Enhancing corneal ectasia susceptibility detection: analysis of a new algorithm (BAD-D v4).

Accurate detection of post-refractive ectasia susceptibility is essential during preoperative evaluation for laser vision correction (LVC) due to the risk of progressive corneal ectasia and vision decline post-surgery. Despite improved screening and a reduced incidence from 0.66 to 0.

Visual Recovery and Endothelial Repopulation after DMEK Graft Removal and Vitrectomy for Late Endophthalmitis: A Case Report.

Introduction: The aim of the study was to report a unique case with excellent clinical outcomes after late endophthalmitis following Descemet's membrane endothelial keratoplasty (DMEK) surgery requiring donor graft removal without replacement.

Case Presentation: A 67-year-old female with a prior ocular history of bilateral cataract surgery, Fuchs endothelial dystrophy, and pseudophakic DMEK in the left eye presented with endophthalmitis 2 months after keratoplasty. DMEK graft removal without replacement with an intracameral washout, pars plana vitrectomy, intracameral, and intravitreal antibiotics resulted in an excellent visual outcome (20/25).

Effect of Astigmatism Treatment With Three Excimer Lasers After Photorefractive Keratectomy.

Objectives: To compare astigmatism correction after photorefractive keratectomy (PRK) using three excimer laser devices, Alcon Wavelight EX500, Schwind Amaris 1,050, and Technolas Teneo317 M2.

Methods: This retrospective study included 414 eyes from 414 subjects with a history of PRK performed using Alcon Wavelight (n=172), Schwind Amaris (n=122), and Technolas (n=120). Uncorrected & corrected distance visual acuity (UDVA & CDVA), and refractive status (spherical equivalent (SE) and vector analysis (J0 and J45)) were postoperatively recorded at the 6-month and 12-month examinations.

Comparison of corneal biomechanical parameters in healthy corneas with symmetric and asymmetric bow-tie topographic pattern with inferior and superior steepening.

Purpose: To compare the corneal biomechanical parameters in healthy corneas with symmetric and asymmetric bow-tie topographic patterns.

Methods: In this cross-sectional study, 144 eyes were divided based on inferior-superior asymmetry value (I-S) into symmetric (zero I-S: - 0.50 to + 0.

Recurrent Keratoconus: Corneal Transplants for Keratoconus Develop Tomographic Ectatic Changes.

Purpose: The purpose of this study was to evaluate postoperative Scheimpflug imaging changes during the first 5 years after penetrating keratoplasty (PK) in patients with keratoconus (KC).

Methods: This retrospective, interventional case series includes 31 eyes of 31 patients who underwent their first PK with a history of KC. Postoperative Scheimpflug imaging was performed 3 months after the removal of the last suture (baseline) and then repeated 3 and 5 years after the PK.

Optimized Artificial Intelligence for Enhanced Ectasia Detection Using Scheimpflug-Based Corneal Tomography and Biomechanical Data.

Purpose: To optimize artificial intelligence (AI) algorithms to integrate Scheimpflug-based corneal tomography and biomechanics to enhance ectasia detection.

Design: Multicenter cross-sectional case-control retrospective study.

Methods: A total of 3886 unoperated eyes from 3412 patients had Pentacam and Corvis ST (Oculus Optikgeräte GmbH) examinations.

Reliability analysis of successive Corvis ST® measurements in keratoconus 2 years after accelerated corneal crosslinking compared to untreated keratoconus corneas.

Purpose: To assess the reliability of successive Corvis ST® measurements (CST, Oculus, Wetzlar, Germany) in keratoconus (KC) ≥ 2 years after accelerated corneal crosslinking (9 mW/cm, 10 min, 5.4 J/cm) compared to untreated KC corneas.

Methods: Three successive CST measurements per eye were performed in ≥ 2 years after CXL (CXLG, n = 20 corneas of 16 patients) and a control group consisting of non-operated, ABC-stage-matched KC corneas according to Belin's ABCD KC grading (controls, n = 20 corneas, 20 patients).

Acute Hydrops with Total Corneal Edema in a Very Young Child with Keratoconus: The Youngest Age Reported Case.

Purpose: To present the youngest age ever reported for acute corneal hydrops with total corneal edema in a child with advanced bilateral keratoconus.

Methods: Patient presentation in ophthalmic clinic. The patient underwent various clinical tests and examinations including anterior segment optical coherence tomography (AS-OCT) and Scheimpflug corneal tomography.

Implications of Diagnostic Drops on Scheimpflug Tomography: The Proper Order for Clinical Testing.

Purpose: The purpose of this article was to study the impact of instillation of 1% fluorescein and mydriatics on measurements made by Scheimpflug imaging.

Methods: This was a cross-sectional study of patients who had measurements of corneal shape (maximum keratometry and best fit sphere of anterior and posterior corneal surfaces), pachymetry (at the pupil center, corneal apex, and thinnest location), and anterior chamber parameters (depth, volume, and angle of anterior chamber and corneal volume) using the Pentacam HR before and after the instillation of fluorescein and mydriatics. Group A had baseline measurements that were repeated 1.

Corneal Stability and Visual Acuity 1 Year After Corneal Cross-linking Assessed Using the ABCD Keratoconus Staging System.

Purpose: To assess corneal stability and corrected distance visual acuity (CDVA) 3, 6, and 12 months following corneal cross-linking (CXL) using the ABCD keratoconus staging system.

Methods: This prospective longitudinal study included 31 eyes with keratoconus receiving CXL based on the standard Dresden protocol. CDVA, refraction, and Scheimpflug tomography with the Pentacam HR (Oculus Optikgeräte GmbH) were evaluated before and after surgery.

Combined biomechanical and tomographic keratoconus staging: Adding a biomechanical parameter to the ABCD keratoconus staging system.

Purpose: This retrospective cross-sectional study evaluated the potential of an additional biomechanical parameter 'E' as an addition to the tomographic ABCD ectasia/keratoconus (KC) staging.

Methods: The Corvis Biomechanical Factor (CBiF) represents the modified linear term of the Corvis Biomechanical Index (CBI) developed based on 448 KC corneas from the Homburg Keratoconus Center (HKC). The CBiF range was divided into five stages (E0 to E4) to create a grading system according to the ABCD stages.

Correlation of the Corvis Biomechanical Factor with tomographic parameters in keratoconus.

Purpose: To investigate the relationship between corneal biomechanics and keratoconus (KC) severity as described by tomographic parameters.

Setting: University-based German ophthalmology department.

Design: Retrospective cross-sectional study.

Keratoconus: Diagnosis and Staging.

The advent of refractive surgery and corneal cross-linking for ectatic disease has further highlighted the need to recognize early or subclinical ectatic disease. Historical systems depend on anterior corneal changes that occur late in the disease course and are commonly associated with visual loss. Tomographic imaging allows for the acquisition of posterior corneal surface data and corneal thickness distribution.

Comparison of Keratoconus Cone Location of Different Topo/tomographical Parameters.

: To compare the corneal cone location on different maps and instruments, and their agreements, with elevation maps.: In 90 left eyes with bilateral keratoconus, the apex of cone location was determined based on the maximum simulated keratometry (Kmax) location on the anterior sagittal curvature map by Pentacam HR, the maximum curvature on the mean curvature map by ATLAS 9000, most elevated point of the island of positive elevation relative to the best fit sphere on the front and back corneal elevation maps by Pentacam HR, and thinnest point on the thickness map by Pentacam HR and Orbscan, and the thinnest points on pachymetry and epithelial thickness maps by RTVue OCT.: There was a significant difference among the location on different maps along the - and -axes ( < .

Outcomes of Conductive Keratoplasty Combined with Corneal Crosslinking in Advanced Ectatic Corneal Disease.

Purpose: To assess the effectiveness of a novel treatment for patients with advanced corneal ectasia and loss of visual acuity (VA). Conductive keratoplasty (CK) is performed to improve VA followed by epithelium-on (epi-on) corneal crosslinking (CXL) to stabilize the cornea after CK.

Methods: Retrospective, exploratory cohort study.

Determining Progression in Ectatic Corneal Disease.

Before the advent of modern tomographic imaging and corneal cross-linking (CXL), diagnosis and treatment of ectatic disease were limited to disease severity where changes on the anterior corneal surface lead to visual complaints. Rigid contact lenses and/or penetrating keratoplasty addressed late stage disease, as identifying early or subclinical disease was not possible, or its need appreciated. The emergence of CXL as a viable treatment to alter the natural progression of keratoconus heightened the need for improved diagnostics.

ABCD: A new classification for keratoconus.

Recent advances in the diagnosis and treatment of ectatic corneal disease have mandated a more modern staging system. The new Belin ABCD keratoconus staging system incorporates anterior and posterior curvature centered on the thinnest point of the cornea, thinnest pachymetry values and distance visual acuity in grades from 0-4. By including posterior curvature and thickness measurements based on the thinnest point, as opposed to apical, the new staging system better reflects anatomical changes seen in keratoconus and other ectatic diseases.

Evaluating keratoconus progression prior to crosslinking: maximum keratometry vs the ABCD grading system.

Purpose: To evaluate the correlation between changes in maximum keratometry (Kmax) and ABC values from the ABCD Progression Display (Pentacam) in progressive keratoconus (KC) and to evaluate whether the ABC changes were able to detect progression earlier than Kmax.

Setting: Humanitas Clinical and Research Center, Rozzano, Milan, Italy.

Design: Retrospective study.

Comparative analysis of two different types of intracorneal implants in keratoconus: A corneal tomographic study.

Objective: To evaluate changes in visual acuity and corneal tomographic outcomes at 6 months after femtosecond-laser assisted implantation of two different types of intracorneal implants in keratoconus.

Methods: A total of 39 keratoconus eyes implanted with two segments KeraRing ( = 22 eyes) or MyoRing ( = 17 eyes) were enrolled. Tomographic data (Pentacam system, Oculus) were analyzed and correlated with enhancement in uncorrected (UDVA) and corrected distance visual acuity (CDVA).

Extreme corneal flattening following collagen crosslinking for progressive keratoconus.

Purpose: To study the clinical, tomographic and densitometric features of eyes that showed >5 D of corneal flattening following collagen crosslinking (CXL) for progressive keratoconus and to identify preoperative predictive factors for such a response.

Methods: This was a retrospective case control study of 548 eyes with progressive keratoconus which had undergone epithelium-off CXL (Dresden protocol) with a follow-up of 1 to 10 years. Eyes that showed ⩾5 D corneal flattening in maximum keratometry (Kmax) following CXL (group A) were compared with one eye of the remaining patients in the same cohort (group B).

Keratoconus and Ectatic Disease: Evolving Criteria for Diagnosis.

The approach to corneal ectatic disease has changed dramatically over the last decade with advances in both diagnosis and treatment. Newer treatments, such as corneal cross-linking, have the potential to slow or stop the progression of the disease, but benefit from earlier identification of the disease than had previously been possible or required. The continued use of older diagnostic criteria and ambiguous terminology can lead to erroneous study conclusions that may not be applicable to patients with true pathology.

Scheimpflug Corneal Densitometry Changes After the Intrastromal Corneal Ring Segment Implantation.

Purpose: To investigate the changes in corneal backward scattering using Scheimpflug tomography (densitometry) 6 months after intrastromal corneal ring segments (Keraring) implant for keratoconus and to correlate with clinical results.

Methods: Along with standard ophthalmic examination, Scheimpflug tomography using Pentacam HR was performed to document corneal densitometry and corneal shape. A densitometry map was displayed using grayscale units (GSUs) ranging from 0 to 100 (minimum to maximum light scattering) in 4 concentric annuluses: central 2-, 2- to 6-, 6- to 10-, 10- to 12-, and total 12-mm corneal diameter and at 3 different depths: anterior 120 μm, posterior 60 μm, middle (varying accordingly to the total thickness), and total thickness.