Pediatric keratoconus epidemiology: a systematic scoping review.

Background: Pediatric keratoconus (pediatric KC) causes progressive deformation of the cornea in children and adolescents, leading to a gradual loss of vision and a need for rehabilitation. However, new treatments may halt the disease and prevent worse outcomes that require penetrating keratoplasty and its associated morbidity and high cost, irreversible loss of vision, and amblyopia. Few systematic reviews focus on keratoconus-and even fewer, on pediatric KC.

Preoperative Predictors for Acute Pain After Photorefractive Keratectomy.

Purpose: The aim of this study was to identify preoperative predictors for the occurrence of early severe postoperative pain in patients undergoing photorefractive keratectomy (PRK). The implementation of preoperative screening methods may facilitate more specific or aggressive pain therapies specifically targeted to individuals at a high risk of experiencing severe postoperative pain.

Methods: This was exploratory research that included patients who underwent PRK.

Codeine plus acetaminophen improve sleep quality, daily activity level, and food intake in the early postoperative period after photorefractive keratectomy: a secondary analysis.

Purpose: To determine whether codeine plus acetaminophen after photorefractive keratectomy (PRK) have beneficial effects on sleep quality, activity levels, and food intake, beyond their effect of pain relief.

Methods: We enrolled 40 patients (80 eyes) in this randomized, double-blind, paired-eye, placebo-controlled, add-on trial. Each eye was treated 2 weeks apart, and the patients were randomly allocated to receive either the placebo or the intervention (30 mg codeine and 500 mg acetaminophen) (4 times a day for 4 days).

Codeine Plus Acetaminophen for Pain After Photorefractive Keratectomy: A Randomized, Double-Blind, Placebo-Controlled Add-On Trial.

Background: Pain after photorefractive keratectomy (PRK) is significant, and the analgesic efficacy and safety of oral opioids in combination with acetaminophen has not been fully investigated in PRK trials.

Purpose: To assess the efficacy and safety of the combination of codeine plus acetaminophen (paracetamol) versus placebo as an add-on therapy for pain control after PRK.

Study Design: Randomized, double-blind, placebo-controlled trial.

Opioids for Ocular Pain - A Narrative Review.

Background: Refractive surgery is a common procedure, but may be associated with severe post-operative pain.

Objectives: To describe studies addressing the use of opioids for control of pain after ocular surgery, with an emphasis on refractive surgery.

Study Design: This is a narrative review of relevant articles on the physiology of corneal pain and the use of opioids for its treatment after surgery.

Mechanisms of Corneal Pain and Implications for Postoperative Pain After Laser Correction of Refractive Errors.

Objective: The cornea is the target of most surgeries for refractive disorders, as myopia. It is estimated that almost 1 million patients undergo corneal refractive surgery each year in the United States. Refractive surgery includes photorefractive keratectomy (PRK) that produces intense postoperative pain.

Corneal Collagen Cross-linking in Advanced Keratoconus: A 4-Year Follow-up Study.

Purpose: To analyze the safety and efficacy of standard corneal collagen cross-linking (CXL) in advanced cases of progressive keratoconus after 4 years of follow-up.

Methods: A retrospective case series of patients with advanced progressive keratoconus (stages 3 and 4 of Amsler-Krumeich classification) underwent standard CXL treatment. The parameters examined were changes in uncorrected visual acuity (UDVA), corrected visual acuity (CDVA), keratometry values (mean, flat, steep, and apical), pachymetry, and endothelial cell count at the baseline and at 12, 24, and 48 months postoperatively.

Intraocular straylight before and after low myopic photorefractive keratectomy with and without mitomycin C.

Purpose: To evaluate ocular straylight before and after photorefractive keratectomy (PRK) for low myopia with and without topical mitomycin (MMC) treatment.

Methods: Patients who underwent PRK for low myopia were enrolled into the study. PRK without MMC was performed in 21 eyes (12 patients), whereas PRK with topical 0.

Ectasia risk factors in refractive surgery.

This review outlines risk factors of post-laser in situ keratomileusis (LASIK) ectasia that can be detected preoperatively and presents a new metric to be considered in the detection of ectasia risk. Relevant factors in refractive surgery screening include the analysis of intrinsic biomechanical properties (information obtained from corneal topography/tomography and patient's age), as well as the analysis of alterable biomechanical properties (information obtained from the amount of tissue altered by surgery and the remaining load-bearing tissue). Corneal topography patterns of placido disk seem to play a pivotal role as a surrogate of corneal strength, and abnormal corneal topography remains to be the most important identifiable risk factor for ectasia.

Advances in femtosecond laser technology.

Femtosecond laser technology has become widely adopted by ophthalmic surgeons. The purpose of this study is to discuss applications and advantages of femtosecond lasers over traditional manual techniques, and related unique complications in cataract surgery and corneal refractive surgical procedures, including: LASIK flap creation, intracorneal ring segment implantation, presbyopic treatments, keratoplasty, astigmatic keratotomy, and intrastromal lenticule procedures.

Predictors of Early Postoperative Pain After Photorefractive Keratectomy.

Purpose: To compare the profiles of postoperative photorefractive keratectomy (PRK) pain between both eyes under the same conditions and to verify the preoperative predictors of pain such as gender, anxiety, knowledge of the procedure, and spherical equivalent refractive error (SERE).

Methods: This prospective study included 86 eyes of 43 patients with myopia who underwent PRK in both eyes at an interval of 14 days between the procedures. Before surgery, subjects answered the State Anxiety Inventory.

Femtosecond Laser-Assisted LASIK Flap Complications.

Purpose: To discuss intraoperative and postoperative femtosecond laser-assisted LASIK flap complications and their management.

Methods: Review of published literature.

Results: Flap creation is a critical step in LASIK.

Improved Evaluation of Postoperative Pain After Photorefractive Keratectomy.

Purpose: Postoperative pain remains an important limiting factor to the selection of photorefractive keratectomy (PRK). There is a consensus in neurology pain research that pain should be evaluated as a multidimensional concept, which differs from current practice in ophthalmology. The purpose of this paper was to validate the use of multidimensional questionnaires, such as the Brief Pain Inventory (BPI) and the McGill Pain Questionnaire (MPQ), to provide an improved analysis of pain after PRK and to better describe its temporal profile.

Intense Early Flattening After Corneal Collagen Cross-linking.

Purpose: To report two cases of significant flattening after corneal cross-linking (CXL) for keratoconus and discuss its potential explanations and implications.

Methods: Observational case report.

Results: One year after standard CXL protocol (3 mW/cm(2) for 30 minutes and total energy of 5.

Screening of refractive surgery candidates for LASIK and PRK.

Purpose: The aim of this study was to evaluate exclusion criteria in screening patients for refractive surgery.

Methods: Patients screened for initial refractive surgery by a single surgeon at the Cole Eye Institute (Cleveland Clinic) between 2007 and 2012 were reviewed. Exclusion criteria for patients who were not offered refractive surgery based on history and/or examination parameters were analyzed.

Quality of vision in refractive and cataract surgery, indirect measurers: review article.

Visual acuity is the measurement of an individual's ability to recognize details of an object in a space. Visual function measurements in clinical ophthalmology are limited by factors such as maximum contrast and so it might not adequately reflect the real vision conditions at that moment as well as the subjective aspects of the world perception by the patient. The objective of a successful vision-restoring surgery lies not only in gaining visual acuity lines, but also in vision quality.

Longitudinal measurements of luminance and chromatic contrast sensitivity: comparison between wavefront-guided LASIK and contralateral PRK for myopia.

Purpose: The present study aimed to compare the postoperative contrast sensitivity functions between wavefront-guided LASIK eyes and their contralateral wavefront-guided PRK eyes.

Methods: The participants were 11 healthy subjects (mean age=32.4 ± 6.

Surgical management of presbyopia.

Presbyopia, the gradual loss of accommodation that becomes clinically significant during the fifth decade of life, is a physiologic inevitability. Different technologies are being pursued to achieve surgical correction of this disability; however, a number of limitations have prevented widespread acceptance of surgical presbyopia correction, such as optical and visual distortion, induced corneal ectasia, haze, anisometropy with monovision, regression of effect, decline in uncorrected distance vision, and the inherent risks with invasive techniques, limiting the development of an ideal solution. The correction of the presbyopia and the restoration of accommodation are considered the final frontier of refractive surgery.

Modulation transfer function and optical quality after bilateral implantation of a +3.00 D versus a +4.00 D multifocal intraocular lens.

Purpose: To determine whether the improvement in intermediate vision after bilateral implantation of an aspheric multifocal intraocular lens (IOL) with a +3.00 diopter (D) addition (add) occurs at the expense of optical quality compared with the previous model with a +4.00 D add.

Visual performance of an apodized diffractive multifocal intraocular lens with +3.00-d addition: 1-year follow-up.

Purpose: To determine whether implantation of a multifocal intraocular lens (IOL) with a lower addition (+3.00 diopters [D]) at the lens plane results in better intermediate visual acuity 1 year after surgery compared with a multifocal IOL with higher addition (+4.00 D).

Intraocular straylight and contrast sensitivity after contralateral wavefront-guided LASIK and wavefront-guided PRK for myopia.

Purpose: To compare intraocular straylight measurements and contrast sensitivity after wavefront-guided LASIK (WFG LASIK) in one eye and wavefront-guided photorefractive keratectomy (WFG PRK) in the fellow eye for myopia and myopic astigmatism correction.

Methods: A prospective, randomized study of 22 eyes of 11 patients who underwent simultaneous WFG LASIK and WFG PRK (contralateral eye). Both groups were treated with the NIDEK Advanced Vision Excimer Laser System, and a microkeratome was used for flap creation in the WFG LASIK group.

Topography-guided (NIDEK customized aspheric treatment zone) photorefractive keratectomy with mitomycin C after penetrating keratoplasty for keratoconus: case report.

Purpose: To report topography-guided photorefractive keratectomy (PRK) with mitomycin C (MMC) after penetrating keratoplasty for keratoconus.

Methods: A 34-year-old woman with irregular astigmatism after penetrating keratoplasty in the right eye underwent PRK. Topography-guided surface ablation using the customized aspheric treatment zone ablation (CATz) was programmed for a 5.