Mediators of the Effect of Corneal Cross-Linking on Visual Acuity for Fungal Ulcers: A Prespecified Secondary Analysis From the Cross-Linking–Assisted Infection Reduction Trial
Purpose:
The purpose of this study was to determine whether astigmatism or corneal scarring is mediating the reduced visual acuity among patients with fungal keratitis randomized to corneal cross-linking (CXL).
Design:
This was a prespecified exploratory outcome from an outcome-masked, 2 × 2 factorial design, randomized controlled clinical trial.
Study Participants:
Consecutive patients presented with moderate vision loss from a smear-positive fungal ulcer at Aravind Eye Hospital, Madurai, India.
Intervention:
Study eyes were randomized to one of 4 treatment combinations using an adaptive randomiz...
Source: Cornea - September 18, 2022 Category: Opthalmology Tags: Clinical Science Source Type: research
ONSET-1 Phase 2b Randomized Trial to Evaluate the Safety and Efficacy of OC-01 (Varenicline Solution) Nasal Spray on Signs and Symptoms of Dry Eye Disease
Purpose:
The purpose of this trial was to evaluate the safety and efficacy of OC-01 (varenicline solution), a nicotinic acetylcholine receptor agonist nasal spray, on signs and symptoms of dry eye disease.
Methods:
A phase 2b, multicenter, randomized, double-masked, vehicle-controlled trial (ONSET-1; NCT03636061) was performed. Patients were aged 22 years or older with a physician's diagnosis of dry eye disease and previous use of artificial tears were randomized 1:1:1:1 to control (vehicle nasal spray twice daily [BID]), OC-01 0.006 mg BID, OC-01 0.03 mg BID, and OC-01 0.06 mg BID. The primary end point was the...
Source: Cornea - September 18, 2022 Category: Opthalmology Tags: Clinical Science Source Type: research
Case for Epithelium-Off Corneal Cross-linking
Abstract:
The question of whether the epithelium should be removed in corneal cross-linking (CXL) in the treatment of keratoconus and other corneal ectatic disorders remains controversial. The motivation for epithelium-on CXL methods, which are not yet FDA approved and vary greatly in methodology, is to reduce the risk of vision-threatening complications related to debridement. However, as discussed in this counterpoint piece, most high-level evidence suggests that removal of the epithelium facilitates greater crosslinking effectiveness as measured by primary clinical outcome metrics such as topographic flattening and ...
Source: Cornea - September 18, 2022 Category: Opthalmology Tags: Invited Submission Source Type: research
Corneal Cross-Linking: Epi-On
Abstract:
When treating corneal ectasias, successful corneal cross-linking (CXL) requires three factors: riboflavin saturation of the corneal stroma, ultraviolet (UV) light, and oxygen. Riboflavin is too large to pass through epithelial tight junctions, so traditionally epithelial debridement is performed before riboflavin is applied making this approach an epithelium-off (epi-off) technique. However, this can result in pain as the epithelium regrows, corneal haze, and an increased infection risk postoperatively, which needs careful management with pharmacotherapy. Epithelium-on (epi-on) CXL should reduce the extent of...
Source: Cornea - September 18, 2022 Category: Opthalmology Tags: Invited Submission Source Type: research
The Chia Surprise!—A Case Report of Finding Chia Seeds in the Fornix After a Corneal Foreign Body
No abstract available (Source: Cornea)
Source: Cornea - August 18, 2022 Category: Opthalmology Tags: Letters to the Editor Source Type: research
Letter to the Editor—Regarding Cladorrhinum Keratitis
No abstract available (Source: Cornea)
Source: Cornea - August 18, 2022 Category: Opthalmology Tags: Letters to the Editor Source Type: research
Review of Corneal Graft Registries
Conclusions:
Clinical registry data are increasingly recognized as a valuable tool to monitor corneal transplant outcomes to improve health care services and optimize resource management. (Source: Cornea)
Source: Cornea - August 18, 2022 Category: Opthalmology Tags: Review Source Type: research
Surgical Management of Fuchs Endothelial Corneal Dystrophy: A Treatment Algorithm and Individual Patient Meta-Analysis of Descemet Stripping Only
This study aims to determine predictive factors for success of Descemet stripping only (DSO) in Fuchs corneal endothelial dystrophy and propose a DSO treatment algorithm.
Methods:
Ovid MEDLINE, Embase, and Cochrane CENTRAL databases were searched to evaluate DSO case series, including combined phacoemulsification and DSO, and the use of Rho-kinase inhibitors (ROC-i). Our primary outcome was success of corneal clearance. Secondary outcomes included the time to corneal clearance, the postoperative endothelial cell count (ECC), and the impact of ROC-i.
Results:
Sixty-eight cases were evaluated with a mean follow...
Source: Cornea - August 18, 2022 Category: Opthalmology Tags: Review Source Type: research
Ocular Surface Squamous Neoplasia Masquerading as Recalcitrant Epithelial Keratitis
Conclusions:
Ocular surface squamous neoplasia can rarely masquerade as a recalcitrant medicamentosa and epithelial keratitis. In subtle cases or in cases with combined ocular surface morbidities, anterior segment high-resolution optical coherence tomography can be helpful to diagnose and direct therapy. (Source: Cornea)
Source: Cornea - August 18, 2022 Category: Opthalmology Tags: Case Report Source Type: research
Long-Standing Corneal Edema and Endothelial Decompensation due to Ecballium elaterium
Conclusions:
Ecballium elaterium may cause a severe corneal chemical burn, with subsequent long-standing corneal edema and endothelial decompensation. Specular microscopy is a modality of great importance in these cases. (Source: Cornea)
Source: Cornea - August 18, 2022 Category: Opthalmology Tags: Case Report Source Type: research
Descemet Membrane Endothelial Transfer (DMET) in Pseudophakic Bullous Keratopathy After DSEK—A Case Report and Review of Literature
Conclusions:
DMET occurs commonly in eyes with Fuch endothelial dystrophy and rarely in patients with PBK. The mechanism of DMET in PBK probably occurs because of migration of the donor endothelial cells from partially attached Descemet stripping endothelial keratoplasty grafts to the host stroma, in contrast to Fuch endothelial dystrophy, where the endothelial cells from the periphery migrate to the center. Hence, waiting for spontaneous corneal clarity is pivotal because of DMET even in patients with PBK for at least 3 months. (Source: Cornea)
Source: Cornea - August 18, 2022 Category: Opthalmology Tags: Case Report Source Type: research
Spontaneous Partial Regression of Bilateral Grade III Corneal Dermoids Associated With Fetal Valproate Spectrum Disorder
Conclusions:
The development of bilateral grade III corneal dermoids in a child with FVSD may be more than fortuitous and enlarges the list of ocular anomalies associated with FVSD. Corneal dermoids may regress spontaneously. (Source: Cornea)
Source: Cornea - August 18, 2022 Category: Opthalmology Tags: Case Report Source Type: research
Corneal Endothelial Dysfunction as a Manifestation of Digoxin Toxicity
Conclusions:
We encountered 1 case of corneal edema secondary to corneal endothelial dysfunction in a patient with digoxin toxicity. Special care should be taken to elicit a complete history because ocular signs can be manifestations of systemic alterations with vital importance for patients. (Source: Cornea)
Source: Cornea - August 18, 2022 Category: Opthalmology Tags: Case Report Source Type: research
Reversible Corneal Decompensation Caused by a Topical Dorzolamide/Timolol Fixed Combination After Descemet Stripping Automated Endothelial Keratoplasty
Conclusions:
Topical DTFC should be used with caution after corneal endothelial transplantation because of the possibility of iatrogenic corneal endothelial dysfunction. (Source: Cornea)
Source: Cornea - August 18, 2022 Category: Opthalmology Tags: Case Report Source Type: research
Bactericidal Efficacy of High Irradiance Ultraviolet A Photoactivation of Riboflavin Versus Standard Corneal Cross-Linking Protocol In Vitro
Conclusions:
Photoactivation of B2 by high UVA irradiance does not seem to be effective for bacterial eradication in this study. (Source: Cornea)
Source: Cornea - August 18, 2022 Category: Opthalmology Tags: Basic Investigation Source Type: research
