Francesco Carones

Bio: Francesco Carones is an academic researcher from University of Milan. The author has contributed to research in topics: Photorefractive keratectomy & Astigmatism. The author has an hindex of 22, co-authored 50 publications receiving 1341 citations.

Evaluation of the prophylactic use of mitomycin-C to inhibit haze formation after photorefractive keratectomy.

Abstract: Purpose To evaluate the results of the prophylactic use of mitomycin-C to inhibit haze formation after excimer laser photorefractive keratectomy (PRK) for medium and high myopia in eyes that were not good candidates for laser in situ keratomileusis (LASIK). Setting Carones Ophthalmology Center, Milan, Italy. Methods This prospective randomized masked study comprised 60 consecutive eyes (60 patients). The inclusion criteria were a spherical equivalent correction between −6.00 and −10.00 diopters (D) and inadequate corneal thickness to allow a LASIK procedure with a residual stromal thickness of more than 250 μm. The eyes were divided into 2 groups according to the randomization protocol. After PRK, the study group eyes were treated with a single intraoperative dose of mitomycin-C (0.2 mg/mL), applied topically with a soaked microsponge placed over the ablated area and maintained for 2 minutes. The control eyes did not receive this treatment. Refraction, uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), and slitlamp evidence of corneal opacity (haze) or other visible complications were evaluated. Results No toxic or side effects were encountered postoperatively. No study group eye had a haze rate higher than 1 during the 6-month follow-up; 19 eyes (63%) in the control group did ( P = .01). At 6 months, the between-group difference in the refractive outcome was statistically significant ( P = .05), with 26 study group eyes (87%) and 14 control eyes (47%) within ±0.50 D of the attempted correction. No study group eye had a BCVA loss during the follow-up; 7 control eyes had lost 1 to 3 lines at 6 months ( P = .0006). Conclusions The prophylactic use of a diluted mitomycin-C 0.02% solution applied intraoperatively in a single dose after PRK produced lower haze rates, better UCVA and BCVA results, and more accurate refractive outcomes than those achieved in the control group.

Excimer laser photorefractive keratectomy for myopia: results in 1165 eyes

Abstract: BACKGROUND We report the results of a prospective study conducted in Italy to evaluate the efficacy, safety, predictability, and complications of excimer laser photorefractive keratectomy for the correction of myopia. METHODS. Photorefractive keratectomy was performed on 1236 myopic sighted eyes in 16 centers, using the Summit Excimed 193 nm excimer laser. The attempted correction ranged from -0.80 to -25.00 diopters (mean, -7.83 +/- 3.88 D). The population was divided into three groups of attempted correction: between -0.80 and -6.00 D, between -6.10 and -9.90 D, and between -10.00 and -25.00 D. We report the data of 1165 eyes at 1 month, 970 eyes at 3 months, 752 at 6 months, and 330 at 12 months. At each visit, we evaluated (1) the refractive changes over time; (2) the difference between attempted and achieved correction; (3) uncorrected and best spectacle corrected visual acuity; and (4) haze. RESULTS Twelve months after surgery, the spherical equivalent refractive error in 146 eyes with attempted correction of -0.80 to -6.00 D was -0.52 +/- 1.04 D; 104 eyes (71.2%) were within +/- 1.00 D of attempted correction. In 145 eyes with attempted correction of -6.10 to -9.90 D, the spherical equivalent refractive error was -1.66 +/- 1.88 D; 50 eyes (34.5%) were within +/- 1.00 D of attempted correction. The spherical equivalent refractive error in 39 eyes with attempted correction of -10.00 to -25.00 D was -1.86 +/- 3.47 D; 11 eyes (28.2%) were within +/- 1.00 D of attempted correction. Eight eyes (2.4%) lost two or more Snellen lines of best spectacle corrected visual acuity. None of the treatments caused severe postoperative complications, or scarring. CONCLUSIONS Photorefractive keratectomy proved safe and effective, but highly predictable only in the correction of myopia up to -6.00 D.

Mechanical vs. alcohol epithelial removal during photorefractive keratectomy.

Abstract: PURPOSE To assess whether a chemical debridement method for excimer laser photorefractive keratectomy may lead to better refractive and visual results than the standard method which involves the use of a blunt blade to scrape off the epithelium. METHODS Ninety-three eyes with a mean attempted correction of -5.72 +/- 2.47 D were debrided using a surgical microsponge after epithelial melting by 20% ethanol solution applied for 20 seconds, and treated by PRK. Results were compared to those from 97 eyes with a mean attempted correction of -6.05 +/- 2.46 D, deepithelialized using a Desmarres blade. RESULTS Debridement time was faster in the eyes where alcohol was used (P = .04). During a 6-month follow-up, we found no significant differences in refractive error, uncorrected, and spectacle-corrected visual acuity. However, haze rates at were lower (1 month, P = .04), and corneal regularity index was better (3 months, P = .01) in the eyes deepithelialized using alcohol. CONCLUSIONS Epithelial debridement using a 20% alcohol solution was faster to perform, and provided sharper edges and a smoother Bowman's layer surface than mechanical debridement. This may explain the better results in terms of haze and corneal regularity.

Scraping and mitomycin C to treat haze and regression after photorefractive keratectomy for myopia.

Abstract: PURPOSE: To evaluate the efficacy, safety, and predictability of therapeutic scraping and application of a diluted 0.02% mitomycin C solution to treat haze and regression after photorefractive keratectomy (PRK) for myopia. METHODS: We performed a non-comparative, non-randomized retrospective study of 35 eyes of 30 patients who had previously undergone PRK for myopia and developed haze and regression after treatment. The range of refractive error after regression was -0.75 to -5.50 D (mean -2.92 D). Haze, ranging from grade 3 to 4 (scale: 0 to 4) caused a best spectacle-corrected visual acuity loss of 1 to 6 Snellen lines. All eyes were treated 6 to 12 months after PRK by scraping the stromal surface and application of a 0.02% mitomycin C solution for 2 minutes using a soaked merocel sponge. No laser ablation was performed. Corneal transparency, refractive error, and visual outcomes were evaluated over a 12-month follow-up period. RESULTS: All eyes had significant improvement in corneal transparency. Thirty-one eyes had haze grades lower than 1, which were maintained over time. Only four eyes showed haze grades 1 to 2 and two of them needed further treatment using the same technique. At 12 months after treatment, all eyes were within +/-1.50 of original intended correction (mean 0.04 +/- 0.63 D). BSCVA improved in all eyes. No toxic effects were observed during re-epithelialization or during follow-up. CONCLUSION: Single application of diluted mitomycin C 0.02% solution following scraping of the corneal surface was effective and safe in treating haze and regression after PRK.

The Role of the Reactive Oxygen Species and Oxidative Stress in the Pathomechanism of the Age-Related Ocular Diseases and Other Pathologies of the Anterior and Posterior Eye Segments in Adults

Abstract: The reactive oxygen species (ROS) form under normal physiological conditions and may have both beneficial and harmful role. We search the literature and current knowledge in the aspect of ROS participation in the pathogenesis of anterior and posterior eye segment diseases in adults. ROS take part in the pathogenesis of keratoconus, Fuchs endothelial corneal dystrophy, and granular corneal dystrophy type 2, stimulating apoptosis of corneal cells. ROS play a role in the pathogenesis of glaucoma stimulating apoptotic and inflammatory pathways on the level of the trabecular meshwork and promoting retinal ganglion cells apoptosis and glial dysfunction in the posterior eye segment. ROS play a role in the pathogenesis of Leber's hereditary optic neuropathy and traumatic optic neuropathy. ROS induce apoptosis of human lens epithelial cells. ROS promote apoptosis of vascular and neuronal cells and stimulate inflammation and pathological angiogenesis in the course of diabetic retinopathy. ROS are associated with the pathophysiological parainflammation and autophagy process in the course of the age-related macular degeneration.

Biomedical Photonics Handbook

Abstract: Biomedical Diagnostics. Edited by Tuan Vo-Dinh Edited by Tuan VoDinh. CRC Press 20142014. Pages 311–356. Print ISBN: 978-1-42008514-3. eBook ISBN:. Bjorn Kemper is a senior researcher at the Biomedical Technology Center of the Srirang Manohar is an associate professor of biomedical photonic imaging. This volume discusses biomedical photonics, spectroscopy and microscopy, the basic physical principles underlying the technology and its applications.