Delphi-Based Global Consensus on Adopting Endothelial Keratoplasty: An Endothelial Keratoplasty Learners Group Initiative.

Purpose: To identify areas of consensus among experts on the performance of endothelial keratoplasty by using a modified Delphi approach, to help create a framework for novice surgeons to adopt these procedures.

Methods: Thirty-one international experts in endothelial keratoplasty participated. Two rounds of electronic survey were followed by a hybrid, virtual meeting.

Age dependence of the average refractive index of the isolated human crystalline lens.

We measured the average group refractive index (RI) of 120 isolated lenses from 120 human donors (age: 0.03 to 61 years). The average group RI was calculated from a measurement of the optical thickness of the lens using optical coherence tomography and the apparent window shift of the test chamber caused by the lens.

Optical phase nullification partially restores visual and stereo acuity lost to simulated blur from higher-order wavefront aberrations of keratoconic eyes.

Contrast demodulation and phase distortions are exaggerated in retinal images blurred by the higher-order wavefront aberrations of keratoconic eyes. While the performance loss from the former parameter is well understood, little is known about the impact of the latter on visual functions in this disease condition. The present study investigated the impact of phase distortions on the monocular logMAR visual acuity, letter discriminability and random-dot stereoacuity of seventeen visually healthy adults (ten for visual acuity and letter discriminability; ten for stereoacuity and three common to both experiments) using images that were computationally blurred by four different higher-order wavefront aberration profiles of keratoconic eyes that showed significant distortions in the phase spectrum.

Evolving Trends in the Diagnosis and Management of Keratoconus Over 3 Decades.

Purpose: To report the trends in the clinical presentation, diagnosis, and management of keratoconus (KC) in patients presenting to a multitier hospital network over 33 years.

Methods: This retrospective study included patients with KC presenting from 1987 to 2020. Patients with KC in at least 1 eye were included.

Investigation of mechanical strength and structure of corneal graft-host junction.

Dehiscence is a common complication of corneal transplant surgery involving separating the graft from the host eye. The present article aims to investigate fundamental insights into the mechanical and structural aspects of the graft-host junction (GHJ) of a graft that survived in a patient for 13 years after penetrating keratoplasty (PK). Additionally, it adopts the sutur retention strength (SRS) test procedure defined in ISO:7198-2016 and aims to provide a comprehensive test protocol to study the biomechanics of the GHJ in extracted PK buttons.

Central toxic keratopathy leading to epithelial ingrowth following femtosecond LASIK.

We report a case of a woman in her 30s who underwent femtosecond LASIK (laser-assisted in situ keratomileusis) in both eyes to correct her simple myopic astigmatism. After the surgery, both eyes developed diffuse lamellar keratitis, and intensive topical steroids were initiated to control the same. Subsequently, central toxic keratopathy (CTK) developed bilaterally.

RiTe conjugate mediated corneal collagen crosslinking, a novel therapeutic intervention for keratoconus - in vitro and in vivo study.

Corneal collagen crosslinking (CXL) is an effective method to halt the disease progression of keratoconus, a progressive corneal dystrophy leading to cone shaped cornea. Despite the efficacy of standard protocol, the concerning step of this procedure is epithelial debridement performed to facilitate the entry of riboflavin drug. Riboflavin, a key molecule in CXL protocol, is a sparsely permeable hydrophilic drug in corneal tissues.

Teleophthalmology at a primary and tertiary eye care network from India: environmental and economic impact.

Objective: To evaluate the environmental and economic impact of teleophthalmological services provided by a primary (rural) and tertiary (urban) eyecare network in India.

Methods: This prospective study utilised a random sampling method, and administered an environmental and economic impact assessment questionnaire. The study included 324 (primary: 173; tertiary: 151) patients who received teleconsultations from July to September 2022.

Structure-Function Relationship in Keratoconus: Spatial and Depth Vision.

Purpose: The purpose of this study was to determine changes in spatial and depth vision with increasing severity of keratoconus and to model the structure-function relationship to identify distinct phases of loss in visual function with disease severity.

Methods: Best-spectacle corrected, monocular high-contrast visual acuity, contrast sensitivity function (CSF) and stereoacuity of 155 cases (16-31 years) with mild to advanced bilateral keratoconus was determined using standard psychophysical tests. Disease severity was quantified using the multimetric D-index.

Keratoconus in India: Clinical presentation and demographic distribution based on big data analytics.

Purpose: This paper aims to describe the clinical presentation and demographic distribution of keratoconus (KCN) in India by analyzing the electronic medical records (EMR) of patients presenting at a multitier ophthalmology hospital network.

Methods: This cross-sectional hospital-based study included the data of 2,384,523 patients presenting between January 2012 and March 2020. Data were collected from an EMR system.

Central Toxic Keratopathy After Collagen Cross-Linking: A Case Series.

Purpose: The aim of this study was to report a case series of central toxic keratopathy (CTK) after collagen cross-linking (CXL) in keratoconus.

Methods: This is a retrospective case series between January 2020 and September 2021. In this period, CXL was performed for progressive keratoconus in 964 eyes.

Efficient reduction of the scrolling of Descemet membrane endothelial keratoplasty grafts by engineering the medium.

The Descemet Membrane Endothelial Keratoplasty (DMEK) procedure for corneal transplantation is challenging due to the need to unscroll the donor graft within the recipient's eye. This process of unscrolling is complex, time-consuming, leads to a loss of endothelial cells and, most importantly, can negatively impact the graft's adhesion and integration with the host tissue after surgery. This problem is particularly evident when the graft is young.

Prevailing practice patterns in keratoconus among Indian ophthalmologists.

Objective: The past few years have seen a rapid advancement in the management of keratoconus (KC). However, there is no prescribed standard of care for the management of KC. This study evaluated the prevailing practice patterns among Indian ophthalmologists in the diagnosis and treatment of KC via an online survey.

Suprathreshold contrast perception of resolvable high spatial frequencies remain intact in keratoconus.

Contrast detection thresholds are elevated with optical quality loss in keratoconus. This study hypothesized that suprathreshold contrast perception is also impaired in keratoconus, with the impairment being predictable from the pattern of loss in threshold-level performance. Contrast detection thresholds were determined across a range of spatial frequencies in 12 cases with mild to severe keratoconus and 12 age-similar controls.

A goat eye, wet lab model for training in Descemet membrane endothelial keratoplasty.

Here we describe a new, non-human, ex-vivo model (goat eye model) for training surgeons in DMEK surgeons. In a wet lab setting, goat eyes were used to obtain a pseudo-DMEK graft of 8 mm from the goat lens capsule that was injected into another goat eye with the same maneuvers described for human DMEK. The DMEK pseudo-graft can be easily prepared, stained, loaded, injected, and unfolded into the goat eye model reproducing the similar maneuvers used for DMEK in a human eye, except for the descemetorhexis, which cannot be performed.

Interocular Contrast Balancing Partially Improves Stereoacuity in Keratoconus.

Significance: Partial improvement in stereoacuity may be achieved by balancing the contrast input to the two eyes of patients with bilaterally asymmetric keratoconus.

Purpose: Interocular differences in image quality, characterized by dissimilar contrast loss and phase shifts, are implicated in stereoacuity loss in keratoconus. This study determined whether contrast balancing improves stereoacuity in this disease condition and, if so, whether it is dependent on the baseline interocular contrast imbalance.

The Evolution of Diagnostics for Keratoconus: From Ophthalmometry to Biomechanics.

Purpose: To enumerate the various diagnostic modalities used for keratoconus and their evolution over the past century.

Methods: A comprehensive literature search including articles on diagnosis on keratoconus were searched on PUBMED and summarized in this review.

Results: Initially diagnosed in later stages of the disease process through clinical signs and retinoscopy, the initial introduction of corneal topography devices like Placido disc, photokeratoscopy, keratometry and computer-assisted videokeratography helped in the earlier detection of keratoconus.

The Value of Eccentric Infrared Photorefraction in Evaluating Keratoconus.

Significance: Nonlinearity in the luminance profile of eccentric, infrared photorefraction may be used to differentiate corneal diseases such as keratoconus that distort the cornea, relative to regular refractive errors.

Purpose: This study aimed to determine the profile of eccentric, infrared photorefraction in keratoconus as a prototypical disease model for distorted corneas and identify a parameter in this profile for differentiating such disease conditions from healthy controls.

Methods: Photorefraction reflex of 75 eyes with forme fruste to advanced keratoconic cases and that of 75 eyes of controls with regular refractive errors (spherical equivalent, +0.

Impact of teleconsultation on visual and refractive outcomes in patients undergoing laser refractive surgery during COVID-19.

Purpose: To assess the role of remote teleconsultation (TC) follow-up care following a successful and uneventful laser vision correction.

Methods: The study is a retrospective, comparative analysis of patients undergoing laser vision correction at tertiary care eye hospital in Southern India. The patients were divided into two groups.

Vitamin B12 deficiency in a large cohort of healthcare professionals across the network of an eyecare organization in India.

Purpose: To evaluate Vitamin B12 levels in healthcare professionals at a tertiary eyecare centre in India.

Methods: This was a cross-sectional study conducted among healthcare professionals working at a tertiary eyecare centre in India. The sample included 2,374 employees.

Clinical Outcomes of Rose Bengal Mediated Photodynamic Antimicrobial Therapy on Fungal Keratitis with Their Microbiological and Pathological Correlation.

Purpose: To report the clinical outcome of Photodynamic Antimicrobial Therapy (PDAT) with Rose Bengal (RB) used as an early adjuvant therapy in patients with fungal keratitis and their microbiological and pathological correlation.

Methods: Patients with microbiologically confirmed fungal keratitis underwent PDAT-RB along with topical natamycin 5% drops hourly and oral ketoconazole 200 mg twice a day. This was performed by applying rose bengal (0.

KEDOP: Keratoconus early detection of progression using tomography images.

Purpose: To investigate a method to identification of early progression of keratoconus using deep learning neural networks.

Methods: Retrospective evaluation of medical records of patients with progressive keratoconus and had more than one followup visits. Images extracted from the single scheimplug analyzer for analysis were captured during the patient visits.