scholarly journals Refractive, Topographic, and Aberrometric Results at 2-Year Follow-Up for Accelerated Corneal Cross-Link for Progressive Keratoconus

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Ercüment Bozkurt ◽  
Engin Bilge Ozgurhan ◽  
Betul Ilkay Sezgin Akcay ◽  
Tugba Kurt ◽  
Yusuf Yildirim ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Spherical Aberration ◽  
Corneal Thickness ◽  
Corneal Topography ◽  
Wavefront Aberration ◽  
Distance Visual Acuity ◽  
Uncorrected Distance Visual Acuity ◽  
Wavefront Error ◽  
The Mean

Purpose. To report the visual, refractive, and corneal topography and wavefront aberration results of accelerated corneal cross-linking (CXL) during a 24-month follow-up.Methods. Forty-seven eyes underwent riboflavin-ultraviolet A-induced accelerated CXL treatment (30 mW/cm2with a total dose of 7.2 joules/cm2). Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), spherical and cylindrical values, keratometry (K) measurements (Ksteep,Kflat,Kavg, andKapex), central corneal thickness, and anterior corneal aberrometric analyses including total wavefront error (WFE), total high order aberration (HOA), astigmatism, trefoil, coma, quadrafoil, secondary astigmatism, and spherical aberration were evaluated.Results. The mean UDVA and CDVA were significantly improved at 1 (p=0.003andp=0.004, resp.) and 2 years after treatment (p=0.001andp=0.001, resp.). The meanKsteep,Kflat,Kaverage, andKapexvalues were significantly lower than baseline at 12 months (p=0.008,p=0.024,p=0.001, andp=0.014, resp.) and 24 months (p=0.014,p=0.017,p=0.001, andp=0.012, resp.). Corneal thickness showed a significant decrease at 1 month. Total HOA and coma decreased significantly at the 12-month (p=0.001andp=0.009, resp.) and 24-month visits (p=0.001andp=0.007, resp.).Conclusion. Accelerated CXL (30 mW/cm2) was found to be effective in improving UDVA, CDVA, corneal topography readings, total HOA, and coma aberrations during the 24-month follow-up.

Seven years follow-up of corneal cross-linking (CXL) in pediatric patients: Evaluation of treated and untreated eye

2021 ◽  
pp. 112067212110206
Author(s):  
Iliya Simantov ◽  
Lior Or ◽  
Inbal Gazit ◽  
Biana Dubinsky-Pertzov ◽  
David Zadok ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Corneal Thickness ◽  
Cross Linking ◽  
Uncorrected Distance Visual Acuity ◽  
Mild Reduction ◽  
Change In The Mean ◽  
The Mean

Background: Retrospective cohort study evaluating long term keratoconus progression amongst cross-linking (CXL) treated pediatric patients in the treated and the fellow untreated eyes. Methods: Data on 60 eyes of 30 patients, 18 years old or younger, who underwent CXL in at least one eye was collected and analyzed. Follow-up measurements taken from the treated and untreated eye up to 7 years after CXL treatment, were compared to baseline measurements. Parameters included uncorrected distance visual acuity (UCDVA), best-corrected spectacle visual acuity (BCSVA), manifest refraction, pachymetry, corneal tomography, and topography. Results: Mean age of patients was 16 ± 2.1 years. For the treated eyes, during follow-up period mean UCDVA had improved (from 0.78 ± 0.22 at baseline to 0.58 ± 0.26 logMAR at 7 years; p = 0.13), as well as mean BCSVA (from 0.23 ± 0.107 at baseline to 0.172 ± 0.05 logMAR at 7 years; p = 0.37). The mean average keratometry showed a significant flattening (from 49.95 ± 4.04 to 47.94 ± 3.3 diopters (D); p < 0.001), However there was no change in the mean maximal keratometry. The mean minimal corneal thickness (MCT) showed a significant mild reduction of 26 µm ( p = 0.006). Although statistically insignificant, the mean manifest cylinder was also reduced to 2D ( p = 0.15). During the follow-up period, eight untreated eyes (26.6%) deteriorated and underwent CXL, while only one treated eye (3.33%) required an additional CXL. Conclusion: CXL is a safe and efficient procedure in halting keratoconus progression in the pediatric population, the fellow eye needs to be carefully monitored but only a 25% of the patients will require CXL in that eye during a period of 7 years.

Outcomes of a 320-degree intrastromal corneal ring segment implantation for keratoconus: Results of a 6-month follow-up

2018 ◽  
Vol 30 (1) ◽  
pp. 139-146 ◽  
Author(s):  
Guilherme Andrade do Nascimento Rocha ◽  
Paulo Ferrara de Almeida Cunha ◽  
Leonardo Torquetti Costa ◽  
Luciene Barbosa de Sousa
Keyword(s):  
Visual Acuity ◽  
Spherical Equivalent ◽  
Distance Visual Acuity ◽  
Uncorrected Distance Visual Acuity ◽  
Intrastromal Corneal Ring ◽  
Corrected Distance Visual Acuity ◽  
Ring Segment ◽  
The Mean ◽  
Corneal Tomography

Importance: This study shows that a newer long-arc length intrastromal corneal ring segment is efficient and safe for keratoconus treatment. Background: To evaluate visual, tomographic results and complications of a 320-degree intrastromal corneal ring segment implantation with the femtosecond laser for keratoconus treatment. Design: A prospective, nonrandomized, and interventional study. Participants: A total of 34 eyes of 31 patients diagnosed with keratoconus were enrolled. Methods: Patients were divided into two groups based on the strategy used for 320-degree intrastromal corneal ring segment thickness selection. In one group, this selection was based on spherical equivalent (SE group) and in the other on the mean asphericity (Q group). The uncorrected and corrected distance visual acuities, spherical equivalent, K1, K2, Km, Kmax, and mean asphericity ( Q) on corneal tomography were evaluated preoperatively and at 3 and 6 months postoperatively. For astigmatism improvement, we analyzed the corneal tomographic vectorial astigmatism change preoperatively and at 6 months postoperatively. The mean follow-up period was 6.63 ± 0.96 months. Results: The mean uncorrected distance visual acuity and corrected distance visual acuity improved with a significant spherical equivalent improvement ( p < 0.05), with no differences between the 320-degree intrastromal corneal ring segment groups. All corneal tomographic parameters improved significantly ( p < 0.05) between the preoperative and postoperative intervals, with a significant better performance when we used spherical equivalent for the 320-degree intrastromal corneal ring segment thickness selection. Finally, the mean vectorial corneal tomographic astigmatism significantly improved after 6 months, again with no differences between groups. Conclusion: This study suggests that implanting a 320-degree intrastromal corneal ring segment is a safe and effective procedure for treating patients with keratoconus. It also suggests that for thickness selection spherical equivalent is the better strategy.

scholarly journals Femtosecond laser-assisted cataract surgery compared with phacoemulsification: the FACT non-inferiority RCT

2021 ◽  
Vol 25 (6) ◽  
pp. 1-68
Author(s):  
Alexander C Day ◽  
Jennifer M Burr ◽  
Kate Bennett ◽  
Rachael Hunter ◽  
Catey Bunce ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Standard Deviation ◽  
Confidence Interval ◽  
Femtosecond Laser ◽  
Cataract Surgery ◽  
Distance Visual Acuity ◽  
Uncorrected Distance Visual Acuity ◽  
Corrected Distance Visual Acuity ◽  
The Mean

Background Cataract surgery is one of the most common operations. Femtosecond laser-assisted cataract surgery (FLACS) is a technique that automates a number of operative steps. Objectives To compare FLACS with phacoemulsification cataract surgery (PCS). Design Multicentre, outcome-masked, randomised controlled non-inferiority trial. Setting Three collaborating NHS hospitals. Participants A total of 785 patients with age-related cataract in one or both eyes were randomised between May 2015 and September 2017. Intervention FLACS (n = 392 participants) or PCS (n = 393 participants). Main outcome measures The primary outcome was uncorrected distance visual acuity in the study eye after 3 months, expressed as the logarithm of the minimum angle of resolution (logMAR): 0.00 logMAR (or 6/6 if expressed in Snellen) is normal (good visual acuity). Secondary outcomes included corrected distance visual acuity, refractive outcomes (within 0.5 dioptre and 1.0 dioptre of target), safety and patient-reported outcome measures at 3 and 12 months, and resource use. All trial follow-ups were performed by optometrists who were masked to the trial intervention. Results A total of 353 (90%) participants allocated to the FLACS arm and 317 (81%) participants allocated to the PCS arm attended follow-up at 3 months. The mean uncorrected distance visual acuity was similar in both treatment arms [0.13 logMAR, standard deviation 0.23 logMAR, for FLACS, vs. 0.14 logMAR, standard deviation 0.27 logMAR, for PCS, with a difference of –0.01 logMAR (95% confidence interval –0.05 to 0.03 logMAR; p = 0.63)]. The mean corrected distance visual acuity values were again similar in both treatment arms (–0.01 logMAR, standard deviation 0.19 logMAR FLACS vs. 0.01 logMAR, standard deviation 0.21 logMAR PCS; p = 0.34). There were two posterior capsule tears in the PCS arm. There were no significant differences between the treatment arms for any secondary outcome at 3 months. At 12 months, the mean uncorrected distance visual acuity was 0.14 logMAR (standard deviation 0.22 logMAR) for FLACS and 0.17 logMAR (standard deviation 0.25 logMAR) for PCS, with a difference between the treatment arms of –0.03 logMAR (95% confidence interval –0.06 to 0.01 logMAR; p = 0.17). The mean corrected distance visual acuity was 0.003 logMAR (standard deviation 0.18 logMAR) for FLACS and 0.03 logMAR (standard deviation 0.23 logMAR) for PCS, with a difference of –0.03 logMAR (95% confidence interval –0.06 to 0.01 logMAR; p = 0.11). There were no significant differences between the arms for any other outcomes, with the exception of the mean binocular corrected distance visual acuity with a difference of –0.02 logMAR (95% confidence interval –0.05 to 0.00 logMAR) (p = 0.036), which favoured FLACS. There were no significant differences between the arms for any health, social care or societal costs. For the economic evaluation, the mean cost difference was £167.62 per patient higher for FLACS (95% of iterations between –£14.12 and £341.67) than for PCS. The mean QALY difference (FLACS minus PCS) was 0.001 (95% of iterations between –0.011 and 0.015), which equates to an incremental cost-effectiveness ratio (cost difference divided by QALY difference) of £167,620. Limitations Although the measurement of outcomes was carried out by optometrists who were masked to the treatment arm, the participants were not masked. Conclusions The evidence suggests that FLACS is not inferior to PCS in terms of vision after 3 months’ follow-up, and there were no significant differences in patient-reported health and safety outcomes after 12 months’ follow-up. In addition, the statistically significant difference in binocular corrected distance visual acuity was not clinically significant. FLACS is not cost-effective. Future work To explore the possible differences in vision in patients without ocular co-pathology. Trial registration Current Controlled Trials ISRCTN77602616. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 25, No. 6. See the NIHR Journals Library website for further project information. Moorfields Eye Charity (grant references GR000233 and GR000449 for the endothelial cell counter and femtosecond laser used).

scholarly journals Reduced High-order Aberrations using Wavefront-guided Partial Photorefractive Keratectomy and Accelerated Epithelium-off Corneal Cross-linking for Keratoconus

2017 ◽  
Vol 6 (2) ◽  
pp. 73-77
Author(s):  
Guillermo Rocha ◽  
Victor Penner ◽  
Kylee Lewis
Keyword(s):  
Visual Acuity ◽  
Spherical Aberration ◽  
Corneal Thickness ◽  
Case Series ◽  
High Order ◽  
Photorefractive Keratectomy ◽  
Cross Linking ◽  
Distance Visual Acuity ◽  
Uncorrected Distance Visual Acuity ◽  
High Order Aberrations

ABSTRACT Purpose To demonstrate clinical outcomes of epithelium-off corneal cross-linking (CXL) in combination with wavefront-guided photorefractive keratectomy (PRK) for the treatment of keratoconuns. Materials and methods Total, 28 keratoconic eyes of 21 patients were included. The Sirius Wavefront Analyzer (SCHWIND eye-tech-solutions GmbH and Co. KG) was used to evaluate the high-order aberrations (HOAs). The coupled Amaris 750S excimer laser then performed a PRK of no more than 40 μm using the measured HOA. The CXL was then carried out respecting the standard of 400 μm of corneal thickness. Results The average age was 32 (15—48) years. Uncorrected distance visual acuity (UDVA) improved from 0.58 to 0.31 logMAR (p < 0.001), with best corrected distance visual acuity (CDVA) improving from 0.03 to 0.02 logMAR (p = 0.7). On manifest refraction, the average spherical component decreased from –1.87 to –1.40 D (0.47 ± 2.12, p = 0.4). Cylinder decreased from 2.18 to 0.87 D (1.31 ± 1.14 D, p < 0.001). All HOAs decreased: total HO 0.94 to 0.58 (0.36 ± 0.42, p = 0.05); spherical aberration: 0.142 to –0.018 (0.160 ± 0.160, p < 0.001); secondary astigmatism: 0.21 to 0.11 (0.10 ± 0.11, p = 0.02); coma: 0.80 to 0.42 (0.38 ± 0.47, p = 0.03); trefoil: 0.33 to 0.29 (0.04 ± 0.17, p = 0.7). Conclusion Utilizing HOA to guide the laser treatment in combination with CXL resulted in a significant decrease of HOA at 6 months postprocedure. This is a small case series, but demonstrates a promising trend of improved HOA. Considering that keratoconic eyes have very irregular surfaces with significant HOA, reducing these aberrations should improve best corrected quality of vision. Having longer follow-up and greater numbers may demonstrate a clearer improvement. How to cite this article Penner V, Lewis K, Rocha G. Reduced High-order Aberrations using Wavefront-guided Partial Photorefractive Keratectomy and Accelerated Epithelium-off Corneal Cross-linking for Keratoconus. Int J Kerat Ect Cor Dis 2017;6(2):73-77.

scholarly journals Safety and Efficacy of Myopic LASIK performed on Thin Corneas

2020 ◽  
Vol 14 (1) ◽  
pp. 33-38
Author(s):  
Jorge E. Valdez-García ◽  
Julio C. Hernandez-Camarena ◽  
Denise Loya-García ◽  
Paloma Lopez-Montemayor ◽  
Gustavo Ortiz-Morales ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Corneal Thickness ◽  
Practice Setting ◽  
Spherical Equivalent ◽  
Visual Outcomes ◽  
Corrected Visual Acuity ◽  
Uncorrected Distance Visual Acuity ◽  
Hispanic Patients ◽  
The Mean

Purpose: The aim was to report on the visual outcomes and safety of myopic LASIK performed in patients with corneas of central thickness below average(<540μm) and normal topography. Methods: This is a retrospective cohort study conducted at a private practice setting on Mexican Hispanic patients who underwent myopic LASIK between January 2014 and January 2015. An analysis of records of patients >18 years-old with previous normal topography, stable refraction, corrected visual acuity ≥ 20/20 (Snellen), Central Corneal Thickness (CCT) < 540μm and at least 12 months follow up after surgery was conducted. The main outcome measures were standard visual outcomes (efficacy, safety, refractive stability) and Percent Tissue Altered (PTA) analysis was conducted. Results: A total of 51 patients (102 eyes) were included; 56% (n=57) were female. The mean age was 26.52 ± 8.06 (range 18-55 years) with a mean follow up of 13.9 ± 1.2 months. Preoperative CCT was 515.44 ± 17.87μm (range 452- 540μm), with a mean refractive spherical equivalent (SEQ): -4.08 ± 2.17 D (range -0.75 to -9.75 D), and mean refractive cylinder: -1.44 ± 1.29 D (range 0.00 to -6.00 D). Mean predictability of postoperative SEQ was -0.20 ± 0.40 D (range -1.25 to +1.25). Postoperative SEQ was ±0.50 D in 71%, ±1.00 D in 93% of the eyes. Postoperative uncorrected distance visual acuity was ≥20/20 in 78% and ≥20/25 in 95%. One line of CDVA was lost in 3% of the eyes, no eyes lost ≥2 lines. No ectasia cases were observed during follow-up. Conclusion: LASIK surgery in Mexican Hispanic patients with thinner than “normal” corneas (<540 μm) is safe, efficient and predictable at 1 year follow up for myopic refractive corrections with no evidence of postoperative keratectasia.

scholarly journals Clinical Outcomes of Accelerated Corneal Cross-Linking for Pediatric Keratoconus

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Abdelrahman Salman ◽  
Taym Darwish ◽  
Marwan Ghabra ◽  
Obeda Kailani ◽  
Hussam Khalil ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Pediatric Patients ◽  
Case Series ◽  
Cross Linking ◽  
Retrospective Case ◽  
Distance Visual Acuity ◽  
Uncorrected Distance Visual Acuity ◽  
Study Results ◽  
The Mean

Aim. To assess the efficacy and safety of accelerated corneal cross-linking in the treatment of pediatric keratoconus. Method. In this retrospective case series, 29 eyes of 20 pediatric patients with keratoconus underwent accelerated corneal cross-linking. Treatment was delivered at 10 mW/cm2 for 9 minutes with a total dose of 5.4 J/cm2. Clinical evaluation included visual acuities and refractive and Scheimpflug corneal tomography assessments. All patients with a minimum follow-up duration of 24 months were included in the study. Results. Mean ± standard deviation age was 15.41 ± 2.13 years (range: 8 to 18 years). Uncorrected distance visual acuity improved significantly from 0.56 ± 0.28 to 0.42 ± 0.29 logMAR P = 0.0003 , and corrected distance visual acuity improved significantly from 0.34 ± 0.23 to 0.28 ± 0.22 logMAR P = 0.014 . The mean manifest refraction spherical equivalent value was significantly reduced (−0.59 ± 0.95 D, P = 0.0024 ). While mean flat keratometry and steep keratometry values were not significantly altered ( P > 0.05 for both), the mean maximum keratometry value was significantly decreased from 56.97 ± 5.24 D preoperatively to 55.84 ± 5.37 D at 24 months postoperatively P = 0.003 . Maximum keratometry had progressed by >1 D in two eyes (6.89%). Permanent corneal haze was reported in one case (3.44%). Conclusion. Our 24-month follow-up demonstrated that accelerated corneal cross-linking appears to halt the progression of keratoconus in pediatric patients without apparent complications. Uncorrected and corrected distance visual acuities were also improved.

scholarly journals Long term results of accelerated 9 mW corneal crosslinking for early progressive keratoconus: the Siena Eye-Cross Study 2

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Cosimo Mazzotta ◽  
Frederik Raiskup ◽  
Farhad Hafezi ◽  
Emilio A Torres-Netto ◽  
Ashraf Armia Balamoun ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Corneal Thickness ◽  
Continuous Light ◽  
Clinical Results ◽  
Asymmetry Index ◽  
Long Term Results ◽  
Distance Visual Acuity ◽  
Long Term Stability ◽  
Uncorrected Distance Visual Acuity

Abstract Purpose To assess clinical results of the 9 mW/5.4 J/cm2 accelerated crosslinking (ACXL) in the treatment of progressive keratoconus (KC) over a span of 5 years. Methods The prospective open non-randomized interventional study (Siena Eye-Cross Study 2) included 156 eyes of 112 patients with early progressive KC undergoing the Epi-Off 9 mW/5.4 J/cm2 ACXL at the Siena Crosslinking Centre, Italy. The mean age was 18.05 ± 5.6 years. The 20-min treatments were performed using the New KXL I (Avedro, Waltham, USA), 10 min of 0.1% HPMC Riboflavin soaking (VibeX Rapid, Avedro, Waltham, USA) and 10 min of continuous-light UV-A irradiation. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), Kmax, coma, minimum corneal thickness (MCT), surface asymmetry index (SAI), endothelial cell count (ECC) were measured, and corneal OCT performed. Results UDVA and CDVA improved significantly at the 3rd (P = 0.028), Δ + 0.17 Snellen lines and 6th postoperative month, respectively (P < 0.001), Δ + 0.23 Snellen lines. Kmax improved at the 6th postoperative month (P = 0.03), Δ − 1.49 diopters from the baseline value. Also, coma aberration value improved significantly (P = 0.004). A mild temporary haze was recorded in 14.77% of patients without affecting visual acuity and without persistent complications. Corneal OCT revealed a mean demarcation line depth at 332.6 ± 33.6 μm. Conclusion The 5-year results of Epi-Off 9 mW/5.4 J/cm2 ACXL demonstrated statistically significant improvements in UCVA and CDVA, corneal curvature and corneal higher-order aberrations which confers a long-term stability for progressive ectasia. Based on the results of the Siena Eye-Cross Study 2, the 9 mW/5.4 J/cm2 ACXL is a candidate to be  the natural evolution of Epi-Off CXL treatment for the management of early progressive corneal ectasia, and thus optimize clinic workflow.

Long term results of accelerated corneal collagen cross-linking in pediatric keratoconus

2021 ◽  
pp. 112067212110183
Author(s):  
Yasin Cinar ◽  
Cagla Cilem Han ◽  
Alparslan Sahin ◽  
Zeba A Syed
Keyword(s):  
Visual Acuity ◽  
Corneal Thickness ◽  
University Hospital ◽  
Long Term Results ◽  
Cross Linking ◽  
Distance Visual Acuity ◽  
The Mean ◽  
Collagen Cross Linking ◽  
Corneal Collagen

Purpose: To evaluate the long term visual, refractive, and corneal tomographic outcomes of epithelium-off accelerated corneal collagen cross-linking (ACXL) in the management of pediatric keratoconus (KC). Methods: This retrospective study included patients under 18 years old with progressive KC who underwent ACXL between 2012 and 2019 at Dicle University Hospital. Complete ophthalmic examination was performed including uncorrected distance visual acuity (UDVA), best spectacle-corrected distance visual acuity (CDVA), manifest refraction, and corneal tomography. Evaluations were performed preoperatively and at 6 months intervals postoperatively. Results: Forty-nine eyes of 49 patients were included in the study. The mean age of patients at the time of ACXL was 14.2 ± 1.8 (range: 9.5–17.3) years. Mean follow up was 4.61 ± 1.90 (range: 2.0–8.1) years. The mean LogMAR UDVA improved from 0.94 ± 0.41 to 0.81 ± 0.43, 0.69 ± 0.41, and 0.67 ± 0.33 after 1, 3, and 5 years respectively ( p = 0.001). The mean LogMAR CDVA improved from 0.58 ± 0.36 to 0.46 ± 0.31, 0.34 ± 0.23, and 0.39 ± 0.27 after 1, 3, and 5 years respectively ( p = 0.015). The mean refractive cylinder improved significantly from 6.01 ± 2.07 diopters (D) to 5.46 ± 1.87, 5.38 ± 2.18, and 5.02 ± 2.31 D after 1, 3, and 5 years respectively ( p = 0.005). As compared to preoperative values, steep keratometry and maximum keratometry were not significantly different ( p = 0.805 and 0.448, respectively) following ACXL, while flat keratometry significantly improved after ACXL ( p = 0.012). Although central corneal thicknesses decreased significantly ( p = 0.029), the decrease in thinnest corneal thickness was not statistically significant ( p = 0.205). Conclusion: Epithelium-off ACXL seems to be effective for halting KC progression with long term clinical benefits in pediatric patients.

scholarly journals Small Incision Lenticule Extraction (SMILE) for Moderate and High Myopia: Seven-Year Outcomes of Refraction, Corneal tomography and Wavefront Aberrations

2019 ◽  
Author(s):  
Fei Xia ◽  
Yang Shen ◽  
Tian Han ◽  
Jing Zhao ◽  
Hai-Peng Xu ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Spherical Aberration ◽  
Case Series ◽  
Final Visit ◽  
Small Incision Lenticule Extraction ◽  
Wavefront Aberrations ◽  
Distance Visual Acuity ◽  
Small Incision ◽  
Uncorrected Distance Visual Acuity ◽  
Lenticule Extraction

Abstract Background To investigate the long-term corneal stability and wavefront aberrations after small incision lenticule extraction (SMILE) for moderate and high myopia.Methods Prospective, non-consecutive case series. A total of 26 patients (42 eyes) who underwent SMILE from May 2010 to March 2013 at the Fudan University Eye and ENT Hospital (Shanghai, China) were enrolled. The periods of follow-up were 1 month, 1 year, 5 years and 7 years after surgery. The routine eye examinations included uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA), manifest refraction and corneal topography.Results All surgeries were executed without any complications. At the final visit, a UDVA of 20/20 or better was achieved in 42 eyes (100%), 21 eyes (50%) exhibited no change in CDVA. 15 eyes (36%) gained one line, 6 eyes (14%) gained two lines, and no eyes lost CDVA lines. 93% and 100% of eyes were within ±0.5 D and ±1.00 D of the target refraction, respectively. A mean refractive regression of -0.17 D was observed between 1 month and 7 years postoperatively. Mean corneal front curvature (KMF) were significantly increased between pre- and post-SMILE surgery (P<0.0001). Higher-order aberrations (HOAs) and vertical coma were significantly increased after SMILE compared to those measured before surgery (all P<0.001). There were no significant differences in horizontal coma, trefoil and spherical aberration between pre- and post-SMILE surgery (all P>0.05).Conclusions SMILE is an effective, safe and stable procedure for myopia correction, with relatively constant corneal stability and wavefront aberrations.

Evolution of corneal flattening after repeated corneal cross-linking during a 6-year follow-up

2020 ◽  
pp. 112067212094566
Author(s):  
Michael A Grentzelos ◽  
Nafsika Voulgari ◽  
Clarice Giacuzzo ◽  
Konstantinos Droutsas ◽  
George D Kymionis
Keyword(s):  
Endothelial Cells ◽  
Visual Acuity ◽  
Case Report ◽  
Corneal Thickness ◽  
Cross Linking ◽  
Distance Visual Acuity ◽  
Corneal Opacification ◽  
Corrected Distance Visual Acuity ◽  
Corneal Flattening

Purpose: To report the evolution of corneal flattening after repeated corneal cross-linking (CXL) in a patient with progressive keratoconus during a 6-year follow-up. Methods: Case report. Results: A 27-year-old female underwent CXL for progressive keratoconus. Postoperatively, corneal topography revealed keratoconus progression with an increase of 1.20 diopters (D) in maximum keratometry (Kmax) and CXL was repeated. After the second treatment, a continuing significant corneal flattening (up to 16.00 D in Kmax) was observed during the first 5 years followed by stabilization during the last sixth year of follow-up. Both uncorrected and corrected distance visual acuity were improved while corneal thickness was decreased. There were no complications such as corneal opacification or endothelial cells decrease during the follow-up period. Conclusion: Repeated CXL can induce an excessive corneal flattening more pronounced during the first years of follow-up followed by stabilization thereafter.

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