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Objectives: To investigate the long-term changes in corneal power in young patients with keratoconus (KC) and compare corneal power between eyes with and without progression by Fourier analysis using anterior segment optical coherence tomography (OCT)., Methods: Clinical records containing OCT data were retrospectively reviewed in patients with KC younger than 25 years at the first visit with a minimum follow-up duration of 2 years and at least one eye with abnormal KC findings. Eyes were divided into progressive (P) and nonprogressive (NP) groups using the ABCD grading system of Scheimpflug-based tomography. Baseline values and changes in Fourier components (spherical, regular astigmatism, asymmetry, and higher-order [HO] irregularity components) from the anterior and posterior corneal surfaces between the initial and last visits obtained with OCT were compared between both groups. Multivariate logistic regression analysis with stepwise selection was performed for baseline values to determine predictive baseline factors., Results: Twenty-three and 16 eyes were assigned to the P and NP groups, respectively. Changes in the anterior spherical and HO irregularity and posterior spherical components were significantly greater in the P group than in the NP group (P<0.05). Baseline HO irregularity, regular astigmatism, and asymmetry components from the posterior cornea were predictive of KC progression, with the highest areas under the receiver operating characteristic curve of 0.796, 0.760, and 0.740, respectively., Conclusions: Indices of regular and irregular astigmatism (asymmetry and HO irregularity) from the posterior corneal surface component can be potential prognostic indicators of KC progression in young patients., Competing Interests: S. Koh and N. Maeda received fees from Tomey for a sponsored seminar, which was not related to this study. R. Inoue is an employee of SEED Co, Ltd. R. Ambrósio is a consultant for Oculus. The remaining authors have no funding or conflicts of interest to disclose., (Copyright © 2025 Contact Lens Association of Ophthalmologists.)

Objective: To investigate the impact of using orthokeratology lenses (OK lenses) for one year on the axial length (AL) and choroidal thickness (ChT) in the 6 mm concentric central retinal region., Methods: 36 myopic children (36 eyes) aged 8 to 16 years were enrolled. For the duration of one year, the OK group (18 subjects) utilized OK lenses, while the spectacles group (18 subjects) utilized single-vision spectacles as a control. Only their right eyes were used for analysis. ChT in nine regions of the retina was evaluated using optical coherence tomography. AL and other ocular parameters were measured using optical biometry. The measurements were obtained at baseline, 3 months, 6 months, and 12 months., Results: After 12 months of treatment, the OK group showed a reduced rate of AL elongation. The first interval (baseline to 3 months) saw the most notable alteration (p < 0.0001). ChT increased in most regions after wearing OK lenses, except for the nasal retinal region. However, the alteration in nasal ChT exhibited the strongest association with the alteration in AL., Conclusion: The efficacy of myopia control with OK lenses is most pronounced during the initial months of wear. Alterations in the thickness of the nasal choroidal region may correlate with the elongation of the AL, implying its potential role as a biomarker for assessing the efficacy of OK lenses in myopia control., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

An 18-year-old boy presented with blurred visual acuity in the left eye for three days associated with mild pain and photophobia. On examination, he had diffuse corneal stromal edema. Anterior segment optical coherence tomography (AS-OCT) revealed stromal edema with a large hypodense fluid pocket in the posterior stroma. A diagnosis of acute hydrops with an intrastromal cleft in the left eye was made, and he was planned for intracameral gas injection. Intraoperatively, microscope-integrated OCT (Mi-OCT)-guided intracameral isoexpansile sulphur hexafluoride(SF6) was injected ensuring an 80% fill of the anterior chamber. Mi-OCT-assisted venting incision with drainage of stromal fluid clefts was done. On the first postoperative day, the fluid pocket and stromal edema resolved completely. At six weeks' follow-up, the central cornea remained clear with the formation of a paracentral scar. Thus, intracameral gas combined with stromal cleft drainage appears to be a highly effective management option for acute hydrops with a single large stromal fluid cleft. Intraoperative OCT (Mi-OCT) can guide real-time drainage of intrastromal fluid clefts, facilitating the closure of focal Descemet's membrane (DM) defects and enabling early visual rehabilitation, as demonstrated in this case as early as one-day postprocedure., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2025, Kumar et al.)

Purpose: Corneal cross-linking (CXL) is the standard of care in patients with keratoconus but presents unique challenges in children and developmentally delayed patients. We present our clinical decision-making algorithm, CXL surgical technique, and outcomes in these groups., Methods: A retrospective chart review was undertaken at a tertiary referral center of all patients who underwent CXL for keratoconus at University of Pittsburgh Medical Center (UPMC) Children's Hospital of Pittsburgh between October 1, 2017, and April 1, 2021. Demographic information along with preoperative, intraoperative, and postoperative ophthalmic examination findings were collected. The main outcome measures were indications of CXL, postoperative complications, and visual acuity (VA)., Results: Forty-eight eyes of 34 patients [21 patients (30 eyes) with developmental delay (DD) and 13 patients (18 eyes) with no DD (NDD)] underwent epithelium-off, standard CXL. General anesthesia was used for CXL in all patients except for 3 with NDD. A temporary central tarsorrhaphy was performed in all patients with DD and 7 patients with NDD. The remaining got a bandage contact lens. There were no immediate postoperative complications. A trend toward improvement in VA was noted postoperatively. The mean logMAR VA (with habitual correction) was 0.67 preoperatively and 0.57 postoperatively ( P = 0.3) in DD and 0.52 and 0.36, respectively ( P = 0.13), in NDD., Conclusions: This retrospective review presents a technique for assessment and treatment of keratoconus in children and those with DD. Our technique ensures timely diagnosis and provides a safe method for CXL in these groups. Temporary central tarsorrhaphy is a well-tolerated option to reduce postoperative pain., Competing Interests: The authors have no funding or conflicts of interest to disclose., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Abstract: An integrated cell, tissue, and eye bank is vital to meet the evolving needs of ocular transplant therapies. In addition to traditional corneal transplant tissues, it encompasses processing and delivery of transplant materials for newer treatments like cell-based therapies and gene-modified products, adhering to rigorous standards, optimizing tissue utilization with comprehensive services for surgeons., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)