International Journal of Keratoconus and Ectatic Corneal Diseases

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2014 | January-April | Volume 3 | Issue 1

RESEARCH ARTICLE

Editorial

[Year:2014] [Month:January-April] [Volume:3] [Number:1] [Pages:1] [Pages No:0 - 0]

PDF  |  DOI: 10.5005/ijkecd-3-1-v  |  Open Access |  How to cite  | 

RESEARCH ARTICLE

Ovette F Villavicencio, Fatimah Gilani, Maria A Henriquez, Luis Izquierdo, Renato R Ambrósio

Independent Population Validation of the Belin/Ambrósio Enhanced Ectasia Display: Implications for Keratoconus Studies and Screening

[Year:2014] [Month:January-April] [Volume:3] [Number:1] [Pages:8] [Pages No:1 - 8]

PDF  |  DOI: 10.5005/jp-journals-10025-1069  |  Open Access |  How to cite  | 

Abstract

How to cite this article

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

RESEARCH ARTICLE

Ramez Barbara, Ariela Gordon-Shaag, Michel Millodot, Einat Shneor, Maron Essa, Miriam Anton

Prevalence of Keratoconus among Young Arab students in Israel

[Year:2014] [Month:January-April] [Volume:3] [Number:1] [Pages:6] [Pages No:9 - 14]

PDF  |  DOI: 10.5005/jp-journals-10025-1070  |  Open Access |  How to cite  | 

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 self-administered 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.

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.

RESEARCH ARTICLE

Albert Daxer

Corneal Thickness after MyoRing Implantation for Keratoconus

[Year:2014] [Month:January-April] [Volume:3] [Number:1] [Pages:5] [Pages No:15 - 19]

PDF  |  DOI: 10.5005/jp-journals-10025-1071  |  Open Access |  How to cite  | 

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.

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.

RESEARCH ARTICLE

Albert Daxer

MyoRing Treatment for Cases of Myopia not eligible for Laser Vision Correction

[Year:2014] [Month:January-April] [Volume:3] [Number:1] [Pages:3] [Pages No:20 - 22]

PDF  |  DOI: 10.5005/jp-journals-10025-1072  |  Open Access |  How to cite  | 

Abstract

Pupose

MyoRing implantation has been shown to be able to mechanically stabilize ectatic corneas like a bone-nail for broken legs do. Here I present typical cases of MyoRing treatment for Myopia which were not eligible for LASIK.

Materials and methods

Four eyes of four patients suffering from moderate to high myopia and showing risk factors for postoperative ectasia have been treated by MyoRing implantation. Two of them have been combined with laser vision correction (LVC).

Results

The refractive results are comparable to those published for LVC. The cases with combined MyoRing LASIK treatment performed slightly better postoperatively than those treated with MyoRing only.

Conclusion

MyoRing implantation is safe and effective in myopic cases presenting with mainfest signs of keratoconus. In myopic eyes without manifest keratoconus but risk factors for post-LASIK keratectasia the combination of MyoRing implantation with Excimer Laser Surface Ablation may be a good treatment option.

How to cite this article

Daxer A. MyoRing Treatment for Cases of Myopia not eligible for Laser Vision Correction. Int J Kerat Ect Cor Dis 2014;3(1):20-22.

RESEARCH ARTICLE

David Zadok, Ali Nassar

Corneal Biomechanical Properties Post-LASEK for the Correction of Myopia

[Year:2014] [Month:January-April] [Volume:3] [Number:1] [Pages:6] [Pages No:23 - 28]

PDF  |  DOI: 10.5005/jp-journals-10025-1073  |  Open Access |  How to cite  | 

Abstract

Introduction

Laser surgeries are effective and safe, however, over the years data has accumulated about several complications of the procedures, particularly corneal ectasia. Various studies demonstrated the importance of the front layers of the cornea to keep its structure fixed. In order to correct various degrees of myopia, different thicknesses of tissue have to be removed. Therefore, it is conceivable that the risk of developing ectasia might increase depending on the depth of corneal tissue removed.

In the last few years, the Reichert Ocular Respond Analyzer (ORA) for measuring the biomechanical parameters of the cornea has been introduced. Studies demonstrated a decrease in the corneal biomechanical parameters after Laser Assisted Sub-epithelial Keratomileusis (LASEK) surgery. However, the, relation between the depth of tissue removed and the amount of change in the biomechanical parameters had not been tested yet.

Purpose

To evaluate the relationship between corneal biomechanical parameters and corneal tissue ablation thickness.

Methods

Data was retrospectively collected from patient's files that underwent LASEK in private medical center – Hadassah Optimal in Haifa between January 2009 and May 2010. All patients were operated by same surgeon (AB). In our study we included patients that had at least three ORA measurements at three set periods of time; before the operation, up to 3 months postoperative and more than 3 months postoperative. We divided the patients into 3 groups depending on the refractive error and tested the effect of variable factors (Age, Total depth ablated-TDA, percent of total depth ablated-%TDA, sex, refraction). The data was analyzed by descriptive statistics and student t-test to find the relation between LASEK and the corneal biomechanical parameters.

Results

Ninety-eight patients participated in our study, which included 98 separate eye operations. A statistically significant decrease (p < 0.001) was found in CRF, CH, IOPg after LASEK. In group 1 (refraction −0.5 to −2.99): on CH – there was a statistically significant (p < 0.05) weak-moderate effect of TDA and %TDA (Pearson coefficient of 0.4, 0.39 respectively), statistically significant (p < 0.05) effect of age. On CRF — we found a statistically significant (p < 0.05) weak-moderate effect of TDA and %TDA (Pearson coefficient of 0.36 for both factors), statistically significant (p < 0.05) effect of age. In the second group (refraction value −3 to −5.99) only on IOPg a statistically significant (p < 0.05) weak effect of TDA (Pearson coefficient of 0.33) was demonstrated. In the third group, we did not find any effect of the variable factors on the change in biomechanical properties characteristics after LASEK.

Importance

Corneal biomechanical properties influence corneal behavior in certain eye diseases. Moreover, it has been noted that operations and procedures affect these biomechanical properties of the cornea. Hence, it is of great importance to reveal factors that could affect and change such parameters.

How to cite this article

Barbara R, Nassar A, Zadok D, Barbara Corneal Biomechanical Properties Post-LASEK for the Correction of Myopia. Int J Kerat Ect Cor Dis 2014;3(1):23-28.

RESEARCH ARTICLE

Hassenien Safa Shuber

Implantable Collamer Lens for Correction of Refractive Errors in Patients with Keratoconus following Collagen Cross-Linking: One Year Follow-up

[Year:2014] [Month:January-April] [Volume:3] [Number:1] [Pages:7] [Pages No:29 - 35]

PDF  |  DOI: 10.5005/jp-journals-10025-1074  |  Open Access |  How to cite  | 

Abstract

Objective

The purpose of this study is to assess the predictability, safety, efficacy and stability of correction of refractive errors in patients with keratoconus using Visian implantable collamer lens (ICL) following collagen cross-linking.

Materials and methods

This prospective, non-comparative study evaluated 20 eyes of 14 patients with keratoconus subjected to implantation of intraocular collamer lens at least 1 year following collagen cross-linking and stable refraction. Mean preoperative myopia was −8.43 ± 5.13 Diopters (D) (–3.5 to −20.0D and mean cylinder was −2.19 ± 1.28D (0.0 to −4.5D). The preoperative spherical equivalent (SE) was −9.52 ± 5.33D (–3.75 to −21.25D). During the 12 months follow-up, uncorrected visual acuity, best corrected visual acuity, refraction, intraocular pressure and vaulting are measured.

Results

At 12 months postoperatively, 90% of eye had refractive cylinder of <1.0D with (p = 0.003) and 20 (100%) eyes was within ±0.75D of sphere at 1 year (r2 = 0.99) and (p = 0.0085). The mean postoperative BCVA in decimal was 0.498 ± 0.232, while the mean preoperative BCVA was 0.484 ± 0.285. The safety index at 12 months was 1.02. The mean postoperative UCVA in decimal was 0.498 ± 0.232 and the mean preoperative BCVA is 0.484 ± 0.29 and the efficacy index at 12 months was 1.01.

Conclusion

Implantation of Visian Intraocular collamer lens is predictable, safe and effective way to correct refractive error in patients with keratoconus following collagen cross-linking.

How to cite this article

Shuber HS. Implantable Collamer Lens for Correction of Refractive Errors in Patients with Keratoconus following Collagen Cross-Linking: One Year Follow-up. Int J Kerat Ect Cor Dis 2014;3(1):29-35.

RESEARCH ARTICLE

Luis Izquierdo, Maria A Henriquez, David Dañin

Corneal Elevation Values in Normal Eyes, forme fruste Keratoconus and Keratoconus at Different Stages Measured by Scheimpflug Imaging

[Year:2014] [Month:January-April] [Volume:3] [Number:1] [Pages:4] [Pages No:36 - 39]

PDF  |  DOI: 10.5005/jp-journals-10025-1075  |  Open Access |  How to cite  | 

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.

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.

RESEARCH ARTICLE

Rodrigo Santos, Renata Siqueira, Bruno Valbon, Daniel Dawson, Luis claudio Pereira, Jorge Augusto Siqueira

Long-term Improvement after the Athens Protocol for Advanced Keratoconus with Significant Ectasia Progression in the Fellow Eye

[Year:2014] [Month:January-April] [Volume:3] [Number:1] [Pages:4] [Pages No:40 - 43]

PDF  |  DOI: 10.5005/jp-journals-10025-1076  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Pereira LC, Siqueira R, Valbon B, Santos R, Dawson D, Ambrósio R, Siqueira JA. Long-term Improvement after the Athens Protocol for Advanced Keratoconus with Significant Ectasia Progression in the Fellow Eye. Int J Kerat Ect Cor Dis 2014;3(1):40-43.

RESEARCH ARTICLE

Noa Avni-Zauberman, David S Rootman

Post-LASIK Keratoectasia Developing with Sleep Apnea and Floppy Eyelid Syndrome: Case Report and Review of the Literature

[Year:2014] [Month:January-April] [Volume:3] [Number:1] [Pages:3] [Pages No:44 - 46]

PDF  |  DOI: 10.5005/jp-journals-10025-1077  |  Open Access |  How to cite  | 

Abstract

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.

RESEARCH ARTICLE

Marouen Berguiga, Alain Saad

Unilateral Post-LASIK Ectasia in a Topographical Normal Eye with a Slight Asymmetry in the Contralateral Eye

[Year:2014] [Month:January-April] [Volume:3] [Number:1] [Pages:5] [Pages No:47 - 51]

PDF  |  DOI: 10.5005/jp-journals-10025-1078  |  Open Access |  How to cite  | 

Abstract

Purpose

To report a case of post-LASIK unilateral corneal ectasia.

Setting

Department of anterior segment and Refractive surgery, Rothschild Foundation, Paris.

Case report

A 33-year-old woman was referred with a history of unilateral post-LASIK ectasia in her left eye, 18 months post operatively. Her best-corrected visual acuity was 20/20 with a manifest refraction of +1.75 (–4.75 × 90). Orbscan ii® revealed an inferior steepening associated with irregular astigmatism. The preoperative Placido topographies revealed a slight skewed radial axis in the right eye associated with an inferior-superior keratometry difference of 1.6 Diopters at 3 mm. in the left eye that developed ectasia, regular symmetric astigmatism was present. Uncorrected visual acuity improved to 20/25 2 weeks after keraRing® segment insertion.

How to cite this article

Berguiga M, saad a, Gatinel D. Unilateral Post-LASIK Ectasia in a Topographical Normal Eye with a slight asymmetry in the Contralateral Eye. int J kerat Ect Cor Dis 2014;3(1):47-51.

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