Refractive Outcomes After Phototherapeutic Refractive Keratectomy for Granular Corneal Dystrophy
Purpose: This retrospective study aimed to evaluate the effectiveness of a novel procedure named phototherapeutic refractive keratectomy (PTRK), which is a sequential procedure composed of phototherapeutic keratectomy ablation for removal of opacities, followed by smoothing ablation for reducing the corneal surface irregularities and photorefractive keratectomy ablation for correcting refractive errors in eyes with primary granular corneal dystrophy. Methods: Twenty-three eyes of 17 patients with granular corneal dystrophy were treated with PTRK. Preoperative and postoperative visual acuity, corneal topography, and ch...
Source: Cornea - March 31, 2018 Category: Opthalmology Tags: Clinical Science Source Type: research

Association Between Visual Acuity and the Corneal Area Occupied by Granular Lesions, Linear Lesions, or Diffuse Haze in Patients With Granular Corneal Dystrophy Type 2
Conclusions: Our findings indicated that LLs associated with GCD2 do not produce significant decreases in visual acuity, whereas DH exerts the most significant negative impact on visual acuity. Late-onset DH may be associated with the termination of LL formation. (Source: Cornea)
Source: Cornea - March 31, 2018 Category: Opthalmology Tags: Clinical Science Source Type: research

Malpractice Litigation in Cornea and Refractive Surgery: A Review of the WestLaw Database
Conclusions: Cornea and refractive surgery is a high-risk subspecialty of ophthalmology. Laser-assisted in situ keratomileusis and corneal transplant claims were the most commonly litigated entities in this series. Many cases focus on failure to achieve patients' desired expectations after elective refractive procedures or the negligent performance of refractive surgery on patients with contraindications to surgery, both highlighting the importance of detailed informed consent discussions, realistic goal setting with patients, and thorough examinations and preoperative evaluation. (Source: Cornea)
Source: Cornea - March 31, 2018 Category: Opthalmology Tags: Clinical Science Source Type: research

Reply: Management of Descemet Membrane Detachment After Forceps Birth Injury
No abstract available (Source: Cornea)
Source: Cornea - March 3, 2018 Category: Opthalmology Tags: Letters to the Editor Source Type: research

Reply
No abstract available (Source: Cornea)
Source: Cornea - March 3, 2018 Category: Opthalmology Tags: Letters to the Editor Source Type: research

Detection and Imaging of Lymphatic and Other Vessels in Corneal Neovascular Complexes
No abstract available (Source: Cornea)
Source: Cornea - March 3, 2018 Category: Opthalmology Tags: Letters to the Editor Source Type: research

Reply
No abstract available (Source: Cornea)
Source: Cornea - March 3, 2018 Category: Opthalmology Tags: Letters to the Editor Source Type: research

Descemetorhexis Without Endothelial Keratoplasty (DWEK): Proposal for Nomenclature Standardization
No abstract available (Source: Cornea)
Source: Cornea - March 3, 2018 Category: Opthalmology Tags: Letters to the Editor Source Type: research

Reply
No abstract available (Source: Cornea)
Source: Cornea - March 3, 2018 Category: Opthalmology Tags: Letters to the Editor Source Type: research

Central Corneal Thickness Measurement After Cataract Surgery
No abstract available (Source: Cornea)
Source: Cornea - March 3, 2018 Category: Opthalmology Tags: Letters to the Editor Source Type: research

Reply
No abstract available (Source: Cornea)
Source: Cornea - March 3, 2018 Category: Opthalmology Tags: Letters to the Editor Source Type: research

Artificial Anterior Chamber Model Using Human Donor Corneas for DMEK Surgical Training
No abstract available (Source: Cornea)
Source: Cornea - March 3, 2018 Category: Opthalmology Tags: Letters to the Editor Source Type: research

Femtosecond Laser-Assisted Ipsilateral Rotational Lamellar Autokeratoplasty
Conclusions: Femtosecond laser-assisted ipsilateral rotational lamellar autokeratoplasty is effective for shifting central corneal opacities and can be considered in appropriate cases. (Source: Cornea)
Source: Cornea - March 3, 2018 Category: Opthalmology Tags: Techniques Source Type: research

Accelerated Corneal Cross-Linking With Photoactivated Chromophore for Moderate Therapy-Resistant Infectious Keratitis
Conclusions: Our results suggest that accelerated PACK-CXL may provide an antimicrobial effect similar to the 1 low-intensity, slow setting (30 minutes at 3 mW/cm2) and may be used as additional treatment in moderate-sized therapy-resistant infectious keratitis. (Source: Cornea)
Source: Cornea - March 3, 2018 Category: Opthalmology Tags: Techniques Source Type: research

Regenerative Therapy for Fuchs Endothelial Corneal Dystrophy
Conclusions: DMT may be effective for treatment of FECD. Achievement of endothelial regeneration without allogenic corneal endothelial cell transplantation and exposure to the attendant risks of graft rejection and chronic immunosuppression represents a significant improvement from the current paradigm of EK. (Source: Cornea)
Source: Cornea - March 3, 2018 Category: Opthalmology Tags: Case Report Source Type: research

Pythium Keratitis Leading to Fatal Cavernous Sinus Thrombophlebitis
Conclusions: Ocular pythiosis may lead to cavernous sinus thrombophlebitis and can even be life threatening. Timely diagnosis and early radical surgery are of value. A high index of suspicion must be kept for P. insidiosum in cases with suspected fungal etiology not responding to conventional treatment. (Source: Cornea)
Source: Cornea - March 3, 2018 Category: Opthalmology Tags: Case Report Source Type: research

Candida Endophthalmitis After Descemet Stripping Automated Endothelial Keratoplasty With Grafts From Both Eyes of a Donor With Possible Systemic Candidiasis
Conclusions: Interface fungal keratitis and endophthalmitis due to infected donor corneal tissue is difficult to treat, and both recipients of grafts originating from the same donor are at risk of developing this challenging condition. (Source: Cornea)
Source: Cornea - March 3, 2018 Category: Opthalmology Tags: Case Report Source Type: research

Estrogen Modulates Corneal Nociception and Maintains Corneal Homeostasis in Rat Eye
Conclusions: This study demonstrates the role of estrogen in corneal nociception and its deficiency as a cause of dry eye. (Source: Cornea)
Source: Cornea - March 3, 2018 Category: Opthalmology Tags: Basic Investigation Source Type: research

Hypoxia and the Prolyl Hydroxylase Inhibitor FG-4592 Protect Corneal Endothelial Cells From Mechanical and Perioperative Surgical Stress
Purpose: To determine whether hypoxia preconditioning can protect corneal endothelial cells from mechanical stress and perioperative procedures mimicking Descemet stripping automated endothelial keratoplasty (DSAEK). Methods: Preconditioning was delivered by 2 hours of 0.5% oxygen incubation in a hypoxia chamber or by exposure to the prolyl hydroxylase inhibitor FG-4592, which prevents hypoxia-inducible factor-1 alpha degradation. Damage to whole corneas was produced by brief sonication. To mimic use with DSAEK, FG-4592-preconditioned and control donor corneas were dissected with a microkeratome, and the posterior don...
Source: Cornea - March 3, 2018 Category: Opthalmology Tags: Basic Investigation Source Type: research

High Inflammatory Infiltrate Correlates With Poor Symptomatic Improvement After Surgical Treatment for Superior Limbic Keratoconjunctivitis
Conclusions: In this study, the most common systemic association with SLK was the patient's autoimmune status. Histopathological evaluation revealed that high inflammatory infiltration in the biopsy might be predictive of minimal symptomatic improvement with surgical management. Finally, the higher COX-2 expression in patients with SLK compared with that in individuals with a normal conjunctiva supports the use of anti-COX-2 drugs as a possible therapeutic target. (Source: Cornea)
Source: Cornea - March 3, 2018 Category: Opthalmology Tags: Basic Investigation Source Type: research

Ocular Surface and Tear Film Characteristics in a Sclerodermatous Chronic Graft-Versus-Host Disease Mouse Model
Purpose: To report the characteristics of the ocular surface in a previously established sclerodermatous chronic graft-versus-host disease (cGVHD) mouse model. Methods: The ocular surface features and tear film parameters of the mouse model were assessed by histopathology, immunohistochemistry, electron microscopy, quantitative polymerase chain reaction, and flow cytometry. Results: The mice exhibited loss of body weight and decreased tear secretion (P (Source: Cornea)
Source: Cornea - March 3, 2018 Category: Opthalmology Tags: Basic Investigation Source Type: research

Comparison of In Vivo Confocal Microscopy, PCR and Culture of Corneal Scrapes in the Diagnosis of Acanthamoeba Keratitis
Conclusions: All 3 diagnostic tests are highly specific, and a positive test result is highly predictive of disease presence. IVCM is both highly sensitive and specific when performed by an experienced operator. PCR is a useful adjunct in the diagnosis of AK because of its wider availability compared with IVCM, and it may be used in combination with IVCM for microbiologic confirmation. (Source: Cornea)
Source: Cornea - March 3, 2018 Category: Opthalmology Tags: Clinical Science Source Type: research

Repeated Same-Day Versus Single Tomography Measurements of Keratoconic Eyes for Analysis of Disease Progression
Conclusions: The approach used to analyze progression in keratoconus, that is, single versus repeated measurements, may confer a great impact on the decision to perform corneal cross-linking treatment or not. (Source: Cornea)
Source: Cornea - March 3, 2018 Category: Opthalmology Tags: Clinical Science Source Type: research

Obstructive Sleep Apnea Assessed by Overnight Polysomnography in Patients With Keratoconus
Purpose: To determine the prevalence of obstructive sleep apnea (OSA) in patients with keratoconus (KCN) and to evaluate the association between the severity of KCN and OSA. Methods: OSA was diagnosed with an overnight home sleep apnea test. As estimated by home monitoring, an apnea–hypopnea index threshold of ≥5 sleep-related obstructive breathing events per hour was considered suggestive of OSA. For grading KCN severity (Amsler–Krumeich classification), slit-lamp biomicroscopy, corneal topography, and pachymetry measurements were performed. Preoperative measurements were included in the analysis for p...
Source: Cornea - March 3, 2018 Category: Opthalmology Tags: Clinical Science Source Type: research

Anterior Segment Parameters in Patients With Wilson Disease
Purpose: To investigate anterior segment parameters in patients with Wilson disease (WD). Methods: In this cross-sectional study, 22 patients with WD (study group) and 22 healthy subjects (control group) were enrolled. Each participant underwent a comprehensive ophthalmic assessment including best-corrected visual acuity, slit-lamp biomicroscopy, fundus examination, and intraocular pressure. Anterior segment parameters were measured by the Sirius anterior segment analyzer system (Costruzione Strumenti Oftalmici, Florence, Italy). Results: Mean central corneal thickness was 522 ± 47 μm in the study group a...
Source: Cornea - March 3, 2018 Category: Opthalmology Tags: Clinical Science Source Type: research

Descemet Stripping Automated Endothelial Keratoplasty for Failed Penetrating Keratoplasty: Influence of the Graft–Host Junction on the Graft Survival Rate
Conclusions: DSAEK for failed PK had a favorable outcome in this study. However, the GHJ should be assessed carefully before performing the procedure. (Source: Cornea)
Source: Cornea - March 3, 2018 Category: Opthalmology Tags: Clinical Science Source Type: research

Scheimpflug Densitometry After DMEK Versus DSAEK—Two-Year Outcomes
Purpose: To compare the course of Scheimpflug corneal densitometry (CD) after Descemet membrane endothelial keratoplasty (DMEK) versus Descemet stripping automated endothelial keratoplasty (DSAEK). Methods: Fifty-four DMEK and 25 DSAEK cases without previous corneal surgery, complicated intraoperative or postoperative course, or vision-limiting ocular comorbidities were included. Pseudophakic eyes of age-matched subjects were recruited as controls (n = 20). Scheimpflug CD of the optically relevant zones (0–2 and 2–6 mm), best-corrected visual acuity (BCVA), endothelial cell density, and central corneal thi...
Source: Cornea - March 3, 2018 Category: Opthalmology Tags: Clinical Science Source Type: research

Early Corneal Innervation and Trigeminal Alterations in Parkinson Disease: A Pilot Study
Conclusions: Corneal innervation changes might occur earlier in patients with PD than in retinal ones. Confocal corneal innervation analysis might provide possible early biomarkers for a better PD evaluation and for its earlier diagnosis. (Source: Cornea)
Source: Cornea - March 3, 2018 Category: Opthalmology Tags: Clinical Science Source Type: research

Ophthalmologic Approach in Epidermolysis Bullosa: A Cross-Sectional Study With Phenotype–Genotype Correlations
Conclusions: Although ophthalmic complications are common in EB, the incidence varied with the EB subtype. We also establish the correlation between esophageal and corneal involvement in RDEB. (Source: Cornea)
Source: Cornea - March 3, 2018 Category: Opthalmology Tags: Clinical Science Source Type: research

Atopy in Patients With Ocular Cicatricial Pemphigoid
Conclusions: Clinicians should consider the coexistence of atopy in patients with OCP, especially in those with persistent symptoms after initiation of immunomodulatory therapy. (Source: Cornea)
Source: Cornea - March 3, 2018 Category: Opthalmology Tags: Clinical Science Source Type: research

Tripolymeric Corneal Coating Gel Versus Balanced Salt Solution Irrigation During Cataract Surgery: A Retrospective Analysis
Purpose: To compare the protective properties and ease of manipulation during cataract surgery of corneal coating with a gel (eyeDRO; AL.CHI.MI.A. S.R.L, Italy) and corneal irrigation with balanced salt solution (BSS). Methods: We analyzed the data of 51 patients receiving either eyeDRO or BSS during routine cataract surgery performed within a 20-day period in 2016. The selected parameters were intraoperative clarity and ease of manipulation; postoperative epithelial integrity; and patient discomfort. Results: Compared with BSS irrigation, eyeDRO coating significantly increased intraoperative clarity and ease of ma...
Source: Cornea - March 3, 2018 Category: Opthalmology Tags: Clinical Science Source Type: research

Prevalence of Meibomian Gland Atrophy in a Pediatric Population
Conclusions: This study reveals a relatively high level of mild meibomian gland atrophy in the pediatric population, though moderate-severe gland atrophy was also present in this young population. This calls into question our current understanding of baseline gland architecture and suggests that perhaps clinicians should be examining young patients for meibomian gland atrophy and dysfunction because it may have implications for future development of dry eye disease. (Source: Cornea)
Source: Cornea - March 3, 2018 Category: Opthalmology Tags: Clinical Science Source Type: research

Eyelid Changes Related to Meibomian Gland Dysfunction in Early Middle-Aged Patients Using Topical Glaucoma Medications
Conclusions: Glaucoma eye drops may be one factor affecting the eyelid changes associated with MGD. The Marx line score may be used as an index to evaluate MGD in patients with glaucoma. (Source: Cornea)
Source: Cornea - March 3, 2018 Category: Opthalmology Tags: Clinical Science Source Type: research

Meibography of Eyes With Sequelae of Trachoma
Purpose: To study the effect of trachoma on meibomian glands using infrared meibography and to correlate the results with tear film parameters. Methods: This is a prospective cohort study in which 86 eyes of healthy volunteers and 90 eyes with trachoma were included. Clinical assessment was performed including the following: slit-lamp examination looking for signs of sequelae of trachoma, tear breakup time (TBUT), superficial punctate keratopathy (SPK), Schirmer II test (with anesthesia), and meibum score. Noncontact meibography was performed on both upper and lower eyelids separately using the meibograde system, whic...
Source: Cornea - March 3, 2018 Category: Opthalmology Tags: Clinical Science Source Type: research

Dry Eye Assessment in Patients With Vitiligo
Purpose: To evaluate tear osmolarity and tear film parameters in patients with vitiligo. Methods: A total of 25 eyes of 25 patients with vitiligo with periocular involvement (group 1), 30 eyes of 30 patients with vitiligo without periocular involvement (group 2), and 20 eyes of 20 controls (group 3) were evaluated using the Ocular Surface Disease Index (OSDI) questionnaire, Schirmer I test, tear film breakup time, scoring of ocular surface fluorescein staining using a modified Oxford scale, and tear osmolarity. Results: Mean tear osmolarity was 332 ± 16.3 mOsm/L in group 1, 308.8 ± 19.5 mOsm/L in grou...
Source: Cornea - March 3, 2018 Category: Opthalmology Tags: Clinical Science Source Type: research

Utility of Novel Autoantibodies in the Diagnosis of Sjögren's Syndrome Among Patients With Dry Eye
Conclusions: Anti-CA6 was the most prevalent novel autoantibody in patients with dry eye, and was associated with younger age and more severe disease. Longitudinal studies are needed to determine whether anti-CA6 is a marker for early SS or perhaps another form of an autoimmune dry eye disease. (Source: Cornea)
Source: Cornea - March 3, 2018 Category: Opthalmology Tags: Clinical Science Source Type: research

Reply
No abstract available (Source: Cornea)
Source: Cornea - February 7, 2018 Category: Opthalmology Tags: Corrected and reprinted letter Source Type: research

Pythium Insidiosum Keratitis: Histopathology and Rapid Novel Diagnostic Staining Technique
No abstract available (Source: Cornea)
Source: Cornea - February 7, 2018 Category: Opthalmology Tags: Letters to the Editor Source Type: research

Keratoconus and Personality—A Review
Conclusions: We hypothesize that the stage of life at which keratoconus commonly presents plays a crucial role in personality and coping mechanism development that significantly affects behavioral patterns and the relationship with caregivers. (Source: Cornea)
Source: Cornea - February 7, 2018 Category: Opthalmology Tags: Review Source Type: research

Recognizing and Managing Bullous Descemet Detachment Secondary to Accidental Hydroseparation During Phacoemulsification/Cataract Surgery by Relaxing Descemetotomy
Conclusions: Rarely stromal hydration performed with an irrigating cannula positioned too close to the posterior stroma can result in hydroseparation of DM creating BDD, seen intraoperatively as a fluid wave propagating across the posterior aspect of the cornea. Large folds, free mobility, and DM tear classically seen with rhegmatogenous Descemet detachment are not seen clinically or on ASOCT in BDD. Pneumodescemetopexy alone cannot resolve BDD because without a DM tear, SDF cannot evacuate. Combining relaxing Descemetotomy with pneumodescemetopexy allows SDF to drain internally and Descemet detachment to resolve. This t...
Source: Cornea - February 7, 2018 Category: Opthalmology Tags: Techniques Source Type: research

Role of Hemidivisional Corneal Topographic Astigmatisms (CorTs) in the Regularization and Reduction of Irregular Astigmatism
Conclusions: HemiCorTs allow for the design of hemidivisional corneal treatments of asymmetric nonorthogonal astigmatism. Such treatments should be suitable in the routine treatment of commonly occurring irregular astigmatism, while also allowing the spherical refractive error to be treated concurrently. (Source: Cornea)
Source: Cornea - February 7, 2018 Category: Opthalmology Tags: Techniques Source Type: research

Selective Endothelial Removal for Peters Anomaly
Conclusions: Selective endothelial removal can potentially be used to treat cases of type 1 Peters anomaly. (Source: Cornea)
Source: Cornea - February 7, 2018 Category: Opthalmology Tags: Case Report Source Type: research

Gout Keratitis: A Case of Peripheral Ulcerative Keratitis Secondary to Gout With a Review of the Literature
Conclusions: Gout is the most common type of inflammatory arthritis in adults with rising incidence and prevalence. Ocular findings in gout are common, but patients are usually asymptomatic. Monosodium urate crystal deposition has been reported to occur in various parts of the eye, with and without ocular inflammation. Crystal deposition in the cornea is extremely rare and may be a cause of peripheral ulcerative keratitis. (Source: Cornea)
Source: Cornea - February 7, 2018 Category: Opthalmology Tags: Case Report Source Type: research

Unilateral Posterior Interstitial Keratitis as a Clinical Presentation of Herpes Simplex Virus Disease
Conclusions: The clinical presentation of unilateral, posterior interstitial keratitis may be a rare manifestation of herpes simplex virus keratitis. (Source: Cornea)
Source: Cornea - February 7, 2018 Category: Opthalmology Tags: Case Report Source Type: research

Outcomes of Corneal Cross-Linking Correlate With Cone-Specific Lysyl Oxidase Expression in Patients With Keratoconus
Conclusions: Our study demonstrates that preoperative levels of molecular factors such as LOX, MMP9, and COL IVA1 aid in understanding CXL outcomes at the tissue level. (Source: Cornea)
Source: Cornea - February 7, 2018 Category: Opthalmology Tags: Basic Investigation Source Type: research

Corneal Cross-Linking With Verteporfin and Nonthermal Laser Therapy
Purpose: To test whether verteporfin with a nonthermal laser increases corneal mechanical stiffness and resistance to enzymatic degradation ex vivo. Methods: Thirty human corneas (n = 5 per group) were treated with verteporfin alone (V), irradiated with nonthermal laser therapy (689 nm) alone (NTL), or received combined treatment of verteporfin with nonthermal laser therapy for 1 sequence (V+NTL1) or 6 sequences (V+NTL6) of 1 minute of NTL exposure. Positive controls were pretreated with 0.1% riboflavin/20% dextran every 3 to 5 minutes for 30 minutes and irradiated with ultraviolet light type A (λ = 370 nm, irr...
Source: Cornea - February 7, 2018 Category: Opthalmology Tags: Basic Investigation Source Type: research

Femtosecond Laser-Assisted Small Incision Endokeratophakia Using a Xenogeneic Lenticule in Rhesus Monkeys
Purpose: To evaluate the feasibility and safety of xenogeneic endokeratophakia in rhesus monkeys and to explore the effects of a concave lenticule on refractive power. Methods: Three adult New Zealand white rabbits and 6 healthy rhesus monkeys were used. The xenogenic concave grafts were created from the rabbits using a modified small incision lenticule extraction technique; after being cryopreserved in glycerol for 1 week, the grafts were implanted into the monkey recipient corneas. Spherical equivalent (SE), central corneal thickness, and keratometry curvature were assessed preoperatively, 1 week, 1, 4 and 6 months ...
Source: Cornea - February 7, 2018 Category: Opthalmology Tags: Basic Investigation Source Type: research

Persistence of the Cone on the Posterior Corneal Surface Affecting Corneal Aberration Changes After Intracorneal Ring Segment Implantation in Patients With Keratoconus
Purpose: To analyze the changes in anterior and posterior corneal surfaces and aberrations in patients who underwent intracorneal ring segment (ICRS) implantation for the treatment of keratoconus. Methods: Eighty-nine eyes of 59 patients with keratoconus who underwent ICRS implantation were analyzed. All eyes were evaluated using a tomography system combining a Placido disc and Scheimpflug photography before and at least 6 months after surgery. Total, anterior, and posterior corneal aberrations, anterior and posterior sagittal and tangential anterior and posterior curve analysis, keratometry (K), minimum corneal thick...
Source: Cornea - February 7, 2018 Category: Opthalmology Tags: Clinical Science Source Type: research

Comparison of Changes in Central Corneal Thickness During Corneal Collagen Cross-Linking, Using Isotonic Riboflavin Solutions With and Without Dextran, in the Treatment of Progressive Keratoconus
Purpose: To compare intraoperative changes in central corneal thickness (CCT) during corneal cross-linking, using 2 different isotonic riboflavin solutions either with dextran or with hydroxy propyl methylcellulose, in the treatment of progressive keratoconus. Methods: In this retrospective study, we analyzed records of corneal thickness measurements, taken during various steps of cross-linking. Cross-linking was performed using either isotonic riboflavin with dextran (group A) or isotonic riboflavin with hydroxy propyl methylcellulose (without dextran) (group B). CCT measurements were recorded before and after epithe...
Source: Cornea - February 7, 2018 Category: Opthalmology Tags: Clinical Science Source Type: research