In our study using confocal microscopy in vivo we found that corneal grafting does not influence keratocyte density and nuclear area in individual layers of the central corneal stroma segment (anterior, midstroma and posterior layers). Donor age influenced an increase in keratocyte nuclei area only in the posterior stroma layer.
Purpose: Corneal collagen cross‐linking by UVA/riboflavin represents a new method for the treatment of progressive keratoconus.
Methods: In the presentation we will present our first 10 cases of keratoconic eyes (maximum K value, 45‐51 diopters) with the follow up time from 4 to 7 months. A complete ophthalmologic examination with uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA) were performed. Listed examinations were performed before surgery and at 1,2,3 and 7 months after surgery: corneal computerized topographic examination, pentacam examination, endothelial cell count and intraocular pressure (IOP) evaluation.
Results: Comparative preoperative and postoperative results showed increases of 1.4 lines for UCVA (P = .000021) and 1.66 lines for BCVA (P = .00051). Topographic analysis showed a mean K reduction of 1.9 +/‐ 0.15 diopters (D) in the central 3.0 mm. Statistical analysis of IOP, corneal thicknes and endothelial cell count did not show significant differences. Corneal and lens transparency remained unchanged. Topographic analysis findings of corneal symmetry showed a trend toward increasing corneal symmetry with a major reduction in asymmetry between vertical hemimeridians.
Conclusions: Refractive results showed a reduction of about 1.5 D in the mean spherical equivalent, topographically confirmed by the reduction in mean K. Results of surface topographic analysis showed improvement in morphologic symmetry. Long‐term results are necessary to evaluate the duration of the stiffening effect and to exclude long term side‐effects.
Background: Multifocal intraocular lens (IOL) implantation is generally not considered in patients with keratoconus; however, it may provide good optical results in selected patients with stage I and II keratoconus based on two case reports. Aims: To evaluate patient satisfaction and clinical outcomes in this patient population.Methods: This is a retrospective single-center, non-interventional, non-comparison study. All patients with frank keratoconus who had undergone a trifocal IOL implantation between 2016 and 2019 were invited to participate in this study (18 eyes of 9 patients). Postoperatively, refractive outcomes, contrast sensitivity, and ocular aberrations were recorded. A questionnaire was used for determining patient satisfaction and their quality of life. The mean follow-up time was 31.22 ± 6.38 months.Results: Postoperatively the patients’ uncorrected distance visual acuity improved from 1.13 ± 0.93 to 0.10 ± 0.17 (p˂0.001), corrected distance visual acuity went from 0.10 ± 0.11 to 0.05 ± 0.09 (p=0.19), mean refractive spherical equivalent changed from -4.34 ± 4.31 to 0.05 ± 0.51 D (p˂0.001), and manifest astigmatism from 2.44 ± 1.92 to 0.88 ± 1.81 D (p=0.017). A target refraction of less than ± 0.50 D was achieved in 17 eyes (94%) and one eye exhibited a hyperopic MRSE of +2.0 D. Three eyes (17%) lost 1 line of best corrected visual acuity and no patient lost two or more lines. The patients were independent of glasses in 78% for all distances. Conclusions: A trifocal IOL currently gives relatively good, predictable results with most patients feeling satisfied with the results of spectacle independence for all distances.
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