AUTHOR LOGIN Close
Please enter author credentials to view Author Manual
Username:
Password:  
   
for New Author Registration
JAYPEE JOURNALS
International Scientific Journals from Jaypee
IndexCopernicus Value: 5.86
Home Instructions Editorial Board Current Issue Pubmed Archives Subscription Advertisement Contact Us
 
LOGIN  
Username: Password:
 
New Author Registration | Forgot Password ?
 
 
International Journal of Keratoconus and Ectatic Corneal Diseases
Current Issue : Volume 4, Issue 3, September-December 2015
 
 
1.  Editorial
Editorial
Jérôme C Vryghem
[Pages No:iv]
Full Text PDF | Abstract | FREE

ABSTRACT

I have been the Instigator and Organizer of the Expert Meeting on the Surgical Management of Keratoconus which has been organized annually just before the European Society of Cataract and Refractive Surgeons (ESCRS) since 2010 in Paris.

 
2.  Original Article
A New Tomographic Method of Staging/Classifying Keratoconus: The ABCD Grading System
Michael W Belin, Josh Duncan, Renato Ambrósio Jr, José AP Gomes
[Pages No:85-93]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10025-1105 | FREE

ABSTRACT

Purpose: To incorporate advanced corneal imaging into a new keratoconus classification system that utilizes posterior curvature, thinnest pachymetry, and best-corrected distance vision (CDVA) in addition to standard anterior parameters.

Materials and methods: A total of 672 eyes of 336 normal patients were imaged with the Oculus Pentacam HR. Anterior and posterior radius of curvature measurements were taken using a 3.0 mm zone centered on the thinnest area and corneal thickness was measured at the thinnest point. Mean and standard deviations were recorded and anterior data were compared to the existing Amsler-Krumeich (AK) classification.

Results: A total of 672 eyes of 336 patients were analyzed. Anterior and posterior values were 7.65 ± 0.236 mm / 6.26 ± 0.214 mm respectively and thinnest pachymetry values were 534.2 ± 30.36 um. Comparing anterior curvature values to AK staging yielded 2.63, 5.47, 6.44 standard deviations for stages 1, 2, and 3 respectively. Posterior staging uses the same standard deviation gates. Comparative pachymetric values yielded 4.42, and 7.72 standard deviations for stages 2 and 3 respectively.

Conclusion: A new keratoconus staging system incorporates posterior curvature, thinnest pachymetric values, and distance visual acuity in addition to the standard anterior curvature and consists of stages 0 to 4 (5 stages), closely matches the existing AK classification stages 1 to 4 on anterior curvature. The new classification system by incorporating curvature and thickness measurements based on the thinnest point, as opposed to apical, better reflects the anatomic changes in keratoconus.

Keywords: Classification, Ectasia, Keratoconus, Radius of curvature.

How to cite this article: Belin MW, Duncan J, Ambrósio R Jr, Gomes JAP. A New Tomographic Method of Staging/ Classifying Keratoconus: The ABCD Grading System. Int J Kerat Ect Cor Dis 2015;4(3):85-93.

Source of support: Nil

Conflict of interest: None

 
3.  Review Article
Collagen Cross-linking for the Treatment of Keratoconus in Pediatric Patients
Rana Hanna, Eran Berkwitz, Jamyl Habib Castillo, Beatrice Tiosano
[Pages No:94-99]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10025-1106 | FREE

ABSTRACT

Keratoconus (KC) is a bilateral noninflammatory, ectatic corneal disorder. It is the most common primary ectasia affecting approximately 1 in 2,000 in the general population. Classically, the disease starts in puberty and progresses throughout the 3rd or 4th decades of life. Ocular signs and symptoms vary depending on disease severity. As the disease progresses, approximately 20% of KC eyes require penetrating keratoplasty. Collagen cross-linking (CXL) with ultraviolet-A (UVA) light and riboflavin is a new treatment that has emerged in the recent years. It is reported to slow the progression of the disease in its early stages, by increasing corneal rigidity and biomechanical stability. As the number of adult KC patients treated using this procedure grew, proving its safety and high efficacy, the pediatric KC patients population has started to receive special attention. In the pediatric KC patients’ eyes, corneas have been shown to be significantly steeper at the time of diagnosis compared to adults, and the severity of KC seems inversely correlated with age. Since treating KC in earlier age may be beneficiary, before developing an advanced disease that may require corneal transplantation, CXL in the pediatric age group has been advocated by many practitioners. The aim of this review is to collect and consolidate all known data regarding the efficacy and safety of CXL in the pediatric population.

Keywords: Cross-linking, Keratoconus, Pediatric, Review.

How to cite this article: Hanna R, Berkwitz E, Castillo JH, Tiosano B. Collagen Cross-linking for the Treatment of Keratoconus in Pediatric Patients. Int J Kerat Ect Cor Dis 2015;4(3): 94-99.

Source of support: Nil

Conflict of interest: None

 
4.  Review Article
Collagen Cross-linking for Pellucid Marginal Degeneration
Cheryl MacGregor, Rakesh Jayaswal, Nick Maycock
[Pages No:100-102]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10025-1107 | FREE

ABSTRACT

Pellucid marginal degeneration (PMD) is a rare progressive condition resulting in inferior corneal thinning and astigmatism. Alongside keratoconus and keratoglobus, it is considered one of noninflammatory corneal ectasias. The focus of corneal thinning is greatest inferiorly resulting in diminished visual acuity and overall reduction in visual quality. Traditional methods of treatment or disease management have been similar to those proposed for keratoconus, contact lenses, escalating to intrastromal rings, lamellar keratoplasty or penetrating keratoplasty.
Collagen cross-linking (CXL) has steadily gained acceptance as the treatment of choice for progressive corneal ectasias. Although it has been described at length for keratoconus, there is little literature describing or advocating its use in PMD. In this article, we will review the evidence for CXL and its use in PMD.

Keywords: Cornea, Corneal collagen cross-linking, Pellucid marginal degeneration, Review article.

How to cite this article: MacGregor C, Jayaswal R, Maycock N. Collagen Cross-linking for Pellucid Marginal Degeneration. Int J Kerat Ect Cor Dis 2015;4(3):100-102.

Source of support: Nil

Conflict of interest: None

 
5.  Review Article
Phakic Intraocular Lenses in Keratoconus
Jorge L Alio, Pablo Sanz-Díez
[Pages No:103-106]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10025-1108 | FREE

ABSTRACT

Purpose: To discuss and summarize the indications, contraindications and results in refractive surgery for keratoconus.

Summary: Keratoconus is an ectatic corneal disease characterized by a progressive corneal thinning and irregular astigmatism that negatively impact in the visual function and the optical quality of the patients. The refractive surgery in keratoconus has been discussed by several authors. The two primary lines of action are phakic lens implantation and corneal tissue ablation using photorefractive keratectomy. The use of phakic intraocular lenses (IOLs) to correct myopia and compound myopic astigmatism associated with keratoconus is gaining popularity.

Recent findings: The use of phakic IOLs to correct myopia and compound myopic astigmatism associated with keratoconus is gaining popularity. According to a recent study by our group the safety of this procedure in visual terms is high (post-CDVA/ pre-CDVA = 1.19 ± 0.29). It is also an effective operation (post- UDVA/pre-CDVA = 0.90 ± 0.26).

Keywords: Corneal ectasia, Keratoconus, Phakic intraocular lens, Refractive surgery.

How to cite this article: Alio JL, Sanz-Díez P. Phakic Intraocular Lenses in Keratoconus. Int J Kerat Ect Cor Dis 2015;4(3): 103-106.

Source of support: Nil

Conflict of interest: None

 
6.  Case Report
Surgical Correction of an Inverse Astigmatic Keratotomy following Penetrating Keratoplasty in a Patient with Keratoconus
Marco Abbondanza, Gabriele Abbondanza
[Pages No:107-109]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10025-1109 | FREE

ABSTRACT

Astigmatic keratotomy (AK) is a common and safe procedure to correct post-penetrating keratoplasty (PKP) astigmatism in patients affected by keratoconus (KC). We report the case of a post-PKP AK that was performed inversely by mistake in a private practice. A new AK was performed by our practice in order to correct the remarkably high astigmatism (19 D) that was created with the previous inverse procedure. Fourteen months later, astigmatism had decreased by 12.9 D and central corneal thickness had increased by 35 µm.

Keywords: Astigmatic keratotomy, Cornea, Keratoconus, Keratotomy, Lri, Surgical error.

How to cite this article: Abbondanza M, Abbondanza G. Surgical Correction of an Inverse Astigmatic Keratotomy following Penetrating Keratoplasty in a Patient with Keratoconus. Int J Kerat Ect Cor Dis 2015;4(3):107-109.

Source of support: Nil

Conflict of interest: None

 
7.  Case Report
Anterior Uveitis after Collagen Cross-linking for Keratoconus
Yakov Goldich, Uri Elbaz, David S Rootman
[Pages No:110-114]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10025-1110 | FREE

ABSTRACT

This report describes a case of severe intraocular inflammation followed after CXL with UVA and riboflavin treatment for progressive keratoconus.

Keywords: Anterior uveitis, Collagen Cross-linking, Keratoconus.

How to cite this article: Goldich Y, Elbaz U, Rootman DS. Anterior Uveitis after Collagen Cross-linking for Keratoconus. Int J Kerat Ect Cor Dis 2015;4(3):110-114.

Source of support: Nil

Conflict of interest: None

 
8.  Case Report
Diffuse Sterile Corneal Infiltration: An Unusual Complication Post Collagen Cross-linkage
Mainak Bhattacharyya, Kirti Singh, Ankush Mutreja, Sonal Dangda, Ritu Arora
[Pages No:115-119]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10025-1111 | FREE

ABSTRACT

Purpose: Presenting the course of visually disabling corneal infiltration post uneventful collagen cross-linking (CXL) in a 23 years old male with bilateral keratoconus.

Methods: A 23 years old male with bilateral keratoconus underwent cross-linking of left eye with indigenous 0.1% riboflavin dye and 370 nm ultraviolet A irradiation. This patient had an uneventful successful cross-linking performed in right eye 6 months prior with good recovery of vision to LogMAR 0.2 (6/9 Snellen).

Results: Patient developed diminution of vision, along with redness of eye, photophobia and watering on 3rd day after uneventful cross-linkage. Examination revealed very poor vision; diffuse corneal clouding with multiple superficial stromal infiltrates and incomplete corneal epithelization. A provisional diagnosis of infective keratitis was made, in situ bandage contact lens (BCL) removed and subjected to culture. Intensive fortified topical antibiotics were initiated and steroids withheld. After complete corneal re-epithelization on 6th day, the infiltrations did not decrease in either intensity or number. Response to antibiotics being inadequate, an immune etiology was suspected and full strength topical steroids reinstituted which resulted in slow resolution of infiltration over a 10 weeks period. Last follow-up at 9 months post-CXL, revealed a diffuse stromal haze with unaided visual acuity of LogMAR 0.8 6/36 and best-corrected visual acuity (BCVA) of 0.3 (6/12) with use of a rigid gas permeable lens.

Conclusion: Sterile infiltration post-CXL requiring intense topical steroids is a rare complication of CXL and needs to be differentiated from infective keratitis.

Keywords: Cross-linkage, Keratoconus, Sterile infiltrate.

How to cite this article: Bhattacharyya M, Singh K, Mutreja A, Dangda S, Arora R. Diffuse Sterile Corneal Infiltration: An Unusual Complication Post Collagen Cross-linkage. Int J Kerat Ect Cor Dis 2015;4(3):115-119.

Source of support: Nil

Conflict of interest: None

 
9.  Case Report
Management of Acanthamoeba and Candida Keratitis in a Young Female: Our Experience at Princess Haya Military Hospital
Nancy Al Raqqad, Naser Al Fgara
[Pages No:120-122]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10025-1112 | FREE

ABSTRACT

Aim: We aim to share our experience in the management of a 19 years old female patient, who presented to Princess Haya Military Hospital in Aqaba, Jordan, with a very aggressive keratitis.

Patients and methods: A 19 years old female patient with 1 year history of keratitis that did not resolve despite several treatment strategies tried elsewhere, presented to the eye clinic in Aqaba.
Ocular examination showed signs of Acanthamoeba keratitis with perineuritis.
Corneal cultures were not informative. Corneal biopsy showed a mixed Candida and Acanthamoeba growth.

Results: The patient was started on topical and oral antiamoebic and antifungal treatment (antiamoebic drops brought from UK). Improvement was drastic after 2 weeks of treatment. The patient maintained a chronic low infective state and scarring of the cornea. She received therapeutic and visual karatoplasty 3 months later.
Patient is now 12 months after her PKP. The cornea is clear and vision is 6/12 unaided.

Conclusion: Cases of mixed fungal and amoebic keratitis are very rare. Prompt treatment and diagnosis is essential for recovery. Controversy still exists on the use of steroids after corneal transplantation for treatment of chronic fungal keratitis. Management should be tailored to each individual case.

Keywords: Acanthamoeba, Cornea, Keratitis.

How to cite this article: Al Raqqad N, Al Fgara N. Management of Acanthamoeba and Candida Keratitis in a Young Female: Our Experience at Princess Haya Military Hospital. Int J Kerat Ect Cor Dis 2015;4(3):120-122.

Source of support: Nil

Conflict of interest: None

 
Article Iamge
 
     

© Jaypee Brothers Medical Publishers (P) Ltd. Jaypee Brothers Medical Publishers (P) Ltd.