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Intimate partner violence in ophthalmology: a global call to action
Purpose of review Intimate partner violence (IPV) is a leading cause of death and disability worldwide. Despite increasing public awareness of IPV, little information is available regarding the prevalence, associated injury patterns, and impact of IPV as a mechanism of ocular and orbital trauma. The purpose of this review is to summarize the literature regarding the impact of IPV in ophthalmology and provide team members with guidance on appropriate practices for screening and referral. Recent findings Data from 48 population-based studies estimates that the lifetime prevalence of IPV ranges from 10 to 69% among women int...
Source: Current Opinion in Ophthalmology - September 1, 2017 Category: Opthalmology Tags: OCULOPLASTIC AND ORBITAL SURGERY: Edited by Richard C. Allen Source Type: research

Invasive fungal sinusitis: treatment of the orbit
Purpose of review To summarize diagnostic techniques for invasive fungal rhinosinusitis and provide a review of treatment options once disease has spread to the orbit. Recent findings Improved imaging criteria, polymerase chain reaction and other serologic tests show promise in advancing our ability to accurately diagnose invasive fungal disease. Currently, there exists three treatment options for infected orbital tissue: exenteration, conservative debridement and transcutaneous retrobulbar injection of amphotericin B. Exenteration, the most frequently reported intervention, has not been proven to enhance survival. Conser...
Source: Current Opinion in Ophthalmology - September 1, 2017 Category: Opthalmology Tags: OCULOPLASTIC AND ORBITAL SURGERY: Edited by Richard C. Allen Source Type: research

Diagnosis of enlarged extraocular muscles: when and how to biopsy
Purpose of review To review current knowledge regarding diagnosis of nonthyroid orbital disorders with extraocular muscle enlargement. Recent findings Recent publications have focused on immunoglobulin G4-related disease as a possible cause of enlarged extraocular muscles, on patterns of strabismus that raise a clinical suspicion of intramuscular lymphoma, and on surgical techniques to access the muscles for tissue biopsy. Summary With enlarged extraocular muscles, features to distinguish between competing diagnostic possibilities are based on imaging in the context of history and clinical signs. Infraorbital nerve enlar...
Source: Current Opinion in Ophthalmology - September 1, 2017 Category: Opthalmology Tags: OCULOPLASTIC AND ORBITAL SURGERY: Edited by Richard C. Allen Source Type: research

Update on Graves disease: advances in treatment of mild, moderate and severe thyroid eye disease
Purpose of review To report the most recent therapeutic advances of thyroid eye disease (TED) and offer general recommendations for management of TED. Recent findings Treatment of Graves ophthalmopathy is traditionally based on the use of high doses of corticosteroids and/or radiotherapy (RT) to decrease the activity of the disease, with the subsequent proptosis, strabismus and eyelid deformites treated with different surgical procedures. In recent years, the evidence that oxidative stress plays a relevant role in exacerbating TED severity has encouraged the use of antioxydative agents such as selenium, which has shown a ...
Source: Current Opinion in Ophthalmology - September 1, 2017 Category: Opthalmology Tags: OCULOPLASTIC AND ORBITAL SURGERY: Edited by Richard C. Allen Source Type: research

Graft versus host disease: what should the oculoplastic surgeon know?
Purpose of review To provide a concise review of the oculoplastic manifestations of ocular graft versus host disease (GVHD), and to discuss their management. Recent findings Ocular GVHD occurs as a common immune-mediated complication of hematopoietic stem cell transplantation that presents as a Stevens–Johnson-like syndrome in the acute phase or a Sjögren-like syndrome in the chronic phase. Cicatricial conjunctivitis may be underreported in ocular GVHD. The spectrum of oculoplastic manifestations includes GVHD of the skin, cicatricial entropion, nasolacrimal duct obstruction, and lacrimal gland dysfunction. Sur...
Source: Current Opinion in Ophthalmology - September 1, 2017 Category: Opthalmology Tags: OCULOPLASTIC AND ORBITAL SURGERY: Edited by Richard C. Allen Source Type: research

Pediatric blepharokeratoconjunctivitis: is there a ‘right’ treatment?
This article highlights the importance of recognizing blepharokeratoconjunctivitis (BKC) in children and reviews the clinical characteristics and current therapeutic modalities. Recent findings The mainstay of BKC treatment remains controlling the meibomian gland inflammation and treating cobormid conditions. BKC can occur in the setting of ocular rosacea and Demodex infestation. Small studies have shown treatment benefits of topical cyclosporine A as well as oral azithromycin in pediatric BKC. Summary BKC is a cause for visual loss in children, and therefore pediatric ophthalmologists should be more vigilant about early...
Source: Current Opinion in Ophthalmology - September 1, 2017 Category: Opthalmology Tags: PEDIATRICS AND STRABISMUS: Edited by J. Mark Engel Source Type: research

PAX6 aniridia syndrome: clinics, genetics, and therapeutics
Purpose of review Aniridia is a rare and panocular disorder affecting most of the ocular structures which may have significant impact on vision. The purpose of this review is to describe the clinical features, genetics, and therapeutic options for this disease and to provide an update of current knowledge and latest research findings. Recent findings Aside from the ocular features, a variety of associated systemic abnormalities, including hormonal, metabolic, gastrointestinal, genitourinary, and neurologic pathologies have been reported in children with aniridia. Although mutations in PAX6 are a major cause of aniridia, g...
Source: Current Opinion in Ophthalmology - September 1, 2017 Category: Opthalmology Tags: OCULAR GENETICS: Edited by Alex V. Levin Source Type: research

Leber hereditary optic neuropathy: bridging the translational gap
Purpose of review Leber hereditary optic neuropathy (LHON) is the most common primary mitochondrial DNA (mtDNA) genetic disorder in the population. We address the clinical evolution of the disease, the secondary etiological factors that could contribute to visual loss, and the challenging task of developing effective treatments. Recent findings LHON is characterized by a preclinical phase that reflects retinal ganglion cell (RGC) dysfunction before rapid visual deterioration ensues. Children can present atypically with slowly progressive visual loss or an insidious/subclinical onset that frequently results in considerable...
Source: Current Opinion in Ophthalmology - September 1, 2017 Category: Opthalmology Tags: OCULAR GENETICS: Edited by Alex V. Levin Source Type: research

Minimally invasive brow lifting techniques
This article will review several minimally invasive techniques that can be used to address the needs of patients with mild-to-moderate brow ptosis. Recent findings:Recent publications describe and analyse efficacy of several variations of browpexy techniques. Summary:Browpexy techniques provide a minimally invasive way to provide stabilization and modest elevation of the lateral brow. They can enhance outcomes of upper eyelid surgery in patients with both functional and cosmetic brow ptosis, who desire to avoid the cost and morbidity of more formal brow lifting techniques. (Source: Current Opinion in Ophthalmology)
Source: Current Opinion in Ophthalmology - August 18, 2017 Category: Opthalmology Tags: OCULOPLASTIC AND ORBITAL SURGERY: Edited by Richard C. Allen Source Type: research

Intimate partner violence in ophthalmology: a global call to action
Purpose of review:Intimate partner violence (IPV) is a leading cause of death and disability worldwide. Despite increasing public awareness of IPV, little information is available regarding the prevalence, associated injury patterns, and impact of IPV as a mechanism of ocular and orbital trauma. The purpose of this review is to summarize the literature regarding the impact of IPV in ophthalmology and provide team members with guidance on appropriate practices for screening and referral. Recent findings:Data from 48 population-based studies estimates that the lifetime prevalence of IPV ranges from 10 to 69% among women int...
Source: Current Opinion in Ophthalmology - August 18, 2017 Category: Opthalmology Tags: OCULOPLASTIC AND ORBITAL SURGERY: Edited by Richard C. Allen Source Type: research

Invasive fungal sinusitis: treatment of the orbit
Purpose of review:To summarize diagnostic techniques for invasive fungal rhinosinusitis and provide a review of treatment options once disease has spread to the orbit. Recent findings:Improved imaging criteria, polymerase chain reaction and other serologic tests show promise in advancing our ability to accurately diagnose invasive fungal disease. Currently, there exists three treatment options for infected orbital tissue: exenteration, conservative debridement and transcutaneous retrobulbar injection of amphotericin B. Exenteration, the most frequently reported intervention, has not been proven to enhance survival. Conser...
Source: Current Opinion in Ophthalmology - August 18, 2017 Category: Opthalmology Tags: OCULOPLASTIC AND ORBITAL SURGERY: Edited by Richard C. Allen Source Type: research

Diagnosis of enlarged extraocular muscles: when and how to biopsy
Purpose of review:To review current knowledge regarding diagnosis of nonthyroid orbital disorders with extraocular muscle enlargement. Recent findings:Recent publications have focused on immunoglobulin G4-related disease as a possible cause of enlarged extraocular muscles, on patterns of strabismus that raise a clinical suspicion of intramuscular lymphoma, and on surgical techniques to access the muscles for tissue biopsy. Summary:With enlarged extraocular muscles, features to distinguish between competing diagnostic possibilities are based on imaging in the context of history and clinical signs. Infraorbital nerve enlar...
Source: Current Opinion in Ophthalmology - August 18, 2017 Category: Opthalmology Tags: OCULOPLASTIC AND ORBITAL SURGERY: Edited by Richard C. Allen Source Type: research

Update on Graves disease: advances in treatment of mild, moderate and severe thyroid eye disease
Purpose of review:To report the most recent therapeutic advances of thyroid eye disease (TED) and offer general recommendations for management of TED. Recent findings:Treatment of Graves ophthalmopathy is traditionally based on the use of high doses of corticosteroids and/or radiotherapy (RT) to decrease the activity of the disease, with the subsequent proptosis, strabismus and eyelid deformites treated with different surgical procedures. In recent years, the evidence that oxidative stress plays a relevant role in exacerbating TED severity has encouraged the use of antioxydative agents such as selenium, which has shown a ...
Source: Current Opinion in Ophthalmology - August 18, 2017 Category: Opthalmology Tags: OCULOPLASTIC AND ORBITAL SURGERY: Edited by Richard C. Allen Source Type: research

Graft versus host disease: what should the oculoplastic surgeon know?
Purpose of review:To provide a concise review of the oculoplastic manifestations of ocular graft versus host disease (GVHD), and to discuss their management. Recent findings:Ocular GVHD occurs as a common immune-mediated complication of hematopoietic stem cell transplantation that presents as a Stevens–Johnson-like syndrome in the acute phase or a Sjögren-like syndrome in the chronic phase. Cicatricial conjunctivitis may be underreported in ocular GVHD. The spectrum of oculoplastic manifestations includes GVHD of the skin, cicatricial entropion, nasolacrimal duct obstruction, and lacrimal gland dysfunction. Sur...
Source: Current Opinion in Ophthalmology - August 18, 2017 Category: Opthalmology Tags: OCULOPLASTIC AND ORBITAL SURGERY: Edited by Richard C. Allen Source Type: research

Avoiding the Hughes flap in lower eyelid reconstruction
Purpose of review:To review current surgical practices of lower eyelid reconstruction with a focus on recent studies. Recent findings:Combination techniques and new flap techniques offer efficacy comparable with existing reconstructive approaches, with the advantage of less local trauma. Inappropriate handling of posterior lamellar grafts, such as kerfing, may predispose to graft failures. Modified Hughes procedure is a favorable choice for large lower eyelid reconstruction; however, it requires temporary eye closure. Other surgical options have been developed to achieve a 1-stage procedure without the need of eye closure...
Source: Current Opinion in Ophthalmology - August 18, 2017 Category: Opthalmology Tags: OCULOPLASTIC AND ORBITAL SURGERY: Edited by Richard C. Allen Source Type: research

Molecularly targeted agents in oculoplastic surgery
Purpose of review:Significant advances have been made in oncology and rheumatology with the introduction of molecularly targeted agents (MTAs). MTAs consist of monoclonal antibodies and small molecule inhibitors. The purpose of this manuscript is to review the recent applications of MTAs to orbital, lacrimal, and eyelid disease. Recent findings:The use of monoclonal antibodies has been described in the treatment of orbital vascular lesions, lymphoma, and squamous cell carcinoma. Inflammatory conditions treated with monoclonal antibodies include thyroid eye disease, IgG4 disease, and granulomatosis with polyangiitis. Immun...
Source: Current Opinion in Ophthalmology - August 18, 2017 Category: Opthalmology Tags: OCULOPLASTIC AND ORBITAL SURGERY: Edited by Richard C. Allen Source Type: research

Pediatric corneal transplants
Purpose of review:Pediatric keratoplasty poses unique challenges in clinical and surgical management. However, successful transplantation can afford a child vision in an otherwise poorly seeing eye. This review will provide an update on recent advances in pediatric keratoplasty. Recent findings:Although children who receive corneal transplants remain at increased risk of rejection, infection, and graft dehiscence compared with adult corneal transplant recipients, new surgical techniques, and advances in clinical management have led to better outcomes. Surgical modifications in penetrating keratoplasty (PKP) offer increase...
Source: Current Opinion in Ophthalmology - August 18, 2017 Category: Opthalmology Tags: PEDIATRICS AND STRABISMUS: Edited by J. Mark Engel Source Type: research

Pediatric orbital blowout fractures
Purpose of review:The current study reviews the recent literature on pediatric orbital blowout fractures and provides guidelines on their management. Recent findings:The most common problem among patients requiring surgical revision of a previously repaired orbital floor fracture is an improperly placed orbital floor implant, usually erroneously placed under the posterior bony ledge. Although the transconjunctival incision can be combined with a lateral canthotomy and cantholysis, excellent surgical exposure can be obtained without the need for these latter relaxing maneuvers. In surgically repaired pediatric orbital blow...
Source: Current Opinion in Ophthalmology - August 18, 2017 Category: Opthalmology Tags: PEDIATRICS AND STRABISMUS: Edited by J. Mark Engel Source Type: research

The role of imaging in strabismus
Purpose of review:To review the most recent literature regarding the clinical experience of imaging modalities in strabismus. Recent findings:MRI of extraocular muscles (EOMs) has elucidated the roles of variation in compartmental contraction of EOMs and further evidence of EOM pulley heterotopy in various strabismus patterns, which may contribute to the clinical and surgical management of patients as this mode of imaging becomes more readily available. Ultrasound biomicroscopy (UBM) and anterior-segment optical coherence tomography (AS-OCT) may play a role in determining the location of EOMs which could also aid in devis...
Source: Current Opinion in Ophthalmology - August 18, 2017 Category: Opthalmology Tags: PEDIATRICS AND STRABISMUS: Edited by J. Mark Engel Source Type: research

The resurgence of botulinum toxin injection for strabismus in children
Purpose of review:The present review discusses recent advances in the use of botulinum toxin for the management of strabismus in children. Recent findings:Botulinum toxin injection produces similar results compared to surgery for certain subtypes of strabismus, especially acute onset esotropia. It may be more effective in many subtypes of esotropia where surgery has been less reliable, including partially accommodative esotropia, esotropia associated with cerebral palsy, and thyroid eye disease. Summary:Small retrospective studies have demonstrated the efficacy of botulinum toxin in the treatment of many types of pediatr...
Source: Current Opinion in Ophthalmology - August 18, 2017 Category: Opthalmology Tags: PEDIATRICS AND STRABISMUS: Edited by J. Mark Engel Source Type: research

Compliance with the prescribed occlusion treatment for amblyopia
Purpose of review:The present review article is an update on the current evidence about compliance to the prescribed occlusion treatment for amblyopia. In particular, the authors focus on the predictors and causes of noncompliance and possible interventions to increase it. Recent findings:Compliance with prescribed occlusion treatment is often challenging. Reported rates of compliance range widely from 49% to 87%. Objective monitoring of occlusion has opened up new research opportunities and allow the design of effective therapeutic regimens. Also, predictors and causes of noncompliance have been investigated and their kn...
Source: Current Opinion in Ophthalmology - August 18, 2017 Category: Opthalmology Tags: PEDIATRICS AND STRABISMUS: Edited by J. Mark Engel Source Type: research

Pediatric blepharokeratoconjunctivitis: is there a ‘right’ treatment?
This article highlights the importance of recognizing blepharokeratoconjunctivitis (BKC) in children and reviews the clinical characteristics and current therapeutic modalities. Recent findings:The mainstay of BKC treatment remains controlling the meibomian gland inflammation and treating cobormid conditions. BKC can occur in the setting of ocular rosacea and Demodex infestation. Small studies have shown treatment benefits of topical cyclosporine A as well as oral azithromycin in pediatric BKC. Summary:BKC is a cause for visual loss in children, and therefore pediatric ophthalmologists should be more vigilant about early...
Source: Current Opinion in Ophthalmology - August 18, 2017 Category: Opthalmology Tags: PEDIATRICS AND STRABISMUS: Edited by J. Mark Engel Source Type: research

Pediatric ophthalmologists wear many hats
No abstract available (Source: Current Opinion in Ophthalmology)
Source: Current Opinion in Ophthalmology - August 18, 2017 Category: Opthalmology Tags: PEDIATRICS AND STRABISMUS: Edited by J. Mark Engel Source Type: research

PAX6 aniridia syndrome: clinics, genetics, and therapeutics
Purpose of review:Aniridia is a rare and panocular disorder affecting most of the ocular structures which may have significant impact on vision. The purpose of this review is to describe the clinical features, genetics, and therapeutic options for this disease and to provide an update of current knowledge and latest research findings. Recent findings:Aside from the ocular features, a variety of associated systemic abnormalities, including hormonal, metabolic, gastrointestinal, genitourinary, and neurologic pathologies have been reported in children with aniridia. Although mutations in PAX6 are a major cause of aniridia, g...
Source: Current Opinion in Ophthalmology - August 18, 2017 Category: Opthalmology Tags: OCULAR GENETICS: Edited by Alex V. Levin Source Type: research

Ocular genetics in Taiwan
Purpose of review:Ocular genetics is an emerging specialty which has accompanied the advancement of modern genetic technology. This review is to understand the current status of practice in ocular genetics in Taiwan. Recent findings:There is only one ocular genetics clinic in Taiwan. Certified clinical laboratories provide few gene tests in ocular genetics. Most ocular genetic study is focused on myopia. Financial obstacles are a major problem for patients to seek gene tests. Summary:Despite a relatively successful, healthcare system in Taiwan, when compared with developed countries, ocular genetics is at an early stage ...
Source: Current Opinion in Ophthalmology - August 18, 2017 Category: Opthalmology Tags: OCULAR GENETICS: Edited by Alex V. Levin Source Type: research

Practical approach to syndromic pediatric retinal dystrophies
Purpose of review:The purpose of this review is to outline those systemic disorders that are associated with pediatric retinal dystrophy, summarize important retinal, and nonretinal clues that aid in syndromic diagnosis, provide an approach for ophthalmic and systematic systemic examination, describe the important systemic findings seen in pediatric syndromic retinal dystrophies and highlight the role of genetic testing. Recent findings:With profound advances being made in the field of molecular genetics, a definitive molecular etiology is increasingly being made even in rare and unusual forms of retinal dystrophies. Earl...
Source: Current Opinion in Ophthalmology - August 18, 2017 Category: Opthalmology Tags: OCULAR GENETICS: Edited by Alex V. Levin Source Type: research

Choroideremia
Purpose of review:Although much has been written to define the phenotype and genotype of choroideremia (CHM), research continues to provide new insights that serve to better understand its pathogenesis and the directions for potential experimental therapies. Recent findings:We would like to highlight new findings, expanding the type of disease-causing mutations to include mutations in the CHM promoter that will dramatically influence gene expression. Information derived from careful phenotyping of patients points increasingly to the central role of the retinal pigment epithelium as the key cell layer affected in the degen...
Source: Current Opinion in Ophthalmology - August 18, 2017 Category: Opthalmology Tags: OCULAR GENETICS: Edited by Alex V. Levin Source Type: research

Leber hereditary optic neuropathy: bridging the translational gap
Purpose of review:Leber hereditary optic neuropathy (LHON) is the most common primary mitochondrial DNA (mtDNA) genetic disorder in the population. We address the clinical evolution of the disease, the secondary etiological factors that could contribute to visual loss, and the challenging task of developing effective treatments. Recent findings:LHON is characterized by a preclinical phase that reflects retinal ganglion cell (RGC) dysfunction before rapid visual deterioration ensues. Children can present atypically with slowly progressive visual loss or an insidious/subclinical onset that frequently results in considerable...
Source: Current Opinion in Ophthalmology - August 18, 2017 Category: Opthalmology Tags: OCULAR GENETICS: Edited by Alex V. Levin Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Ophthalmology)
Source: Current Opinion in Ophthalmology - August 18, 2017 Category: Opthalmology Tags: Editorial Introductions Source Type: research

Accelerated versus conventional corneal crosslinking for refractive instability: an update
Purpose of review:Corneal crosslinking (CXL) is a relatively new treatment modality offering refractive stability in patients with ectatic disorders. The procedure as initially described (Dresden protocol) is time consuming; accelerated protocols have been lately developed. The purpose of this review is to present the recent findings regarding the comparison of accelerated CXL with the conventional Dresden protocol. Recent findings:A variety of accelerated protocols are described in the literature. Safety and efficacy of the procedures with regard to stability seem to be equivalent in initial studies but indirect measures...
Source: Current Opinion in Ophthalmology - June 13, 2017 Category: Opthalmology Tags: REFRACTIVE SURGERY: Edited by Jimmy K. Lee Source Type: research

Refractive error in underserved adults: causes and potential solutions
Purpose of review:To evaluate the epidemiology of uncorrected refractive errors (URE) in adults both in the United States and globally, health outcomes impacted by URE, common barriers to treatment, and propose potential interventions. Recent fndings:URE is the main cause of visual impairment and the second leading cause of blindness globally. Rates of URE are rising, and cause disability that reduces productivity, economic earnings, and the quality of life of affected individuals. Economic barriers, healthcare access, and sociocultural constraints are among the most fundamental barriers to correcting URE. However, innova...
Source: Current Opinion in Ophthalmology - June 13, 2017 Category: Opthalmology Tags: REFRACTIVE SURGERY: Edited by Jimmy K. Lee Source Type: research

The osteo-odonto-keratoprosthesis
Purpose of review: To describe the practice of and recent developments in the osteo-odonto-keratoprosthesis. Recent findings: Formal psychological assessment and support have been described. A sub-aqua system for fashioning the osteo-odonto-keratoprosthesis lamina; adoption of thicker laminae; use of bisphosphonate drugs; advances in laminar imaging; and use of bone augmentation and bone morphogenetic protein have been described for prevention, detection, and management of laminar resorption. Two systems of optical cylinders available commercially. A stepladder approach to buccal mucous membrane overgrowth onto the optica...
Source: Current Opinion in Ophthalmology - June 10, 2017 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research

The Boston keratoprosthesis
Purpose of review: The Boston keratoprosthesis (BKPro) is often the only hope for visual rehabilitation in severe corneal disease. Since Food and Drug Administration approval of the device in 1992, there have been a series of advances in its design, surgical techniques, and postoperative care, which have widened its applicability and decreased associated complications. The purpose of this review is to highlight the indications, management, outcomes, and advances in the BKPro literature. Recent findings: With more surgeons reporting long-term data, it is evident that modifications to the device and perioperative care have ...
Source: Current Opinion in Ophthalmology - June 10, 2017 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research

Cultivated limbal epithelial transplantation
Purpose of review: To provide an updated literature review on the status of cultivated limbal (corneal) epithelial transplantation. Cultivated limbal stem-cell transplantation recently received regulatory approval. We provide a comprehensive overview of recent developments in the field. Recent findings: The current article reviews and highlights recent developments in the field of cultivated limbal stem-cell transplantation as retrieved from a literature search for the last year. Summary: The implications of clinical/research findings in terms of transplanted cell source and cultivation methods in limbal stem-cell transp...
Source: Current Opinion in Ophthalmology - June 10, 2017 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research

Simple limbal epithelial transplantation
We described how the provision of this procedure adds to the armamentarium of techniques available to treat some of the many thousands of uniocular corneal blind around the world. Recent findings: A total of 125 patients from a recent series from our centre and 68 from a multicentre study provide evidence for efficacy mainly in cases of unilateral corneal burn. Results were comparable to other stem cell techniques described in other papers. Numerous small case reports describe the use of SLET in other contexts including ocular surface squamous neoplasia and pterygium excision. Summary: SLET offers a cheaper and perhaps s...
Source: Current Opinion in Ophthalmology - June 10, 2017 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research

Keratolimbal allograft
Purpose of review: Keratolimbal allograft (KLAL) transplants limbal tissue attached to a corneoscleral carrier from a cadaveric donor to deliver a large number of stem cells to the recipient. The present article will provide a review of KLAL focusing on the recent literature. Recent findings: Recent findings pertain to tissue selection, immunosuppression and adverse event profiles, and postoperative complications (particularly related to immunologic rejection). Summary: KLAL permits the treatment of limbal stem cell deficiency eyes when there is no available living-related or autograft tissue with minimal risk of irrever...
Source: Current Opinion in Ophthalmology - June 10, 2017 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research

Conjunctival–limbal autograft
Purpose of review: To provide an overview of conjunctival–limbal autografting (CLAU) for ocular surface rehabilitation with emphasis on more recent literature detailing outcomes of the procedure over the last 2 decades as well as technique variations and adjuvant techniques. Recent findings: Limbal autografting initially described in 1964 by Barraquer and Strampelli and later popularized by Kenyon and Tseng is considered the best option for restoration of corneal phenotype in unilateral limbal stem-cell deficiency. Although there have been developments in alternative limbal epithelial stem-cell techniques including ...
Source: Current Opinion in Ophthalmology - June 10, 2017 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research

Amniotic membrane use for management of corneal limbal stem cell deficiency
Purpose of review: The current article reviews the most recent surgical techniques for management of corneal limbal stem cell deficiency (LSCD) using amniotic membrane tissue. Recent findings: Early successes with amniotic membrane transplantation (AMT) for the treatment of ocular surface disorders have encouraged clinicians to investigate new applications. The use of AMT as a temporary patch in emergency cases in which LSCD may develop has considerably improved the prognosis of these patients. Amniotic membrane does not have stem cells of its own, but it supports regeneration of limbal epithelial stem cells (LESCs). Simi...
Source: Current Opinion in Ophthalmology - June 10, 2017 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research

Diagnosis of corneal limbal stem cell deficiency
Purpose of review: A state of limbal stem cell deficiency (LSCD) can be secondary to a number of etiologies, resulting in either a reduction in the total number of limbal stem cells or an abnormality in stem cell function. Initially, the epithelium becomes irregular and hazy; however, this condition may progress to persistent corneal epithelial defects, stromal scarring, ulceration, and even perforation. Since LSCD secondary to a variety of etiologies may be reversible, and various factors are prognostic of disease progression, timely diagnosis is important. This review will describe current knowledge of diagnostic techniq...
Source: Current Opinion in Ophthalmology - June 10, 2017 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research

Limbal and corneal epithelial homeostasis
Purpose of review: The aim of this review is to describe the underlying mechanisms of corneal epithelial homeostasis in addition to illustrating the vital role of the limbal epithelial stem cells (LESCs) and the limbal niche in epithelial regeneration and wound healing. Recent findings: The shedded corneal epithelial cells are constantly replenished by the LESCs which give rise to epithelial cells that proliferate, differentiate, and migrate centripetally. While some recent studies have proposed that epithelial stem cells may also be present in the central cornea, the predominant location for the stem cells is the limbus....
Source: Current Opinion in Ophthalmology - June 10, 2017 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research

Accelerated versus conventional corneal crosslinking for refractive instability: an update
Purpose of review: Corneal crosslinking (CXL) is a relatively new treatment modality offering refractive stability in patients with ectatic disorders. The procedure as initially described (Dresden protocol) is time consuming; accelerated protocols have been lately developed. The purpose of this review is to present the recent findings regarding the comparison of accelerated CXL with the conventional Dresden protocol. Recent findings: A variety of accelerated protocols are described in the literature. Safety and efficacy of the procedures with regard to stability seem to be equivalent in initial studies but indirect measur...
Source: Current Opinion in Ophthalmology - June 10, 2017 Category: Opthalmology Tags: REFRACTIVE SURGERY: Edited by Jimmy K. Lee Source Type: research

Risk profiles of ectasia after keratorefractive surgery
Purpose of review: To identify and evaluate the risk factors of iatrogenic ectasia after refractive surgery. Recent findings: We reviewed recently published papers that identified various risk factors associated with ectasia after LASIK, photorefractive keratectomy, small incision lenticule extraction, and other refractive surgical procedures. We also attempted to evaluate the relative contributions of these factors to the development of ectasia following refractive surgery. Forme fruste keratoconus, genetic predisposition to keratoconus, low residual stromal bed thickness (through high myopia, thin preoperative cornea, o...
Source: Current Opinion in Ophthalmology - June 10, 2017 Category: Opthalmology Tags: REFRACTIVE SURGERY: Edited by Jimmy K. Lee Source Type: research

Role of the corneal epithelium measurements in keratorefractive surgery
Purpose of review: Refractive surgery has stimulated considerable progress in corneal and anterior segment imaging, and optical characterization of the eye. From front surface corneal topography, we evolved to three-dimensional corneal tomography with limbus to limbus characterization of the front and back corneal surfaces and pachymetric mapping. Corneal anatomical evaluation has further evolved to layered or segmental tomography with the ability to characterize corneal epithelial thickness profile and the elevation of stromal front surface. Further characterization of even more specific structures, such as Bowman's layer...
Source: Current Opinion in Ophthalmology - June 10, 2017 Category: Opthalmology Tags: REFRACTIVE SURGERY: Edited by Jimmy K. Lee Source Type: research

Descemet membrane endothelial keratoplasty and refractive surgery
This article reviews the clinical outcomes in these cases and discusses the possibility of refractive interventions following DMEK. Recent findings: DMEK has been successfully performed in eyes after laser in-situ keratomileusis, eyes after anterior chamber intraocular lens (IOL) implantation and aphakic eyes. Often, DMEK is combined with cataract surgery (triple-DMEK). Initial reports on reducing the refractive cylinder by toric IOL implantation are available. Although there are some reports on phacoemulsification and IOL implantation after phakic DMEK, reports on laser refractive procedures following DMEK are lacking. ...
Source: Current Opinion in Ophthalmology - June 10, 2017 Category: Opthalmology Tags: REFRACTIVE SURGERY: Edited by Jimmy K. Lee Source Type: research

Considerations for refractive surgery in the glaucoma patient
Purpose of review: Given the popularity of keratorefractive surgery, and an aging populous of patients who have undergone these procedures, there is an increasing need for updated management protocols. This is particularly relevant for patients with chronic progressive diseases such as glaucoma, due to the variety of related diagnostic and management challenges inherent to these diseases. Here, we will review the current literature to provide an update on the management of patients with glaucoma who are undergoing, or have had laser ablative refractive surgery. Preoperative testing and eligibility considerations, intraoper...
Source: Current Opinion in Ophthalmology - June 10, 2017 Category: Opthalmology Tags: REFRACTIVE SURGERY: Edited by Jimmy K. Lee Source Type: research

Pediatric refractive surgery
This article will review this history as well as current thoughts on treating children with large refractive errors. Recent findings: Pediatric refractive surgery has developed slowly as very few children fit the criteria for treatment. For this reason, practice patterns are varied and publications are rare. Publications in recent years have focused on intraocular procedures over laser refractive surgery. Summary: Pediatric refractive surgery is an evolving field as surgeons try to find the best long-term treatments for these young patients. (Source: Current Opinion in Ophthalmology)
Source: Current Opinion in Ophthalmology - June 10, 2017 Category: Opthalmology Tags: REFRACTIVE SURGERY: Edited by Jimmy K. Lee Source Type: research

Refractive error in underserved adults: causes and potential solutions
Purpose of review: To evaluate the epidemiology of uncorrected refractive errors (URE) in adults both in the United States and globally, health outcomes impacted by URE, common barriers to treatment, and propose potential interventions. Recent fndings: URE is the main cause of visual impairment and the second leading cause of blindness globally. Rates of URE are rising, and cause disability that reduces productivity, economic earnings, and the quality of life of affected individuals. Economic barriers, healthcare access, and sociocultural constraints are among the most fundamental barriers to correcting URE. However, inno...
Source: Current Opinion in Ophthalmology - June 10, 2017 Category: Opthalmology Tags: REFRACTIVE SURGERY: Edited by Jimmy K. Lee Source Type: research

Editorial
No abstract available (Source: Current Opinion in Ophthalmology)
Source: Current Opinion in Ophthalmology - June 10, 2017 Category: Opthalmology Tags: REFRACTIVE SURGERY: Edited by Jimmy K. Lee Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Ophthalmology)
Source: Current Opinion in Ophthalmology - June 10, 2017 Category: Opthalmology Tags: Editorial Introductions Source Type: research

Optic pathway glioma of childhood
Purpose of review:Optic pathway gliomas (OPG) are the most common tumor of the anterior visual pathway and can involve the optic nerve, chiasm, tract, and optic radiations. They are typically benign lesions, often pilocytic astrocytomas, which are diagnosed in childhood. We review the epidemiology, clinical presentation, diagnosis, and management of these lesions in patients with and without neurofibromatosis type 1 (NF-1). Recent findings:Most commonly, patients diagnosed with OPG have NF-1 especially if the lesions are bilateral. Such lesions tend to have a relatively indolent course and at least 50% of patients have no...
Source: Current Opinion in Ophthalmology - April 11, 2017 Category: Opthalmology Tags: Special Commentary Source Type: research