Corneal Cross-linking at the Slit Lamp.

Purpose: To describe a new surgical technique where corneal cross-linking (CXL) (to treat corneal ectasias) and photo-activated chromophore for keratitis-CXL (PACK-CXL) are performed while the patient is seated in an upright position at the slit lamp.

Methods: Topical anesthesia is applied in the waiting room, 10 minutes before the procedure. Once in the office or procedure room, eyelids and periorbital areas are disinfected with chloramphenicol and the patient is seated at the slit lamp.

Pupil influence on the quality of vision in rotationally asymmetric multifocal IOLs with surface-embedded near segment.

Purpose: To evaluate the influences of preoperative pupil parameters on the visual outcomes of the SBL-3, a rotationally asymmetric multifocal intraocular lens (IOL) with a surface-embedded near segment.

Setting: Cathedral Eye Clinic, Belfast, Northern Ireland, United Kingdom.

Design: Retrospective comparative case series.

Visual quality and performance comparison between 2 refractive rotationally asymmetric multifocal intraocular lenses.

Purpose: To compare the 12-month postoperative quality of vision and visual performance of 2 different refractive rotationally asymmetric multifocal intraocular lenses (IOLs).

Setting: Cathedral Eye Clinic, Belfast, Northern Ireland, United Kingdom.

Design: Retrospective case series.

Visual outcomes and patient satisfaction 3 and 12 months after implantation of a refractive rotationally asymmetric multifocal intraocular lens.

Purpose: To assess the 3-month and 12-month postoperative visual performance and subjective patient satisfaction after refractive lens exchange (RLE) with implantation of a rotationally asymmetric multifocal intraocular lens (IOL).

Setting: Cathedral Eye Clinic, Belfast, United Kingdom.

Design: Prospective case series.

Repeated Cross-linking After a Short Time Does Not Provide Any Additional Biomechanical Stiffness in the Mouse Cornea In Vivo.

Purpose: To study whether repeated collagen cross-linking (CXL) performed in vivo in mice shows an additive effect on mechanical corneal stiffness.

Methods: In this experimental study, epithelium-off CXL was performed in a total of 18 eyes from male C57BL/6 mice, with 0.27%-riboflavin solution applied for 20 minutes, followed by ultraviolet-A (UVA) irradiation (365 nm, 9mW/cm) for 2:50 minutes (fluence 1.

Comparison of the visual performance and quality of vision with combined symmetrical inferonasal near addition versus inferonasal and superotemporal placement of rotationally asymmetric refractive multifocal intraocular lenses.

Purpose: To compare the postoperative quality of vision between different bilateral placements of near segments of rotationally asymmetric refractive multifocal intraocular lenses (IOLs) and to determine how this affects visual performance.

Setting: Cathedral Eye Clinic, Belfast, Northern Ireland, United Kingdom.

Design: Retrospective comparative case series.

Threshold limit of postoperative astigmatism for patient satisfaction after refractive lens exchange and multifocal intraocular lens implantation.

Purpose: To determine the degree of tolerance toward different magnitudes of residual refractive astigmatism and corneal astigmatism and the angles of corneal astigmatism after implantation of an asymmetric multifocal intraocular lens (IOL).

Setting: Cathedral Eye Clinic, Belfast, United Kingdom.

Design: Retrospective comparative case series.

Optimized Visual Outcome After Asymmetrical Multifocal IOL Rotation.

Purpose: To report improved visual outcome after rotation of an asymmetrical multifocal intraocular lens (IOL).

Methods: Case report.

Results: A 58-year-old patient underwent bilateral phacoemulsification with asymmetrical multifocal IOL implantation.

Analysis of Riboflavin Compounds in the Rabbit Cornea In Vivo.

Purpose: To investigate the composition and concentration of individual riboflavin compounds in the corneal stroma in vivo after soaking with various commercially available riboflavin formulations.

Methods: Experiments were performed in 26 rabbit corneas in vivo: 24 corneas were soaked with riboflavin formulations for 30 minutes or with 0.9% NaCl for control (n = 2).

Increased Biomechanical Efficacy of Corneal Cross-linking in Thin Corneas Due to Higher Oxygen Availability.

Purpose: To compare the currently available ultraviolet-A (UV-A) corneal cross-linking (CXL) treatment protocols for thin corneas with respect to oxygen, UV fluence, and osmotic pressure.

Methods: Freshly enucleated murine (n = 16) and porcine (n = 16) eyes were used. The dependency on oxygen and the amount of UV absorption were evaluated using different CXL protocols, including standard CXL, contact lens-assisted CXL (caCXL), and CXL after corneal swelling.

Establishing Corneal Cross-Linking With Riboflavin and UV-A in the Mouse Cornea In Vivo: Biomechanical Analysis.

Purpose: To establish corneal cross-linking (CXL) with riboflavin and UV-A in in the mouse cornea in vivo and to develop tools to measure the biomechanical changes observed.

Methods: A total of 55 male C57BL/6 wild-type mice (aged 5 weeks) were divided into 14 groups. Standard CXL parameters were adapted to the anatomy of the mouse cornea, and riboflavin concentration (0.

PACK-CXL: Corneal Cross-linking for Treatment of Infectious Keratitis.

This article discusses corneal cross-linking (CXL) and how it transitioned from a modality for treating corneal ectatic disorders to an inventive means of treating infectious keratitis. Initially, CXL was successfully developed to halt the progression of ectatic diseases such as keratoconus, using the standard Dresden protocol. Later, indications were extended to treat iatrogenic ectasia developing after laser-assisted in situ keratomileusis (LASIK) and photo-refractive keratectomy (PRK).

Failure analysis of adhesive restorations with SEM and OCT: from marginal gaps to restoration loss.

Objective: The objective of this study was to analyse the failure mode of adhesive interfaces by comparing OCT and scanning electron microscope (SEM) analysis of class V restoration margins located on enamel and dentin.

Materials And Methods: Three groups were tested that differed in the application of a 3-step etch-and-rinse adhesive system (OptiBond FL) prior to cavity filling with restorative composite resin (Clearfil AP-X). After tooth restoration and polishing, the samples were loaded in a fatigue machine, and adhesive interfaces were evaluated with OCT and SEM.

Accelerated photoactivated chromophore for keratitis-corneal collagen cross-linking as a first-line and sole treatment in early fungal keratitis.

Purpose: To report the use of accelerated photoactivated chromophore for keratitis-corneal collagen cross-linking (PACK-CXL) as a first-line treatment in a patient with an atypical fungal keratitis.

Methods: Case report and literature review.

Results: A patient who presented with a painful peripheral corneal infiltrate underwent PACK-CXL with a local limited abrasion and accelerated ultraviolet-A irradiation at 365 μm and 9 mW/cm² for 10 minutes.

Antibacterial efficacy of accelerated photoactivated chromophore for keratitis-corneal collagen cross-linking (PACK-CXL).

Purpose: To investigate whether optimized photoactivated chromophore for keratitis-corneal collagen cross-linking (PACK-CXL) treatment settings allow accelerating treatment while maintaining antibacterial efficacy.

Methods: Staphylococcus aureus and Pseudomonas aeruginosa strains were irradiated with ultraviolet-A light of equal fluence but different intensity settings (18 mW/cm² for 5 minutes and 36 mW/cm² for 2.5 minutes).

Additive effect of repeated corneal collagen cross-linking in keratoconus.

Purpose: To report the long-term clinical outcome in a patient diagnosed as having bilateral progressive keratoconus who received a single corneal collagen cross-linking (CXL) treatment in the right eye and repeated CXL in the left eye.

Methods: Observational case report. Topographical changes were assessed by high-resolution Scheimpflug imaging.

Determination of the excimer laser ablation rate in previously cross-linked corneas.

Purpose: To evaluate the need for and quantify the extent of nomogram adjustments to compensate for potential changes in the amount of effective corneal stroma ablated in previously cross-linked corneas.

Methods: Ex vivo porcine corneas were divided into two groups (the corneal cross-linking [CXL] group, n = 30; and the control group, n = 3): these experimental corneas underwent CXL including deepithelialization, instillation of riboflavin solution for 25 minutes, and ultraviolet-A irradiation at 9 mW/cm2 for 10 minutes. The control group was deepithelialized only.

A constant-force technique to measure corneal biomechanical changes after collagen cross-linking.

Purpose: To introduce a constant-force technique for the analysis of corneal biomechanical changes induced after collagen cross-linking (CXL) that is better adapted to the natural loading in the eye than previous methods.

Methods: For the biomechanical testing, a total of 50 freshly enucleated eyes were obtained and subdivided in groups of 5 eyes each. A Zwicki-Line Testing Machine was used to analyze the strain of 11 mm long and 5 mm wide porcine corneal strips, with and without CXL.

The effect of standard and high-fluence corneal cross-linking (CXL) on cornea and limbus.

Purpose: When treating peripheral ectatic disease-like pellucid marginal degeneration (PMD), corneal cross-linking with UV-A and riboflavin (CXL) must be applied eccentrically to the periphery of the lower cornea, partly irradiating the corneal limbus. Here, we investigated the effect of standard and double-standard fluence corneal cross-linking with riboflavin and UV-A (CXL) on cornea and corneal limbus in the rabbit eye in vivo.

Methods: Epithelium-off CXL was performed in male New Zealand White rabbits with two irradiation diameters (7 mm central cornea, 13 mm cornea and limbus), using standard fluence (5.

[Keratoconus treatment by corneal cross-linking (CLX)].

Keratoconus is a disease of the cornea that usually begins during puberty and progressively weakens its biomechanical structure. Keratoconic eyes show a conic shape and progressive thinning, both leading to irregular astigmatism and reduced vision that cannot be corrected by glasses. In early cases, special contact lens can partly compensate for the visual loss while they do not stop disease progression.

Corneal biomechanical properties at different corneal cross-linking (CXL) irradiances.

Purpose: New corneal cross-linking (CXL) devices are capable of using higher UV-A light irradiances than used in original CXL protocols. The Bunsen-Roscoe law states that a photochemical reaction should stay constant if the delivered total energy is kept constant; however, little clinical data are available to support this hypothesis.

Methods: We investigated the biomechanical properties of four groups (n = 50 each) of porcine corneas.

Impact of fluorescein on the antimicrobial efficacy of photoactivated riboflavin in corneal collagen cross-linking.

Purpose: To investigate the effect of fluorescein on the antimicrobial efficacy of photoactivated riboflavin in corneal collagen cross-linking (CXL) in vitro.

Methods: The ultraviolet light-A (UVA) absorption by fluorescein and riboflavin in different concentrations was analyzed with a spectrophotometer. The killing rate of Staphylococcus aureus strains after CXL with UV-A irradiation using different solutions containing riboflavin and/or fluorescein, was evaluated in vitro.