Delayed Late-Onset Severe Progressive Corneal Flattening: A Complication 9 Years After Corneal Collagen Crosslinking.

Purpose: We describe a case of late visual deterioration with marked progressive corneal flattening 9 years after crosslinking (CXL) was performed using the Dresden protocol.

Case Presentation: This patient with bilateral keratoconus underwent epithelium off crosslinking of the left eye only in 2007. After almost a decade of stability, he developed significant progressive corneal flattening with Descemet and stromal folds without inflammation, and a large hyperopic shift.

Involvement of the Superior Cerebellar Peduncles in GAA- Ataxia.

Objectives: GAA- ataxia (SCA27B) is a recently reported late-onset ataxia caused by a GAA repeat expansion in intron 1 of the gene. After the clinical observation of superior cerebellar peduncle (SCP) involvement in some affected patients, we sought to verify the prevalence of this finding in our cohort and 4 additional independent cohorts of patients with SCA27B.

Methods: We performed a retrospective review of the brain MRI scans of a total of 87 patients (median age at MRI 69 years; range 28-88 years) from different independent cohorts to assess the presence of SCP involvement, defined as abnormally high T2 signal along the SCP tract.

Eccentric Superficial Anterior Lamellar Keratoplasty for Bilateral Limbal Stem Cell Deficiency.

Purpose: To describe and report the outcomes of allogeneic eccentric superficial anterior lamellar keratoplasty (SALK), a novel surgical technique, in the management of total bilateral limbal stem cell deficiency (LSCD).

Methods: Data were collected retrospectively on all patients with total bilateral LSCD who underwent SALK. Previous surgery, preexisting glaucoma, conjunctivalization, vascularization, lens status, and preoperative best-corrected visual acuity (BCVA) were collected from medical notes.

Prehospital video triage of suspected stroke patients in Greater Manchester: pilot project report.

Introduction: Stroke is a leading cause of mortality and morbidity, demanding prompt and accurate identification. However, prehospital diagnosis is challenging, with up to 50% of suspected strokes having other diagnoses. A prehospital video triage (PHVT) system was piloted in Greater Manchester to improve prehospital diagnostic accuracy and appropriate conveyance decisions.