Showing papers in "Cornea in 2003"
TL;DR: The monitoring and assessment of corneal and conjunctival staining can be greatly enhanced by the use of a grading scale, controlled instillation of dyes, and standard evaluation techniques.
Abstract: PurposeTo describe the Oxford Scheme for grading ocular surface staining in dry eye and to discuss optimization of stain detection using various dyes and filters. Also, to propose a sequence of testing for dry eye diagnosis.MethodsThe grading of corneal and conjunctival staining is described
1,112 citations
TL;DR: Antilymphangiogenic strategies may improve transplant survival both in the high- and low-risk setting of corneal transplantation.
Abstract: Purpose The normal cornea is devoid of blood and lymphatic vessels but can become vascularized secondary to a variety of corneal diseases and surgical manipulations. Whereas corneal (hem)angiogenesis, i.e., the outgrowth of new blood vessels from preexisting limbal vessels, is obvious both clinically and histologically, proof of associated corneal lymphangiogenesis has long been hampered by invisibility and lack of specific markers. This has changed with the recent discovery of the lymphatic endothelial markers vascular endothelial growth factor receptor 3, LYVE-1 (a lymphatic endothelium-specific hyaluronan receptor), Prox 1, and Podoplanin. Methods We herein summarize the current evidence for lymphangiogenesis in the cornea and describe its molecular markers and mediators. Furthermore, the pathophysiologic implications of corneal lymphangiogenesis for corneal transplant immunology are discussed. Results Whereas corneal angiogenesis in vascularized high-risk beds provides a route of entry for immune effector cells to the graft, lymphangiogenesis enables the exit of antigen-presenting cells and antigenic material from the graft to regional lymph nodes, thus inducing alloimmunization and subsequent graft rejection. Conclusions Antilymphangiogenic strategies may improve transplant survival both in the high- and low-risk setting of corneal transplantation.
224 citations
TL;DR: Early reports on the efficacy of topical Iterferon alpha 2b indicate significant promise in providing another alternative for the treatment of some of these neoplasms and represent a minimally invasive and highly successful approach to the diagnosis and treatment of OSSN.
Abstract: Even though ocular surface squamous neoplasia (OSSN) has been recognized for well over a century, the past decade has witnessed advances that have helped rewrite many of the paradigms for the diagnosis and management of these lesions. OSSN occurs predominantly in the elderly for whom they are the third most common oculoorbital tumors after melanoma and lymphoma. In addition to advanced age and male sex, other major risk factors linked to its pathogenesis are ultraviolet light, cigarette smoking, and the human papilloma virus. Although the latter has been linked to OSSN for nearly 4 decades, its identification and role in the pathogenesis of these tumors has been elucidated recently and is addressed in detail in this review. Newer techniques of impression cytology represent a noninvasive and reliable method of diagnosing OSSN and monitoring treated cases. The efficacy of chemotherapeutic agents such as mitomycin C and 5-fluorouracil have been proven in the recent past, making them a clear alternative to the time-tested treatment of surgical excision and cryotherapy. Early reports on the efficacy of topical Iterferon alpha 2b indicate significant promise in providing another alternative for the treatment of some of these neoplasms. These advances thus represent a minimally invasive and highly successful approach to the diagnosis and treatment of OSSN.
195 citations
TL;DR: Corneal sensitivity correlated with corneal thickness: both were higher on awakening and then decreased and remained below the levels measured the previous night, and the lack of significant differences between the values after 14:00 suggests that baseline may be measured at any time from 7 hours after eye opening.
Abstract: Purpose.To measure the diurnal variation of central corneal sensitivity and thickness over 24 hours.Methods.A noncontact pneumatic esthesiometer to measure central corneal sensitivity and an optical pachymeter to measure central corneal thickness were used on 20 noncontact lens wearers. These measur
181 citations
TL;DR: Therapy with LA and GLA and tear substitutes reduces ocular surface inflammation and improves dry eye symptoms and long-term studies are needed to confirm the role of this new therapy for keratoconjunctivitis sicca.
Abstract: Purpose.To evaluate the efficacy and anti-inflammatory activity of systemic linoleic (LA) and γ-linolenic acid (GLA), which decrease chronic inflammation in rheumatoid arthritis, on the ocular surface of patients with keratoconjunctivitis sicca.Methods.In a randomized clinical trial, 26 patients wit
168 citations
TL;DR: It is suggested that periductal fibroblasts are involved in fibrogenic and immune processes by interacting with T cells in the lacrimal gland of patients with chronic GVHD, resulting in rapidly progressive dry eye.
Abstract: PurposeTo review the condition of dry eye associated with chronic graft-versus-host disease (GVHD).MethodsThe immunopathogenic processes and therapeutic options for lacrimal gland chronic GVHD are discussed.ResultsDry eye is the most frequent ocular complication after hematopoietic stem cell
163 citations
TL;DR: Results from the survey concur with a previous local report that keratoconus affects males more frequently and earlier in life than females in New Zealand, and an association between the early development of the disease and latitude of the childhood domicile emerged.
Abstract: Purpose. To examine the characteristics and risk factors for keratoconus in a New Zealand population. Methods. A one-page questionnaire was designed and sent to optometrists and ophthalmologists in New Zealand. Eye care practitioners then issued questionnaires to their keratoconic patients over a 6-month period. Results. A total of 673 completed questionnaires were received from patients with keratoconus. A male bias (59%) was apparent in the sample. In line with previous work, a high proportion of the keratoconic cohort rubbed their eyes and suffered from atopy. A familial rate of 23.5% was evident, with several families reporting multiple keratoconus cases. Eleven pairs of twins were identified with at least one keratoconic sibling. Multivariate statistical analysis revealed significant independent correlations between the early development of keratoconus and gender, allergy, asthma, and latitude of childhood domicile. Conclusion. Results from the survey concur with a previous local report that keratoconus affects males more frequently and earlier in life than females in New Zealand. The concurrence of atopic disease and eye rubbing with keratoconus was as expected, and an association between the early development of the disease and latitude of the childhood domicile emerged. A strong familial component, exceeding previously reported figures, was evident in the cohort.
158 citations
TL;DR: GP-ScCL can provide successful and safe visual and therapeutic solutions for ocular conditions when conventional contact lenses and medical treatment have failed and where surgery is undesirable or contraindicated.
Abstract: Purpose.To describe the vision-correcting and therapeutic benefits of gas-permeable scleral contact lenses (GP-ScCL) in the management of irregular corneal surface disorders and ocular surface diseases.Methods.The charts of 48 consecutive patients (66 eyes) whose management included the use of GP-Sc
132 citations
TL;DR: Ex vivo xeno- and autologous transplantation of cultivated oral epithelial cells onto the ocular surfaces of keratectomized rabbit eyes is believed to be a feasible method for ocular surface reconstruction.
Abstract: PurposeTo investigate the possibility of using cultivated oral epithelial cells in ocular surface reconstruction.MethodsAn ocular surface injury was created in adult albino rabbits by a lamellar keratectomy. Oral mucosal biopsy specimens taken from both adult albino rabbits and human volunte
127 citations
TL;DR: The results demonstrate that CAIS is associated with meibomian gland alterations and a significant increase in dry eye signs and symptoms and suggest that androgen insensitivity may promote meibOMian gland dysfunction and an increase in the signs and Symptoms of dry eye.
Abstract: Purpose. This study’s purpose was to determine whether complete androgen insensitivity syndrome (CAIS) is associated with alterations in the meibomian gland and ocular surface. Methods. Individuals with CAIS, as well as age-matched female and male controls, completed questionnaires which assessed dry eye symptoms and underwent slit lamp evaluations of the tear film, tear meniscus, lids and lid margins and conjunctiva. The quality of meibomian gland secretions was also analyzed. Results. Our results demonstrate that CAIS is associated with meibomian gland alterations and a significant increase in dry eye signs and symptoms. Clinical assessment revealed that CAIS women, as compared to controls, had a significant increase in telangiectasia, keratinization, lid erythema and orifice metaplasia of the meibomian glands, and a significant decrease in the tear meniscus and quality of meibomian gland secretions. Questionnaire results showed that dry eye symptoms were increased over twofold in CAIS individuals, as compared to controls, including a significant increase in the sensations of dryness, pain and light sensitivity. Conclusion. Our results suggest that androgen insensitivity may promote meibomian gland dysfunction and an increase in the signs and symptoms
121 citations
TL;DR: The author and colleagues are developing a method to transplant cultivated cell sheets that uses a temperature-responsive culture dish and introduces the results of this program of research.
Abstract: Tissue engineering of the cornea represents a paradigm shift in medical treatment to overcome the present disadvantages of corneal transplantation, primarily immune rejection and the shortage of donor corneas. Transplantation of cultivated corneal epithelial cells expanded ex vivo from corneal epithelial stem cells has been developed and has already entered the clinical realm. However, there remain many hurdles to be overcome. The author and colleagues are developing a method to transplant cultivated cell sheets that uses a temperature-responsive culture dish. This article reviews the present situation regarding tissue-engineered corneal epithelium and introduces the results of this program of research.
TL;DR: In this article, the authors reviewed the clinical course, treatment, and visual outcomes of Fusarium keratitis with endophthalmitis caused by the filamentary fungus fusarium.
Abstract: Purpose.To review the clinical course, treatment, and visual outcomes of keratitis with endophthalmitis caused by the filamentary fungus Fusarium.Method.One hundred fifty-nine cases of Fusarium keratitis at Bascom Palmer Eye Institute between January 1, 1987 and August 21, 2000 were reviewed. Ten pa
TL;DR: This classification scheme, based on clinical characteristics, should aid diagnosis, management, and treatment of corneal infiltrates as well as assisting investigations into the etiology of each of these conditions.
Abstract: Purpose.Corneal infiltrates are commonly observed during adverse reactions associated with contact lens wear. Broad ranges of presentations are encountered, and there is no well-established classification system. The aim of this paper is to categorize corneal infiltrates associated with soft lens we
TL;DR: Pterygia exhibit significantly lower PEDF but higher VEGF levels than those in normal corneas and conjunctivae, and may play a role in the formation and progression of pteryGia.
Abstract: Purpose.Pterygia are histologically composed of proliferating fibrovascular tissue. This study compared expression levels of an angiogenic inhibitor, pigment epithelium-derived factor (PEDF), in pterygia with those in normal corneal and conjunctival tissues.Methods.The normal human conjunctival and
TL;DR: Two- and 5-year survival rates for repeat PKP were 63.9% and 45.6%, respectively, and the difference in graft survival rates between the two groups can be partially explained on the basis of higher rates of the latter two risk factors among regrafts.
Abstract: Purpose. To compare repeat penetrating keratoplasty (PKP) with primary PKP with respect to patient characteristics, survival rates, and risk factors for graft failure. Methods. Retrospective, consecutive, noncomparative case series of 116 patients who underwent repeat PKP and who were identified from a cohort of 696 PKPs performed by one surgeon over a 7.5-year period. Results. Compared with patients who underwent primary PKP, regraft patients were 5 years older, had a higher rate of peripheral anterior synechiae (PAS), were more likely to require intraocular pressure (TOP)-lowering medications prior to surgery, were more likely to develop postoperative corneal neovascularization, were less likely to be phakic, and were more likely to undergo PKP in conjunction with a lens procedure. There was no difference between the two groups with respect to the distribution of original diagnoses leading to PKP and the rate of graft rejection. Two- and 5-year survival rates for repeat PKP were 63.9% and 45.6%. respectively. In a multivariate analysis, the original diagnosis leading to corneal transplantation, the presence of preoperative PAS, intraoperative anterior vitrectomy, and postoperative corneal neovascularization were identified as risk factors for graft failure in patients undergoing a regraft. Conclusions. Patients undergoing PKP for the first and second time share common risk factors for graft failure, namely, the original diagnosis leading to corneal transplantation, the presence of preoperative PAS, and the occurrence of postoperative corneal neovascularization. The difference in graft survival rates between the twig groups can be partially explained on the basis of higher rates of the latter two risk factors among regrafts.
TL;DR: The mucin profile of the lacrimal gland resembles that of the salivary gland and contributes not only to the aqueous component of tears but also, in concert with the conjunctiva, may contribute to the total pool of ocular surface mucins.
Abstract: Purpose Several mucins including MUC1, MUC2, MUC4, and MUC5AC have been identified at the ocular surface and in tears. The lacrimal gland, however, is not generally considered a source of ocular mucin. Because the lacrimal glands are similar to the salivary glands, we hypothesized that the lacrimal gland would express MUC7, a distinctive salivary mucin. We report the presence of MUC7 RNA and protein in normal human lacrimal glands as determined by reverse transcription-polymerase chain reaction (RT-PCR), in situ hybridization, and Western blot analysis. Methods RNA from lacrimal glands and conjunctivae was isolated and subjected to RT-PCR with primers specific for MUC7. The identity of the PCR products was confirmed by sequencing. In situ hybridization with PCR product-based riboprobes was used to locate MUC7 transcripts in the lacrimal gland. MUC7 protein was detected by Western blot analysis. Results Of six normal human lacrimal glands from which relatively intact mRNA could be extracted, four expressed MUC7. Hybridization with an antisense riboprobe for MUC7 indicates the presence of MUC7 transcripts in the cytoplasm of acinar cells. Western blot analysis confirms expression of the protein in the lacrimal gland. The presence of MUC1, MUC4, and MUC5B was also demonstrated by RT-PCR in lacrimal gland tissue. MUC7 transcripts and protein were also detected in normal human conjunctivae. Conclusions The mucin profile of the lacrimal gland resembles that of the salivary gland. Both RNA and protein corresponding to MUC7 are present in the normal human lacrimal gland. Reverse transcription-polymerase chain reaction indicates that other transcripts of MUC1, MUC4, and MUC5B are present as well. Ocular MUC7 is also produced by the conjunctival mucosa. The lacrimal gland, therefore, contributes not only to the aqueous component of tears but also, in concert with the conjunctiva, may contribute to the total pool of ocular surface mucins.
TL;DR: It is believed that this technique could have an important role in evaluating patients undergoing therapeutic penetrating keratoplasty to select those who would benefit from limbal stem cell transplantation and to evaluate the diagnostic potential of this approach.
Abstract: Purpose.The impaired function of corneal epithelial stem cells, located in the limbus, is responsible for corneal surface damage and is clinically characterized by recurrent epithelial defects, conjunctivalization, neovascularization, and corneal opacity. The aim of this study was to investigate cor
TL;DR: C cultivated allogeneic corneal epithelial transplantation in 13 eyes from 11 patients with severe ocular surface disorders is performed, showing that, in cases where the initially transplanted cultivated epithelium becomes opaque, it is possible to repeat the transplantation process with new cultivated epithelialium on AM.
Abstract: Purpose.Our group performed cultivated allogeneic corneal epithelial transplantation in 13 eyes from 11 patients with severe ocular surface disorders. After the clinical application of this new surgical treatment, some patients experienced epithelial and subepithelial opacities. We applied our proce
TL;DR: The major and most easily observable ocular problems in rosacea patients presenting either to ophthalmology or dermatology are lid disease-related manifestations, as might be expected, eye signs and symptoms are more commonly noted in the eye clinic.
Abstract: Purpose. To describe and compare the ocular signs in patients diagnosed with acne rosacea by the ophthalmologist with the ocular signs in the patients diagnosed with rosacea by the dermatologist. Methods. We reviewed the medical records of 176 randomly selected patients diagnosed with rosacea at the University of California, Davis, Medical Center: 88 patients each from the Department of Dermatology and the Department of Ophthalmology. Of the 88 patients diagnosed with acne rosacea by a dermatologist, 22 (25%) had an ophthalmologic evaluation done prior to the study. In those patients without an ophthalmologic assessment, ocular complaints noted by the dermatologist were recorded. We recorded ocular signs including lid, conjunctival, corneal, episcleral, and scleral manifestations as well as charted observations of the iris, lens, intraocular pressures (IOPs), best corrected visual acuity (VA), and funduscopic examination. Age and sex were recorded from the initial ophthalmologic evaluation. The analysis was designed to compare the prevalence of signs and symptoms in two clinical settings. Results. The prevalence of documented meibomian gland dysfunction (p < 0.001), telangiectasia (p = 0.004), and anterior blepharitis (p = 0.008) was significantly higher in ophthalmology patients when compared with dermatology patients. Of the conjunctival signs evaluated, only the presence of interpalpebral conjunctival hyperemia (p = 0.005) was found to be significantly higher in ophthalmology patients. The corneal, episcleral, scleral, and lens findings did not demonstrate a statistically significant difference between groups. Conclusion. The major and most easily observable ocular problems in rosacea patients presenting either to ophthalmology or dermatology are lid disease-related manifestations. As might be expected, eye signs and symptoms are more commonly noted in the eye clinic. A clinician's increased awareness of the common ocular findings of rosacea, however, may aid in earlier diagnosis and treatment of ocular rosacea.
TL;DR: Autologous cultured epithelial transplantation is as an excellent option in selected patients with bilateral partial LSCD with small area(s) of healthy limbus in either eye and avoids the attendant risk of rejection and cost and potential toxicity of immunosuppression in allogeneic tissue transplantation.
Abstract: Purpose Reconstruction of the ocular surface in a case of severe bilateral partial limbal stem cell deficiency (LSCD) with extensive symblephara using autologous cultured conjunctival and limbal epithelium. Case report A 31-year-old woman presented with severe bilateral ocular surface disease with partial limbal stem cell deficiency, symblephara, lid and facial scarring, with a vision of 20/400 and counting fingers at 1 m in both eyes. Limbal and conjunctival tissue was harvested from the healthy-appearing left eye and used to generate two sheets of composite epithelium consisting of central limbal and peripheral conjunctival cells. The limbal tissues were explanted in the central region while the conjunctival tissues were explanted on the periphery of the deepithelialized human amniotic membrane (HAM) and nurtured using human corneal epithelial cell medium. After successful generation of a monolayer from both tissues had been confirmed, the composite of cultivated limbal and conjunctival epithelium with HAM was transplanted in each eye after excision of fibrous tissue and release of symblephara. One year postoperatively, the patient had a best spectacle-corrected visual acuity of 20/40 in the right eye (preoperative acuity 20/400) and counting fingers at 1 m in the left eye (same as preoperative) with a stable ocular surface. Conclusions Autologous cultured epithelial transplantation is as an excellent option in selected patients with bilateral partial LSCD with small area(s) of healthy limbus in either eye and avoids the attendant risk of rejection and cost and potential toxicity of immunosuppression in allogeneic tissue transplantation. This case also highlights the feasibility of generating a composite culture of limbal and conjunctival epithelium using a single amniotic membrane.
TL;DR: Both corneal sensation and total or reflex tear secretion are reduced in individuals with diabetes, consistent with the notion that both diabetic retinopathy and polyneuropathy result from a basement membrane abnormality.
Abstract: Purpose.To examine the possible relation between corneal sensation or tear secretion and the stage of diabetic retinopathy in diabetic patients.Methods.Total reflex or basal tear secretion and corneal sensation were determined in 95 patients with type II diabetes mellitus and 58 nondiabetic control
TL;DR: Corneal dystrophy of Bowman's membrane has the highest rate of simple recurrence followed by granular and lattice dystrophies, respectively, however, the rate of clinically significant recurrence, both recurrent erosions and decreased visual acuity, in the first 5 years is similar in CDB and lattices.
Abstract: Purpose.To assess the rates of simple and clinically significant recurrences of stromal dystrophies in corneal grafts.Methods.We conducted a retrospective review of Wills Eye Hospital records from 1984 to 2001, identifying all patients with stromal corneal dystrophies who had penetrating keratoplast
TL;DR: The ICL was safer and more effective than LASIK and appears to be a viable alternative to corneal refractive excimer surgery in the treatment of moderate to high myopia.
Abstract: Purpose.To compare the results of laser assisted in situ keratomileusis (LASIK) and implantable contact lenses (ICL) in the correction of moderate/high myopia.Methods.Five hundred fifty-nine LASIK eyes from the Davis Duehr Eye Center, Madison, WI, and 210 ICL eyes from the 14-site U.S. FDA Clinical
TL;DR: This study establishes that the epithelial thinning associated with hydrogel lens wear is topographically uniform and confirms that this effect is inversely related to lens oxygen transmissibility but does not appear to increase with longer duration of wear.
Abstract: Purpose.To characterize the epithelial thickness profile and study the effects of long-term wear of hydrogel lenses on this profile.Methods.A cross-sectional study was designed. Epithelial thickness was evaluated in 15 subjects who had worn one of two types of low oxygen transmissibility (Dk) hydrog
TL;DR: Both noncontact specular microscopy and confocal biomicroscopy revealed the shapes and number of endothelial cells in the normal cornea, however, for corneas with Fuchs dystrophy, clear images were obtained only by confocal biomedical microscopy.
Abstract: Purpose. To compare the clinical efficacy of confocal biomicroscopy with that of noncontact specular microscopy for the evaluation of the corneal endothelium. Methods. The corneal endothelium was examined in 14 normal subjects (28 eyes) and in 6 patients (11 eyes) with Fuchs corneal endothelial dystrophy using a noncontact specular microscope (SP-2000P, Topcon, Japan) and a confocal biomicroscope (ConfoScan, Tomey, Japan). The images and the calculated densities of corneal endothelial cells obtained by the 2 techniques were compared. Results. For normal subjects, the images of corneal endothelial cells obtained by the 2 techniques were almost identical, although the density of these cells determined by confocal biomicroscopy (2916 ± 334 cells/mm2) was slightly higher than that determined by noncontact specular microscopy (2765 ± 323 cells/mm2). In contrast, whereas clear images of corneal endothelial cells, allowing the determination of cell density, were obtained for all 11 eyes of the patient group by confocal biomicroscopy, clear images were obtained for only 4 of these 11 eyes (36.4%) by noncontact specular microscopy. Conclusion. Both noncontact specular microscopy and confocal biomicroscopy revealed the shapes and number of endothelial cells in the normal cornea. However, for corneas with Fuchs dystrophy, clear images were obtained only by confocal biomicroscopy. Confocal biomicroscopy is thus an effective tool for evaluation of the diseased corneal endothelium.
TL;DR: In this paper, a videokeratoscope was modified to present an accommodation stimulus that was coaxial with the instrument's measurement axis, and the authors investigated whether there are significant changes in corneal topography during accommodation.
Abstract: Purpose. To investigate whether there are significant changes in corneal topography during accommodation in normal corneas and corneas that are pathologically thinner due to keratoconus. Methods. A videokeratoscope was modified to present an accommodation stimulus that was coaxial with the instrument's measurement axis. Six subjects with normal corneas and four subjects with keratoconus were studied. Eighteen videokeratoscope measurements of one eye of each subject were taken at 0 diopter (D) accommodation demand and six for both of 4 D and 9 D accommodation demand. The effects of ocular micromovements on multiple topography maps were minimized using software algorithms. Average maps for the 4 D and 9 D accommodation demands were calculated and subtracted from the average map of the 0-D accommodation demand. A t test was applied at each point location within the topography maps to analyze the statistical significance of change (p < 0.001) within the difference maps. Results. In the initial analysis, we found that a number of the subjects showed significant changes in corneal topography as accommodation changed. However, further analysis showed a significant group mean excyclotorsion of the topography maps of 1.6 +/- 1.1[degrees] (p < 0.03) for the 4-D stimulus and 2.0 +/- 1.3[degrees] (p < 0.01) for the 9-D stimulus compared with the 0-D stimulus. When we accounted for the excyclotorsion, we did not find clear evidence of statistically significant changes in corneal topography as a result of accommodation, either for the normal corneas or the keratoconic corneas. Conclusions. It appears unlikely that changes occur in central corneal shape during accommodation up to a level of 9 D in normal or keratoconic corneas. A small ocular excyclotorsion typically accompanies accommodation, and this changes the relative orientation of the topography of the cornea. This has significant implications for the interpretation of the optical characteristics of eyes during near viewing conditions.
TL;DR: An increase in predictability of the postoperative corneal curvature makes the choice of IOL power for the new “triple procedure” more accurate, eliminates the need for contact lens wear after PK, and provides earlier visual rehabilitation after endothelial replacement.
Abstract: PurposeTo determine if the new technique for endothelial transplantation of DLEK (deep lamellar endothelial keratoplasty) can offer predictable corneal curvature and improved refractive spherical equivalent results compared with reports for traditional penetrating keratoplasty.MethodsTwenty-
TL;DR: Infrequent replacement of these lenses seems to be especially advantageous in patients for whom frequent lens insertion and removal may be associated with epithelial trauma, pain, and a potential increase in infection risk.
Abstract: PurposeTo evaluate the safety and efficacy of Focus® Night & Day™ extended-wear contact lenses when used for therapeutic purposes.MethodsFifty eyes of 50 consecutive patients presenting at the Ankara University Medical Center, Cornea and Contact Lens Service, and requiring bandage contact le
TL;DR: Ahmed glaucoma valve implant is effective in controlling IOP in a majority of eyes during a 3-year time span, however, corneal graft success continues to pose challenges.
Abstract: Purpose.To investigate the success of corneal graft and intraocular pressure (IOP) control after simultaneous penetrating keratoplasty (PKP) and Ahmed glaucoma valve implant in patients with coexisting corneal opacity and glaucoma.Methods.A retrospective review was undertaken of adult patients at Ki
TL;DR: This effect of anesthetic eye drops must be considered by refractive surgeons when carrying out preoperative laser in situ keratomileusis corneal thickness measurements.
Abstract: Purpose To determine changes in corneal thickness after topical anesthesia. Methods Corneal thickness was measured before and 3 minutes after administration of two drops of oxybuprocaine 0.4% to 26 patients (26 eyes). We analyzed the corneal thickness of a control group, which was made up of 26 patients (26 eyes) before and 3 minutes after administration of two drops of saline solution. Corneal thickness was measured with the Orbscan Topography System II (Bausch Lomb Surg., Barcelona). Results Variations higher than ± 10 μm were found following the instillation of 2 oxybuprocaine eye drops in eight eyes (30.76%) at the inferonasal cornea, in six eyes (23.08%) at the superotemporal, temporal and inferotemporal cornea, in five eyes (19.23%) at the nasal cornea, in three eyes (11.53%) at the central cornea, and in two eyes (7.69%) at the superonasal cornea. Nevertheless, no significant differences in the mean corneal thickness at each corneal location between the first and the second corneal thickness measurements were found in anesthetized eyes. Conclusions Some individuals can present important increases and decreases in corneal thickness values after anesthetic eye drops. This effect of anesthetic eye drops must be considered by refractive surgeons when carrying out preoperative laser in situ keratomileusis corneal thickness measurements.