keratoplasty astigmatism

INTRODUCTION: The production of ultrasonic energy during phacoemulsification is associated with heat generation that could damage ocular tissues, particularly at the corneoscleral wound site. CASE PRESENTATION: This study presents an 89-year-old patient with senile hypermature cataract and Fuchs endothelial dystrophy developing severe thermal corneoscleral injury during phacoemulsification. At presentation, visual acuity was finger count at 40 cm and there was a 1 × 2-mm area of corneal melting at the corneal tunnel with diffuse corneal oedema...

INTRODUCTION: This case report describes a rare case of fungal keratitis following femtoLASIK. Despite targetted antifungal therapy, this case necessitated an innovative surgical approach to manage an unexpected corneal perforation. CASE PRESENTATION: A 35-year-old male presented 3 weeks post-femtoLASIK for myopic astigmatism with discomfort and reduced vision in his right eye. He was diagnosed with fungal keratitis surgery caused by Purpureocillium lilacinum and was treated with a myriad of therapy...

Background: Descemet Membrane Endothelial Keratoplasty (DMEK) has been widely adopted to treat Fuchs endothelial dystrophy (FED) and Bullous keratopathy (BK). Graft detachment (GD) is one of the common earliest post-operatory complications, and it is usually recovered by Air Rebubbling (ARB). Methods: Retrospectively, we investigated predictive factors related to GD between January 2016 and March 2020, a pre-COVID era, in 72 patients, 72 eyes, and their donors' lamellar characteristics, focusing on donor's cause of death...

BACKGROUND: New developments in artificial intelligence, particularly with promising results in early detection and management of keratoconus, have favorably altered the natural history of the disease over the last few decades. Features of artificial intelligence in different machine such as anterior segment optical coherence tomography, and femtosecond laser technique have improved safety, precision, effectiveness, and predictability of treatment modalities of keratoconus (from contact lenses to keratoplasty techniques)...

UNLABELLED: Deep anterior lamellar keratoplasty or penetrating keratoplasty are currently considered the optimal methods of surgical treatment of stromal dystrophies and corneal degeneration. Despite certain advantages and benefits of these methods, they also have significant limitations: involvement of superficial corneal layers in the surgery, need for suturing, development of post-keratoplasty astigmatism etc. PURPOSE: This study aimed to test and describe the new method of closed sutureless keratoplasty (intracorneal selective stromal transplantation), which was indicated in isolated dystrophic and degenerative pathology of the stroma...

PURPOSE: The purpose of this study was to highlight characteristic clinical and microscopic findings and report the long-term follow-up of pediatric excimer laser-assisted penetrating keratoplasty (excimer-PKP) for congenital stromal corneal dystrophy (CSCD). METHODS: A 2-year-old Greek child presented with CSCD at our department. Clinical examination showed bilateral flake-like whitish corneal opacities affecting the entire corneal stroma up to the limbus. Genetic testing identified a mutation of the decorin gene (c...

This review analyzed all pertinent articles on keratoconus (KCN) and cataract surgery. It covers preoperative planning, intraoperative considerations, and postoperative management, with the aim of providing a simplified overview of treating such patients. Preoperatively, the use of corneal cross-linking, intrastromal corneal ring segments, and topo-guided corneal treatments can help stabilize the cornea and improve the accuracy of biometric measurements. It is important to consider the advantages and disadvantages of traditional techniques such as penetrating keratoplasty and deep anterior lamellar keratoplasty, as well as newer stromal augmentation techniques, to choose the most appropriate surgical approach...

PURPOSE: To assess and contrast the visual and refractive results of Descemetic deep anterior lamellar keratoplasty (DALK) and penetrating keratoplasty (PK) in the treatment of advanced keratoconus. DESIGN: Retrospective, comparative, interventional study. METHODS: This study enrolled eyes affected by keratoconus with preoperative mean keratometry ≥60 diopters (D) that were treated with either Descemetic DALK (30 eyes) or PK (29 eyes) by using always the same corneal diameters (8...

The birefringent nature of the human cornea plays an important role in comprehending its structural behavior in both diseased and surgical conditions. During corneal transplantation, irregular astigmatism is a common post-surgical complication that depends on the characteristics of suturing. Four human cadaver corneas are subjected to an in-vitro model of a typical full-thickness penetrating keratoplasty (PK) procedure using 16 simple interrupted 10-0 vicyrl sutures. The birefringence of these four corneas is analyzed using digital photoelasticity and compared with the control cornea (without PK)...

The present study reports the case of a superficial limbal dermoid surgically treated without suture by using a new technique of lamellar keratoplasty with allogenic lenticule from small incision lenticule extraction. The limbal lesion area was circumscribed by a trephine marker and lamellae were peeled off the anterior corneal stroma and sclera. After excision of the dermoid, the liquid on the bed was dried as much as possible and an appropriate stromal lenticule was attached to the implant bed without fibrin glue or suture...

PURPOSE: To assess the outcomes of Descemet stripping automated endothelial keratoplasty (DSAEK) via a sclerocorneal frown incision. STUDY DESIGN: Retrospective comparative study. METHODS: The outcomes of Descement stripping endothelial keratoplasty (DSAEK) were retrospectively compared between 36 patients (36 eyes) who underwent surgery via a 3.8-mm frown incision (frown incision group) and 20 patients (20 eyes) who underwent surgery via a 4...

PURPOSE: To compare the outcomes of deep anterior lamellar keratoplasty (DALK) using dehydrated versus standard organ culture-stored donor corneas for eyes with keratoconus. DESIGN: Prospective, randomized, single-center trial conducted in Italy. PARTICIPANTS: Adult patients (age ≥ 18 years) with keratoconus scheduled for elective DALK. METHODS: Patients undergoing successful type 1 bubble pneumatic dissection using a standard DALK technique were randomized during surgery to receive either dehydrated (n = 30) or standard organ culture-stored (n = 30) donor corneas...

PURPOSE: The purpose of the study was to evaluate the visual outcomes and recurrence rate of patients with macular corneal dystrophy (MCD) who have undergone phototherapeutic keratectomy (PTK). METHODS: This retrospective, single-centered study enrolled patients from King Khaled Eye Specialist Hospital who had undergone PTK for MCD between 2000 and 2020. Pre-, intra-, and post-operative data were collected, and the primary outcome measures included uncorrected visual acuity, best-corrected visual acuity (BCVA), spherical equivalent, central keratometry, keratometric astigmatism, recurrence rate, and necessity of subsequent surgery...

PURPOSE: The aim of this study was to evaluate the outcomes of deep anterior lamellar keratoplasty (DALK) and compare it with penetrating keratoplasty (PKP) in keratoconic eyes with Descemet membrane (DM) rupture. METHODS: In this comparative retrospective case series, 33 keratoconic eyes with a history of hydrops underwent DALK and 27 received PKP. Baseline and postoperative visual acuity, corneal astigmatism, mean keratometry, endothelial cell density, and complication rates were measured...

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PURPOSE: To analyze different tomographic and refractive parameters for predicting successful visual outcome following femtosecond laser-assisted arcuate keratotomy (FSAK) for post-keratoplasty astigmatism. DESIGN: Retrospective. METHODS: Retrospective study evaluating patients with astigmatism following penetrating keratoplasty (PKP) or deep anterior lamellar keratoplasty (DALK) who underwent FSAK. Vector analysis using the Alpins method was done to calculate surgically induced astigmatism (SIA)...

Femtosecond laser (FSL) applications in corneal surgery have increased since its inception. Corneal surgery has undergone a tremendous transformation thanks to the introduction of FSL technology. This laser makes precise, three-dimensional incisions while causing minimal damage to surrounding tissue. This review updates and summarizes current and upcoming FSL applications in corneal surgery, current commercially available FSL, and its respective applications. Refractive surgery applications include laser in-situ keratomileusis flaps, refractive corneal lenticule extraction such as small incision lenticule extraction, astigmatic keratotomy, intracorneal ring segments tunnels for keratoconus including corneal allogenic intrastromal ring segments, and presbyopia treatments with intrastromal pockets for corneal inlays and intrastromal incisions (INTRACOR)...

PURPOSE: The aim of this study was to describe the indications and outcomes of flap amputation after laser in situ keratomileusis (LASIK) at a referral-based institution. METHODS: In this retrospective consecutive case series, medical records of patients who underwent LASIK flap amputation at Mayo Clinic, Rochester, MN, between January 1, 1998, and January 31, 2023, were reviewed. RESULTS: Fifteen eyes (15 patients) underwent flap amputation during the study period...

PURPOSE: The aim of this study was to describe the safety and efficacy of the Tel-Aviv Protocol (epithelial photorefractive keratectomy and corneal cross-linking) as a treatment for postrefractive surgery corneal ectasia. METHODS: This study includes 8 eyes from 7 patients, each diagnosed with postrefractive surgery ectasia years after refractive surgery and treated with the Tel-Aviv Protocol. The procedure included transepithelial PRK using the EX500 excimer laser, a 50-μm laser ablation of the epithelium and anterior stroma, delivered on the visual axis with cyclotorsion correction, treating up to 50% of refractive astigmatism...

Even after a successful corneal transplant, patients experience severe refractive errors, impeding their rehabilitation and satisfaction. Refractive errors can be caused by recipient pathology and corneal thickness, as well as intraoperative factors such as donor-host discrepancy, recipient's eccentric trephination, vitreous length, wound apposition, technique of suturing, and suture material. Also, wound healing and the interim between keratoplasty and suture removal contribute to astigmatism. Lamellar keratoplasty outperforms penetrating keratoplasty in terms of endothelial cell loss and endothelial graft rejection, yet the risk of developing refractive errors is comparable...