Cross-linking of corneal collagen (CXL) is a promising approach for the treatment of keratoconus and secondary ectasia. Several long-term and short-term complications of CXL have been studied and documented. The possibility of a secondary infection after the procedure exists because the patient is subjected to epithelial debridement and the application of a soft contact lens. Formation of temporary corneal haze, permanent scars, endothelial damage, treatment failure, sterile infiltrates, and herpes reactivation are the other reported complications of this procedure. Cross-linking is a low-invasive procedure with low complication and failure rate but it may have direct or primary complications due to incorrect technique application or incorrect patient's inclusion and indirect or secondary complications related to therapeutic soft contact lens, patient's poor hygiene, and undiagnosed concomitant ocular surface diseases.
Keratoconus is the most common corneal ectatic disorder, the cause of which is largely unknown. Many factors have been implicated, and the ocular allergy is being one of them. The commonly proposed pathogenesis includes the release of inflammatory mediators due to eye rubbing which may alter the corneal collagen and lead to corneal ectasias. The onset of keratoconus is often early in cases associated with allergy and routine corneal topography may detect subtle forms of keratoconus. These cases may require early keratoplasty and are at an increased risk of having acute corneal hydrops. Surgical outcomes are similar to primary keratoconus cases. However, post-operative epithelial breakdown may be a problem in these cases. Control of allergy and eye rubbing is the best measure to prevent corneal ectasias in cases of ocular allergy.
Purpose. To investigate age- and position-related changes of anterior chamber angle anatomy in normal, healthy eyes. Patients and Methods. Thirty subjects were separated into a younger and older cohort. The superior and inferior anterior chamber angles of the eyes were measured in supine and sitting positions by ultrasound biomicroscopy (UBM) with bag/balloon technology. Statistical analysis was used to evaluate positional and age-related changes in angle morphology. Results. In the younger cohort, no location or positional differences in angle anatomy were observed. In the older cohort, the inferior quadrant was significantly narrower than the superior quadrant (P = 0.0186) in the supine position. This cohort also demonstrated an interaction effect between position and location. In the older cohort, the angle was deeper inferiorly while the subject was sitting but was deeper superiorly while the subject was supine.
Conclusion. Comparison of positional variations in anterior chamber angle anatomy as measured by UBM has recently become possible. This study found that age-related positional changes in the anterior chamber angle anatomy exist in normal healthy eyes.
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