Purpose:
To evaluate the correlation between changes in maximum keratometry (Kmax) and ABC values from the ABCD Progression Display (Pentacam) in progressive keratoconus (KC) and to evaluate whether the ABC changes were able to detect progression earlier than Kmax.
Setting:
Humanitas Clinical and Research Center, Rozzano, Milan, Italy.
Design:
Retrospective study.
Methods:
Kmax, ABC values, and thinnest point (ThCT) were recorded at the day of corneal crosslinking (CXL) (T0) and previous follow-up (T-1). In patients without earlier progression in Kmax, follow-up examination (T-2) was used to determine whether any of the ABC parameters reached statistical significance for progression.
Results:
Seventy-six eyes of 63 patients scheduled for CXL with documented progression (Kmax increase of >1.00 diopter) were included. There was a significant, albeit moderate, correlation between the change in Kmax between T0 and T-1 and the change in both A (ρ = 0.391) and B values (ρ = 0.339). There was no significant correlation between the change in Kmax between T0 and T-1 and the change in either C or ThCT. In patients with T-2 examinations, 16 (51.6%) of 31 patients showed a statistically significant change on the ABCD progression display that was not detected with Kmax.
Conclusions:
This study showed a significant, but moderate, correlation between the change in Kmax and the change in A and B values in progressive KC. Moreover, more than half of the cases showed documented progression earlier with the ABCD progression display than that detected by standard Kmax changes. This study suggests possible changes in progression criteria to allow for earlier intervention.
Purpose: To explore the relationship between topical antiglaucoma therapy, both prostaglandin and non-prostaglandin based eyedrops, and persistence of epiphora in glaucoma patients who underwent EN-DCR surgery for PANDO. Methods: prospective observational cohort study of all over 65 years-old patients with a dacryo-CT documented diagnosis of PANDO who underwent EN-DCR, were affected by glaucoma and treated with either topical monotherapy prostaglandin eyedrops or other antiglaucoma molecules, up to 12-month postoperative follow-up. Patients were assessed with Fluorescein Dye Disappearance Test and Munk scale. Results: Fifteen right eyes from 15 PG-group patients and 15 eyes right eyes from 15 non-PG-group patients were considered. Epiphora occurred in 1/15 (7%) of PG-group patients at 3 months, in 8/15 (53%) at 6 months, and in 11/15 (73%) at one year. In comparison, only 1/15 of non-PG-group patients developed epiphora at 6 months. The relative risk of epiphora in PG-group patients versus non-PG-group patients was 3.00 (95% CI, 0.13–68.1; p = 0.99) at 3 months, 8.00 (95% CI, 1.14–56.3; p = 0.014) at 6 months, and 11.0 (95% CI, 1.62–74.9; p < 0.001) at 12 months. Conclusion: Based on our results, we speculate that prostaglandin eye drops may affect the outcome of EN-DCR in terms of increasing epiphora recurrence from early to late postoperative follow up. The toxicity of antiglaucoma eye drops might damage spiral fibers of the mucous membrane of the lacrimal system inducing fibrosis by a proinflammatory mechanism.
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