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JAYPEE JOURNALS
International Scientific Journals from Jaypee
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List of All Articles
1.  Review Article
Eye Rubbing, a Sine Qua Non for Keratoconus?
Damien Gatinel
[Year:2016] [Month:January-April] [Volume:5 ] [Number:1] [Pages:51] [Pages No:6-12] [No of Hits : 2578]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10025-1114 | FREE

ABSTRACT

Keratoconus, a dystrophy of unknown origin, remains an ophthalmic enigma. The contrast between the presence of marked structural changes and deformation of the corneal wall and the relative absence of specific genetic and biomolecular findings continues to intrigue ophthalmologists. In Marfan syndrome, where genetic and molecular abnormalities are well identified, and similar changes in collagen observed, the cornea tends not to be steeper, irregular or ectatic, but are globally flatter. This suggests that an external mechanical force may be necessary to induce the apparition and progression of the ectatic process in keratoconus. Eye rubbing has long been acknowledged as a risk factor for keratoconus and its progression, but could it in fact be the root cause? Many clinical observations and reports support the hypothesis of eye rubbing as a first and necessary hit for inducing progressive ectatic deformation of the corneal wall. Validating or refuting this hypothesis on the basis of patient admission may be impossible. It is difficult to document the frequency, duration and intensity of eye rubbing in patients with keratoconus, and virtually impossible to prove that every patient who denies the habit truly does not rub his eyes. Both the increase in incidence of atopy and the time spent in front of the computer screen in the general population may account for an increased tendency for eye rubbing, and lead to the perceived increased prevalence of keratoconus in both urban and non-urban areas. This paper explores the possibility that the mechanical stress imposed on the cornea by rubbing may not be as much a second hit evoking the structural changes of a predisposed cornea exhibiting unknown collagen progressive alteration, but rather the necessary trigger and sine qua non of the keratoconic process. Even if this provocative hypothesis is impossible to prove, it is equally difficult to refute, and acknowledging eye rubbing as a possible root cause increases awareness within the general population and if true, could dramatically reduce the incidence of keratoconus, and halt its progression in eyes already affected.

Keywords: Computer vision syndrome, Corneal biomechanics, Crosslinking, Ectasia, Eye rubbing, Etiology of keratoconus, Keraotoconus, Marfan syndrome.

How to cite this article: Gatinel D. Eye Rubbing, a Sine Qua Non for Keratoconus? Int J Kerat Ect Cor Dis 2016;5(1):6-12.

Source of support: I thank Cordelia Chan, MD, for assisting the revision of the manuscript.

Conflict of interest: None

 
2.  
Keratoconus Management Guidelines
Jorge L Alió, Alfredo Vega-Estrada, Pablo Sanz-Díez, Pablo Peña-García, María Luisa Durán-García, Miguel Maldonado
[Year:2015] [Month:January-April] [Volume:4 ] [Number:1] [Pages:39] [Pages No:1-39] [No of Hits : 4154]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10025-1095 | FREE

ABSTRACT

This study was partly financed by a project of the Spanish Ministry of Economy and Competitiveness, the Carlos III Health Institute and the Cooperative Health Research Thematic Network on ‘Age-related Eye Disease, Visual Quality and Quality-of-Life’, sub-project ‘Visual Quality’ (RD07/0062); and another project of the Spanish Ministry for Economy and Competitiveness, the Carlos III Health Institute, the Cooperative Health Research Thematic Network ‘Prevention, Early Detection and Treatment of Prevalent, Degenerative and Chronic Eye Diseases’, sub-program ‘Ocular Structures and Common Pathologies’ (RD12/0034).

 
3.  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
[Year:2015] [Month:September-December] [Volume:4 ] [Number:3] [Pages:37] [Pages No:85-93] [No of Hits : 1394]
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

 
4.  CASE REPORT
Corneal Collagen Cross-linking in a Prepubescent 10-Year-Old Girl with Aggressive Keratoconus
Marco Abbondanza, Margherita Guidobaldi
[Year:2015] [Month:May-August] [Volume:4 ] [Number:2] [Pages:42] [Pages No:63-65] [No of Hits : 1049]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10025-1101 | FREE

ABSTRACT

Keratoconus (KC) is a corneal ectatic disease that results in bilateral and asymmetrical corneal distortion, altered refractive powers and reduced vision. In 20 to 25% of cases, corneal transplantation may be required, although a number of conservative procedures are available. We report a case of an aggressive stage II keratoconus in a prepubescent 10-year-old girl, successfully treated with corneal collagen cross-linking (CXL) with epithelium removal.

Keywords: Cornea, Corneal collagen cross-linking, Keratoconus, Pediatric.

How to cite this article: Abbondanza M, Guidobaldi M. Corneal Collagen Cross-linking in a Prepubescent 10-Year- Old Girl with Aggressive Keratoconus. Int J Kerat Ect Cor Dis 2015;4(2):63-65.

Source of support: Nil

Conflict of interest: None

 
5.  Case Report
Surgical Correction of an Inverse Astigmatic Keratotomy following Penetrating Keratoplasty in a Patient with Keratoconus
Marco Abbondanza, Gabriele Abbondanza
[Year:2015] [Month:September-December] [Volume:4 ] [Number:3] [Pages:37] [Pages No:107-109] [No of Hits : 793]
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

 
6.  Original Article
Prevalence of Keratoconus among Young Arab Students in Israel
Einat Shneor, Michel Millodot, Ariela Gordon-Shaag, Maron Essa, Miriam Anton, Ramez Barbara, Adel Barbara
[Year:2014] [Month:January-April] [Volume:3 ] [Number:1] [Pages:51] [Pages No:9-14] [No of Hits : 2342]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10025-1070 | FREE

ABSTRACT

Purpose: To determine the prevalence of keratoconus (KC) in an Arab population in Israel.

Materials and methods: Videokeratography was performed on volunteer students from the Academic Arab College of Education, in Haifa, Israel. All participants filled out a selfadministered questionnaire to evaluate possible risk factors for KC. Univariate and multivariate analysis were performed.

Results: Data of 314 participants were analyzed and a prevalence of (N = 10), 3.18% (95% CI, 1.2 to 5.1%) was found. The only significant factor (both in univariate and multivariate analysis) that was associated with KC was parental consanguinity (OR 5.10, p = 0.02). Druzes and Bedouins had a higher prevalence than Muslims and Christians. However, the differences were not significant possibly due to the small size of the sample.

Conclusion: The result of this study was similar to other studies conducted in the Middle East, which indicate a higher prevalence of KC than in western countries. It is also recommended that people who have consanguinity in their family should be topographically tested to detect the early stages of KC.

Keywords: Keratoconus, Consanguinity, Videokeratography.

How to cite this article: Shneor E, Millodot M, Gordon-Shaag A, Essa M, Anton M, Barbara R, Barbara A. Prevalence of Keratoconus among Young Arab Students in Israel. Int J Kerat Ect Cor Dis 2014;3(1):9-14.

Source of support: Nil

Conflict of interest: None declared

 
7.  Original Article
Independent Population Validation of the Belin/Ambrosio Enhanced Ectasia Display: Implications for Keratoconus Studies and Screening
Ovette F Villavicencio, Fatimah Gilani, Maria A Henriquez, Luis Izquierdo Jr, Renato R Ambrosio Jr, Michael W Belin
[Year:2014] [Month:January-April] [Volume:3 ] [Number:1] [Pages:51] [Pages No:1-8] [No of Hits : 2281]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10025-1069 | FREE

ABSTRACT

With advances in technology and imaging, finding diagnostic criteria that are both sensitive and specific for keratoconus while using the latest corneal imaging modalities is paramount. The Belin/Ambrosio enhanced ectasia display final 'D' index, tested on an independent population, illustrated excellent false positive rates for refractive screening while eliminating 99% of keratoconus corneas. A false positive rate of 0% is achieved with a final 'D' of 2.69, meeting the more stringent criteria for treatment studies.

Keywords: Keratoconus, Ectasia, Tomography, Cornea, Imaging, Refractive surgery, Cross-linking, Scheimpflug, Placido, Topography.

How to cite this article: Villavicencio OF, Gilani F, Henriquez MA, Izquierdo L Jr, Ambrosio RR Jr, Belin MW. Independent Population Validation of the Belin/Ambrosio Enhanced Ectasia Display: Implications for Keratoconus Studies and Screening. Int J Kerat Ect Cor Dis 2014;3(1):1-8.

Source of support: Nil

Conflict of interest: Drs Ambrosio and Belin are consultant to OCULUS GmbH.

 
8.  Cross-Sectional Study
Corneal Elevation Values in Normal Eyes, forme fruste Keratoconus and Keratoconus at Different Stages Measured by Scheimpflug Imaging
Maria A Henriquez, Luis Izquierdo Jr, David Danin
[Year:2014] [Month:January-April] [Volume:3 ] [Number:1] [Pages:51] [Pages No:36-39] [No of Hits : 2122]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10025-1075 | FREE

ABSTRACT

Purpose: To compare corneal elevation values in normal eyes, forme fruste keratoconus (FFKC) and different stages of keratoconus using Scheimpflug imaging.

Materials and methods: This prospective, comparative study included 267 eyes (107 normal eyes, 21 FFKC and 139 keratoconus). Keratoconic eyes were divided into four groups according to keratometry values. Maximum posterior elevation (PE) above the (best fit sphere (BFS) at the central 5 mm were measured using the Pentacam (Oculus Optikgeräte GmbH). Receiver operating characteristic curves were used to determine the test’s overall predictive accuracy and to identify optimal cutoff points to discriminate between the groups.

Results: PE had the smallest values in normal eyes and increased in FFKC and each progressive stage of keratoconus. Mean PE was 9.98 ± 5.33 µm in normal eyes, 18.09 ± 9.23 µm in FFKC and 24.97 µm ± 15.89, 37.82 ± 18.64, 46.82 ± 21.41 and 66.07 ± 39.09, in keratoconus stage I, II, III and IV respectively.

Conclusion: Posterior elevation values increased according to the severity of keratoconus disease. PE can be used as indicator of keratoconus progression.

Keywords: Keratoconus, Scheimpflug imaging, Posterior elevation, Amsler-Krumeich.

How to cite this article: Henriquez MA, Izquierdo L Jr, Dañin D. Corneal Elevation Values in Normal Eyes, forme fruste Keratoconus and Keratoconus at Different Stages Measured by Scheimpflug Imaging. Int J Kerat Ect Cor Dis 2014;3(1):36-39.

Source of support: Nil

Conflict of interest: None declared

 
9.  Original Article
Corneal Thickness after MyoRing Implantation for Keratoconus
Albert Daxer
[Year:2014] [Month:January-April] [Volume:3 ] [Number:1] [Pages:51] [Pages No:15-19] [No of Hits : 1973]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10025-1071 | FREE

ABSTRACT

Purpose: To analyze the corneal thickness development after MyoRing implantation as a tissue-related indicator of keratoconus progression.

Materials and methods: Twelve eyes suffering from keratoconus were treated for visual rehabilitation by means of MyoRing implantation into a corneal pocket. The postoperative development of the corneal thickness at the thinnest point was analyzed. Follow-up ranged from 16 to 74 months (mean 37 months).

Results: Out of the 12 eyes only one eye showed a thinner cornea at the last follow-up 60 months after MyoRing implan-tation compared to the last preoperative data. None of these 12 eyes required an additional intervention like corneal cross-linking, explantation or keratoplasty. Four eyes showed even thickening of the cornea during the postoperative period.

Conclusion: MyoRing implantation for keratoconus does not only allow visual rehabilitation. It also seems to stop the progression of the disease by creating a new biomechanical equilibrium within the tissue which eliminates a constant stimulus that drives the vicious circle of progression.

Keywords: Keratoconus, MyoRing, Corneal thickness, Progression, Corneal cross-linking, PocketMaker.

How to cite this article: Daxer A. Corneal Thickness after MyoRing Implantation for Keratoconus. Int J Kerat Ect Cor Dis 2014;3(1):15-19.

Source of support: Nil

Conflict of interest: None declared

 
10.  Case Report
Post Lasik Keratoectasia Developing with Sleep Apnea and Floppy Eyelid Syndrome: Case Report and Review of the Literature
Noa Avni-Zauberman, David S Rootman
[Year:2014] [Month:January-April] [Volume:3 ] [Number:1] [Pages:51] [Pages No:44-46] [No of Hits : 1844]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10025-1077 | FREE

ABSTRACT

We report a case of unilateral keratoectasia in a patient who underwent uneventful hyperopic LASIK 8 years prior and was diagnosed with obstructive sleep apnea syndrome (OSAS) and Floppy eyelid syndrome. The before and after LASIK topographies demonstrated clear development of the ectasia after the patient developed OSAS. The patient was treated with collagen crosslinking in the involved eye to stop ectatic progression. Our report emphasizes the importance of inquiring about the patient’s sleeping postures and habits (specifically asking about OSAS) and a careful examination of eyelid laxity prior to refractive laser treatment.

Keywords: Post-LASIK ectasia, Floppy eyelid syndrome, Obstructive sleep apnea syndrome.

How to cite this article: Zauberman NA, Rootman DS. Post- Lasik Keratoectasia Developing with Sleep Apnea and Floppy Eyelid Syndrome: Case Report and Review of the Literature. Int J Kerat Ect Cor Dis 2014;3(1):44-46.

Source of support: Nil

Conflict of interest: None

 
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