No abstract

PKP in chronic or delayed-onset mustard gas keratitis should be considered as a high-risk graft; however, with appropriate management, graft clarity and visual outcomes may be favorable.

No abstract

Vacuum level did not have a significant effect on total US energy or total fluid consumed during phacoemulsification. There was a strong relationship between total US energy and endothelial cell loss but not between total infused fluid and endothelial cell loss.

The incidence of KCN in our context is apparent and comparable with rates in other studies on Asian ethnic populations. This is much higher than the incidence in European Caucasians and warrants further genetic and environmental studies.

Relatives of patients with KCN have a high prevalence of undiagnosed KCN. Corneal topography is important for the diagnosis of KCN and KCN suspects in family members of patients with KCN. Therefore, keratorefractive surgery should be considered cautiously in these individuals.

No author has a financial or proprietary interest in any material or method mentioned.

PURPOSE: To investigate the potential benefit of keratoconus surgery using customized corneal stromal donor lenticules obtained from myopic small incision lenticule extraction (SMILE) surgery by femtosecond laser. METHODS: In this prospective, consecutive, non-comparative series of cases, 22 lenticules were obtained from 22 myopic patients who had SMILE with a lenticule central thickness of greater than 110 µm. The lenticules were implanted in 22 eyes with advanced keratoconus. The lenticules were customized for the purpose of the implantation with either a simple necklace or necklace-with-ring shape (compound form) depending on the corneal thickness and corneal topography configuration of the implanted keratoconic eyes. The lenticules were implanted into a 9.5-mm corneal lamellar pocket created by the femtosecond laser. Changes in densitometry, thickness, confocal microscopy, corrected distance visual acuity (CDVA), and endothelial cell density were investigated. RESULTS: Intrastromal lenticule implantation was successfully performed in all cases without any complication. Corneal thickness showed a mean enhancement of 100.4 µm at the thinnest point. On biomicroscopy, all corneas were clear at 1 year postoperatively and there was a significant improvement in corneal densitometry during the entire follow-up period. Confocal biomicroscopy showed collagen reactivation without any inflammatory features caused by the implanted fresh lenticules. CDVA improved from 0.70 to 0.49 logMAR ( P = .001) and keratometry decreased from 54.68 ± 2.77 to 51.95 ± 2.21 diopters ( P = .006). CONCLUSIONS: Customized SMILE lenticule implantation by femtosecond laser proved to be feasible, resulting in an improvement in vision, topography, and refraction in the implanted eyes. [ J Refract Surg . 2020;36(12):786–794.]