in both groups at 4 years (all P 0.05).
Conclusions:
DAI-CXL was as effective as S-CXL in arresting the progression of keratoconus and showed similar clinical results to S-CXL at the 4-year follow-up.
Cornea
Impact of Graves Disease on Ocular Surface and Corneal Epithelial Thickness in Patients With and Without Graves Orbitopathy
Purpose:
Our aim was to assess ocular surface and tear film stability and corneal epithelial thickness (CET) in patients with Graves disease (GD) with and without Graves orbitopathy (GO).
Methods:
This study included healthy age-matched controls and patients with GD. Symptoms (Ocular Surface Disease Index questionnaire) and signs (schirmer test and tear breakup time test) of dry eye disease were determined, according to the International Dry Eye Workshop II criteria of DED. CET map was also assessed.
Results:
Twenty-four eyes were included in the control group, with a mean age of 41.00 ± 13.65 years, and 34 in the GD group, 18 with GO and 16 without GO, with a mean age of 44.44 ± 13.95 and 45.75 ± 10.59 years, respectively. All patients with GO had inactive disease (mean clinical activity score: 1.33 ± 0.69). Patients with GD had higher proportion of clinical diagnosis of dry eye disease (GO vs. GD without GO vs. controls: 77.77% vs. 75.00% vs. 4.17%), with higher Ocular Surface Disease Index (GO vs. GD without GO vs. controls: 15.44 vs. 15.06 vs. 9.88) and lower tear breakup time test (GO vs. GD without GO vs. controls: 6.33 s vs. 7.25 s vs. 11.63 s). Superior CET was lower in patients with GD (P 0.05).
Conclusions:
GD negatively influenced ocular surface and CET, with a higher level of eye dryness and corneal thinning regardless of GO status, suggesting that subclinical chronic inflammation may play a role in the pathogenesis of tear film and ocular surface stability.
Cornea
Corneal Neurotization: A Novel Surgical Procedure for Neurotrophic Keratopathy
Purpose:
The aim of this study is to describe techniques, results, and open issues of corneal neurotization (CN) for the treatment of neurotrophic keratopathy (NK).
Methods:
An overview of the most important studies of CN is provided. The 2 …
Cornea
Best Indicators for Detecting Keratoconus Progression in Children: A Report From the Shahroud Schoolchildren Eye Cohort Study
Purpose:
The purpose of this study was to investigate 3-year changes in keratoconus (KC) indices to determine the indicators of KC progression compared with age-related changes in children aged 6 to 12 years.
Methods:
In this report of the S…
Cornea
Clinical Outcomes of a New Type of Continuous Intrastromal Corneal Ring for Treatment of Keratoconus
Purpose:
The purpose of this study was to evaluate the efficacy and safety of implantation of a new continuous corneal ring in keratoconic corneas of an Iranian population.
Methods:
This study was conducted on 95 contact lens–intolerant keratoconic eyes with clear central corneas. A continuous corneal ring, annular intrastromal corneal inlay (AICI), was inserted using femtosecond laser in all cases. Patients were followed up for 1, 3, and 12 months postsurgery. Visual and subjective refractive outcomes were evaluated in each examination. Besides, keratometry and aberrometric values were recorded before and 12 months after surgery. Finally, vector analysis of refractive astigmatism was performed using the Alpins method.
Results:
The uncorrected and corrected distance visual acuities improved significantly 12 months after surgery from 0.91 ± 0.39 to 0.38 ± 0.22 (P
Cornea
C-DU(KE) Calculator: A Clinical Tool for Risk Stratification in Infectious Keratitis
Purpose:
The aim of this study was to identify characteristics of infectious keratitis predictive of poor outcome to develop a web-based predictive calculator.
Method:
A retrospective chart review was performed at the Duke Eye Center. Two hu…