Purpose: To evaluate the clinical outcomes after implantation of a new 320°-arc length Ferrara intrastromal corneal ring segment (320-ICRS) in eyes of patients with keratoconus.
Methods: A multicentric nonrandomized study was conducted in which a new 320-ICRS was placed in 138 eyes of 130 patients with keratoconus. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), keratometry, corneal volume, asphericity, lines of vision gain/loss, and vectorial analysis were assessed preoperatively and at the final follow-up visit after the procedure.
Background: Ectasia development occurs due to a chronic corneal biomechanical decompensation or weakness, resulting in stromal thinning and corneal protrusion. This leads to corneal steepening, increase in astigmatism, and irregularity. In corneal refractive surgery, the detection of mild forms of ectasia pre-operatively is essential to avoid post-operative progressive ectasia, which also depends on the impact of the procedure on the cornea.
View Article and Find Full Text PDFPurpose: To evaluate the performance of the Ocular Response Analyzer (ORA) (Reichert Ophthalmic Instruments, Depew, NY) variables and Pentacam HR (Oculus Optikgeräte GmbH, Wetzlar, Germany) tomographic parameters in differentiating forme fruste keratoconus (FFKC) from normal corneas, and to assess a combined biomechanical and tomographic parameter to improve outcomes.
Methods: Seventy-six eyes of 76 normal patients and 21 eyes of 21 patients with FFKC were included in the study. Fifteen variables were derived from exported ORA signals to characterize putative indicators of biomechanical behavior and 37 ORA waveform parameters were tested.
Ectasia after refractive surgery represents a major concern among refractive surgeons. Corneal abnormalities and preexisting corneal ectasia are the most important risk factors. Corneal topography and central corneal thickness are the factors traditionally screening for in refractive surgery candidates.
View Article and Find Full Text PDFPurpose: To evaluate the performance of corneal hysteresis (CH), corneal resistance factor (CRF), 37 Ocular Response Analyzer (ORA) waveform parameters, and 15 investigator-derived ORA variables in differentiating forme fruste keratoconus (KC) from normal corneas.
Design: Case-control study.
Methods: Seventy-eight eyes of 78 unaffected patients and 21 topographically normal eyes of 21 forme fruste KC patients with topographically manifest KC in the contralateral eye were matched for age, the thinnest point of the cornea, central corneal thickness, and maximum keratometry.
Purpose: To evaluate ocular biomechanical metrics given by the CorVis ST (Oculus, Inc., Berlin, Germany) in a population of healthy Brazilian patients.
Methods: An observational and cross-sectional study involving 1 eye randomly selected from 90 healthy patients.
Purpose: To evaluate the Ocular Response Analyzer (ORA; Reichert Ophthalmic Instruments, Depew, NY) performance in differentiating grades I and II keratoconus from normal corneas using 41 parameters individually and to assess the effect of analyzing all parameters together.
Methods: This study compared the mean value of 41 ORA parameters in grades I and II keratoconus with healthy age-matched control eyes. Only eyes with a central corneal thickness between 500 and 600 μm were included.
Purpose: To evaluate the ability of the Ocular Response Analyzer (ORA; Reichert Ophthalmic Instruments, Buffalo, NY) to distinguish between normal and keratoconic eyes, by comparing pressure and waveform signal-derived parameters.
Methods: This retrospective comparative case series study included 112 patients with normal corneas and 41 patients with bilateral keratoconic eyes. One eye from each subject was randomly selected for analysis.
Purpose Of Review: To review the principles and clinical applications of Scheimpflug corneal and anterior segment imaging with special relevance for laser refractive surgery.
Recent Findings: Computerized Scheimpflug imaging has been used for corneal and anterior segment tomography (CASTm) in different commercially available instruments. Such approach computes the three-dimensional image of the cornea and anterior segment, enabling the characterization of elevation and curvature of the front and back surfaces of the cornea, pachymetric mapping, calculation of the total corneal refractive power and anterior segment biometry.
Purpose: To report the tomographic and biomechanical findings before and after treatment of a case of pressure-induced stromal keratopathy (PISK), which was misdiagnosed as diffuse lamellar keratitis (DLK).
Methods: A case report of a referred patient with supposed diagnosis of DLK after LASIK in the right eye. Scheimpflug-based corneal tomography and biomechanical assessment were provided by the Pentacam HR and CorVis ST (Oculus Optikgeräte GmbH, Wetzlar, Germany).
Purpose: To describe pachymetric progression indices (PPI) of the Pentacam HR (Oculus Optikgeräte GmbH) and the concept of relational thickness, and to test their accuracy for differentiating keratoconic and normal corneas compared with single-point thickness values.
Methods: One hundred thirteen individual eyes randomly selected from 113 normal patients and 44 eyes of 44 patients with keratoconus were studied using the Pentacam HR by acquiring central corneal thickness (CCT), thinnest point (TP), position of the TP and PPI at minimal (PPI Min) and maximal (PPI Max) meridians, and the average (PPI Ave) of all meridians. Relational thickness parameters were calculated as the ratios of TP and CCT and PPI values.
Purpose: To evaluate the functional outcome and macular index in patients with macular hole who underwent surgery with internal limiting membrane removal.
Methods: Fifteen eyes of 15 patients with idiopathic macular hole stages 2, 3 or 4 were enrolled in this study. All patients underwent conventional macular hole surgery with trypan blue staining to remove the internal limiting membrane.
Purpose: To study the variation and progression of the pachymetric values from the thinnest point towards the limbus in normal and keratoconic corneas; to establish reference curves for this parameter.
Methods: One hundred eyes with normal corneas and twenty-five eyes with mild keratoconus (stages I and II - Krumeich) were analyzed using the Orbscan. Concentric circles were drawn on the thinnest point of the cornea with increasing radii from 1 to 7 mm.
Purpose: To evaluate whether the corneal-thickness spatial profile and corneal-volume distribution differentiate keratoconic corneas from normal corneas using new tomography parameters.
Setting: Subspecialty cornea and refractive practice, Fluminense Federal University, Rio de Janeiro, Brazil.
Methods: Forty-six eyes diagnosed with mild to moderate keratoconus and 364 normal eyes were studied by the Pentacam Comprehensive Eye Scanner.