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International Journal of Keratoconus and Ectatic Corneal Diseases
Current Issue : Volume 5, Issue 2, May-August 2016
 
 
1.  Editorial
Keratoconus Awareness Day
Adel Barbara
[Pages No:iv]
Full Text PDF | Abstract | FREE

ABSTRACT

Keratoconus Awareness Day

Keratoconus affects negatively the quality of life of the patients suffering from this disease, it affects uncorrected visual acuity and the best spectacle corrected visual acuity, the quality of vision is degraded.

 
2.  Research Article
Individual Long-term Visual Stability after MyoRing Treatment of Keratoconus
Andreas Prangl-Grötzl, Armin Ettl, Robert Hörantner, Albert Daxer
[Pages No:53-56]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10025-1121 | FREE

ABSTRACT

Purpose: The article aims to study the individual long-term stability of visual acuity after MyoRing treatment of keratoconus.

Materials and methods: This is a retrospective study of the individual visual acuity development for 5 years after MyoRing implantation for keratoconus.

Results: In no single case did uncorrected and corrected distance visual acuity lose one line or more during the first 5 years after MyoRing treatment for keratoconus. Moreover, visual acuity was even further ameliorated in most of the cases until the last follow-up period of 5 years after surgery.

Conclusion: The results indicate that MyoRing placement inside the cornea can achieve both visual rehabilitation and stop of progression of the disease.

Keywords: Corneal ring, Keratoconus, MyoRing, Stop of progression, Visual rehabilitation.

How to cite this article: Prangl-Grötzl A, Ettl A, Hörantner R, Daxer A. Individual Long-term Visual Stability after MyoRing Treatment of Keratoconus. Int J Kerat Ect Cor Dis 2016;5(2):53-56.

Source of support: The study was partly supported by the Austrian Research Fund (FFG).

Conflict of interest: Dr. Daxer has an investment interest in DIOPTEX GmbH, Dr. Prangl-Grötzl, Dr. Ettl, and Dr. Hörantner have no financial interest. Preliminary results were presented at the Keratoconus Expert Meeting held during the annual meetings of the ESCRS 2014 in London and 2015 in Barcelona.

 
3.  Research Article
Effect of Circular Keratotomy on Progression of Keratoconus
Jörg H Krumeich, Nino Hirnschall
[Pages No:57-62]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10025-1122 | FREE

ABSTRACT

Purpose: Studies on keratoconus treatment with regard to the stage of the disease have not been published. We evaluated patient outcomes over a 5-year period after circular keratotomy (CKT) to treat stage I and II progressive keratoconus.

Setting: Clinic Krumeich, Bochum, Germany.

Design: Retrospective clinical study.

Materials and methods: We retrospectively evaluated the outcomes of 185 consecutive CKT procedures to treat early, progressing keratoconus. A 7-mm trephine incision, with a depth that was 90% of the thinnest pachymetry value but not less than 400 µm, was made with the guided trephine system concentric to the pupil and sutured with a double running anti-torque suture. Keratometry readings and astigmatism measurements at 1-year postsurgery were compared with values obtained at 3 and 5 years postsurgery. Preoperative values of best-corrected visual acuity with glasses were compared with values obtained at 3 and 5 years postsurgery. Statistical analyses for significance were performed.

Results: Keratometric readings revealed stability at 5 years postsurgery in 84.3% (n = 51) of those eyes for which all values at all time points were available. Likewise, astigmatism values revealed stability in 92.2% of eyes. Best-corrected visual acuity improved significantly from preoperative to 5 years in 73.68% (n = 38). Best-corrected visual acuity did not change in 18.42% (n = 36).

Conclusion: Circular keratotomy halted the progression of early-stage keratoconus for at least 5 years in 84.3% of the eyes studied. The stable keratometric results suggest that CKT treatment should be considered for patients diagnosed early in the progression of this disease.

Keywords: Circular keratotomy, Guided trephine system, Keratoconus treatment.

How to cite this article: Krumeich JH, Hirnschall N. Effect of Circular Keratotomy on Progression of Keratoconus. Int J Kerat Ect Cor Dis 2016;5(2):57-62.

Source of support: Nil

Conflict of interest: None

 
4.  Research Article
Abnormal Regulation of Extracellular Matrix and Adhesion Molecules in Corneas of Patients with Keratoconus
Yelena Bykhovskaya, Anastasia Gromova, Helen P Makarenkova, Yaron S Rabinowitz
[Pages No:63-70]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10025-1123 | FREE

ABSTRACT

Aim: To identify changes in the expression of genes coding for extracellular matrix (ECM) proteins in patients with noninflammatory corneal disorder keratoconus (KC), patients with corneal scarring, and normal controls.

Materials and methods: Total ribonucleic acid extracted from corneal tissue of 13 KC patients, 2 patients with corneal scaring, and 4 normal controls was analyzed using Human Extracellular Matrix & Adhesion Molecules Profiler Polymerase Chain Reaction Array. Statistically significant changes in gene expression were identified using the Data Analysis software.

Results: Comparison of KC and control corneas with thresholds of 1.5 or greater fold change and a p-value of 0.05 or lower revealed 21 differentially expressed genes: 16 genes were downregulated and 5 were upregulated. Among transcripts downregulated in KC patients, we identified thrombospondin 1, disintegrin and metalloproteinase with thrombospondin motif 1, secreted phosphoprotein 1, several collagens, and integrins. We found transforming growth factor beta-induced (TGFBI or BIGH3) gene was the most significantly upregulated transcript.

Conclusion: The development of KC results in deregulation of gene expression of ECM and adhesion molecules.

Clinical significance: Downregulation of collagens and upregulation of TGFBI repeatedly identified in KC patients may be used as clinical markers of the disease.

Keywords: Adhesion, Collagens, Extracellular matrix, Expression, Keratoconus, Laboratory research.

How to cite this article: B ykhovskaya Y , G romova A , Makarenkova HP, Rabinowitz YS. Abnormal Regulation of Extracellular Matrix and Adhesion Molecules in Corneas of Patients with Keratoconus. Int J Kerat Ect Cor Dis 2016;5(2): 63-70.

Source of support: This study was supported by The Eye Defects Research Foundation Inc., the Skirball Fund for Molecular Ophthalmology, and the National Eye Institute grant R01-09052 (Y.S.R) and NEI 2R01-EY012383-11A1 (H.P.M.).

Conflict of interest: None

 
5.  Case Series
Simultaneous Topography-guided Surface Ablation with Collagen Cross-linking for Keratoconus
Lily Karmona, Tzahi Sela, Oz Franco, Avi Shoshani, Gur Munzer, Igor Kaiserman
[Pages No:71-76]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10025-1124 | FREE

ABSTRACT

Purpose: In this article, we present the results of eight eyes of patients who underwent combined same-day partial topographyguided surface ablation followed by accelerated collagen cross-linking (CXL) procedure at Care-Vision Laser Centers to achieve stabilization of corneal ectasia and enhance visual rehabilitation in keratoconus.

Materials and methods: A retrospective nonrandomized review of 8 eyes of 6 patients who underwent the Athens Protocol for progressive keratoconus. Each patient underwent topography-guided ablation followed by CXL procedure.

Follow-up: Follow-up was done on day 1, day 7, and then at 1, 3, 6, and 12 months.

Results: There was a rapid and significant improvement in uncorrected visual acuity and best-corrected visual acuity in 100% eyes, a reduction of keratometric values, and symmetry between vertical hemimeridians. Topographic evaluation showed a marked improvement in irregularity. There were no signs of keratoconic progression noted in any of the eyes on last follow-up. No adverse events were reported in any patient.

Conclusion: Simultaneous surface ablation + CXL seems to be a promising treatment capable of offering patients functional vision and halting progression of the disorder.

Precis: Simultaneous topography-guided custom ablation treatment and photorefractive keratectomy with CXL offers keratoconic patients intolerant to contact lenses both stabilization of the cornea and improved functional vision with spectacles correction.

Keywords: Athens protocol, Keratoconus, Topography-guided surface ablation.

How to cite this article: Karmona L, Sela T, Franco O, Shoshani A, Munzer G, Kaiserman I. Simultaneous Topography-guided Surface Ablation with Collagen Cross-linking for Keratoconus. Int J Kerat Ect Cor Dis 2016;5(2):71-76.

Source of support: Nil

Conflict of interest: None

 
6.  Case Series
Acanthamoeba Keratitis: Different Surgical Approaches
Mukharram Bikbov, Valentina Surkova, Emin Usubov
[Pages No:77-80]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10025-1125 | FREE

ABSTRACT

The features of acanthamoeba keratitis (AK) progression, clinical cases, and results of early and delayed penetrating keratoplasty as the main method of severe AK treatment are presented. It is described as two clinical cases with different surgical approaches: Case 1 - delayed keratoplasty after remission and case 2 - early keratoplasty during a severe flare up of the disease.
In the 1st case the keratitis led to the development of chronic keratouveitis, secondary glaucoma, complicated cataract, and vision loss. The received keratoplasty was of only anatomic effect. In the 2nd case early keratoplasty allowed avoiding secondary complications and retaining a satisfactory visual acuity along with avoiding reoperations.

Keywords: Acanthamoeba keratitis, Keratitis, Penetrating keratoplasty.

How to cite this article: Bikbov M, Surkova V, Usubov E. Acanthamoeba Keratitis: Different Surgical Approaches. Int J Kerat Ect Cor Dis 2016;5(2):77-80.

Source of support: Nil

Conflict of interest: None

 
7.  Case Report
Clinical Dilemmas in the Management of a Monocular Patient with Down’s Syndrome, Dementia, Advanced Keratoconus, and a Mature Cataract
Hala Ali, Mayank A Nanavaty
[Pages No:81-84]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10025-1126 | FREE

ABSTRACT

There are reports on the successful management of mild to moderate keratoconus in patients with Down’s syndrome. However, when Down’s syndrome is coexistent with Dementia, poor general health, and very advanced keratoconus in only one eye, then clinicians may face challenges at all stages from diagnosis, treatment, and follow-up. Our case is one such example of a combination of Down’s syndrome, Dementia, poor general health, and very advanced keratoconus with a white cataract in the only functioning eye. This report highlights the dilemmas which were encountered and learning points on selection of the safest, yet effective management options in such patients.

Keywords: Dementia, Downs syndrome, Keratoconus.

How to cite this article: Ali H, Nanavaty MA. Clinical Dilemmas in the Management of a Monocular Patient with Down’s Syndrome, Dementia, Advanced Keratoconus, and a Mature Cataract. Int J Kerat Ect Cor Dis 2016;5(2):81-84.

Source of support: Nil

Conflict of interest: None

 
8.  Case Report
Late-onset Post-Lasik Ectasia with no Apparent Risk Factor except Eye Rubbing: A Case Report and Literature Review
Adel Barbara, Ramez Barbara
[Pages No:85-91]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10025-1127 | FREE

ABSTRACT

Post-lasik ectasia is the most feared complication following lasik, occurring in majority of cases within 1 year of surgery. Furthermore, it is reported many years after surgery. In this case report, we describe and analyze a post-lasik ectasia case in one eye which was diagnosed after 11 years without any risk factor or apparent reason except eye rubbing.

Keywords: Corneal biomechanics, Eye rubbing, Flap thickness, Keratoconus, Keratoectasia, Lasik, Post-lasik ectasia, Residual stromal bed.

How to cite this article: Barbara A, Barbara R. Late-onset Post-lasik Ectasia with no Apparent Risk Factor except Eye Rubbing: A Case Report and Literature Review. Int J Kerat Ect Cor Dis 2016;5(2):85-91.

Source of support: Nil

Conflict of interest: None

 
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