Short-Term Outcomes of Pediatric Keratoprosthesis With the Near-Complete Conjunctival Flap.

Purpose: The Boston keratoprosthesis (KPro) has been used for certain indications in pediatric patients with congenital corneal opacities. Here, we describe the use of a near-complete conjunctival flap at the time of Boston type 1 KPro surgery in pediatric patients, with the goal of improving pediatric KPro outcomes.

Methods: We performed a retrospective chart review of 21 eyes from 16 patients who received their first KPro before the age of 18 years at a tertiary care center in Rochester, NY.

ISOPT Hot Topic Panel Discussion on Cornea Anterior Segment Disease.

The cornea and its adnexa pose a unique situation of a tightly defined set of requirements for its function. This includes: transparency, perfect built to obtain appropriate refractive power, protective barrier from microbial invaders. Moreso, the cornea also endures extreme external physical conditions (temperature, high and low humidity, winds and alike).

Chemical Burns of the Eye: The Role of Retinal Injury and New Therapeutic Possibilities.

Purpose: To propose a new treatment paradigm for chemical burns to the eye - in the acute and chronic phases.

Methods: Recent laboratory and clinical data on the biology and treatment of chemical burns are analyzed.

Results: Corneal blindness from chemical burns can now be successfully treated with a keratoprosthesis, on immediate and intermediate bases.

Keratoprosthesis in Ectodermal Dysplasia.

Purpose: To describe the complex surgical management and novel medical approach for a keratoprosthesis (KPro Boston type I) in a monocular, 73-year-old patient with ectodermal dysplasia and chronic, noninfectious corneal necrosis.

Methods: Best-corrected visual acuity (BCVA) was measured with Snellen letters. Surgical intervention included an amniotic membrane graft, complete replacement of the KPro, conjunctival flap graft, corneal donor tissue grafts combined with inferior rectus muscle advancement, periosteal tissue graft, tarso-conjunctival flap construction, and symblepharolysis.

Temperatures of the Ocular Surface, Lid, and Periorbital Regions of Sjögren's, Evaporative, and Aqueous-Deficient Dry Eyes Relative to Normals.

Purpose: To compare the temperatures of the ocular surface, eyelid, and periorbital skin in normal eyes with Sjögren's syndrome (SS) eyes, evaporative dry eyes (EDE), and aqueous deficient dry eyes (ADDE).

Methods: 10 eyes were analyzed in each age-matched group (normal, SS, EDE, and ADDE). A noninvasive infrared thermal camera captured two-dimensional images in three regions of interest (ROI) in each of three areas: the ocular surface, the upper eyelid, and the periorbital skin within a controlled environmental chamber.

Outcomes of Repeat Boston Type 1 Keratoprosthesis Implantation.

Purpose: To describe the outcomes and prognostic characteristics of patients who had a repeat Boston type 1 keratoprosthesis (KPro) implantation.

Design: Retrospective case series.

Methods: setting: Data regarding preoperative clinical and demographic characteristics and postoperative course during initial and repeat KPro placement were collected at multiple centers across the country.

Protective effect of soft contact lenses after Boston keratoprosthesis.

Purpose: To evaluate associations between preoperative diagnosis, soft contact lens (SCL) retention and complications.

Methods: A retrospective chart review was conducted of 92 adult patients (103 eyes) who received a Boston keratoprosthesis type I at the Massachusetts's Eye and Ear Infirmary or the Flaum Eye Institute. Records were reviewed for preoperative diagnosis, SCL retention and subsequent complications.

Thermal analysis of dry eye subjects and the thermal impulse perturbation model of ocular surface.

In this study, we explore the usage of ocular surface temperature (OST) decay patterns to distinguished between dry eye patients with aqueous deficient dry eye (ADDE) and meibomian gland dysfunction (MGD). The OST profiles of 20 dry eye subjects were measured by a long-wave infrared thermal camera in a standardized environment (24 °C, and relative humidity (RH) 40%). The subjects were instructed to blink every 5 s after 20 ∼ 25 min acclimation.

Measurement of a multi-layered tear film phantom using optical coherence tomography and statistical decision theory.

To extend our understanding of tear film dynamics for the management of dry eye disease, we propose a method to optically sense the tear film and estimate simultaneously the thicknesses of the lipid and aqueous layers. The proposed method, SDT-OCT, combines ultra-high axial resolution optical coherence tomography (OCT) and a robust estimator based on statistical decision theory (SDT) to achieve thickness measurements at the nanometer scale. Unlike conventional Fourier-domain OCT where peak detection of layers occurs in Fourier space, in SDT-OCT thickness is estimated using statistical decision theory directly on the raw spectra acquired with the OCT system.

Long-term outcomes of boston type 1 keratoprosthesis implantation: a retrospective multicenter cohort.

Purpose: To study the long-term outcomes of Boston type 1 keratoprosthesis (KPro) surgery.

Design: Retrospective, multicenter case series.

Participants: A total of 158 eyes of 150 patients underwent KPro implantation at 5 participating tertiary centers in the United States between January 2003 and December 2006.

Maximum-likelihood estimation in Optical Coherence Tomography in the context of the tear film dynamics.

Understanding tear film dynamics is a prerequisite for advancing the management of Dry Eye Disease (DED). In this paper, we discuss the use of optical coherence tomography (OCT) and statistical decision theory to analyze the tear film dynamics of a digital phantom. We implement a maximum-likelihood (ML) estimator to interpret OCT data based on mathematical models of Fourier-Domain OCT and the tear film.

Phantom study of tear film dynamics with optical coherence tomography and maximum-likelihood estimation.

In this Letter, we implement a maximum-likelihood estimator to interpret optical coherence tomography (OCT) data for the first time, based on Fourier-domain OCT and a two-interface tear film model. We use the root mean square error as a figure of merit to quantify the system performance of estimating the tear film thickness. With the methodology of task-based assessment, we study the trade-off between system imaging speed (temporal resolution of the dynamics) and the precision of the estimation.

The use of precut, γ-irradiated corneal lenticules in Boston type 1 keratoprosthesis implantation.

Purpose: To report the use of a sterile, γ-irradiated corneal tissue without viable endothelium (VisionGraft Sterile Cornea; Tissue Banks International) in lieu of fresh donor cornea in Boston type 1 keratoprosthesis (KPro) implantation.

Design: Retrospective, interventional small case series.

Methods: Eleven eyes of 11 patients underwent Boston type 1 keratoprosthesis implantation using VisionGraft Sterile Cornea between April 2009 and October 2010.

Effect of airflow exposure on the tear meniscus.

Purpose. To compare the effect of airflow exposure on the tear meniscus and blink frequency in normal and evaporative dry eye subjects. Methods.

Novel formulation of glycerin 1% artificial tears extends tear film break-up time compared with Systane lubricant eye drops.

Purpose: To evaluate the effectiveness of glycerin 1% formulated with the novel and proprietary ophthalmic excipient poly(l-lysine)-graft-poly(ethylene glycol) (PLL-g-PEG) (Eyeon Particle Sciences LLC) in extending tear film break-up time (TFBUT) compared with a market-leading artificial tear formulation of propylene glycol (0.3%) and polyethylene glycol (0.4%) (Systane(®) Lubricant Eye Drops; Alcon, Fort Worth, TX).

Integrated multimodal metrology for objective and noninvasive tear evaluation.

The clinical tests used to assess tear film and diagnose dry eye are invasive and produce results that are different from natural tear characteristics. There is a need to objectively and noninvasively assess tear parameters under controlled environmental circumstances to refine dry eye diagnosis and therapy. We have developed multimodal tear imaging systems integrated in a chamber in which individual environmental factors can be precisely varied to investigate their impacts on tear parameters.

Infectious endophthalmitis in adult eyes receiving Boston type I keratoprosthesis.

Purpose: To report the clinical characteristics of infectious endophthalmitis after Boston type I keratoprosthesis (K-Pro) implantation.

Design: Retrospective study.

Participants: One hundred forty-one adult eyes receiving a K-Pro at a single institution from May 2004 through July 2008.

Noninvasive, objective, multimodal tear dynamics evaluation of 5 over-the-counter tear drops in a randomized controlled trial.

Purpose: To assess the ability of a noninvasive, objective, multimodal system to compare the efficacy and optical quality of 4 different groups of 5 over-the-counter tear drops.

Methods: Wavefront sensing and optical coherence tomography (OCT) were used to objectively assess visual quality and tear volume, respectively, after the over-the-counter tear drops [2 polyethylene glycol (PEG)-400, 1 carboxymethyl cellulose (CMC), 1 polyvinyl alcohol/PEG-400 (PVA), and 1 glycerine/polysorbate-80] were administered to 23 patients with aqueous-deficient dry eye in a randomized, controlled, double-masked trial. Measurements at each of the 5 visits were taken from both eyes at baseline and 5, 20, and 40 minutes after drop instillation.

Micrometer axial resolution OCT for corneal imaging.

An optical coherence tomography (OCT) for high axial resolution corneal imaging is presented. The system uses 375 nm bandwidth (625 to 1000 nm) from a broadband supercontinuum light source. The system was developed in free space to minimize image quality degradation due to dispersion.

Titanium back plate for a PMMA keratoprosthesis: clinical outcomes.

Background/purpose: To compare the rate of retroprosthetic membrane (RPM) formation in Boston Keratoprosthesis (BKPro) with polymethyl methacrylate (PMMA) versus titanium backplates.

Design: Retrospective comparative chart review.

Methods: Multicenter study population: a total of 78 eyes with keratoprosthesis implants with either PMMA or titanium backplates were included in the study.

A safe Nd:YAG retroprosthetic membrane removal technique for keratoprosthesis.

Purpose: To describe a technique for Nd:YAG laser photodiscission of retroprosthetic membrane (RPM) in keratoprosthesis patients that minimizes damage to the optic.

Methods: Prospective review of Boston type I keratoprosthesis patients at 1 site who received Nd:YAG treatment for RPM from 2005 to 2009. Outcomes were based on slit-lamp examination of the optic immediately after YAG treatment, tactile intraocular pressure at follow-up, and complications from the outpatient procedure.