Visual Improvement With Wavefront-Guided Scleral Lenses for Irregular Corneal Astigmatism.

Purpose: To report interim results of a single center, randomized, double-blind, crossover-controlled clinical trial comparing wavefront-guided (wfg) scleral lenses (SLs) to traditional scleral lenses (tSLs) for patients with a history of irregular corneal astigmatism (ICA).

Methods: Thirty-one ICA eyes of 18 participants were reviewed, 23 with keratoconus, six postcorneal refractive ectasia, and two postpenetrating keratoplasty. Patients with corneal or lens opacities were not excluded from participating.

The Pathophysiology of Keratoconus.

Purpose: Keratoconus is a progressive disease characterized by changes in corneal shape, resulting in loss of visual function. There remains a lack of comprehensive understanding regarding its underlying pathophysiology. This review aims to bridge this gap by exploring structural failures and inflammatory processes involved in the etiology and progression of keratoconus.

Update on corneal crosslinking for keratoconus and corneal ectasia.

Purpose Of Review: To review corneal crosslinking for keratoconus and corneal ectasia, and recent developments in the field. This study will review the mechanism of crosslinking, clinical approaches, current results, and potential future innovations.

Recent Findings: Corneal crosslinking for keratoconus was first approved by U.

Prevalence of Keratoconus Based on Scheimpflug Corneal Tomography Metrics in a Pediatric Population From a Chicago-Based School Age Vision Clinic.

Purpose: Determine the pediatric prevalence of keratoconus (KC) using Scheimpflug corneal tomography.

Methods: A prospective observational study was done on subjects aged 3 to 18 years at the Princeton Vision Clinic, Chicago, IL. Scheimpflug tomography (Pentacam HR, OCULUS Optikgerate GmbH) scans (Belin/Ambrósio Enhanced Ectasia BAD3) yielded BAD Final D (Final D) and Back Elevation at the Thinnest Point (BETP) measurements.

Correlation of Manifest Refraction and Simulated Keratometry to Tomography Characteristics in Patients With Keratoconus.

Objectives: To report on baseline refractive and keratometric values and their correlation with tomographic characteristics of eyes with keratoconus (KC).

Methods: Retrospective chart review of patients treated in a single-center cornea and refractive surgery practice. Baseline topographic measurements were reviewed for 1,012 keratoconic eyes of 586 patients between 2008 and 2018.

Less Complex Contact Lens Required for a Patient With Keratoconus After Topography-Guided Photorefractive Keratectomy.

In this report, we discuss contact lens (CL) fitting in a patient with a history of keratoconus (KC), before and after undergoing topography-guided photorefractive keratectomy (TG PRK). Before TG PRK, the patient failed multiple CL modalities and reported difficulty with his habitual CLs and inadequate spectacle-corrected visual acuity to perform his activities of daily living. In this case, a collaborative, comprehensive approach to visual management in a patient with KC was used, and after TG PRK was performed to improve his corneal contour and symmetry, our patient was fit with a standard soft CL and additionally had improved spectacle-corrected visual acuity.

Long-Term Outcomes After Corneal Cross-linking for Progressive Keratoconus and Corneal Ectasia: A 10-Year Follow-Up of the Pivotal Study.

Objectives: To report on the topographic and visual outcomes 10 years after corneal cross-linking in patients with progressive keratoconus and corneal ectasia after refractive surgery.

Methods: Cross-sectional cohort study of an original, prospective, randomized, clinical trial. Patients treated in a single center cornea and refractive surgery practice as part of the U.

Corneal tissue addition keratoplasty: new intrastromal inlay procedure for keratoconus using femtosecond laser-shaped preserved corneal tissue.

Purpose: To report results of Corneal Tissue Addition Keratoplasty (CTAK) for keratoconus (KC) and ectasia after laser in situ keratomileusis.

Setting: Cornea and refractive surgery practice.

Design: Single center, prospective, open label clinical trial.

Ocular Impression-Based Scleral Lens With Wavefront-Guided Optics for Visual Improvement in Keratoconus.

This case reports on the use of wavefront-guided (wfg) optics on custom ocular impression-based scleral lenses (IBSLs) for visual improvement in a patient with keratoconus (KC). A 28-year-old man with KC, who had previously failed a traditional, diagnostically fit scleral lens (tSL), was fit with IBSLs with traditional optics. Using a system that included a dot matrix on the IBSL and a wavefront aberrometer with pupil and dot registration software, a wfgIBSL was created.

Lipid Keratopathy Management With Therapeutic Scleral Lens Wear.

Purpose: To report on the use of scleral lens therapy for a patient with lipid keratopathy secondary to rigid gas permeable contact lens wear and ocular surface disease.

Methods: Case report and literature review.

Results: A 40-year-old man with a history of keratoconus and rigid gas permeable contact lens wear, resulting in corneal neovascularization and lipid keratopathy.

Corneal Crosslinking for Progressive Keratoconus and Corneal Ectasia: Summary of US Multicenter and Subgroup Clinical Trials.

Purpose: The multicenter studies reviewed were designed to evaluate the safety and efficacy of corneal collagen crosslinking (CXL) for the treatment of progressive keratoconus and corneal ectasia after laser refractive surgery. The results of these studies led to approval by the United States Food and Drug Agency for both conditions in 2016. This paper reviews these studies, as well as single-center substudies investigating other aspects of crosslinking outcomes.

Descemetocele Management With Therapeutic Scleral Lens Wear.

Objectives: This case reports on the use of scleral lens therapy for a patient with a descemetocele secondary to exposure and neurotrophic keratopathy.

Methods: Case report and literature review.

Results: A 31-year-old man had undergone emergency surgery to repair a ruptured arteriovenous malformation resulting in left facial and trigeminal nerve palsies.

Corneal higher-order aberrations after crosslinking and intrastromal corneal ring segments for keratoconus.

Purpose: To assess anterior corneal higher-order aberrations (HOAs) after corneal crosslinking (CXL) and intrastromal corneal ring segments (Intacs) used adjunctively.

Setting: Cornea and refractive surgery practice.

Design: Prospective, randomized clinical trial.

Corneal Haze After Transepithelial Collagen Cross-linking for Keratoconus: A Scheimpflug Densitometry Analysis.

Purpose: To quantitate corneal haze and analyze the postoperative time course of corneal haze after transepithelial corneal collagen cross-linking (TECXL) in patients with keratoconus.

Methods: Patients underwent TECXL and were randomized into 2 groups. One group received intraoperative riboflavin 0.

Corneal crosslinking and intracorneal ring segments for keratoconus: A randomized study of concurrent versus sequential surgery.

Purpose: To assess outcomes of corneal crosslinking (CXL) and intracorneal ring segments (ICRS) (Intacs) used adjunctively, and then compare the safety and efficacy of concurrent versus sequential surgery.

Setting: Cornea and refractive surgery subspecialty practice.

Design: Prospective randomized clinical trial.

Incidence and associations of intracorneal ring segment explantation.

Purpose: To assess the incidence and motivating determinants of explantation of intracorneal ring segments (ICRS) (Intacs) used for the treatment of keratoconus and corneal ectasia.

Setting: Cornea and refractive surgery subspecialty practice.

Design: Retrospective case series.

Transepithelial corneal crosslinking for keratoconus.

Purpose: To evaluate outcomes of corneal crosslinking (CXL) using a transepithelial technique for the treatment of keratoconus.

Setting: Cornea and refractive surgery subspecialty practice.

Design: Prospective case series.

U.S. Multicenter Clinical Trial of Corneal Collagen Crosslinking for Treatment of Corneal Ectasia after Refractive Surgery.

Purpose: To evaluate the safety and efficacy of corneal collagen crosslinking (CXL) for the treatment of corneal ectasia after laser refractive surgery.

Design: Prospective, randomized, multicenter, controlled clinical trial.

Participants: One hundred seventy-nine subjects with corneal ectasia after previous refractive surgery.

United States Multicenter Clinical Trial of Corneal Collagen Crosslinking for Keratoconus Treatment.

Purpose: To evaluate the safety and efficacy of corneal collagen crosslinking (CXL) for the treatment of progressive keratoconus.

Design: Prospective, randomized, multicenter, controlled clinical trial.

Participants: Patients with progressive keratoconus (n = 205).

Removal and Repositioning of Intracorneal Ring Segments: Improving Corneal Topography and Clinical Outcomes in Keratoconus and Ectasia.

Purpose: To evaluate the efficacy of removal and relocation of intracorneal ring segments for improving outcomes in treatment of keratoconus and corneal ectasia.

Methods: This is a retrospective case series conducted at a cornea and refractive surgery subspecialty practice setting. Patients with previous insertion of 2 intracorneal ring segments underwent surgical removal and repositioning of segments because of unsatisfactory visual and topographic outcomes.

Intraoperative corneal thickness change and clinical outcomes after corneal collagen crosslinking: Standard crosslinking versus hypotonic riboflavin.

Purpose: To determine intraoperative changes in corneal thickness and outcomes of corneal collagen crosslinking (CXL) using 2 intraoperative regimens: riboflavin-dextran or hypotonic riboflavin.

Setting: Cornea and refractive surgery practice, Teaneck, New Jersey, USA.

Design: Prospective randomized case series.

Use of a hydrogel sealant in epithelial ingrowth removal after laser in situ keratomileusis.

Unlabelled: We describe 2 cases in which clinically significant epithelial ingrowth was removed by debridement and followed by the use of a hydrogel sealant (Resure) to seal the flap edge. In both cases, the epithelial ingrowth was seen after otherwise uneventful laser in situ keratomileusis retreatment. The visual outcomes were good with no recrudescence of interface epithelium.

New intrastromal corneal reshaping procedure using high-intensity femtosecond laser pulses.

Unlabelled: A minimally invasive keratorefractive procedure using high-intensity, low-energy femtosecond laser pulses to perform intrastromal ablation is described. Because of the low pulse energy and the ultrashort duration, tissue in the corneal stroma can be ablated with almost no heat or shockwave generation. This technique obviates the need for the laser in situ keratomileusis (LASIK) flap but retains the advantages of the LASIK procedure.