Three-Year Results of Simultaneous Transepithelial Phototherapeutic Keratectomy and Conventional Photorefractive Keratectomy (Cretan Protocol Plus) Followed by Corneal Crosslinking for Keratoconus.

Purpose: The aim of this study was to present the 3-year outcomes after simultaneous transepithelial phototherapeutic keratectomy (t-PTK) and conventional photorefractive keratectomy (PRK) followed by corneal crosslinking (CXL) for keratoconus.

Methods: In this prospective, interventional case series, patients with progressive keratoconus underwent simultaneous t-PTK and conventional PRK followed by CXL (Cretan protocol plus). Visual, refractive, and topographic outcomes were evaluated along with endothelial cell density (ECD) preoperatively and at 1, 2, and 3 years postoperatively.

Intraocular Lens Refractive Index and Its Impact on External Surface Reflections.

Purpose: To determine and compare the origin of the external surface reflections produced by commonly used intraocular lenses (IOLs).

Methods: The specular reflection taking place at the anterior surface of eight types of IOLs (IOL power = 22.00 diopters [D]) with different refractive indices (RIs), optical design, and ultraviolet and blue light-filtering function were measured.

Long-Term Follow-Up of Combined Photorefractive Keratectomy and Corneal Crosslinking in Keratoconus Suspects.

Purpose: To present the long-term outcomes of photorefractive keratectomy (PRK) combined with accelerated corneal cross-linking (CXL) for refractive error correction in a series of keratoconus suspects.

Setting: University practice.

Design: Retrospective case series.

Small incision lenticule extraction retreatment in a patient with high residual refractive error after photorefractive keratectomy: A case report.

A 36-year-old male underwent uneventful small incision lenticule extraction (SMILE) for the correction of his high residual refractive error 12 years after photorefractive keratectomy (PRK). Preoperatively, uncorrected distance visual acuity (UDVA) was counting fingers in both eyes. Corrected distance visual acuity was 20/20 in the right and 20/30 in the left eye due to amblyopia.

Corneal cross-linking (CXL) combined with refractive surgery for the comprehensive management of keratoconus: CXL plus.

The past two decades have witnessed an unprecedented evolution in the management of keratoconus that demands a holistic approach comprising of inhibiting the ectatic progression as well as visual rehabilitation. The advent of corneal cross-linking (CXL) in the late 1990s resulted in long-term stabilization of the ectatic cornea along with limited reduction in corneal steepening and regularization of corneal curvature. However, CXL as a standalone procedure does not suffice in rehabilitating the functional vision especially in patients who are unwilling or intolerant towards contact lenses.

Evolution of corneal flattening after repeated corneal cross-linking during a 6-year follow-up.

Purpose: To report the evolution of corneal flattening after repeated corneal cross-linking (CXL) in a patient with progressive keratoconus during a 6-year follow-up.

Methods: Case report.

Results: A 27-year-old female underwent CXL for progressive keratoconus.

A New Surgical Approach for the Management of Acute Corneal Hydrops Complicated With Corneal Perforation.

Purpose: To report an unusual case of a patient with keratoconus and acute hydrops complicated with corneal perforation and describe its management using a new surgical approach.

Methods: A case report and new surgical approach description.

Results: A 47-year-old female patient with a history of keratoconus and implantable contact lens surgery presented at our institute with symptoms of acute corneal hydrops in her right eye.

Burr-Assisted Anterior Lamellar Keratoplasty (DALK) in Patients with Corneal Stromal Scarring: A Case Series.

Purpose: To describe a modified technique of deep anterior lamellar keratoplasty (DALK) assisted by diamond ophthalmic burr (DOB) in two patients with corneal stromal scarring.

Methods: Two patients with corneal stromal scarring underwent a modified DALK technique with corneal stromal polishing assisted by a DOB until the level of the Descemet membrane.

Results: There were no intra- or postoperative complications.

Using corneal graft from keratoconic donor for lamellar and penetrating keratoplasties.

We report the use of two corneal grafts derived from a donor, with a history of early stage keratoconus, for lamellar and penetrating keratoplasty. The first graft was used to perform Descemet stripping automated endothelial keratoplasty (DSAEK) in a patient with endothelial dysfunction and advanced pseudoexfoliative glaucoma. The second graft was used for an emergency penetrating keratoplasty in a patient with corneal perforation secondary to uncontrolled herpes keratitis.

Predictors of Visual Acuity Improvement and Supernormal Vision After Refined Single-Step Transepithelial Photorefractive Keratectomy.

Purpose: To investigate predicting factors of visual acuity improvement and achieving uncorrected (UDVA) or corrected (CDVA) distance visual acuity supernormal vision (⩾ 15/10; Snellen 20/13) 1 year after refined transepithelial photorefractive keratectomy (TransPRK).

Methods: In this retrospective case series, a total of 155 eyes with myopia (mean ± standard deviation = -3.53 ± 1.

Femtosecond-Assisted Elliptical LASIK Flap for the Correction of Post-Arcuate Keratotomy Residual Astigmatism.

We report the application of an elliptical femtosecond laser-assisted in situ keratomileusis (LASIK) flap for the management of post-arcuate keratotomy (AK) residual astigmatism. An 82-year-old male was referred to our institute for evaluation of his right eye due to residual regular astigmatism 1 year after AK. On examination, uncorrected distance visual acuity (UDVA) was 20/50 and corrected distance visual acuity was 20/25 (+3.

Long-term Comparison of Combined t-PTK and CXL (Cretan Protocol) Versus CXL With Mechanical Epithelial Debridement for Keratoconus.

Purpose: To compare the long-term outcomes of corneal cross-linking (CXL) for the treatment of keratoconus using two different techniques for epithelial removal: transepithelial phototherapeutic keratectomy (t-PTK) and mechanical epithelial debridement.

Methods: In this prospective, comparative, interventional case series, 26 patients (30 eyes) with progressive keratoconus underwent CXL treatment. Fifteen eyes (13 patients) underwent epithelial removal with t-PTK (Cretan protocol) and 15 eyes (13 patients) underwent mechanical epithelial debridement (Dresden protocol) during CXL.

Combined DSAEK and intraocular lens flipping with retropupillary fixation in a patient with anterior chamber iris-claw intraocular lens and corneal edema.

An 84-year-old monocular woman was referred to our institution for the management of corneal decompensation in her only eye, the right eye. The patient had secondary implantation of an anterior chamber iris-claw intraocular lens (IOL) for IOL dislocation in the setting of pseudoexfoliation syndrome 2 years before presentation. Descemet-stripping automated endothelial keratoplasty (DSAEK) combined with retropupillary repositioning of the iris-claw IOL using a flipping technique was performed for the treatment of corneal edema.

Combined Pupilloplasty and Retropupillary Iris-Claw Intraocular Lens Implantation with DSAEK in a Patient with Traumatic Iridoplegia, Aphakia and Corneal Decompensation.

Purpose: To report the management of a patient with traumatic mydriasis, aphakia and corneal decompensation with a triple procedure: simultaneous pupilloplasty and retropupillary iris-claw intraocular lens (IOL) implantation combined with Descemet stripping automated endothelial keratoplasty (DSAEK).

Results: An 88-year-old woman was referred to our Institute for consultation on her left eye. The patient had undergone surgical removal of the IOL, without re-implantation, in her left eye 10 months prior to presentation due to traumatic IOL dislocation.

Resolution of epithelial ingrowth after combined photorefractive keratectomy and corneal crosslinking in a patient with post-LASIK ectasia.

A 34-year-old man was referred to our institute for evaluation of the left eye because of corneal ectasia 10 years after bilateral laser in situ keratomileusis (LASIK). Three months before his referral, the patient had a flap lift for the management of interface fluid accumulation. Topography demonstrated post-LASIK corneal ectasia and slitlamp evaluation revealed epithelial ingrowth in the stromal interface inferiorly.

Comparison of Single-Step Transepithelial Photorefractive Keratectomy With or Without Mitomycin C in Mild to Moderate Myopia.

Purpose: To compare efficacy and safety of single-step transepithelial photorefractive keratectomy (PRK) with or without mitomycin C (MMC) in patients with mild to moderate myopia.

Methods: Patients with mild to moderate myopia (≤ -5.50 diopters [D]) underwent single-step transepithelial PRK using the Amaris laser (SCHWIND eye-tech-solutions GmbH, Kleinostheim, Germany).

Mini descemet membrane stripping (m-DMES) in patients with Fuchs' endothelial dystrophy: A new method.

We present two cases with focal corneal edema due to Fuchs' endothelial dystrophy that were successfully treated with mini Descemet membrane stripping (m-DMES) (diameter of 3-4 mm; at the area of preexisting focal corneal edema) without endothelial replacement during cataract surgery. Specular microscopy demonstrated Fuchs' endothelial dystrophy and histopathologic evaluation confirmed the diagnosis. Anterior segment optical coherence tomography and confocal microscopy were used for the evaluation of the corneal tissue recovery course after the surgical procedure.

Combined transepithelial phototherapeutic keratectomy and conventional photorefractive keratectomy followed simultaneously by corneal crosslinking for keratoconus: Cretan protocol plus.

Purpose: To evaluate the visual, refractive, and topographic outcomes after combined transepithelial phototherapeutic keratectomy (PTK) and conventional photorefractive keratectomy (PRK) followed simultaneously by corneal crosslinking (CXL) for keratoconus.

Setting: Vardinoyiannion Eye Institute of Crete, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece.

Design: Prospective case series.

The Effect of LASIK Procedure on Peripapillary Retinal Nerve Fiber Layer and Macular Ganglion Cell-Inner Plexiform Layer Thickness in Myopic Eyes.

Purpose: To evaluate the effect of applied suction during microkeratome-assisted laser in situ keratomileusis (LASIK) procedure on peripapillary retinal nerve fiber layer (RNFL) thickness as well as macular ganglion cell-inner plexiform layer (GC-IPL) thickness.

Methods: 89 patients (124 eyes) with established myopia range from -3.0 to -8.

Four-Stage Procedure for Keratoconus: ICRS Implantation, Corneal Cross-linking, Toric Phakic Intraocular Lens Implantation, and Topography-Guided Photorefractive Keratectomy.

Purpose: To evaluate a four-stage combined treatment for keratoconus including intrastromal corneal ring segment (ICRS) implantation followed by corneal cross-linking (CXL), toric phakic intraocular lens (IOL) implantation, and topography-guided photorefractive keratectomy (TG-PRK).

Methods: In this retrospective interventional case series, 11 eyes of 7 patients with progressive keratoconus were treated with a four-stage procedure including the following: Keraring ICRS (Mediphacos Ltda, Belo Horizonte, Brazil) implantation followed by CXL, phakic IOL implantation, and TG-PRK (minimum 6 months between each stage). Minimum follow-up was 12 months after TG-PRK.

Long-term outcomes of corneal cross-linking for keratoconus in pediatric patients.

Purpose: To report the long-term outcomes of corneal cross-linking (CXL) in pediatric patients with bilateral progressive keratoconus.

Methods: The medical records of consecutive pediatric patients with bilateral progressive keratoconus who underwent CXL at a single institution from June 2007to December 2009 were reviewed. All eyes underwent CXL treatment in accordance with the original Dresden protocol.