Cornea

Long-Term Zonal Average Analysis of Corneal Tomography in Keratoconus Eyes

imagePurpose:

The scope of this study was to investigate keratoconus progression using zonal average analysis of corneal tomography.

Methods:

The corneal tomographies of patients participating in initial baseline and all scheduled follow-up visits up to 4 years were analyzed. Data were exported in custom software, which delineated 4 zones of analysis and calculated the average values of the anterior and posterior curvature and the average thickness for each zone at each visit. In particular, a 3.1 mm2 area containing the Kmax, termed “keratoconus cone zone,” was defined for assessing disease progression during the follow-up.

Results:

A total of 201 patients were enrolled in this prospective study. At 4 years, 31% of the eyes (n = 62) had an average increase of ≥1.0 D in the keratoconus cone zone in baseline visit, whereas only 11% of the eyes (n = 22) had ≥1.0 D Kmax increase in the same period. The zonal anterior average curvature (+1.1 D; P 0.05) during the follow-up.

Conclusions:

Single-point tomography indexes for keratoconus progression did not capture the overall structure and shape changes of the cornea. It would be recommended to update criteria for keratoconus management including the zonal average analysis of curvature and thickness values for tracking disease progression over observation periods longer than 1 year.

By Lombardo, Giuseppe; Serrao, Sebastiano; Lombardo, Marco, ago

Possible Synergistic Role of Cryo-Alcohol Therapy in Infectious Scleritis—Scope and Rationale for Expanding Indications and Review of the Literature

Purpose:

The purpose of this study was to highlight the use of topical ethanol as an adjunct to cryotherapy, termed cryo-alcohol therapy, in the management of fungal/acanthamoeba scleritis along with a review of the literature.

Method:

Retro…

By Agarwal, Shweta; Pandey, Sunita; Srinivasan, Bhaskar; Anand, Appakkudal R.; Iyer, Geetha, ago

Establishing a Biomarker for the Prediction of Short-Term Graft Detachment After Descemet Membrane Endothelial Keratoplasty

imagePurpose:

The purpose of this study was to investigate the predictive value of pachymetry mapping 1 day after Descemet membrane endothelial keratoplasty (DMEK) as a biomarker for early graft detachment.

Methods:

This was a post hoc analysis of 65 pseudophakic subjects with Fuchs endothelial dystrophy who underwent DMEK surgery between December 2018 and April 2021 as part of the Advanced Visualization In Corneal Surgery Evaluation international multicenter randomized controlled trial. One eye per patient was included. Preoperatively and 1 day postoperatively, patients underwent anterior segment optical coherence tomography imaging. Using a grid consisting of 25 zones (ie, pachymetry map), corneal thickness and presence of a graft detachment were mapped for each patient. Detachments of any size were considered, regardless of subsequent clinical interventions. Missing data were imputed and subsequently divided into a training and test set. Two prediction methods were evaluated: one model based on absolute corneal thickness and a regression model.

Results:

A total of 65 eyes were included for analysis of which 33 developed any form of graft detachment. Preoperatively, no significant differences were observed between the groups (P = 0.221). Corneal thickness in the corneal zones with a detached graft was significantly increased compared with corneal zones with an attached graft (P

By , ago

Diurnal Variation in Straylight in Patients With Fuchs Endothelial Corneal Dystrophy and Controls

imagePurpose:

The goal of this study was to investigate diurnal changes in intraocular straylight in relation to other corneal parameters and subjective complaints in patients with Fuchs endothelial dystrophy and healthy controls.

Methods:

This is a prospective study conducted in 2 tertiary care hospitals in Germany and the Netherlands. Patients with Fuchs endothelial dystrophy (n = 71) and healthy controls (n = 34) were included. Patients with Fuchs dystrophy were grouped by the presence of subjective complaints and measured over multiple time points during the day. Measurements included intraocular straylight using the C-Quant and corneal thickness and backscatter using a Scheimpflug camera. A separate group of healthy controls was measured intensively with repeated straylight measurements directly after waking. An exponential decay model was used to model the diurnal change.

Results:

Healthy controls showed an average straylight baseline of 1.17 log(s) with an increase in straylight after waking of 0.22 log(s). In the repeated measurements subgroup, the increase in morning straylight lasted for 22 minutes. Patients with Fuchs dystrophy showed a morning increase in straylight of 0.21 log(s) present up to 4 hours after waking before reaching an average baseline of 1.30 log(s). Straylight was positively correlated with anterior corneal backscatter, r = 0.21, P = 0.022, and corneal thickness, r = 0.46, P

By , ago