Accelerated Corneal Crosslinking to Arrest Progression of Corneal Ectasia: A Prospective Multicenter Study.

Objectives: To report the results of epithelium-off accelerated corneal collagen crosslinking (accelerated corneal crosslinking [ACXL]) in patients with progressive keratoconus.

Methods: This prospective, nonrandomized, noncomparative, interventional, multicenter clinical study included all patients who underwent ACXL, either continuous (c-ACXL; 9 mW/cm 2 , 10', 5.4 J/cm 2 ) or pulsed (p-ACXL; 2″ON/1″OFF, 30 mW/cm 2 , 4.

Intrastromal Allogeneic Inclusions for the Management of Keratoconus: A Review of Current Literature.

A new therapeutic alternative has been developed in the past 6 years to treat severe keratoconus in young patients. Those patients had only corneal transplantation as an option, but now a variety of surgical alternatives in the form of allogeneic corneal inclusions have bloomed and are becoming more popular. Although Bowman layer transplantation is the most studied technique, recent studies have described different options with very promising preliminary results.

Challenges in using both eyes of the same patient when evaluating the results after implantation of intrastromal corneal ring segments.

Purpose: To assess correlation between results from both eyes of the same patient after implantation of intrastromal corneal ring segments (ICRS) and define whether they can be used together in clinical studies.

Methods: A review of medical records of 74 patients with keratoconus implanted with bilateral Ferrara ICRS at Centro de Oftalmología Barraquer from January 2005 until December 2014. Data were collected on uncorrected visual acuity, best-corrected visual acuity and subjective refractive values (sphere, cylinder and axis).

Steroid-eluting contact lenses for corneal and intraocular inflammation.

Ocular inflammation is one of the leading causes of blindness worldwide, and steroids in topical ophthalmic solutions (e.g. dexamethasone eye drops) are the mainstay of therapy for ocular inflammation.

Bilateral Boston keratoprosthesis type 1 in a case of severe Mooren's ulcer.

Introduction: Mooren's ulcer is a painful, inflammatory chronic keratitis that affects corneal periphery, progressing centripetally, ultimately ending in perforation. The first line of treatment includes systemic immunomodulators, with surgery being the last option. We present a case of bilateral Boston keratoprosthesis implantation for severe Mooren's ulcer that responded differently in each eye.

Oral mucosa for reconstructive surgery in a case of severe inflammatory necrotizing sclero-uveitis.

The purpose of this case is to show the efficacy of buccal mucosa as an alternative to treat a case of severe necrotizing sclero-uveitis (NSU) associated with ocular perforation. We show a severe inflammatory NSU case that did not improve with topical treatment and scleral patch. We performed a buccal mucosa graft taken from the lower lip with excellent functional and anatomical result, with no signs of relapse of the NSU after 2 years of follow-up.

Unilateral spontaneous filtering bleb dissecting into the cornea in a patient with high myopia.

Purpose: To report a case of a unilateral spontaneous filtering bleb dissecting into the cornea in a patient with high myopia.

Clinical Case: A 33-year-old woman with high myopia (-18 D) presented with discomfort in the left eye. Ocular history included pars plana vitrectomy and cataract extraction and posterior chamber intraocular lens implantation in the left eye.

Long-term Outcomes on de novo Ocular Hypertensive Response to Topical Corticosteroids After Corneal Transplantation.

Purpose: To determine incidence, demographics, management, and outcomes of topical steroid-induced ocular hypertension after penetrating keratoplasty (PKP) and to establish effects on intraocular pressure (IOP) and graft rejection when alternate corticosteroids are used.

Methods: A single-center, retrospective review of 568 consecutive PKPs performed between 1997 and 2010 was conducted. Data were collected on demographics, best-corrected visual acuity, surgical indications, lens status, IOP, postoperative management, and incidence of rejection.

Topical sustained drug delivery to the retina with a drug-eluting contact lens.

Intravitreal injections and implants are used to deliver drugs to the retina because therapeutic levels of these medications cannot be provided by topical administration (i.e. eye drops).

Epithelial Ingrowth After Descemet Membrane Endothelial Keratoplasty.

Purpose: To report the diagnosis, histological findings, and treatment of a patient who developed epithelial ingrowth after Descemet membrane endothelial keratoplasty (DMEK).

Methods: We present the case of a type 2 diabetic 60-year-old man who underwent DMEK for Fuchs dystrophy. Two months after surgery, an epithelial ingrowth in the graft-host interface was suspected.

Osteo-odonto-, Tibial bone and Boston keratoprosthesis in clinically comparable cases of chemical injury and autoimmune disease.

Purpose: To compare anatomical and functional results between three types of keratoprosthesis (KPro) in chemical injury and autoimmune disease.

Methods: 70 clinically comparable cases were included as follows: Boston KPro Type 1 25 eyes, osteo-odonto-keratoprosthesis (OOKP) 23 eyes, Tibial bone KPro 22 eyes. Survival times for anatomical and functional success were evaluated with Kaplan-Meier estimations and Log-rank tests.

Combined Keratectomy and Localized Limbal Cauterization for Treating Lisch Epithelial Corneal Dystrophy.

Purpose: To present a new technique for treating Lisch epithelial corneal dystrophy (LECD) in cases of recurrence of the disease.

Methods: We present a single case report of a 41-year-old man who presented to the cornea clinic with progressive loss of vision in the right eye. Slit-lamp examination showed a large white-gray whorl-like epithelial opacity connected to the limbus, which spread over the visual axis, affecting visual acuity.

Acute Chemical Eye Injury and Limbal Stem Cell Deficiency-A Prospective Study in the United Kingdom.

Purpose: To analyze the incidence, nature, outcomes, and complications of acute chemical eye injuries, including the incidence of limbal stem cell deficiency (LSCD) and to compare the 2 main classifications for ocular chemical injuries: Roper-Hall (RH) and Dua.

Methods: This is a prospective, consecutive, interventional single-center study between April and October 2009 of all new patients with acute chemical eye injury presenting to the Royal Victoria Infirmary eye emergency department (EED).

Results: Of 11,683 patients who attended the EED, 98 patients (110 eyes) presented with acute chemical eye injury (60% male).

Long-term Results of Corneal Cross-linking for Terrien's Marginal Degeneration.

Purpose: To report the long-term clinical outcomes of a patient with Terrien's marginal degeneration who underwent successful peripheral corneal cross-linking (CXL) to arrest progression.

Methods: Clinical assessment included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), corneal topography, anterior segment optical coherence tomography, ultrasonic pachymetry, corneal hysteresis, and corneal resistance factor. Eccentric epithelium-off CXL was performed in both eyes after limbal conjunctival resection.

Outcomes of Penetrating Keratoplasty Following Autologous Cultivated Limbal Epithelial Stem Cell Transplantation.

The purpose of this study is to investigate the outcomes of penetrating keratoplasty (PKP) following autologous cultivated limbal epithelial stem cell transplantation (CLET). A prospective, single center, interventional cohort study investigating patients with unilateral total limbal stem cell deficiency (LSCD) treated with CLET who underwent PKP. Patients with confirmed corneal re-epithelialization > 6 months post-CLET, and with best-corrected visual acuity (BCVA) <0.

Corneal Cross-Linking With Verteporfin and Nonthermal Laser Therapy.

Purpose: To test whether verteporfin with a nonthermal laser increases corneal mechanical stiffness and resistance to enzymatic degradation ex vivo.

Methods: Thirty human corneas (n = 5 per group) were treated with verteporfin alone (V), irradiated with nonthermal laser therapy (689 nm) alone (NTL), or received combined treatment of verteporfin with nonthermal laser therapy for 1 sequence (V+NTL1) or 6 sequences (V+NTL6) of 1 minute of NTL exposure. Positive controls were pretreated with 0.

Keratoprosthesis: A Review of Recent Advances in the Field.

Since its discovery in the years of the French Revolution, the field of keratoprostheses has evolved significantly. However, the path towards its present state has not always been an easy one. Initially discarded for its devastating complications, the introduction of new materials and the discovery of antibiotics in the last century gave new life to the field.

Titanium Coating of the Boston Keratoprosthesis.

Purpose: We tested the feasibility of using titanium to enhance adhesion of the Boston Keratoprosthesis (B-KPro), ultimately to decrease the risk of implant-associated complications.

Methods: Cylindrical rods were made of poly(methyl methacrylate) (PMMA), PMMA coated with titanium dioxide (TiO) over a layer of polydopamine (PMMA), smooth (Ti) and sandblasted (Ti) titanium, and titanium treated with oxygen plasma (Ti and Ti). Topography and surface chemistry were analyzed by scanning electron microscopy (SEM), atomic force microscopy (AFM), and X-ray photoelectron spectroscopy (XPS).

Boston Keratoprosthesis Type 1 in Chemical Burns.

Purpose: To describe and further analyze the long-term results in visual acuity (VA), anatomical retention, and rate of complications from patients who underwent Boston keratoprosthesis (B-Kpro) type 1 after ocular chemical burns in the Dominican Republic.

Methods: A retrospective review of 42 eyes (22 OD:20 OS) of 36 patients who underwent B-Kpro type 1 implantation after severe ocular burn at Hospital Elías Santana in Santo Domingo, Dominican Republic, between April 2006 and October 2014, were included.

Results: Demographics, VA, anatomical retention, and the rates of postoperative complications and concurrent surgeries were evaluated.

Corneal Anesthesia With Site 1 Sodium Channel Blockers and Dexmedetomidine.

Purpose: Amino-amide or amino-ester local anesthetics, which are currently used for topical ocular anesthesia, are short acting and may delay corneal healing with long-term use. In contrast, site 1 sodium channel blockers (S1SCBs) are potent local anesthetics with minimal adverse tissue reaction. In this study, we examined topical local anesthesia with two S1SCBs, tetrodotoxin (TTX) or saxitoxin (STX) individually or in combination with α2-adrenergic receptor agonists (dexmedetomidine or clonidine), and compared them with the amino-ester ocular anesthetic proparacaine.

High-irradiance CXL combined with myopic LASIK: flap and residual stroma biomechanical properties studied ex-vivo.

Background/aims: To evaluate ex vivo biomechanical and enzymatic digestion resistance differences between standard myopic laser in-situ keratomileusis (LASIK) compared with LASIK+CXL, in which high-irradiance cross-linking (CXL) is added.

Methods: Eight human donor corneas were subjected to femtosecond-assisted myopic LASIK. Group A (n=4) served as a control group (no CXL).

NIR-triggered drug delivery by collagen-mediated second harmonic generation.

Second harmonic generation is a process through which nonlinear materials such as collagen can absorb two photons and scatter one with twice the energy. Collagen upconverts 730 nm (near-IR) to 365 nm (UV) through second harmonic generation, which cleaves a molecule bound to collagen via a UV-sensitive linker.

Glaucoma progression and role of glaucoma surgery in patients with Boston keratoprosthesis.

Purpose: The aim of this study was to evaluate glaucoma onset and progression after implantation of Boston Keratoprostheses (B-KPro) and the role of glaucoma surgery.

Methods: Records of patients with B-KPro implantation during 2004 to 2009 were reviewed. Parameters relevant to B-KPro surgery and glaucoma status were recorded.

Very low risk of light-induced retinal damage during Boston keratoprosthesis surgery: a rabbit study.

Purpose: The aim of this study was to assess the possibility of light damage to the retina by a surgical microscope during implantation of a Boston Keratoprosthesis (B-KPro) in rabbits.

Methods: The retinal irradiance from a Zeiss OPMI Lumera S7 operating microscope was measured at the working distance (16.5 cm).