No longer available
Presentation Type: Cornea
Co Authors:
Abstract Details:
Purpose:Bilateral corneal ectasia is a serious complication of Lasik, always leading to patient dissatisfaction and frequently complicated by legal issues. Initial disaster followed by good outcome after several surgical procedures is reported here
Setting:
Method: A patient with myopia of -15 D underwent bilateral Lasik in 1998. Residual stromal bed was about 220 micron in both eyes. Two years after surgery ectasia developed in one eye, followed by the contralateral eye 12 months later. The patient accepted penetrating keratoplasty (PK) in the first eye, followed by clear lens exchange to solve the residual high myopia. In the second eye, deep lamellar keratoplasty (DLK) was performed, also followed by clear lens exchange. Three years after the PK, and two years after the DLK, the patient requested Lasik to solve the residual refractive error and astigmatism. Current follow-up after second Lasik is 36 months. The patient did not show any graft rejection, and is almost spectacle-free due to residual small astigmatism.Conclusion: Bilateral ectasia can have a good outcome if the patient still trust in the doctor and, after thorough consultation, follows his suggestions.
Presentation Type: Cornea
Co Authors:
Abstract Details:
Purpose:Background/
Purpose:
We aim to describe the clinical and in vivo laser confocal microscopic (Corneal HRT III module) findings of a patient with limbal dermoid.
Setting:
Report of Case or Case Series:Report of Case: An 8-year old boy admitted for the existence of a white lesion on his left eye. His visual acuity (VA) was 20/20 in the right eye and corrected VA was 20/100 with the left eye. The refractive error of the left eye measured as -1,75 (-5,00x140) and keratometry was 37,5 and 42,00 D x 145. Slit-lamp biomicroscopy revealed a yellowish white lesion at the inferior temporal part of the cornea and there were some concentric haze, extending to the optic zone of the cornea. The family complained of cosmetic disfigurement and the lesion was excised. On the first day of the excision, the area of the limbal dermoid was filled with a white vascularized tissue. Compared to normal eye, the keratocytes were irregular and the extracellular matrix demonstrated highly reflective fibrotic tissue among keratocytes in laser scanning confocal microscopy. Conclusion: Cosmetic disfigurement, interference of the visual axis, important astigmatism, dellen formation and irritation are common surgical indications for limbal dermoids. In the present case, although the dome shape decreased, the area of the lesion was filled with granulation tissue and family did not satisfy with the appearance. Before surgery, the family should be warned for the possibility of
Presentation Type: Cornea
Co Authors:
Abstract Details:
Purpose:
Acanthamoeba is a free-living protozoa that usually can be found in water and floor. The keratitis by acanthamoeba is tipically seen on lens-wearing patient and threats the vision because of its severe lesions. We report a case about some complications of acanthamoeba infection and its relationship with other keratitis agents and secondary ocular hypertension
Setting:
Method: A 25 years-old woman referred a red painful eye and photophobia since one week, her visual acuity was <0,05 in her left eye and 1 in right eye. We could observed a corneal ulceration with a characteristic ring infiltration 4x4mm, the first clue to acanthamoeba diagnosis. The treatment was Brolene
Presentation Type: Cornea
Co Authors:
Abstract Details:
Purpose:
To describe in-vivo ultra high-resolution optical coherence tomography (UHR-OCT) findings of a patient with peripheral flap melt after LASIK surgery
Setting:
Methods:
A 32 year old woman underwent three step treatment for myopia and astigmatism in both eyes. The manifest refraction was -11.00 +2.00x85 in the right and -10.00 +1.25x90 in the left eye. In the first step LASIK flaps were prepared without flap lifting. In the second step implantable Collamer lens was implanted. In the third step flap lift was performed and excimer laser ablation was performed. The initial examination after excimer laser treatment revealed intorsion of epithelial sheets under the lasik flap in the left eye. A novel UHR-OCT was used to evaluate the in-vivo morphological properties of the epithelial defect of the patient. UHR-OCT images demonstrated residual epithelial cells invaginating into the side cut immediately after manually repositioning of the epithelial irregularity. Postoperative 2 months visit revealed a localized flap melt at the same area. Conclusion: UHR-OCT can be used to analyze in-vivo morphology of the LASIK flap in detail. The epithelial sheets invaginating into the side-cut can be responsible for the development of epithelial ingrowth and flap melt in LASIK cases.
Presentation Type: Cornea
Co Authors:
Abstract Details:
Purpose:Lipid keratopathy is a rare disease which courses with yellow-whitish fatty stromal deposits in the cornea. Corneal opacity may be primary without any associated ocular disease, secondary with vascularization in the cornea or represent a systemic disorder of lipid metabolism. We report a case of bilateral severe secondary lipid keratopathy with Sj
Presentation Type: Cornea
Co Authors: Ahmed Abd EL Alim Mohamed - - - - - - - - - -
Abstract Details:
Purpose:
To assess corneal topographic changes in phakic eyes undergoing TC20V without scleral buckling or silicone oil tamponade.
Setting:
Faculty of Medicine,Ain Shams University-Faculty of Medicine ,Benha University-Egyptian Eye Academy
Methods:
40 eyes of 40 patients undergoing TC20V for a variety of vitreo-retinal conditions, neither scleral buckle nor silicone oil tamponade were used not to affect the final corneal changes,patients with postoperative hypotony were excluded.Corneal keratometric readings were obtained before surgery,one week and one month after surgery.
Results:
The mean preoperative vertical keratometry (K1) was 44.87 ± 3.55, the mean preoperative horizontal keratometry (K2) was 44.57 ± 3.68 ,the mean postoperative K1 after one week was 45.1 ± 6.82 while the mean postoperative K2 after one week was 45.7 ± 3.97, using Paired t test, the p value of K1 change was < 0.01 and p value of K2 change was < 0.02 and both indicates minimal significant difference ,one month postoperative, ,the mean K1 was 45.2 ± 2.53 and the mean K2 was 45.1 ± 1.56 and p value of both K1 and K2 change after one month was > 0.05 which indicates insignificant changes.
Conclusions:
TC20V does not induce significant changes in corneal topography and these changes also decrease within the first one month.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: Inara Abbasova Mirana Mirishova
Abstract Details:
"
Purpose:
To value the results of the II-III stage keratoconus treatment (by Amsler) by the introstromal keratoplasty method with implantation of segments with corneal collagen crosslinking.
Setting:
National Ophthalmology Center named after acad. Z.Aliyeva, Azerbaijan.
Methods:
15 patients (18 eyes) with keratoconus of II and III stages by Amsler (7 and 11 eyes accordingly) were included to the investigation all patients were subjected to the intrastromal keratoplasty with implantation of one or two intracorneal segments Keraring (""Mediphacos""). Implantation was made into the depth, equal to the 2/3 of corneal thickness. During 3-5 days after segments implantation we'd performed the crosslinking of cornea on the CBM Vega (""BON"") apparatus using riboflavin- Ricrolin (""BON""). Total time of ultraviolet irradiation exposure with the wave length of 370nm has made up 30 minutes.
Preoperative examination had revealed the mean values of next data: UCVA was 0.05±0.2; BSCVA was 0.2±2.2; refraction spheroequivalent -8.1±2.4D; cylindrical component 8.5±2.9D; keratometry 55.5±1.8D; refraction value in the ectasia zone 59.4±1.2D; thickness of cornea on the center 406±2.6µ.
Results:
In all patients we're observed the successive decrease of the refractive induces after the performed surgeries. In 6-12 months postoperatively the spheroequivalent in average was -2.2±1.6D; cylindrical component in average was -1.8±1.1D. According to the topography data of cornea the considerable decrease of refraction strength in the ectasia zone till 46.5±1.5D and also the deviation of zone of the largest ectasia towards the center. According to the OCT data the corneal thickness varied in the postoperative period: during the first two months after the intervention the decrease of the corneal thickness in the average was by 25±1.2µ ; in 6 months the in induces of pachymetry were stabilized and were 385±1.2µ in average. Postoperatively the visual improvement in all patients was noted. Visual acuity without correction was 0.5±0.2; with the maximal spectacles correction 0.8±0.7. More than 95% of the eyes had a post-operative UCVA which was better than or equal to the preoperative BSCVA.
Conclusions:
The combination of two treatment methods - implantation of the intracorneal segments and corneal collagen crosslinking - makes it feasible to get the high functional results and stabilization of the progressing disease.
Financial Disclosure:
No.-"
Presentation Type: Cornea
Co Authors: Khalil Huseynov Khalilov Rafadar Narmina Mustafazadeh - - - - - -
Abstract Details:
Purpose:
To value the efficacy of the Femto-LASIK with Topography Treatment Method (TTM) for correction of the irregular astigmatism in the patients after the penetrating and deep anterior lamellar keratoplasty.
Setting:
National Ophthalmology Center named after acad. Z.Aliyeva, Azerbaijan.
Methods:
Femtokeratomylesis was made in 8 patients after the perforating and anterior lamellar keratoplasty in keratoconus. The surgeries were made on the eximer-laser MEL-80 and femtosecond VisuMax (Zeiss, Germany). All patients were subjected to the TTM ablation. Preoperative spheroequivalent of refraction was -9.5 ±2.2 D; cylindrical component -5.5±2.1D. Pachimetry was 520±2.2µ in average. UCVA was 0.2±0.08; BSCVA was 0.5±1.2.
Results:
Out of the intraoperative complications in one case we observed the hole in the periphery of the flap, in the second one - the loss of suction. In 1 month after the surgery UCVA was 0.5±0.08; BSCVA was 0.8±0.1. The keratorefractive induces had been stable during the 8 months after the Femto-LASIK. The postoperative spheroequivalent of refraction was -3.25±2.4 D; cylindrical component -1.5±1.1D. UCVA was 0.65±1.3; BSCVA was 0.73±0.8. More than 90% of the eyes had a post-operative UCVA which was better than or equal to the preoperative BSCVA. In none of cases we observed the development of subepithelial opacification, vascularization and diseases of transplant.
Conclusions:
Femto-LASIK with TTM in the effective and safety procedure of correction of the irregular surface of cornea and refraction anomaly in the patients after the keratoplasty, allows to improve the corrected visual acuity and to get the tolerable spectacle correction.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: Banu Acar - - - - - - - - - -
Abstract Details:
Purpose:
To compare the recurrence rate following treatment of recurrent pterygium using one of two techniques- limbal conjunctival autograft transplantation versus low-dose intraoperative mitomycin C (0.2 mg/ml) combined with conjunctival autograft transplantation.
Setting:
Haydarpasa Numune Education and Research Hospital, Ophthalmology Clinic, Istanbul, Turkey
Methods:
Sixty-six patients with recurrent pterygium were included in this study. Patients were divided in two groups. In the first group limbal conjunctival autograft transplantation was applied to 34 eyes and in the second group mitomycin C combined with conjunctival autograft transplantation was applied to 32 eyes. The main outcome measure was recurrence after surgery, defined as fibrovascular tissue over the corneoscleral limbus onto clear cornea in the area of previous pterygium excision.
Results:
Average duration of follow-up in the limbal conjunctival autograft transplantation and mitomycin C combined with conjunctival autograft transplantation groups were 16.2±1.5 months and 15.8±1.31 months, respectively (P = 0.29). During this follow-up period, five recurrences (14.7%) in the limbal conjunctival autograft transplantation group and four recurrences (12.5%) in the mitomycin C combined with conjunctival autograft transplantation group were observed (p=0.79). The difference between the mean ages of recurrent (24.8±7.6 years) and nonrecurrent (34.6±9.8 years) cases for all patients was statistically significiant (p=0.012).
Conclusions:
Both techniques showed similar recurrence rates in the treatment of recurrent pterygium. Surgeon experience and preference should dictate the procedure of choice in treating patients with this challenging clinical problem.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: Banu Torun Acar - - - - - - - - - -
Abstract Details:
Purpose:
To evaluate the efficacy of deep anterior lamellar keratoplasty using the big-bubble technique in patients with post-LASIK keratectasia
Setting:
Haydarpasa Numune Education and Research Hospital, Ophthalmology Clinic, Istanbul, Turkey
Methods:
Eight eyes of 8 patients (5 male and 3 female) who had post- LASIK ectasia were included in this study. Deep anterior lamellar keratoplasty (DALK) was performed using the big-bubble technique. Indications for keratoplasty were intolerance of rigid gas-permeable contact lenses or unacceptable corrected visual acuity. Preoperative and postoperative uncorrected (UCVA) and best-corrected (BCVA) visual acuities, spherical equivalent, keratometry and keratometric astigmatism were compared.
Results:
After a mean follow-up period of 14.1±2.6 months (range, 10-18 months), the mean UCVA increased from 20/400 before DALK to 20/200 after DALK (p<0.05), and the BCVA increased from 20/125 to 20/30, respectively (p<0.05). The decrease in the mean SE refractive error was -3.28 diopters (D) (from -6.53±5.85 D to -3.25±2.08 D) (p<0.05). The mean keratometry was 48.09±4.59 D preoperatively and 43.68±1.42 D postoperatively (p<0.05), and the mean keratometric astigmatism was -5.50±1.48 D preoperatively and -2.68±0.45 D postoperatively (p<0.05).
Conclusions:
Deep anterior lamellar keratoplasty is a safe and effective technique to restore corneal irregularities for iatrogenic keratectasia.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: Abdullah Özkaya Ulviye Yigit Yakup Acet Hande Mefkure Özkaya - - - -
Abstract Details:
Purpose:
In this case report we aimed to evaluate a patient who has a conjunctival filtrating bleb secondary to a blunt truma long after the repairment of a previous penetrating injury.
Setting:
Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Ophthalmology Department, Istanbul.
Methods:
Case report of a patient representing a conjunctival filtrating bleb due to two different eye traumas.
Results:
Case Report: In July 2009, a 45-year-old male presenting a corneoscleral penetrating injury in the left eye came to our clinic. The best corrected visual acuity (BCVA) of the patient was 20/400, and penetrating injury had been radially at the temporal side of the glob involving the cornea and sclera. End of the wound was reaching to the insertion of the lateral rectus muscle. 10-0 nylon suture has been used for cornea and limbus and 7-0 polyglycolic acid suture for sclera in wound repairment. BCVA of the patient was 20/25, there was no leakage from the injury site and minimal vitreus hemorrhage was detected postoperatively. In April 2010, the patient came with a story of minimally blunt trauma in the same eye. The BCVA was 20/25 and a filtrating conjunctival bleb was detected at the site of the previous injury. The intraocular pressure was 7mmHg. There was neither leakage from the bleb site nor signs of maculopathy of hipotony. Ultrasonic evaluation and optical coherent tomography did not show any abnormality. By means of all these findings, the patient is told to be careful for these kind of injuries and to continue to be followed up every 2 months.
Conclusions:
Filtrating conjunctival bleb is the goal of filtrating glaucoma surgeries especially in trabeculectomy. But inadvertent filtrating cases can occur in different kinds of intraocular surgeries. In our case the wound was well closed in first 9 months. But an incidental blunt trauma occured and had been the cause of the filtrating bleb. If any complications occur during the follow up the sclera can be repaired by several methods. It is important to notice that precautional measures should be taken in order to prevent these types of injuries and the patients must be counselled about how to protect themselves.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: Abdullah Özkaya Ulviye Yigit Betül Tu?cu Ismail Umut Onur Yalē?n ??can - -
Abstract Details:
Purpose:
To evaluate a patient who presented with acute glaucoma crisis secondary to recurrent herpetic keratouveitis disease and became dependent to acyclovir therapy.
Setting:
Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Ophthalmology Department, Istanbul.
Methods:
Case report of a patient who presented with acute glaucoma crisis secondary to recurrent herpetic keratouveitis disease and became dependent to acyclovir therapy.
Results:
In March 2008 a 45 year old male patient came to our clinic with complaints of redness and pain in his left eye. In his evaluation, visual acuity of left eye was 20/63, cornea was edematous, intraocular pressure (IOP) was 45 mmHg. Further evaluation was not possible. He was treated with intravenous mannitol and oral acetozolamid. After 5 days, corneal edema decreased and tiny keratic precipitates was detected on corneal endothelium with many dendritic ulserations on epithelium and the patient was diagnosed as herpetic keratouveitis. Acyclovir 4000 mg/day was administired. After the regression of the epithelial ulcerations, topical rimexolon was added. When the symptoms and findings disseappered and IOP decreased, acyclovir dose has been tapered. After 4 months, while maintaining acyclovir therapy at 800mg/day, herpetic keratouveitis and secondary glaucoma recurred. The acyclovir dose has been reincreased to 4000 mg/day, rimexolon and fix combination of dorzolamide timolol have been added. In the follow-up, when acyclovir dose was tapered below 2000 mg /day, the patient had a new attack in 2-3 months. The last attack was treated with 3200 mg /day acyclovir, rimexolon and fix combination of dorzolamide-timolol. Eventually as maintenance therapy acyclovir 2000 mg /day and rimexolon have been ordered.
Conclusions:
We presented a case of herpetic keratouveitis recurring with acyclovir therapy withdrawal and who became dependent on therapy. The variability in the diseases courses between patients emphasize that the acyclovir dose and total time of the therapy should be assesed carefully in terms of each patient.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors:
Abstract Details:
Purpose:
Ingrowth of epithelium into the corneal flap interface is a relatively uncommon complication of primary laser in situ keratomileusis (LASIK). We report two cases with epithelial in-growth after primary LASIK.
Setting:
Method: Two cases with significant epithelial in-growth are reported. In one case, significant epithelial in-growth appeared immediately after the surgery. The epithelial in-growth was localized on the visual axis and negatively affecting uncorrected and corrected visual acuity. Treatment included lifting the flap, scraping the epithelial cells, epithelial debridement, followed by placement of a bandage contact lens for 3-5 days. In the second case, patient did not have any epithelial in-growth in the first postoperative day, but he did not come for further examinations thereafter. He came to our clinic five weeks after the surgery, when significant epithelial in-growth was noticed. He was also treated with flap lifting, scraping the epithelial cells, epithelial debridement, and placement of a bandage contact lens. Eight weeks after the treatment, no recurrence of epithelial in-growth was noted in the first case, while in the second case recurrence of epithelial ingrown was noticed. The influence on vision, topography and cell recurrences was evaluated. Conclusion: Epithelial in-growth after LASIK is rare in our practice. Mild in-growth can be observed, whereas significant in-growth can respond well to removal, but needs to be done in an early phase.
Presentation Type: Cornea
Co Authors: Ahmet Hondur ?engül Özdek Kamil Bilgihan - - - - - -
Abstract Details:
Purpose:
To present a case of leukemia relapse in the anterior segment, and to describe the course of disease and its treatment.
Setting:
Gazi University Medical School, Department of Ophthalmology, Ankara, Turkey
Methods:
A four year old boy with a history of acute lymphocytic leukemia presented with loss of vision in his left eye. Anterior uveitis with hemorrhagic hypopyon was observed. Cytologic examination of aqueous humor confirmed the presumed diagnosis of ocular leukemic infiltration. The patient was at first treated with radiotherapy and systemic chemotherapy. The afterward pathologies involving the ocular surface, cornea and crystalline lens were treated successively.
Results:
The best corrected visual acuity (BCVA) of the eye was finger counting (FC) at initial presentation. After 3 months of treatment with radiotherapy and systemic chemotherapy, the BCVA improved to 20/63. At 6 months, radiotherapy induced dry eye, band keratopathy and cataract became prominent, and the BCVA decreased to FC. After rehabilitation of the ocular surface with topical steroids, cyclosporine A and artificial tears; cataract surgery and intraocular lens implantation were performed. Postoperatively, the other eye was patched for 5 hours daily, and rigorous treatment for dry eye was continued. The patient had no sign of radiation retinopathy, and BCVA improved to 20/25 at 6 months.
Conclusions:
Urgent cytologic examination of aqueous humor in cases with presumed ocular leukemic infiltration is of utmost value in the diagnosis. The management can be challenging, and involves careful and forbearing treatment of various pathologies involving the ocular surface, cornea and crystalline lens.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: Banu Satana Fethi Cengiz Berna Demirel Hüseyin Dundar Ahmet Demirok Omer Faruk Y?lmaz
Abstract Details:
Purpose:
To compare the corneal biomechanical parameters measured by Ocular Response Analyzer (ORA) between eyes with normal tension glaucoma (NTG), primary open angle glaucoma (POAG) and ocular hypertension (OHT).
Setting:
Cross-sectional, comparative clinical trial.
Methods:
Forty-two eyes with POAG, 31 eyes with NTG and 47 eyes with OHT were recruited (n=120). Patients who had corneal abnormalities and history of previous ocular surgery or topical medication were excluded. Intraocular pressure (IOP) measured by Goldmann applanation tonometry (GAT) were recorded. Central corneal thickness (CCT) was measured by ultrasonographic pachimetry. Metrics of corneal biomechanical properties, including corneal hysteresis (CH) and corneal resistance factor (CRF), were measured with the ORA. The ORA also determined the values of intraocular pressure (IOPg) and corneal compensated IOP (IOPcc).
Results:
The age, visual acuity and CCT were not significantly different between groups (p>0.05 for each). Mean IOP measured by GAT were 27,4±3,7; 17,8±2,6 and 24,9±2,9 mmHg in POAG, NTG and OHT groups respectively (p<0,001). Corneal hysteresis (9,6±2,2 in POAG; 10,0±1,4 in NTG and 10,1±1,9 in OHT) did not differ significantly between three groups (p=0,57). Significant differences of other ORA parameters such as CRF (13,4±2,2; 11,2±1,8 and 13,3±1,9 respectively), IOPg (27,6±6,2; 19,2±4,9 vs 25,9±5,2, respectively), IOPcc (27,2±6,4; 19,6±4,6 and 25,3±5,4 mmHg, respectively) were present between the groups (p<0,001).
Conclusions:
Corneal hysteresis of the cornea measured by ORA were not significantly different in POAG, NTG and OHT. Corneal resistance factor were lowest in eyes with NTG. These factors may help to understand the role of the corneal rigidity in IOP measurement for monitoring the NTG, POAG and OHT.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: Canan Asl? Utine Maryo Cenk Kohen Ferda Ēiftēi - - - - - -
Abstract Details:
Purpose:
To examine the corneal structural findings by confocal microscopy (CM) (CS4, Nidek Technologies, Albignasego, Italy) in a case of Vortex Keratopathy
Setting:
Case presentation. 60 year old man under amiodarone therapy
Methods:
Bilateral full thickness corneal images with 768 x 576 pixel image size, 0.6 µm lateral resolution and 500X magnification by contact mode of CM achieved under topical anaesthesia
Results:
Surface epithelial cells were in normal appearance. There were intracellular bright deposits at the basal epithelial layer. Stromal cell type and density were ordinary. Endothelial cell arrangement, size and appearance were regular.
Conclusions:
Vortex keratopathy can be seen due to Fabrys Disease, melanokerotosis and at certain drug deposits. To make differential diagnosis, quantitative analysis of clinical findings and for possible drug change or termination confocal microscopy findings may be good guide .
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: Buzzonetti Luca - - - - - - - - - -
Abstract Details:
Purpose:
to evaluate corneal trasparency by taking slit lamp photographs, best spectacle corrected visual acuity (BSCVA) and the keratometric parameters were calculated by Pentacam after Cross-Linkin Transepithelial ( CLX TE) using RICROLIN TE (Riboflavin 0,1% and Enhancer)
Setting:
* Ophthalmology Departement, IRCCS- Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo (Foggia), Italy.
° Ophthalmology Departement,Bambino Gesł Hospital - Roma,Italy
Methods:
10 eyes of 10 patients with keratoconus 2°-3° stage ( according to Krumeich) was treated with CLX TE ( Riboflavin0,1 % + trishydroxymethhylaminomethane + ethylenediaminetetraacetic acid).
Laser CSO CBM Vega was used.
Corneal transparency, BSCVA, and keratometric parameters were calculated in preoperatory and after six months posttreatment.
Advantages of transepithelial cross-linking: it doesnt need operating room,
corneal thickness ? 400 ?, easier technique, pre-treatment VA maintenance, better patient compliance children, no post treatment pain, no complications derived from disepithelization.
Results:
no pain, good corneal transparency, BSCVA improved of 2 lines, keratometric parameters evaluation with Pentacam. The Cross-Linking technique works at 100 microns depth.
Conclusions:
The preliminary study is as safe and effective. Further studies are warranted to determine the long term outcomes.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: Zeynep Ozbek Hakan Oner Ismet Durak Ali Osman Saatci - - - -
Abstract Details:
Purpose:
To evaluate the effect of silicone oil removal on central corneal thickness in aphakic and pseudophakic eyes prospectively.
Setting:
Dokuz Eylul University, School of Medicine, Department of Ophthalmology, Izmir, Turkey
Methods:
Patients who underwent silicone oil removal surgery between June 2005 - August 2007 were included in this study. Silicon oil was actively removed behind the posterior capsule through the pars plana sclerotomy site (posterior approach) in pseudophakic eyes and through the corneal tunnel incision via pupilla (anterior approach) in aphakic eyes with the 18-gauge cannula. Central corneal thickness was assessed with Orbscan II corneal topography system preoperatively and at one month and three months postoperatively.
Results:
A total of 34 eyes of 34 patients (26 males, 8 females) comprised the study group. Mean age was 55.6±12.3 years (Range: 25 - 80 years). Twenty-six eyes (76.5%) were pseudophakic and 8 (23.5 %) aphakic. At baseline, central corneal thickness was 576.4 ± 46.0 µm in pseudophakic eyes and 611.6 ± 36.2 µm in aphakic eyes. At postoperative one month central corneal thickness was 573.3 ± 40.1 µm and 630.9 ± 72.9 µm in pseudophakic and aphakic eyes respectively. At third postoperative month central corneal thickness was 582.7 ± 49.5 µm and 614.5 ± 82.4 µm in pseudophakic and aphakic eyes respectively. There was no statistically significant difference in central corneal thickness measurements at one month and at 3 month after silicone oil removal when compared to preoperative values in both aphakic and pseudophakic eyes (P>0.05).
Conclusions:
Silicone oil removal actively either by anterior or posterior approach did not affect the central corneal thickness.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: RAMAKRISHNAN RENGAPPA ARAVINDA BACHU SUSHANTH BACHU PRANEETH VADDADI RAJAGOPAL KUNNATUR ANOOP SIVARAMAN
Abstract Details:
Purpose:
To evaluate the effect of pterygium extent and pterygium surgery on visual acuity, astigmatism and corneal topography.
Setting:
Study done at tertiary center- Aravind Eye Care System
Methods:
Prospective study included patients undergoing pterygium excision and conjuctival limbal autograft Preoperative and postoperative UCVA and BCVA were recorded by snellen's chart. Refraction was done by objective and subjective methods.Anterior segment examination was done by Slit lamp examination. Corneal topography by ORBSCAN.
Results:
A total of 21 patients 10 (47.6 %) males and 11(52.4 ) females were included in the study. UCVA and BCVA significantly improved. Mean refractive cylinder decreased from 0.94 to -0.04 by end of 6 months . CORNEAL TOPOGRAPHY : Mean SIMK astigmatism decreased significantly. .Preoperatively 90% of cases had with the rule astigmatism which decreased to 57.1% while against the rule astigmatism increased from 9.5% to 23.8% and 19% developed oblique astigmatism. Mean anterior power at 3mm and 5mm increased significantly while mean anterior irregularity in 3mm and 5mm zone decreased.
Conclusions:
Pterygium excision with autograft leads to significant improvement in visual acuity and decrease in astigmatism with no significant change in axis.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: RAMAKRISHNAN RENGAPPA PRAMOD PATIL ARAVINDA BACHU PRANEETH VADDADI SUSHANTH BACHU RAJAGOPAL KUNATTUR
Abstract Details:
Purpose:
With the advent of new contact lenses & increase in prevalence of their use, there has been a raise in microbial contamination of the eye. Thus there is a need to determine the source of this contamination
Setting:
study done at tertiary center - Aravind Eye Hospital
Methods:
Total of 210 cases were studied in our hospital between Jan to Dec 2008. Standard microbiological techniques were used for sample collection from conjunctiva, lens storage cases & lens care solutions & inoculated on appropriate culture media.
Results:
Altered microbiological flora was found in 100%, 18.6% & 8.6% of symptomatic, asymptomatic contact lens users & controls respectively. Gram-negative bacilli were most commonly found from symptomatic CL users (94.3%). Gram-positive cocci were more common in asymptomatic users & controls. Contamination of lens care solution was 11.4% & 4.3% among symptomatic & asymptomatic users. All storage cases of symptomatic (100%) & most of asymptomatic (89%) users showed gram negative bacilli. The most common adverse events were CLARE (48.6%), Microbial Keratitis (21.4%), Papillary conjunctivitis (15.7%) & Peripheral Ulcers (14.3%).
Conclusions:
We conclude that the pattern of microbial flora of symptomatic lens users were significantly varied from asymptomatic users. Due to improper hygiene bacterial contamination may occur in contact lens storage cases thereby contaminating contact lenses. Undoubtedly the microbial contamination of storage cases was a great risk for gram negative related ocular inflammation among lens users, especially pseudomonas species.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: Hamish McKee Arun Brahma Fiona Carley - - - - - -
Abstract Details:
Purpose:
To investigate the posterior pressure required to rupture the posterior lamella obtained during big-bubble deep anterior lamellar keratoplasty (DALK). Despite previous assumptions there is now evidence that big-bubble DALK does not routinely bare Descemet membrane.
Setting:
The University of Manchester, Manchester Academic Health Science Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester Royal Eye Hospital, Oxford Road, Manchester, United Kingdom M13 9WL
Methods:
DALK using the big-bubble technique was carried out on donor corneas mounted on an artificial anterior chamber connected to a mercury manometer. Once the anterior lamella was removed the pressure inside the chamber was increased until rupture occurred or the manometer reached its measurement limit.
Results:
A big-bubble was obtained in 12 donor corneas. The deep lamella in one cornea ruptured at 252 mmHg, the other nine had not ruptured at 300 mmHg.
Conclusions:
The posterior lamella of big-bubble DALK confers structural integrity on the globe. This may have therapeutic implications.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: Adem TURK Volkan Hürmeriē Üzeyir Erdem Gökēen Gökēe Selim Da?l? - -
Abstract Details:
Purpose:
To investigate the alterations of corneal pachymetry maps in keratoconus eyes.
Setting:
Gulhane Military Medical School, Department of Ophthalmology, Ankara, Turkey
Methods:
Forty keratoconus eyes from 20 patients and 40 normal eyes from 20 subjects were enrolled in this study. The rotating Scheimpflug camera (Pentacam Oculus, Wetzlar, Germany) was used to map the corneal thickness in keratoconus (Group 1) and normal (Group 2) eyes. Obtained data from the groups were compared statistically.
Results:
Keratoconic corneas had thinner corneal thickness and higher keratometric index than the control group. Mean values of corneal thickness at pupil center, apex, and thinnest location were 471.68±62.83 microm, 468.55±63.44 microm, 447.23±80.57 microm respectively in Group 1. These values were 543.63±28.74 microm, 545.2±28.53 microm, 540.2±28.93 microm respectively in Group 2. Statistically significant differences between the groups were found in all values (t test, p<0.05 for all)
Conclusions:
In our study, pentacam pachymetry maps properly detected the characteristic corneal thinning pattern in keratoconus group. Pachymetry maps with Pentacam were reliable in locating the apex of the cone in keratoconic corneas
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: Adem TURK Volkan HURMERIC Uzeyir ERDEM Gokcen GOKCE Selim DAGLI - -
Abstract Details:
Purpose:
To investigate the alterations of anterior chamber parameters including corneal volume (CV), anterior chamber volume (ACV), anterior chamber depth (ACD), and anterior chamber angle (ACA) in keratoconus eyes.
Setting:
Gulhane Military Medical School, Department of Ophthalmology, Ankara, Turkey
Methods:
In this study, CV, ACV, ACD, and ACA values were measured with the rotating Scheimpflug camera (Pentacam Oculus, Wetzlar, Germany) in 40 keratoconus (Group 1) and 40 normal (Group 2) eyes. Obtained data from the groups were compared statistically.
Results:
Mean values of CV, ACV, ACD, and ACA were 57.48±4.8 mm3, 197.75±49.56 mm3, 3.41±0.6 mm, 37.36±8.74° respectively in Group 1. These values were 59.94±3.32 mm3, 182.83±31.77 mm3, 3.07±0.24 mm, 36.49±4.48° respectively in Group 2. Statistically significant differences between the groups were found in CV (p=0.009) and ACD (p=0.002) values. There were no statistically significant differences in ACV (p=0.114) and ACA (p=0.579) measurements between the groups.
Conclusions:
In our study, CV and ACD values in keratoconus eyes were different from the normal eyes. However, further study is needed to assess the diagnostic usefulness of these parameters in keratoconus.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: Bar?s Sonmez Benjamin D. Sullivan Michael A. Lemp - - - - - -
Abstract Details:
Purpose:
To assess the effect of the topical cyclosporine on longitudinal variation in signs and symptoms of dry eye disease.
Setting:
19 May?s University, Departmant of Ophthalmology, Samsun/ TURKEY
Methods:
10 subjects (n=9 female, n=1 male, mean age= 44.5, in a range 27- 64) with a history of dry eye disease (DED), whose osmolarity scores were > 329 mOsm/L in one eye and > 316 mOsm/L in the other eye, were included. Without a change in topical artificial therapy, additionally, one month before the first evaluation, patients started to use topical cyclosporine twice in a day. Bilateral TearLab osmolarity, fluorescein tear film breakup time (TBUT), Schirmers test without anesthesia, corneal & conjunctival staining (NEI/Industry scale), meibomian dysfunction assessment (Bron/Foulks scoring), and symptoms (OSDI) were evaluated at 0, 30 and 60-day time points.
Results:
The average osmolarity of the first three visits was significantly reduced from 339 ± 18 to 307 ± 8 mOsms/L (p =0.000002), while OSDI was significantly reduced from 51 ± 18 to 38 ± 18 (p=0.04). None of the other signs showed a significant change in value.
Conclusions:
There is a significant decrease in tear osmolarity in DED subjects being treated with topical cyclosporine. The severity of symptoms shows a positive correlation with the osmolarity value. It can be suggested that osmolarity measurement is the best method to show the effect of topical cyclosporine in DED subjects.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: Bar?s Sonmez Benjam?n D. Sullivan Michael A. Lemp - - - - - -
Abstract Details:
Purpose:
The objective of this study was to evaluate the longitudinal variability of signs and symptoms of dry eye disease.
Setting:
19 May?s University, Departmant of Ophthalmology, Samsun/ TURKEY
Methods:
At a single site, 21 subjects (n=18 female, n=3 male, 47±13 years old) with a history of dry eye symptoms were recruited. Bilateral TearLab osmolarity, fluorescein tear film breakup time (TBUT), Schirmers test without anesthesia, corneal & conjunctival staining (NEI/Industry scale), meibomian dysfunction assessment (Bron/Foulks scoring), and symptoms (OSDI) were evaluated on three separate days, spaced roughly at 0, 30 and 90-day time points. In order to compare the day-to-day repeatability of the clinical tests coefficients of variation were calculated for each test, defined as the ratio of the standard deviation of measurements across the three visits to the dynamic range of the clinical test. The dynamic range was used rather than the average value to avoid artificially high values for low test results. The comparison to dynamic range also gives a more relevant indication of the impact of variability on the monitoring of disease severity in clinical studies.
Results:
There were no significant differences in the longitudinal variability of each of the clinical signs or symptoms. In particular, osmolarity (11.6% variation over time) was found to be no different than TBUT, Schirmers, corneal staining, OSDI (13.1%, 11.8%, 11.4%, and 10.2%, with p=0.46, 0.94, 0.89, 0.42 respectively).
Conclusions:
The longitudinal variation of signs and symptoms is equivalent within mild/moderate dry eye subjects. The best dry eye tests for clinical trials are therefore those that are objective, quantitative, rapid, simple and operator independent.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors:
Abstract Details:
Purpose:Isolated Descemet
Presentation Type: Cornea
Co Authors: Dimitra Portaliou Alexandra Karavitaki George Kymionis - - - - - -
Abstract Details:
Purpose:
To evaluate a mechanical automated technique for preparing a donor Descemet membrane (DM) carrying autologous endothelium for Descemet Membrane Endothelial Keratoplasty (DMEK).
Setting:
Institute of Vision & Optics
University of Crete
Dep. of Medicine
Methods:
Ten rabbit corneas were placed on an artificial anterior chamber and mechanical separation of the DM was conducted using an Epi-keratome (Senturium - Norwood Abbey EyeCare, Victoria, Australia). All DM specimens were properly fixated and optical microscopy was performed.
Results:
DM separation was achieved in a controlled fashion in 7 out of 10 eyes. As demonstrated by optical microscopy of the specimens, no corneal stroma was attached on the DM, while the endothelial layer was preserved in several areas.
Conclusions:
Automated separation of the DM can be achieved using an Epikeratome. Additional studies and improvements of the current technique are needed in order to draw final conclusions.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors:
Abstract Details:
Purpose:Trephination of the DSAEK graft may prove to be very challenging for surgeons especially when flap diameter is small, this can result in an eccentric trephination and the presence of epithelium on the DSAEK graft. Insertion of epithelium with the DSAEK donor graft into the anterior chamber could result in epithelial ingrowth and downgrowth, complications which may lead to poor visual outcomes, graft detachment and anterior chamber angle closure.
Setting:
Methods:
A 52 year old woman was referred to our institute for corneal edema and decreased visual acuity (especially in the morning) in both eyes. One year prior to the patient
Presentation Type: Cornea
Co Authors: Alireza Baradaran-Rafii Mohammad Zare Mohammad-Mehdi Sadoughi shahed fadaii fard javad rezaii golazani - -
Abstract Details:
Purpose:
Evaluate non invasive and simple way to treatment of ocular surface disorders with new device (amniotic membrane Ring)
Setting:
30 patients (20 male and 10 female) with different ocular surface disorders
Methods:
We applied sterile amniotic membrane Ring from 2009 to 2010 for one year in those patients with non epithelial healing cornea
15 history of mustard gas contact in war
5 Steven Jensen syndromes
6 new chemical burns
4 post penetrating keratoplasty
Results:
Epithelial healing begins 2days after Suture less amniotic membrane Ring implantation (mean time was 4 days)
We had not any complication related to ring
Conclusions:
the use of amniotic membrane Ring in ocular surface disorders is simple, safe procedure especially in patient that cannot tolerate risk of surgery
With usual surgery and anesthesia
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: - - - - - - - - - - - -
Abstract Details:
Purpose:
Pterygium represents a pathologic condition frequently seen in our Egyptian society. As different investigators have emphasized the importance of the limbus and its stem cells in the pathogenesis of the pterygium and its recurrence, I tried the use of Ipsilateral- Conjunctival Autograft Transplantation (ILCAT) for the treatment of advanced recurrent pterygium.
Setting:
* Department of Ophthalmology, Faculty of Medicine, Sues Canal University, Egypt
Methods:
Patients with recurrent pterygium who attended Ophthalmic Out-patient Clinic in Suez Canal University Hospital and had previously been treated a minimum once by simple excision (three of them with intraoperative mitomycin C) were allocated randomly for ILCAT after approval of written informed consent. The minimum follow-up period was six months.
Results:
There were no recurrences of pterygial growth beyond the limbal edge in all patients (30 patients) and there were no significant complications noted. Only, one case of graft retraction was recorded and no further surgical intervention were needed in any patient. Fourteen out of thirty patients had improved visual acuity by one and two lines on the Landolts broken rings chart.
Conclusions:
Ipsilateral limbal-conjunctival autograft transplantation is a promising technique for the treatment of patients with recurrent pterygium aiming at elimination of its recurrences without disruption of the healthy contralateral eye.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: Hande Taylan Sekeroglu ?nan Harbiyeli Meltem Yagmur Reha Ersoz - - - -
Abstract Details:
Purpose:
Purpose:
To assess corneal spherical aberations at different age, pupil size and refractive status and evaluate of impact these factors on aspherical intraocular lens selection.
Setting:
Cukurova University Faculty of Medicine, Adana, Turkey
Methods:
In this cross-sectional study, topographic measurements were taken from one eye of 103 healty subjects. Parameters were determined as age, refraction error, corneal astigmatism and corneal radius. Corneal spherical aberrations (CSA) were recorded for 3, 5 and 7 milimeters pupil size.
Results:
Mean age was 41,7 ± 8,7 (20-77) of subjects. There were significant correlations between CSA and age (p<0.05). Mean CSA were 0,01±0,02 µm (limits; -0,03 and 0,09) for pupil size 3 mm, 0,17 ± 0,1 µm (0,02-0,57) for pupil size 5 mm, 0,56 ± 0,27 µm (0,08 1,41) for pupil size 7 mm. There were no correlations between myopia or hyperopia and CSA, but significant correlation between corneal astigmatism and CSA. There was significant relationship between low corneal radius and high CSA values (p<0.05).
Conclusions:
There was wide individual variability in corneal spherical aberrations. Thus, proper correction of spherical aberrations with intraocular lenses requires attentively selection of asphericity of intraocular lens surfaces based on age, individual corneal radius and astigmatism.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: fatih ēak?r gündo?an gökēen gökēe ?enol y?ld?z hakan ay kemal ?im?ek - -
Abstract Details:
Purpose:
To describe a new treatment method with the support of Hyperbaric Oxygen Therapy (HBO) and give long term follow-up results for severely neovascularized (NV) cornea with total limbal dysfunction by alkaline burn
Setting:
Gulhane Military Faculty of Medicine Department of Ophthalmology
Methods:
In 23 eyes (20 cases),scar tissue was removed, surface was smoothed with a diamond burr, and the cornea and corneal limbus exposed to 0.02mg¬/ml Mitomycin-C (MMC) for 1 min, and the superior limbus grafted with 4x3 mm size autograft from the fellow eye (18 eyes) or allograft (5 eyes). Patients were underwent to HBO therapy ( 2.4 ATA, %100 oxygen saturation, 1 hour exposure time) for 14 days after surgery to support reepitelization. Topical steroid and cyclosporine-A drop (for allograft) was applied after reepithelization. Anatomic and histological evaluations were done.
Results:
In all eyes, corneal surface recovered in 14 days and NV regressed in 1 month, the anatomic and histological features maintained during 23.1±4.2 months of mean follow-up. Transient corneal hypotony that has been seen in 3 cases is the main but manageable complication after the surgery.
Conclusions:
MMC and HBO assisted- Limbal Minitransplantation (LMT) surgery seems to be one of the best treatment options for severe corneal burns with severe neovascularization
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: Sedat Ozmen Serdal Ēelebi - - - - - - - -
Abstract Details:
Purpose:
To report the late corneal haze formation after Keraflex (KF) treatment in a 28 years-old woman with keratoconus (KC).
Setting:
Department of Ophthalmology, Izzet Baysal Medical Faculty, Abant Izzet Baysal University, Bolu, Turkey
Methods:
Clinical case description and documentation with anterior segment photographs and corneal topography.
Results:
A 28 years-old woman with one week history of blurred vision in her right eye applied to our clinic. She has had KC for 5 years. She was contact lens intolerant and underwent combined KF and collagen cross-linking treatment in her right eye about 2,5 monts before. Until last week, she had had no complaints with relative satisfaction. On ophthalmologic examination, her best-corrected visual acuity was 20/25 OU. Slitlamp examination showed a diffuse subepitelyal, anterior stromal corneal haze with a surrounding more dense (approximately 5 mm in diameter) ring shaped haze, and Vogts stria in the right eye and minimal apical scarring in the left eye. Corneal topography showed bilateral inferocentral steepening which consistent with KC. The lens, optic nerve, and fundus examination were in normal limits in both eyes. Intraocular pressure was 13 mmHg in OD and 14 mmHg in OS. Topical fluorometholone 0.02% eye drops were prescribed four times a day. One week later, corneal haze was resolved significantly.
Conclusions:
Corneal haze can be observed after KF treatment for keratoconus. Topical steroid drops may help relieve this clinical entity.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors:
Abstract Details:
Purpose:
To present an atypical presentation of a severe case of allergic conjunctivitis in a 12 year old girl, masquerading as an orbital tumor.
Setting:
Method:A twelve year old girl with no ophthalmological history has been suffering from itchy eyes for 2 weeks. She presented with bilateral conjunctival follicles and no corneal involvement, compatible with a seasonal allergic. The symptoms resolved temporally after a week of topical administration of olopatadine hydrochloride. Three weeks later the patient returned to the department, presenting with a large salmon color tumefaction of her infero-external conjunctival cul-de sac. A large biopsy of the lesion was performed. The pathologist concluded to a non-specific inflammation of the conjunctiva compatible with allergic conjunctivitis. After a week of topical preservative free dexamethasone and 3 weeks of olopatadine, the symptoms resolved completely. Conclusion: Allergic conjunctivitis in children can masquerade as a malignancy. Nevertheless a biopsy will always be performed if there is any doubt on a malignancy.
Presentation Type: Cornea
Co Authors: Anna MATHEU FABRA Jose GRACIA MARTINEZ Miguel CASTILLA CESPEDES Jorge ARMENTIA PEREZ DE MENDIOLA - - - -
Abstract Details:
Purpose:
With conversion of extraction cataract technique from extracapsular to phacoemulsification, retained nuclear fragments in anterior chamber has turned into an additional reason of corneal decompensation.
Above all orbitary or ocular traumatism is necessary the suspicion of an intraocular foreign body, well-known caused of corneal decompensation.
Setting:
1. Hospital de la Esperanza y Hospital del Mar (Parc de Salut Mar). Universidad Autonoma de Barcelona, Spain. 2. Hospital de Sabadell (CSPT). Universidad Autonoma de Barcelona, Spain.
Methods:
We report two cases with visual acuity decrease and existence of persistent and located corneal edema.
Case 1. 97-year-old male who underwent phacoemulsification surgery in his right eye without rupture of the posterior capsule in 2002. One year after the surgery visual acuity of right eye was 20/30. Patient comes for 4 months evolution progressive decrease of visual acuity of right eye that was count fingers at 20 cm.
Case 2. 27-year-old patient male, who consulted for red eye and 1 month evolution visual acuity decrease in his right eye that was 40/200.
Results:
Case 1. Gonioscopy revealed a nuclear fragment in the low angle. Under retrobulbar anesthesia, we removed it but the delay to come to us and an endotelial corneal density of 1497 cel/mm2, only it solved part of corneal edema staying a low zone of epitelial fibrosis and Descemet central folds that provides visual acuity of 20/200.
Case 2. Gonioscopy revealed a chunk of crystal lodged in the low angle that we extracted under peribulbar anesthesia. Four days after the surgery visual acuity of right eye was 20/20 with resolution of corneal edema.
Conclusions:
Both nuclear fragments and intraocular foreign bodies can cause an inflammatory response or endotelial mechanical damage inducing a located corneal edema.
We recommend gonioscopy on all patients with persistent inflammation and/or inferior corneal edema after cataract extraction to exclude the presence of a retained anterior chamber nuclear fragment.
In patients who are diagnosed as having retained anterior chamber nuclear fragments causing persistent inflammation or corneal edema refractory to treatment with topical corticosteroids, we recommend prompt fragment surgical remove.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: Nursal Melda Yenerel Raciha Beril Kucumen - - - - - - - -
Abstract Details:
Purpose:
To report the in vivo confocal microscopic findings of acute hydrops in two patients with keratoconus.
Setting:
Yeditepe University Medical Faculty, Department of Ophthalmology, Istanbul, Turkey.
Methods:
Two male patients with decreased visual acuity, pain and redness in one eye were admitted to our ophthalmology department. The symptoms, clinical presentation, ophthalmological examination and topographical findings of the fellow eyes revealed keratoconus; therefore the conditions were diagnosed as acute hydrops. Additional evaluation by confocal microscopy (Confoscan 4, Nidek, Albignasego, Italy) was performed.
Results:
The in vivo confocal microscopy of the corneal epithelium showed a number of swollen epithelial cells at both superficial and intermediate cell layers. The swollen epithelial cells had lost their polygonal shape; they were round-oval like a balloon and larger than the standard cells. Big, dark, egg-like cysts were imaged within the epithelium. In the superficial layers, bright cell bodies were also visualized. In some scans, larger hyporeflective areas with smooth round linings were also imaged in the epithelium layer which were probably belonging to a subepithelial pseudocyst- epitheliocele. The stromal keratocytes could not be visualized clearly due to excessive hyperreflectivity of the stromal edema. As expected, the endothelium could not be assessed.
Conclusions:
The in vivo confocal microscopic findings of acute hydrops exhibit unique morphological changes at cellular level.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: Emine Ēatak Ö. Ömür Uēakhan Gündüz - - - - - - - -
Abstract Details:
Purpose:
To determine the effect of upper eyelid gold weight implantation on corneal astigmatism and topography.
Setting:
Department of Ophthalmology, Ankara University Faculty of Medicine
Methods:
Twelve eyelids of twelve patients (8 female, 4 male) who had lagophthalmos due to facial nerve palsy for various etiologies (tumor, infection, idiopathic) , and underwent upper eyelid gold weight implantation (1 gr) between June 2007- June 2010 were evaluated prospectively. The avarage time from onset of facial paralysis to upper eyelid gold weight implantation was 85.7 months (2-480). All weight implants were implanted by one surgeon. Automated refraction, keratometry and corneal topography measurements with the Scheimpflug system (Pentacam- Oculus) were performed to all patients preoperatively and postoperatively first week, 1 month, six months and 1 year after the procedure. Four patients were excluded from final analysis because of imcomplete data. The data were analyzed looking for statistically changes in lagophthalmos, automatized refraction, keratometry readings , keratometry axis, thinnest corneal thickness, corneal volume, anterior chamber depth, highest corneal elevation on the anterior and posterior corneal surface.
Results:
A statistically significant improvement in lagopthalmos was noted postoperatively (p=0.27, p=0.18, p=0.12, p=0.12). Also corneal volume significantly decreased at the end of the first year (p=0.042). No significant differences were found when comparing preoperative and postoperative keratometry readings, keratometry axis, thinnest corneal thickness, anterior chamber depth(p>0.05).
Conclusions:
Implantation of a 1 gr gold weight in the upper eyelid does not appear to cause a significant change in corneal astigmatism and topography for a longterm follow-up. Studies with greater number of patient groups and which includes different weight of the gold implant should be performed for definitive results.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: Pavel Rozsival - - - - - - - - - -
Abstract Details:
Purpose:
To evaluate the long-term clinical outcomes of AlphaCor keratoprosthesis (Kpros) implantation in 15 patients with corneal pathology judged untreatable by repeated penetrating keratoplasty.
Setting:
Department of Ophthalmology, University Hospital, Hradec Krįlové, Czech Republic
Methods:
: Mean preoperative visual acuity (VA) was hand movement. Patients typically had complex ocular histories with multiple pathologies: serious chemical burn in 7 cases (47%), penetrating injury (dilaceratio bulbi) in 2 eyes (13%), bulous corneal dystrophies in 4 cases (27%), herpes simplex viral infection (HSV) in 1 eye (7%), and ocular cicatrical pemphigoid (OCP) in 1 case (7%). The operations were performed by a standardised two stage technique.
Results:
The survival rate of the device at 1 year, 2 years, and 3 years was 87%, 58%, and 42%, respectively. Postoperative VA ranged from hand movement to 0.8. The most significant complications were stromal melt (9 cases), optic deposition (3 eyes), and retroprosthetic membrane formation (3 eyes). The most common device unrelated complication was trauma (3 patients). All complications were managed without loss of the eye.
Conclusions:
AlphaCor provides a treatment option for patients with corneal blindness where a donor tissue graft would not succeed. As with all Kpros, ongoing vigilance in follow-up is essential, and care of these patients is challenging and time-consuming.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: Michalina Gora Karol Karnowski Andrzej Kowalczyk Maciej Wojtkowski - - - -
Abstract Details:
Purpose:
Swept Source Optical Coherence Tomography (SS OCT) is a Fourier domain OCT employing wavelength tunable lasers to significantly improve imaging speed. The aim of this study is to evaluate the applicability of high-speed SS OCT for a quantitative evaluation of the cornea and to compare the SS OCT topography with current technologies.
Setting:
Department of Ophthalmology, Collegium Medicum, NCU, Bydgoszcz, Poland and Institute of Physics, Nicolaus Copernicus University, Torun, Poland
Methods:
Three patients with different corneal pathologies of keratoconus, a postinfectious scar, and 5 months post keratoplasty were enrolled. Corneal topography analysis was performed with Placido-based topographer, a rotating Scheimpflug camera, and a prototype SS OCT system constructed at the Institute of Physics, Nicolaus Copernicus University, Torun, Poland. The axial resolution of the prototype is 20 µm, imaging depth is 9 mm, and sensitivity is 105 dB. The imaging speed of 108 kHz enabled the acquisition of 3D data consisting of 500x50 A-scans in 230 ms. Topographic maps of both anterior and posterior surface of the cornea and pachymetry maps were created based on 3D data sets.
Results:
We found good agreement among all instruments in the case of keratoconus. In more complicated cases of a superficial post-infectious corneal scar and a cornea 5 months after penetrating keratoplasty, major differences were revealed. Comparison of source data showed SS OCT to have the highest reliability. Moreover, OCT technology provides cross-sectional images sufficient for evaluation of corneal structure.
Conclusions:
High-speed SS OCT is a promising technology for topographic evaluation of the cornea that has some advantages over the Placido-based and Scheimpflug systems. SS OCT can be used both for elevation-based topography and assessment of corneal structure.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors:
Abstract Details:
Purpose:to identify and consider treatment options of a serious post-operative complication of intra-corneal ring segment complication.
Setting:
Method: a 45 year old female with keratoconus underwent intraconreal ring segment implantation (upper and lower). 7 months later small deposit-like opacities that has developed early on appeared to spread and be involved with cornea melt. The cornea biopsy identified originally tuberculous mycobacterium species. The decision for segment removal and aggressive topical and systemic therapy was taken. The explantation of the segments did not seem to halt the disease spread in the cornea and a large diameter therapeutic keratoplasty took place. The histology of the removed cornea identified Candida species. The long term follow-up of 6 years confirmed resolution of the disease. Conclusion: Infectious keratitis appears to be an eminent danger with cornea implantation techniques. Most implants and inlays are associated with amorphous white material intra-corneal deposits. Extreme caution for the differential diagnosis of these lesions is necessary among clinicians.
Presentation Type: Cornea
Co Authors: Necip Kara Hasan Alt?nkaynak Ahmet Taylan Yazici Ercument Bozkurt Ahmet Demirok Omer Faruk Yilmaz
Abstract Details:
Purpose:
To compare parameters of biomechanical response of the human cornea measured as corneal hysteresis (CH) and corneal resistance factor (CRF) in patients with rheumatoid arthritis and healthy control subjects
Setting:
Beyoglu Eye Research and Training Hospital, Istanbul, Turkey
Methods:
Thirty two eyes of 16 healthy individuals (control group) and 32 eyes of 16 patients with RA (study group) were prospectively recruited. The corneal biomechanical parameters including corneal hysteresis (CH) and corneal resistance factor (CRF) were measured with the Ocular Response Analyzer. Central corneal thickness (CCT) was also measured by ultrasonic pachymetry. Findings were compared between the 2 groups (control and RA)
Results:
The mean CH was 11,4±1,5 mmHg and 11.5±2,1 mmHg and the mean CRF was 11.5±1,6 mmHg and 12.1±2,3 mmHg in the study group and control group, respectively (both P > 0.05). The mean CCT was 562.8±34.2 µm in the control group and 567.2±31.1 µm in the study group (p=0,6).
Conclusions:
The biomechanical parameters measured with ORA were not statistical difference in patients with rheumatoid arthritis and age matched healthy individuals.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: UZEYIR ERDEM SELIM DAGLI GOKCEN GOKCE - - - - - -
Abstract Details:
Purpose:
To investigate functional outcomes and effectiveness of wet field phototherapeutic keratectomy (PTK) for the treatment of superficial central stromal corneal opacities.
Setting:
Department of Ophtalmology, Gulhane Military Medical Academy, Ankara, Turkey.
Methods:
28 eyes of 14 patients with central superficial stromal plaque-like opacities treated with 193 nm excimer laser PTK between October 2004 and June 2009 were included. Opacities were caused by macular corneal dystrophy in 24 eyes and crystalline corneal dystrophy in 4 eyes. After epithelial debridement with 20% isopropyl alcohol ; PTK was performed with the 193 nm excimer laser under 0.5% topical proparacaine HCL anesthesia. We applied balanced salt solution (BSS) irrigation to the corneal surface to fill the valleys of prominent superficial corneal lesions and Wet PTK was performed with laser ablation of protruded stromal opacities and irregularities. Pre-set laser ablation depth was 100 µm; ablation zone was 7 to 9 mm. Actual ablated stromal depth was 65 µm±10 µm. Main outcome measures included uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA).
Results:
Mean age of the patients was 29.14 (18-68 years). Mean follow up was 2.7 ±2. 1 (0.5-4.8) years. UCVA increased from 0.25±0.14 before the operation to 0.5±0.16 after the operation. BCVA increased from 0.45±0.14 before the operation to 0.7±0.19 after the operation. During follow-up, recurrences occurred in four eyes with crystalline corneal dystrophy and re-PTK was performed. No clinically significiant recurrence was confirmed in macular dystrophies.
Conclusions:
In superficial stromal opacities PTK is effective in removing large subepithelial stromal plaques and can increase visual acuity. There were no subepithelial recurrences in macular corneal dystrophy cases yet. Wet PTK is found to be effective for macular dystropy, if the patients have dominantly central and superficial lesions. More patient series and longer follow up times are needed for more definite results.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: Harilaos Ginis Alexandros Pennos Nikolaos Karyotakis Iro Pentari George Kymionis Ioannis Pallikaris
Abstract Details:
Purpose:
To evaluate in-vitro the immediate effect of corneal collagen cross-linking (CXL) on corneal hydration.
Setting:
University of Crete, Heraklion, Greece
Methods:
Forty four corneal buttons from freshly enucleated porcine eyes where immersed in riboflavin 0.1% in dextran 20% dilution for three hours in order for their hydration to reach an equilibrium. Corneal buttons where divided in two groups; the first group was stored in dark conditions while the other group was irradiated with UV radiation (390nm) for 30 minutes to simulate CXL according to the clinically applied protocol. After irradiation all corneas were immersed in dextran 20% solution for one additional hour. Subsequently, each button underwent weighting and thickness measurement. Finally all corneal buttons were dehydrated for 48 hours in a desiccating oven set at 62Co and weighted again to obtain their dry mass. Hydration (%) of each button was calculated.
Results:
Mean corneal hydration in the irradiated and the non-irradiated group of corneas was 70% and 73% respectively (p=0.02, Students t-test). Thickness of buttons in the irradiated group was lower in the non-irradiated, but differences were not statistically significant.
Conclusions:
CXL causes corneal dehydration and thinning that can be detected immediately after the procedure. This phenomenon may contribute to increased mechanical stiffness of the cornea.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: Kata Mihįltz Jįnos Németh Zoltįn Nagy - - - - - -
Abstract Details:
Purpose:
To evaluate ocular wavefront aberrations due to keratoconus and sub-clinical keratoconus compared to normal controls and to describe the changes of wavefront parameters characteristic of the disease.
Setting:
Department of Ophthalmology, Semmelweis University, Budapest, Hungary.
Methods:
We studied 43 eyes with keratoconus, 33 with sub-clinical keratoconus and 112 eyes of refractive surgery candidates with normal corneas. Ocular aberrations over a 4.5 mm (undilatated) pupil were measured with a Hartmann-Shack sensor. Defocus, higher-order root mean square (HORMS) values and ocular aberrations up to the sixth Zernike order were measured. Predictors were evaluated by generalized estimating equation (GEE) and logistic regression analysis. The goodness of fit of the different models were then compared. Receiver operating characteristic (ROC) curves were used to analyze the most sensitive parameters and to identify cutoff values.
Results:
According to multivariable ordinal GEE model oblique astigmatism and vertical coma were significant predictors to discriminate between sub-clinical keratoconus, keratoconus and normal corneas. Multivariable regression analysis indicated that vertical and horizontal coma increase the predictive accuracy of Inferior-Superior (I-S) value in the diagnosis of sub-clinical keratoconus. ROC curve analysis for horizontal coma showed an acceptable accuracy (AUROC: 0.78) for those sub-clinical cases where diagnosis by vertical coma was uncertain.
Conclusions:
Analyzing aberrometric parameters further increases the precision of diagnosing keratoconus. Sub-clinical keratoconus cases can be characterized by increased vertical and horizontal coma values, while keratoconus by a negative shift of both astigmatic and coma like aberrations.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: - - - - - - - - - - - -
Abstract Details:
Purpose:
To eliminate postoperative clinical unwanted effects regarding sphere and cylinder of the ensuing refraction. Knowing the need to avoid any tilt of the trephine during trephination we analysed the significance of the difference of the radii of donor and recipient.
Setting:
Clinic Dr. Krumeich Bochum Germany
Methods:
The arc length of the radii of donor and recipient are evaluated in a mathematical model. Both radii resume different diameters on their return to their original shape after they have been cut in an applanated state (Intralase, Femtosecond) to the seemingly same diameter. Mechanical trephines have different size openings and beak like shaped undercuts and undergo a similar problem. Fitting the donor button to the recipient opening leads to unisometropias. A prediction of kerato-refractive outcome is mathematically evaluated. Compensation for the arc-length difference is effectuated on the donor button by cutting wider diameters for steeper corneas and vice versa.
Results:
Clinical examples of high unpredicted ametropias match the mathematically outcome Differences of every 0.1 mm in arc length may cause 2 D of cylinder.
Results:
Clinical examples of high unpredicted ametropias match the mathematically outcome Differences of every 0.1 mm in arc length may cause 2 D of cylinder.
Conclusions:
The corneal radii of donor and recipient must be measured prior to PKP. To achieve identical dimensions of donor button and recipient bed is possible if the arc length difference is calculated and the trephination is carried out accordingly. This consideration may help to diminish undesired refractive results in PKP and DALK.
Financial Disclosure:
-.-
Presentation Type: Cornea
Co Authors:
Abstract Details:
Purpose:
Use of the ISCR should be made known and defined better. Advantage and limits should become clear by demonstration of clinical cases.
Setting:
Method: A 58 y old female lost her right eye by a shot. The left eye (LE) was severely injured by a dog bite in a robbery attack. Cornea and lens of the right eye were torn apart. Emergency suturing of the cornea resulted in multiple scars. BCVA was HM with +12.0 D, tension was 5 to 10 mm Hg. US showed no gross retinal pathology. Patient asked for corneal transplant. ISCR was suggested to increase stability of postoperative situation. An 8 mm
Presentation Type: Cornea
Co Authors: Nursal Melda Yenerel Ebru Gorgun - - - - - - - -
Abstract Details:
Purpose:
To evaluate eyes with full-thickness corneal grafts by anterior segment optical coherence tomography (AS-OCT).
Setting:
Yeditepe University Medical Faculty, Department of Ophthalmology, Istanbul, Turkey.
Methods:
Seventy eyes of 58 patients who had penetrating keratoplasty (PKP) for advanced keratoconus, pseudophakic bullous keratopathy, corneal scars and corneal dystrophy were included in the study. High resolution AS-OCT scans of the cornea and anterior segment were performed before and after transplantation in 17 eyes with the Visante anterior segment OCT system (Visante OCT; Carl Zeiss Meditec, Inc, Dublin, California, USA). Fifty-three eyes were examined in the late postoperative period.
Results:
The mean follow-up period was 4.3 years (range 1-15 years). The graft-host relations were assessed and six types of graft-host junctions were identified. Three patients with graft rejection, 4 patients with anterior synechia and 3 patients with corneal ulcer were evaluated. The preoperative evaluation of eyes with semiopaque and totally opaque corneas revealed important information about anterior segment structures additional to slit-lamp findings.
Conclusions:
AS-OCT images provided important information on graft-host junctions, graft rejection, anterior synechia and graft ulceration after PKP as well as distinguishing the features of the diseased cornea in the preoperative evaluation. It is a useful investigative tool both for the evaluation of penetrating corneal transplantation surgery and in the management of its postoperative complications.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: Nursal Melda Yenerel Ebru Gorgun Ferda Ciftci - - - - - -
Abstract Details:
Purpose:
To present the confocal microscopic features of corneas that have undergone femtosecond laser assisted intrastromal corneal ring segment (ICRS) implantation.
Setting:
Yeditepe University Medical Faculty, Department of Ophthalmology, Istanbul, Turkey.
Methods:
Ten eyes of 7 keratoconic patients (5 female, 2 male) were included in the study. All patients had uneventful femtosecond laser (IntraLase Corp, Irvine, California) assisted ICRS (Keraring, Mediphacos, Belo Horizonte, Brazil) implantation by the same surgeon (RBK). The confocal microscopy (Confoscan 4, Nidek, Albignasego, Italy) was performed in the late postoperative period (1-3 years).
Results:
The confocal microscopy performed over the ring segment showed hyperreflective band-shaped area corresponding to the ICRS. The edge of the tunnel which lied adjacent to this area was acellular with medium reflectivity. The anterior stroma next to the tunnel was rich with keratocytes. Deeper corneal layers underneath the ring area could not be visualized due to high reflectancy. The confocal microscopy from the central cornea revealed prominent and thicker corneal nerves, Vogts striae in some patients and normal stroma and endothelial morphology.
Conclusions:
In vivo confocal microscopy shows cellular changes around the implanted ring segments. This imaging technique may give additional information in the long-term follow-up of patients with implanted ICRS.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: üzeyir erdem - - - - - - - - - -
Abstract Details:
Purpose:
Autokeratoplasty is very helpful surgical procedure with some theorical advantages. The possibility of graft rejection is almost zero. The need of steroid usage is limited and the procedure has less potential complications comparing with conventional penetrating keratoplasty.
We had planned this study to determine the value of penetrating ipsilateral rotational autokeratoplasty for the treatment of severe central corneal scars after corneal trauma and laceration
Setting:
none
Methods:
In this prospective study, corneal pictures and OPD Scan measurement used for surgical planning in 17 eyes of 17 patients. All corneas had ipsilateral rotational eccentric autokeratoplasty and the patients corneal opacity had taken away from central cornea and from the visual axis and replaced by clear peripheral cornea at Gulhane Military Medical Hospital Eye Clinic over 5 years period
Results:
There were no significant postoperative complications were encountered. The mean follow-up time was 16.56 months (SD_ 7.53 months). One patient had failed graft (5.4%). The mean astigmatism at final correction was 2.53 diopters in cylinder (SD_3.26). Final visual acuity of 5/10 or better in 11 eyes (65%).
Conclusions:
Rotational autokeratoplasty must be considered as a primary choice if there is a cantral cornal scar with enough clear peripheral cornea. The aid of corneal picture, pupillometric measuremens and topographic evaluation were also very helpful for surgical planning and to determine the placement of trephine incission for better visual outcome
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors:
Abstract Details:
Purpose:To report a patient with severe post
Presentation Type: Cornea
Co Authors: BS Oum - - - - - - - - - -
Abstract Details:
Purpose:
This study was to evaluate the toxic effect of topical cyclosporine on cultured human corneal epithelium, and to investigate the apoptotic response and the cellular morphologic changes associated with cyclosporine in vitro.
Setting:
Department of Ophthalmology, Medical Research Institute, Pusan National University Hospital.
Methods:
Human corneal epithelial cells were exposed to concentration of cyclosporine A 0.05% for period of 3, 5, and 10 minutes. MTT(3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide) based colorimetric assay was performed to assess the metabolic activity of cellular proliferation and lactate dehydrogenase (LDH) leakage assay for cytotoxicity. Apoptotic response was evaluated with flow cytometric analysis and fluorescence staining with Annexin V and propiodium iodide. Cellular morphology was evaluated by inverted phase-contrast light microscopy and electron microscopy.
Results:
The inhibitory effect of human corneal epithelial proliferation and cytotoxicity showed the time-dependent response and significant effect when exposed for 10 minutes (P<0.05). The maximun response did not reach the leathal dose (LD)50. Apoptosis developed in flow cytometry and apoptotic cells were demonstrated in fluorescent micrograph after treating with cyclosporine 0.05%. Human corneal epithelial cells were more detached from the bottom of the dish and damaged cells have degenerative changes like microvilli disappearance, vacuoles formation and chromatin of the nuclear remnant condensed along the nuclear periphery.
Conclusions:
Cyclosporine 0.05% could be used without any significant toxic effect on human corneal epithelial cells. Induction of modulation of apoptosis may be one of the mechanism of cyclosporine in inhibiting cellular proliferation.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: Patrizia Tschuor Ivo Guber Philippe Othenin-Girard Francis Munier - - - -
Abstract Details:
Purpose:
To describe the efficacy and efficiency of automated lamellar graft i.e. ALTK (Anterior Lamellar Therapeutic Keratoplasty) in children.
Setting:
Twelve eyes (3 rights, 9 left eyes) of twelve children (6 girls and 6 boys), with mean age of 6.78 years (range from 0.3 to 16 years) were operated between March 2003 and May 2010.
Methods:
The lamellar grafts were all performed at the Jules-Gonin University Eye Hospital of Lausanne. Indications were: trisomy 8 (n=2), herpes (n=2), Goldenhars syndrome (n=1), atopy (n=2), rosacea (n=2), bacterial abscess (n=1) and unknown etiology (n=2).
Results:
The mean follow-up time was 38.5 months (range from 4 to 90 months). Mean preoperative BUCVA was 0.17 (20/125). Mean postoperative BCVA was 0.44 (20/50). Eyes with a visual acuity more than 0.33 (58%). Complications : epithelial ingrowth (n=1), hypermetropia (n=5), postoperative astigmatism or ametropia more then 3D (n=5). Dislocation of the lamellae (n=1).
Conclusions:
Our data show that ALTK in children in appropriate cases is an effective technique for restoring the visual function when combined with an adequate therapy of amblyopia and an intensive follow-up.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors:
Abstract Details:
Purpose:
Spontaeous suprachoroidal haemorrhage has been described exceptionally, sometimes associated with a predisposing ocular or systemic scenario, such as thrombolysis. Systemic thrombolysis may predispose choroidal haemorrhage. We present a case of suprachoroidal haemorrhage during thrombolysis secondary to previous keratolpasty for a traumatic ocular perforation, this situation had not been previosuly described.
Setting:
Methods:
A 56-year-old man, had suffered from an acute myocardial infarction, treated with thrombolytic drug, presented to the ophthalmology department with onset of discomfort and decreased brightness of vision in the left eye. He had been treated with keratolpasty for an ocular perforation secondary to trauma 20 years before, and his visual acuity had been limited to hand movement since then. We observed a massive choroidal detachmanent associated with an orange-brown coloured haemorrhage, of apparent choroidal origin B-scan ultrasonography showed suprachoroidal haemorrhage. Conclusion:The patient had suffered an ocular contusion 20 years before. Although there were no references to previous bleeding or chorioretinal involvement, a significant trauma or a keratoplasty itself seems reasonable as a possible risk factor. Systemic thrombolysis may predispose to haemorrhagic complications: hyphema and subconjunctival, suprachoroidal, vitreous, subretinal, and orbital haemorrhages. Ophthalmologists should be especially aware of choroidal haemorrhage.
Presentation Type: Cornea
Co Authors: Luciane Irion Fiona Carley Arun Brahma - - - - - -
Abstract Details:
Purpose:
To investigate the level of the dissection plane in big-bubble deep anterior lamellar keratoplasty (DALK).
Setting:
The University of Manchester, Manchester Academic Health Science Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester Royal Eye Hospital, Manchester, United Kingdom
Methods:
DALK using the big-bubble technique was carried out on donor corneoscleral discs mounted on an artificial anterior chamber. Intraoperative findings were noted. Samples were sent for histological evaluation to determine the presence of any residual stroma on Descemet membrane (DM).
Results:
Big-bubble formation was achieved in 32 donor corneas. Two distinct types of intraoperative findings were seen, the big-bubble had either a white margin (30 corneas), or a clear margin (2 corneas). The posterior lamellae of all 30 white-margin big-bubble corneas showed residual stroma overlying DM. The 2 clear-margin big-bubble corneas showed no residual stroma over DM.
Conclusions:
Intraoperative findings predict the dissection plane in big-bubble DALK. A white- margin big-bubble signifies stromal dissection, whilst the less common clear-margin big-bubble signifies baring of DM.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: Milenko Stojkovic Dijana Risimic Vesna Jaksic - - - - - -
Abstract Details:
Purpose:
To determine whether EOM surgical procedures, performed due to comitant strabismus, has impact on global corneal topography, changes in anterior and posterior corneal surface, in Sim-K value, non corrected visual acuity, refraction and results of visual scale comparing to preoperative results
Setting:
University Eye Clinic in Belgrade,Serbia during 2008 up to 2010
Methods:
Prospective study included 59 eyes of 37 operated patients on 80 EOM. Four groups were analyzed: recession, dessinsertion, combined recess-resect and recession with dessinsertion. Corneal topography was measured in 19 positions, before and after operation. We measured and registered: Sim-K, corneal irregularity, non corrected visual acuity, visual verbal scale and cicloplegic refraction.
Results:
All types of surgical procedures demonstrated significant changes in postoperative corneal topography on anterior, posterior and total corneal surface. The most significant influence on corenal topography has surgical procedure of recession. Depending on type of surgical procedures of certain EOM the most significant changes were noticed postoperative in the group with recession MRI. Sim-K value and irregularity of cornea have been significantly changed in all postoperative groups. Non corrected visual acuity, visual scale and cicloplegic refraction did not show postoperative change in any group
Conclusions:
Significant topographic changes in the corneal flattening at the horizontal corneal meridian and flattening at the center on the map of total curvature were noticed in the group recession horizontal EOM, particularly this change combined with flattening of the nearest oblique meridian, clock wise, was noticed in the group recession MRI.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors:
Abstract Details:
Purpose:
Nowadays the optimum size of a transplant considers
Presentation Type: Cornea
Co Authors: Arsen Ak?nc? - - - - - - - - - -
Abstract Details:
Purpose:
To evaluate the parameters obtained by the Pentacam rotating Scheimpflug camera that are important in distinguishing keratoconic from normal eyes.
Setting:
Ankara University School of Medicine
Methods:
36 eyes of 36 patients (25 men, 11 women) with keratoconus suspect in one eye (topographically) and keratoconus in fellow eye and 72 eyes of 36 age-matched controls (16 men, 20 women) were included in the study. Control eyes were selected from normal subjects who presented for keratorefractive surgery. All eyes underwent measurement with the Pentacam rotating Scheimpflug imaging system to evaluate the anterior and posterior corneal elevation, topography, and corneal higher-order aberrations from the anterior and posterior corneal surfaces.
Results:
The mean posterior elevation was not statistically higher in keratoconus suspect eyes (15.2 ± 16.3 µm) compared to normal corneas (11.8 ± 6.12 µm) (p>0.05) with common inferolateral posterior elevation in both groups. Excluding the inferolateral posterior elevation, with cut-off value of 17 µm, the sensitivity in distinguishing keratoconus suspects from normal was 83% with a specificity of 74%. Although the mean values were higher in keratoconus suspects, the anterior surface-based corneal variance indices (ISV, Abr, IVA, KI, IHD, CKI, IVA), and the anterior and posterior corneal higher order aberrations were not significantly different between keratoconus suspects and controls.
Conclusions:
Although posterior corneal elevation, excluding inferolateral posterior elevation, seems to be helpful, different parameters with rotating Scheimpflug imaging should be used to distinguish normal from keratoconus suspects.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: - - - - - - - - - - - -
Abstract Details:
Purpose:
Purpose:
To evaluate an intracuring method by changing the corneal curvature.
Setting:
Istanbul Surgery Hospital, Istanbul, Turkey
Methods:
An intrastromal tunnel was created by femtosecond laser in 5 cadaveric sheep eyes. Dental Flowable Restorative composite was used to fill the tunnel. A lightemitting diode (LED) light was applied for polymerization for 20 seconds. Flat plastic material was used for pressure on the cornea during polymerization. Keratometric measurements were obtained in all eyes using a rotating Scheimpflug camera (Pentacam; Oculus Inc., Wetzlar,Germany)
Results:
Remarkable changes on the cornea curvature were observed after the intracuring method. Inferior or inferior-nasal flattening and opposite steepening was observed in all the sheeps eyes. The average flattening effect of this method was 10,6 D.
Conclusions:
This new application may be a promising technique for the treatment of keratoconus. The application of this technique in humans could offer improved treatment options in the future.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: Ahmet A?aēhan Ulviye Yi?it Betül Tu?cu ?smail Umut Onur Yalē?n ??can - -
Abstract Details:
Purpose:
To evaluate a patient presenting with recurrent herpetic stromal keratitis and dependent to systemic acyclovir therapy.
Setting:
Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Ophthalmology Department, Istanbul.
Methods:
Case report of a patient with recurrent herpetic stromal keratitis and dependent to systemic acyclovir therapy.
Results:
In September 2003 a 30 year old male patient came to our clinic with a diagnosis of herpetic stromal keratitis. He was being followed up for 2 years in a different clinic and at the time he was taking 3200 mg acyclovir a day. But he had given up his examinations a year ago. Therefore we took the patient into observation. We tried to decrease the acyclovir dosage during control examinations. Below the level of a total dose of 800 mg /day we observed recurrences. We used to treat attacks 1600-4000 mg/day acyclovir and topical steroid drops. The patient has taken, for one year, 800 mg/day acyclovir, topical rimeksolon twice a day and lubricant eye drops and we did not observe any attacks during this treatment. The patients hepatic function tests and blood tests are still in normal limites.
Conclusions:
It is important to take into consideration that recurrences in herpetic eye disease can be related to the systemic use of acyclovir and a maintenance therapy of a threshold dose of acyclovir assessed in terms of each patient should be necessary to control disese activity. In our case the threshold dose of acyclovir that prevented the disease recurrence was 800 mg /day. Our patient has now reached his sixt year under maintenance therapy and stil had no recurrences.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: stefano baiocchi cosimo mazzotta aldo caporossi - - - - - -
Abstract Details:
Purpose:
To evaluate the clinical effects of transepithelial corneal cross-linking(CXL) and to compare the clinical results whit histopatological findings.
Setting:
Perspective non randomized study.
Methods:
Prospective not randomized study on 10 eyes of 10 patients candidates to corneal transplantation (PK or DALK) were treated with transepithelial croo-linking iusing Ricrilin TE 1 to 4 months before substitutive surgery.
The patients was evaluated clinically and instrumentally (OCT and HRT II confocal microscopy) before and 1months, 2 months and 3 months after CXL.
The removed cornea was fixed in Karnowsky solution and analyzing with optical and electronic transmission microscopy.
Results:
The optical analysis conduced with immunostaining for collagen (C3-C17) and with Hematossilin-Eosin staining shows a compacting collagen layer with positive staining for CD34 in anterior 30-50 micron. Some results were obteined in TEM samples.
Conclusions:
The comparative analysis confirm that the transepithelial CXL produce a collagen crosslinking and apoptotic effect in the anterior layer of the cornea with inhomogeneus thicknessand dont induce any collagen keratocites modification deeper than100 micron of corneal stroma (epithelium included).
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: Kalliopi Diamantopoulou Bettina Neureither Spyros Georgaras - - - - - -
Abstract Details:
Purpose:
To evaluate the effectiveness of these growth factors when used in various corneal and ocular surface disorders refractory to other conventional treatment modalities.
Setting:
1. Ophthalmos eye institute Athens
2. Theracell Clinical Biology Center Athens
3.Instituto di Neurobiologia e Medicina Molecolare, Rome, Italy.
Methods:
Case series of 32 eyes (20 patients) treated in OPHTHALMOS Institute. A) 26 eyes received plasma rich growth factors prepared from autologous blood sample. Of them, 6 eyes had severe dry eye disease, 6 drug related corneal toxicity (allergic reaction to antiglaucoma treatment), 6 recurrent corneal erosions / corneal ulcers, 6 neurotrophic keratitis and 2 bullous keratopathy. B) Neurotrophic growth factors were administered in the form of drops in 6 eyes; 2 with bullous keratopathy and 4 with neurotrophic keratopathy. All drops were used 3 to 4 times a day for a minimum of one month, patients continued with their previous topical medication. Objective improvements of ocular signs as well as subjective improvement of patients symptoms were assessed at the end of treatment.
Results:
Topical treatment was well tolerated by the patients. We observed objective improvement in all patients but one (bullosa eye). There were no adverse effects during the treatment period .
Conclusions:
Plasma rich growth factors and neurotrophic growth factors appear to be a promising evolving field in the treatment of specific ocular surface diseases, giving impressive results in this study.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: Beata Soldanska Mateusz Burduk Bartlomiej Kaluzny Jozef Kaluzny - - - -
Abstract Details:
Purpose:
The aim of the study was to evaluate agreement, repeatability and reproducibility of measurements of central and minimal corneal thickness (CCT an MCT) obtained by means of spectral optical coherent tomography (SOCT), Scheimpflug system and ultrasound pachymetry by three operators
Setting:
Department of Ophthalmology, Collegium Medicum Nicolaus Copernicus University, Bydgoszcz, Poland
Methods:
A total number of 28 eyes of 14 healthy patients were enrolled. Each fivefold measurement was taken by 3 operators on 3 devices (RTVue 100 FD, Optovue; Pentacam HR, Oculus; Pachette 3, DGH) with 10 minute intervals giving a total number of 2100 measurements. A subsequent statistical analysis was conducted using Statistica 6.0 software
Results:
Mean CCT obtained with RTvue 100 FD was 537.92 (±50.21) ?m, Pentacam HR 545.94 (±47.11) ?m and Pachette 555.74 (±49.09) ?m, p<0.000001. Mean MCT obtained by RTVue 100 FD was 528.32 ±49.92 ?m and by Pentacam 544.37 ±47.42 ?m, p<0.000002. The mean coefficient of repeatability was 0.61, 0.82 and 0.80 for CCT and 0.41 and 0.81 for MCT, respectively, p<0.0003. The coefficient of interoperator reproducibility was 0.91, 1.11 i 1.25 for CCT and 0.91 and 1.27 for MCT, respectively, p<0.0003
Conclusions:
CCT and MCT measurements show moderate agreement between instruments. Thus different technologies cannot be used interchangeably without using correcting coefficients. The repeatability of the results obtained by RTVue 100 FD is to some extent higher than that of other systems. The operators impact on CCT and MCT measurements is insignificant in all devices
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: Nerea Sįenz Madrazo Beatriz Sarmiento Torres Marķa Jesśs Alonso Porres - - - - - -
Abstract Details:
Purpose:
To evaluate the efficacy of the use of Oculusgen® in pterygium surgery.
Setting:
Ophthalmology Department. Universitary Hospital 12 de Octubre, Madrid (Spain).
Methods:
A non-randomized longitudinal prospective study was carried out from October 2008 until July 2010. It included 86 eyes from 85 different patients. The surgical technique used was in all cases simple excision with biodegradable collagen matrix subconjunctival implant. Subsequently, the recurrence rate was evaluated. The average follow-up period was 3.9 months.
Results:
From the total 85 patients, 52 were men (61%) and 33 were women (39%). The average age was 44,3 years (19-83). 62 patients had South American origin (72,9%).
The location of the lesion was nasal in 82 eyes (95%) and temporal in the 4 remaining cases (5%). 54 cases were primary (67%) and 28 were recurrent (33%). 36 patients presented pterygium in both eyes (43%).
The global recurrence rate was 29%.
None of the patients presented intraoperative complications. One of them developed a pyogenic granuloma and another one a Dellen during the follow-up.
Conclusions:
Our data shows a slightly higher rate of recurrence than expected, specially in comparison to the results in published data for conjunctival autografts. This is probably due to the high number of recurrent cases included in our population, and a major number of young South American patients whom have a particular predisposition to recurrence.
In our experience, the principal advantages of the use of subconjunctival Oculusgen® after pterygium resection are the decreased operative time in comparison with other procedures and the lack of intraoperative complications.
Nevertheless, it would be necessary to perform more studies to evaluate the efficacy of this material.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: Vijay Savant Jeremy Prydal - - - - - - - -
Abstract Details:
Purpose:
: To study the slippage of 3 different types of knots used in penetrating Keratoplasty (PK) using the 10-0 nylon suture.
Setting:
Department of Ophthalmology,
University Hospitals of Leicester NHS Trust,
Leicester,
United Kingdom
Methods:
10-0 Ethilon black monofilament suture was used for the study, as it is commonly used for PK procedures in our centre. The three different knots under study were 3/1/1; 1/1/1(slipknot); 1/1/1/1(modified slipknot). Two single ended sutures were used simultaneously. One end was attached to the fixed end of a stand and the other was attached to a weight(10g and 20g) and passed through a pulley system on the opposite side. The knot under study was then tied using the loose ends of the sutures. The slippage was measured using a Nikon-E50i binocular bright-field microscope with an eyepiece graticule. Readings were taken at 5 and 24 hours. Knot size and morphology was noted.
Results:
The 3/1/1knot slipped the least. 1/1/1/1 was next, although its rate of slippage was found to be more at 5 hours with 20g weight in comparison with 1/1/1knot, which slipped the most of the three knots. The 3/1/1knot was noted to be largest of the three. The 1/1/1/1knot was found to be only slightly larger than 1/1/1.
Statistical analysis was done using Paired t test comparing 1/1/1 vs 3/1/1, 1/1/1/1 vs 1/1/1 and 1/1/1/1 vs 3/1/1. Statistically insignificant results (p>0.05) were found on comparison of 1/1/1 vs 3/1/1(p=0.09) at 5hours and 1/1/1 vs 1/1/1/1(p=1) using 20g weight. With 10g weight p values were insignificant on comparison of 1/1/1 vs 1/1/1/1(p=0.1) at 5 hours and 24 hours.
The knot size was measured in vertical (v) and horizontal (h) axis to the suture line (Paired T test- for 1/1/1 vs 3/1/1 p value was 0.03, for 1/1/1 vs 1/1/1/1, p value was 0.3 and for 3/1/1 vs 1/1/1/1, p value was 0.03).
Conclusions:
3/1/1knot slipped the least but was the biggest in dimension, whereas 1/1/1/1(modified slip knot) slipped less as compared to 1/1/1 and was almost the same size as the latter. The 1/1/1/1knot may be a better knot type for penetrating keratoplasty with benefits of minimum slippage and a smaller knot size making it easy to bury.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: Daniela Mitova prof Tocho Mitov - - - - - - - -
Abstract Details:
Purpose:
: to present a patient who simultaneously performed PRK bitoric CAP method VISX and C3R .
Setting:
: Saint Petka eye clinic ; Varna ; Bulgaria
Laserex eye center ; Plovdiv ; Bulgaria
Methods:
: PRK bitoric CAP method VISX - one treatment is in hyperopic cylinder form, and the other treatment is in myopic cylinder form. The steepest meridian is flattened with a cylindrical myopic ablation, and the flattest meridian is steepened with a paracentral hyperopic ablation and immediately after this Corneal Collagen Crosslinking with Riboflavin (C3R ) .
Results:
two months after treatment : astigmatism , coma , total aberration ( RMS ) , curv. irreg. SD , SAI , SI significantly decreased and visual acuity was significantly improved
Conclusions:
PRK bitoric CAP method VISX and C3R simultaneously has the following advantages : less tissue removal for the same refractive defect ( ablation is only toric ) , not consuming tissue in the center while working on the weak meridian ( paracentral hyperopic ablation ) , significantly reduces astigmatism and coma , no removal of crosslinked tissue , improve the biomechanical properties of cornea , flattens cone apex and positioned it more centrally
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: Okan Toygar Aysel Pelit Yonca Akova - - - - - -
Abstract Details:
Purpose:
To compare corneal thickness in patients with diabetes mellitus and age and gender-matched normal subjects, and to determine a possible relationship with the severity of the disease.
Setting:
Baskent University, School of Medicine, Department of Ophthalmology
Methods:
Type II diabetes mellitus patients without retinopathy, with non-proliferative and proliferative retinopathy were organized as the study group, and an age-matched control group was formed. All subjects underwent full ophthalmological examination, and corneal thickness measurement with ultrasonographic pachymetry. Corneal thickness values were compared between groups; correlation of corneal thickness and intraocular pressure was performed.
Results:
The average central corneal thickness was significantly higher in diabetic patients than in the control group (p=0.041). Severity of the disease caused no significance in corneal thickness (p=0.640). Average intraocular pressure values did not significantly differ between groups (p=0.110). In the whole study population, corneal thickness was significantly correlated with intraocular pressure (p<0.01).
Conclusions:
Increased corneal thickness is significantly affected by diabetes mellitus. Further studies would be beneficial in detecting and analyzing the relationship.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: Stefan Schulze Helmut Fath - - - - - - - -
Abstract Details:
Purpose:
A transconjunctival suturing technique of the scleral flap in cases of over filtration after trabeculectomy was recently published by Eha and Pfeiffer. Despite its simplicity this technique has a few drawbacks, in particular the difficulty to identify the border of the scleral flap.
Setting:
Department of Ophthalmology, Philipps University of Marburg, Germany
Methods:
We developed a new surgical applanator to better visualize the scleral flap edge and the old scleral sutures intra-operatively
Results:
The use of this new instrument will be presented using video material
Conclusions:
This new applanator simplifies the technique of transconjunctival scleral flap suturing in cases of post-trabeculectomy hypotony
Financial Disclosure:
Yes.... is employed by a for-profit company with an interest in the subject of the presentation
Presentation Type: Cornea
Co Authors: Miniri Asani Valbon Ajazaj Ermal Dida Mentor Ilazi - - - -
Abstract Details:
Purpose:
To report the efficacy of subconjunctival bevacizumab injection in patients with corneal neovascularisation, and intracameral injection in patients with rubeosis.
Setting:
German Eye Clinic, Pristina, Kosova
Methods:
In this study were included three eyes of three different patients with corneal neovascularisation, One eye had neovascularisation because of herpetic keratitis and the other two eyes of two different patients with neovascular leucoma. In this study we have also included three eyes with rubeosis from patients suffering from neovascular glaucoma at which 0.1ml subconjunctival was applied, and in the cases with a iris neovascularisation 0.04ml bevacizumab was applied. Morphologic changes were investigated by slit-lamp biomicroscopy and anterior segment photography.
Results:
Corneal and iris neovascularisation regressed dramatically a week after the injection in all of the cases. In one case, iris NV reappeared after 4 months, therefore in this case for the second time intracameral injection of bevacizumab was applied. In the other cases no relapse was seen within the follow-up of four to six months. No infection, no bleeding and no inflammation were observed.
Conclusions:
Subconjunctival and intracameral injection of bevacizumab may offer an additional treatment for corneal neovascularization and rubeosis.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: Mohammad-Reza Fazel Seyed Ahmad Jenaban Vahideh Hadid - - - - - -
Abstract Details:
Purpose:
To evaluate the combination of supratarsal injection of dexamethasone and cromolyn in compare with cromolyn alone to determine its efficacy in treating moderate to sever vernal keratoconjunctivitis
Setting:
Department of ophthalmology , Matini Hospital ,Kashan university of Medical Sciences, Kashan, Iran.
Methods:
Prospective randomized study was done including 126 eyes of 63 patients( 44 male= 70%) with bilateral limbal and palpebral vernal keratoconjunctivitis between 2003 to 2009 in kashan university of medical sciences IRAN. Thirty three cases in cromolyn group and 30 cases in dexamethasone+ cromolyn group. Both eyes of each patient received topical cromolyn sodium 4% ophthalmic solution 4 times daily for 2-3 weeks in first group and combination of cromolin sodium 4% and single dose dexamethasone phosphat ( 2 mg) in another group.
Results:
Patients rang was 7-20 years old. In patients that treated with cromolyn sodium 4% alone relief of symptoms( photophobia ,red eye, limbal edema ) and decreased in papillae ,SPK was achieved gradually during 4 to 8 weeks and 6 patients with refractory treatment was seen. But all patients experienced symptomatic relief during 2 to 7 days after dexamethasone injection, decreased in papillae of tarsus and limbus was noted during 2 - 3 weeks (P< 0.05).
Conclusions:
The symptomatic and clinical improvement suggests that supratarsal injection of dexamethasone combined with cromolin sodium 4% is very effective for management of moderate to sever VKC.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: Kasra Taherian - - - - - - - - - -
Abstract Details:
Purpose:
To describe the technique for the use electrolysis tip for cautery of deep corneal stromal blood vessels by illustrating two cases.
Setting:
Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
Methods:
Small case series of 2 cases. We report 2 cases, one of Herpetic stromal keratitis and the other of lipid keratopathy, uncontrolled with topical and /or oral medication in which an electrolysis tip was successfully used to gain access to the lumen of deep stromal corneal blood vessels and cauterise them.
Results:
No complications were noted post-operatively apart from a very transient sensation of mild soreness by the patients. Best corrected visual acuities improved from 2/36 pre-operatively to 6/18 postoperatively in the first case and was maintained at 6/9 in the second case. No progression of the keratopathies were noted until the last follow up which was at 4 months and 1 months post-operatively respectively.
Conclusions:
This is an easy to perfom and relatively straightforward technique which can be employed in various forms of keratopathies which have an element of deep stromal vascularisation and are progressive despite maximal medical therapy. The technique may not result in complete obliteration of the abnormal blood vessels but reduces them significantly and is repeatable as required. It is especially useful in cases where the keratopathy is threatening the visual axis area.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors:
Abstract Details:
Purpose:To evaluate the visual and refractive outcomes in eyes with keratoconus that had new implantation of complete corneal ring (Myoring) in an intrastromal pocket after previous intracorneal segment ring extrusion.
Setting:
Methods:
retrospective evaluation of 3 patients with the diagnosis of keratoconus. They had implantation of segment ring, but after few months (3,9,2) we must explant the ring for extrusion. Six months after explantation we have implanted new complete corneal ring into an intrastromal pocket. We evaluated the postoperative visual and refractive outcomes. The minimal follow up time was 6 months. Conclusion: Patient 1: pre-myoring implantation UCVA was 0,1, BCVA 0,15, refraction -1 -3/170; postop UCVA 0,2, BCVA 0,6, refraction -5/140. Patient 2: pre-op UCVA 0,5, BCVA 0,2, refraction -1-3/170 postop UCVA 0,2, BCVA 0,3, refraction -2,25-1,5/5; Patient 3: preop BCVA 0,02, UCVA 0,16, refraction -13-8,5, postop. UCVA 0,08, BCVA 0,3, refraction -8-3/55. Myoring implantation DMEK-S surgery seems to be an effective method to treat patients with keratoconus after previous explantation of segment ring for extrusion.
Presentation Type: Cornea
Co Authors: Suphi Acar - - - - - - - - - -
Abstract Details:
Purpose:
To evaluate the effects of different doses of subconjunctival bevacizumab injection in the treatment of patients with corneal neovascularization
Setting:
Haydarpasa Numune Education and Research Hospital, Ophthalmology Clinic, Istanbul, Turkey
Methods:
Twenty-four eyes of 24 patients with corneal neovascularization were treated with subconjunctival injection of bevacizumab. Patients were randomized to two treatment groups. Fourteen eyes were treated with 2.5 mg/0.1 ml (group 1), and 10 eyes were treated with 5.0 mg/0.2 ml (group 2)of subconjunctival bevacizumab. Digital photographs of the cornea were used to determine the area of corneal neovascularization before injection and at 1 month, 3 months, and 6 months after treatment.
Results:
During the 6-month-follow-up, no significant ocular or systemic adverse events were observed related to subconjunctival bevacizumab injection. In group 1, total area of corneal neovascularization before injection was 14.8±3.2% of the corneal surface, and 10.2±2.8% six months after injection (p<0.01). A mean decrease in group 1 was 32±3.0%. In group 2, total area of corneal neovascularization before and 6 months after injection was 14.2±2.5%, 9.8±2.3%, respectively (p<0.01). A mean decrease in group 2 was 31±2.3%. The difference between two groups was not statistically significant (p>0.05).
Conclusions:
Subconjunctival injection of bevacizumab is well tolerated and associated with a partially regression of corneal neovascularization. The efficacy of this treatment is not correlated with the injection dose.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: Sheri Rowen - - - - - - - - - -
Abstract Details:
Purpose:
The purpose of the study is to identify the effect of exclusive treatment of Meibomian Gland Dysfunction (MGD) and Dry Eye Syndrome (DES) by Intense Pulse Light Treatment
Setting:
Private, Clinical Setting
Methods:
10 subjects with symptomatic DES and a tear break up time (TBUT) of less than 6 seconds measured by Oculus Keratograph will be enrolled. Patients must discontinue all medications used in the treatment of MGD and DES. These medications include but are not limited to: ophthalmic NSAIDs, oral and topical antibiotics, artificial tears, topical steroids. Patients will undergo IPL followed by meibomian gland expression. Four weeks later TBUT will be measured by Keratograph and patient will complete a dry eye survey. Then a second IPL treatment will be administered. Treatments will be repeated for a total of 4 visits unless a successful endpoint is reached earlier.
Results:
Pending Conclusion of the study.
Conclusions:
Pending Conclusion of the study.
Financial Disclosure:
Yes.... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented
Presentation Type: Cornea
Co Authors:
Abstract Details:
Purpose:
Many cataract patients have meibomian gland dysfunction and dry eye syndrome that is unresolved with traditional methods of treating dry eye. We know that proceeding with surgery on these patients will yield less than optimal results. Our clinic has invented a way to treat dry eye patients with Intense Pulse Light. We have treated these patients successfully prior to surgery to maximize their vision.
Setting:
N/A
Methods:
I report on a cataract patient who suffers from dry eye who has failed many different medications to improve his dry eye prior to cataract surgery. We treated the patient with our Intense Pulse Light protocol with resolution of his dry eye with subsequently led to our proceeding with cataract surgery successfully. Conclusion: Intense Pulse Light is an effective treatment for dry eye syndrome due to meibomian gland dysfunction. It can be used in these patients to maximize surgical results in Cataract and Lasik Surgery.
Presentation Type: Cornea
Co Authors: Massimo Turtoro - - - - - - - - - -
Abstract Details:
Purpose:
Evidence of effectiveness of the cross -linking treatment in a patient with bilateral keratoconus and previously treated with intrastromal rings (intacs) insertion
Setting:
Ophthalmology department Bambino Gesū Hospital, Rome,Italy
Methods:
The Authors will present the clinical study of a 52 years old patient, suffering from bilateral keratoconus since he was 20 years old and subjected to penetrating keratoplasty surgery in 2000 for the LE (BCVA 8/10) and intrastromal rings insertion in 2005 for the RE (BCVA 6/10). The progressive BCVA reduction, the conus ectasy and the reduction of the central corneal thickness made the retreating of the case necessary.
Results:
Treated with cross-linking (following the international protocol and partially transepithelial) the patient was showing after 10 months from the treatment: BCVA 8/10, orbscan stabilization of the conus and central corneal thickness increased at the pachymetry measurement.
Conclusions:
Corneal cross-linking represents a valid therapeutic solution in evolving keratoconus cases and in patients treated intacs insertion.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: Kaan Gündüz Melisa Karsl?o?lu Aylin Okēu-Heper Ayfer Kanpolat - - - -
Abstract Details:
Purpose:
To report three cases of corneal melanoma without conjunctival involvement.
Setting:
Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey
Methods:
Case reports and literature review
Results:
Medical records of three patients with the diagnosis of corneal melanoma were reviewed. Total excisional biopsy with keratectomy using 20% ethanol was performed. Post-operative topical chemotherapy with mitomycin-C (MMC) 0.04% was used for 2 weeks as adjunctive therapy. Follow-up ranged from 5 months to 7 years. Two patients experienced recurrences which were treated in a fashion similar to the initial tumors. Enucleation was performed in one patient who had multiple recurrences. None of the patients developed regional or distant metastasis.
Conclusions:
Malignant melanoma can rarely occur on the cornea with no conjunctival component. The disease has variable prognosis and eye conserving treatment should be tried first.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: Maged Roshdy - - - - - - - - - -
Abstract Details:
Purpose:
To compare the different indices of keratoconus detection using the rotating Scheimpflug imaging (Oculyzer, Pentacam) version 1.16r12 in order to show the sensitivity and specificity of each one of them
Setting:
National Eye Hospital, Cairo, Egypt
Methods:
Data of 103 normal eyes and 73 keratoconus eyes, imaged by Oculyzer between June 2008 and December 2009, including slit lamp examination, refraction, Scheimpflug images and follow up data were collected. The area under the receiver operating characteristic curve (AUROC) was calculated for different keratoconus detecting indices
Results:
The indices with AUROC more than 0.97 were Ambrosio Relational Thinnest (ART) -Max, Pachymetric Progression Index (PTI) Max, Posterior elevation (PE) at Best Fit Sphere (BFS) analysed for 8 mm, Anterior Elevation (AE) at BFS analysed for 9 mm, PE at BFS analysed for 7 mm, PE at BFS analysed for 9 mm and ART Mid (AUROC = .987, .987, .979, .979,.978, .977,and .976 respectively). The most sensitive was ART Max (97.3% at ? 412 ?m) while the most specific were PE at BFS analysed for 8 and 7 mm (both 100% at >20 ?m and >10 ?m respectively)
Conclusions:
The most useful rotating Scheimpflug imaging indices to detect keratoconus were ATR -Max, PTI Max, PE BFS 8 mm, AE BFS 9 mm, PE BFS 7 mm, PE BFS 9 mm and ART Mid
Financial Disclosure:
Yes.... travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented , ... travel has been funded, fully or partially, by a competing company
Presentation Type: Cornea
Co Authors: Graeme Pollock Grant R Snibson - - - - - - - -
Abstract Details:
Purpose:
The aim of this poster is to describe and interpret localised changes in reflectivity observed in the corneal stroma following collagen cross-linking in patients with progressive keratoconus.
Setting:
Royal Victorian Eye and Ear Hospital, Melbourne, Australia &
Centre for Eye Research Australia
Methods:
Fifteen eyes of 14 patients were examined before and after corneal cross-linking using slit-lamp biomicroscopy and confocal microscopy (Confoscan 4, Nidek). A subset of patients was additionally studied with high resolution Scheimpflug imaging (HR Pentacam, Oculus) and further software-based measurements were taken.
Results:
After collagen cross-linking, confocal microscopy revealed a layer of distinctly increased reflectivity in the mid to deep stroma. Different to the more diffuse reflectivity of an anterior area of postoperative haze, this layer comprised numerous linear reflective structures (Intrastromal Striate Reflections, ISRs). While observed in all treated eyes, the first detection of these changes varied between one week and one month postoperatively. Prior to the cross-linking procedure, no ISRs were observed in any of the patients. A narrow zone of higher reflectivity was also detected on high-resolution Pentacam images correlating in depth with the confocal findings. Densitometry generated from Pentacam images revealed a double peak in density in these corneae corresponding with the postoperative haze (anterior peak) and the described zone of ISRs in mid-deep stroma (posterior peak). Furthermore, the location of the Intrastromal Striate Reflections appeared to correlate with a zone of increased reflectivity visible on postoperative slit-lamp examinations which has previously been described as demarcation line.
Conclusions:
Altered stromal reflectivity after corneal collagen cross-linking was observed using confocal microscopy and Scheimpflug-Imaging technologies and the findings of those examinations appeared to correlate. In the future, these findings could potentially provide a non-invasive tool to monitor and measure the cross-linking effect in individual corneae.
Financial Disclosure:
No.-
Presentation Type: Cornea
Co Authors: Raciha Beril Kucumen Ebru Gorgun Ferda Ciftci - - - - - -
Abstract Details:
Purpose:
To assess the corneal biomechanical properties of patients with nanophthalmos.
Setting:
Yeditepe University Medical Faculty, Department of Ophthalmology, Istanbul, Turkey.
Methods:
Ten eyes of 5 patients with nanophthalmos with an axial length of ? 20.5 mm were enrolled in the study. Metrics of corneal biomechanical properties, including corneal hysteresis (CH) and corneal resistance factor (CRF) were measured with the Ocular Response Analyzer (ORA). The ORA also determined the values of intraocular pressure (IOPg) and corneal compansated IOP (IOPcc). Central corneal thickness (CCT) was measured by the ORA integrated hand-held ultrasonic pachymeter. The values recorded by ORA were compared between eyes with nanophthalmos and age-matched control group (18 eyes of 18 subjects).
Results:
The mean IOPg (21.9±4.22mmHg), CH (12.36±1.98mmHg), CRF (14.01±1.69mmHg) and CCT (619.20±31.71µm) of all nanophthalmic eyes were significantly higher than the control eyes (p<0,05). The mean IOPcc (19.35± 4.87mmHg) in nanophthalmus was higher than normal subjects but this was not statistically significant.
Conclusions:
Nanophthalmic eyes display different biomechanical behaviour than normal eyes. This finding should be taken into consideration since it may play a role in evaluating the intraocular pressure in patients with nanophthalmus who are prone to have glaucoma.
Financial Disclosure:
No.-
Please wait while information is loading.
ESCRS,Templehouse, Temple Road, Blackrock, Co Dublin, Ireland
Phone:+ 353 1 2091100
Fax:+ 353 1 2091112
Email:escrs@escrs.org
EuroTimes
JCRS
EuroTimes (Russia)
EuroTimes (India)
EuroTimes (Turkey)