Search

Background/Aim. Corneal cross-linking (CXL) treatment shows the best results in stabilizing the cornea and stopping the progress of the ectatic process. The aim of the study was to assess the impact of CXL on the keratoconus regarding higher-order aberrations (HOAs) and potential improvement of visual function. Methods. In 19 patients, a standard epithelium-off CXL was performed with an energy density of three mW/cm2 for half an hour. The cornea was examined by Pentacam topography before CXL and one and six months after CXL. Best-corrected visual acuity (BCVA), topographic data, and aberrations were collected. Results. A significant reduction in vertical coma was observed from preoperative -1.03 ± 1.89 to -0.74 ± 1.73 (p = 0.004) six months after CXL, and in spherical aberration from preoperative -0.22 ± 1.05 to -0.08 ± 1.13 (p = 0.002) six months after CXL. Root mean square (RMS) HOAs six months after CXL also significantly reduced from 2.31 ± 1.82 to 2.26 ± 1.84 six months after CXL (p = 0.001). BCVA improved from preoperative 0.43 ± 0.15 to 0.71 ± 0.19 six months after surgery (p < 0.001). Conclusion. CXL is a very potent treatment method for keratoconus, which significantly reduces certain corneal wavefront aberrations, especially vertical coma, spherical aberration, and RMS, and leads to a significant improvement in visual acuity.

Background Accelerated photoactivated chromophore for keratitis–corneal collagen cross-linking (PACK-CXL) was investigated to be effective in the treatment of fungal keratitis in many studies. High-fluence CXL was used effectively in the treatment of progressive keratoconus but not tested in PACK-CXL for fungal infection. Aim To evaluate the antifungal efficacy of high-fluence CXL in the treatment of induced fusarium corneal ulcer in rabbits. Design This is an experimental interventional study. Patients and methods This is an experimental interventional study conducted on 16 eyes of eight rabbits for which fusarium corneal infection was induced by intrastromal corneal injection. The rabbits were divided into two groups: group A received no treatment and was left as a control group. Group B received a single high-fluence PACK-CXL session. All rabbits were followed up for 6 days and then the eyes were enucleated. Culture was performed for seven corneas and histopathology for the remaining cornea. Results There was statistically significant deterioration in group A (P=0.003), while a statistically significant clinical improvement was seen in group B (P

PurposeThe Argus II Retinal Prosthesis System (Second Sight Medical Products, Inc, Sylmar, CA) was developed to restore some vision to patients blind as a result of retinitis pigmentosa (RP) or outer retinal degeneration. A clinical trial was initiated in 2006 to study the long-term safety and efficacy of the Argus II System in patients with bare or no light perception resulting from end-stage RP.DesignProspective, multicenter, single-arm clinical trial. Within-patient controls included the nonimplanted fellow eye and patients' native residual vision compared with their vision with the Argus II.ParticipantsThirty participants in 10 centers in the United States and Europe.MethodsThe worse-seeing eye of blind patients was implanted with the Argus II. Patients wore glasses mounted with a small camera and a video processor that converted images into stimulation patterns sent to the electrode array on the retina.Main outcome measuresThe primary outcome measures were safety (the number, seriousness, and relatedness of adverse events) and visual function, as measured by 3 computer-based, objective tests. Secondary measures included functional vision performance on objectively scored real-world tasks.ResultsTwenty-four of 30 patients remained implanted with functioning Argus II Systems at 5 years after implantation. Only 1 additional serious adverse event was experienced after the 3-year time point. Patients performed significantly better with the Argus II on than off on all visual function tests and functional vision tasks.ConclusionsThe 5-year results of the Argus II trial support the long-term safety profile and benefit of the Argus II System for patients blind as a result of RP. The Argus II is the first and only retinal implant to have market approval in the European Economic Area, the United States, and Canada.

Purpose: To describe a patient who developed major topographical changes mimicking post-laser in situ keratomileusis (LASIK) ectasia during breast cancer treatment with tamoxifen. Methods: Case report and literature review. Results: A 36-year-old woman who had had 10 years of stable vision after LASIK surgery was diagnosed as having breast cancer 6 months before presentation. As therapy, the patient received tamoxifen, a selective estrogen receptor modulator. After the initiation of therapy, the patient experienced rapidly decreasing vision in her left eye. Assessment of corneal tomography showed marked steepening with irregular astigmatism, leading to the diagnosis of postoperative ectasia in the left eye. After 3 months of treatment with tamoxifen, the anterior cornea showed marked flattening again and improvement of corrected distance visual acuity, both of which were maintained at the 6-month follow-up visit. Conclusions: Serum estrogen level changes during breast cancer treatment may induce major topographical changes, mimicking postoperative ectasia after LASIK. [Journal of Refractive Surgery Case Reports. 2024;4(1):e20–e23.] [ABSTRACT FROM AUTHOR]