Purpose: The purpose of this study was to describe 5 cases (10 eyes) that, following purely cosmetic femtosecond laser-assisted keratopigmentation (KTP), showed evolution toward corneal ectasia during a variable postoperative period.
Methods: In a case series, 5 patients after bilateral purely cosmetic KTP showed progressive changes in topographic, refractive, and even in visual performance values manifesting from 6 months to 4 years following the procedure. A femtosecond laser-assisted cosmetic intrastromal KTP technique was performed in all patients using micronized mineral pigments. Two patients underwent a retouch using superficial automated KTP to optimize cosmetic outcome.
Results: All patients preoperatively demonstrated normal corneal topography with no intraocular pathology and unimpaired visual acuity. One of the cases developed corneal ectasia after magnetic resonance imaging, another confirmed intensive eye rubbing due to allergic conjunctivitis, and 1 patient underwent previous myopic laser in situ keratomileusis procedure. The rest did not show any preoperative clinical evidence potentially related to the development of the keratectasia. One case rather demonstrated modification of keratometry (K) values than a clear corneal ectasia. Three cases were treated with epi-off corneal cross-linking.
Conclusions: Corneal ectasia is a potential complication after cosmetic KTP and should be included in the preoperative informed consent. A comprehensive preoperative screening is necessary to exclude suspicious cases, and patients should be instructed to avoid eye rubbing and other maneuvers that could affect the potential development of this complication.
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http://dx.doi.org/10.1097/ICO.0000000000003754 | DOI Listing |
J Clin Med
November 2024
Ophthalmology Department, LaserVision Ambulatory Eye Surgery Unit, 11521 Athens, Greece.
To report a novel application within the USA of excimer ablation for the normalization of central corneal refractive irregularity, combined with higher fluence CXL in the effective management and visual rehabilitation of progressive keratoconus. 17 consecutive cases with progressive keratoconus were treated with corneal surface excimer laser ablation normalization using topography-guided (Contura) myopic ablation for customized corneal re-shaping with a 6 mm optical zone. The epithelial removal was accounted for by adding a -2.
View Article and Find Full Text PDFProg Retin Eye Res
December 2024
ELZA Institute, Webereistrasse 2, CH-8953, Dietikon, Switzerland; Laboratory for Ocular Cell Biology, University of Zurich, Winterthurerstrasse 190, CH-8057, Zurich, Switzerland; Faculty of Medicine, University of Geneva, Rue Michel-Servet 1, CH-1206, Geneva, Switzerland. Electronic address:
First introduced over 20 years ago as a treatment for progressive keratoconus, the original "Dresden" corneal cross-linking (CXL) protocol involved riboflavin saturation of the stroma, followed by 30 min of 3 mW/cm-intensity ultraviolet-A (UV-A) irradiation. This procedure generates reactive oxygen species (ROS) that cross-link stromal molecules, thereby stiffening the cornea and counteracting the ectasia-induced weakening. Due to their large size, riboflavin molecules cannot readily pass through the corneal epithelial cell tight junctions; thus, epithelial debridement was performed.
View Article and Find Full Text PDFTransl Vis Sci Technol
December 2024
Department of Ophthalmology, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.
Purpose: Eye rubbing is considered to play a significant role in the progression of keratoconus and of corneal ectasia following refractive surgery. To our knowledge, no tool performs an objective quantitative evaluation of eye rubbing using a device that is familiar to typical patients. We introduce here an innovative solution for objectively quantifying and preventing eye rubbing.
View Article and Find Full Text PDFEye Contact Lens
December 2024
Cornea and Laser Eye Institute-CLEI Center for Keratoconus (J.D.G., B.S., T.P., C.E., P.S.H., S.A.G.), Teaneck, NJ; Department of Ophthalmology (J.D.G., D.K., P.S.H., S.A.G.), Rutgers-New Jersey Medical School, Newark, NJ; TX; OVITZ Corporation (N.B., J.W.), Rochester, NY; College of Optometry (G.Y.), University of Houston, Houston, TX.
Purpose: To report interim results of a single center, randomized, double-blind, crossover-controlled clinical trial comparing wavefront-guided (wfg) scleral lenses (SLs) to traditional scleral lenses (tSLs) for patients with a history of irregular corneal astigmatism (ICA).
Methods: Thirty-one ICA eyes of 18 participants were reviewed, 23 with keratoconus, six postcorneal refractive ectasia, and two postpenetrating keratoplasty. Patients with corneal or lens opacities were not excluded from participating.
Ophthalmic Physiol Opt
December 2024
Department of Ophthalmology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany.
Purpose: To compare the parameters and indices of a novel swept-source optical coherence tomography device (SS-OCT, ANTERION) with those of a rotating Scheimpflug camera (RSC)-based tomograph (Pentacam) in normal and keratoconic (KC) eyes.
Methods: This prospective, monocentric, cross-sectional study included individuals with unoperated normal and KC eyes, selecting one eye per subject. Ectasia-specific parameters analysed with the SS-OCT were difference in mean keratometry (K) in the inferior and superior meridians, maximum keratometry value (K), elevation of the posterior surface at the thinnest point, screening corneal objective risk of ectasia (SCORE) and thinnest point thickness.
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