Purpose: Long-term evaluation of corneal epithelial thickness (ET) profile changes after photorefractive keratectomy (PRK) using Fourier-domain anterior segment optical coherence tomography. Methods: Three hundred twenty-six eyes of 163 patients were included in this prospective observational study. The corneal epithelial map was obtained across a 9-mm diameter area of the cornea before and up to 27 months after surgery. ET was assessed in 25 sectors and 4 annular zones (central 2 mm, paracentral 2–5 mm, midperipheral 5–7 mm, and peripheral 7–9 mm). Results: There was a significant reduction in mean ET in all zones 1 month after PRK. Subsequently, ET increased in all annular zones. The change in mean ET became stable in the midperipheral and peripheral zones at 3 to 6 months and in the central zone at 12 months, and it continued to increase in the paracentral zone even after 18 months after surgery. The ET was 3.40 μm and 4.05 μm in the central and paracentral zones at 6 months, respectively. Postoperative spherical equivalent changed significantly only from 1 to 3 months (P < 0.04). There was a significant correlation between postoperative spherical equivalent at month 1 and ET change in the paracentral and midperipheral zones (P < 0.027). Conclusions: There is a significant reduction in ET 1 month after myopic PRK with a gradual thickening thereafter until it reaches stability at 12 months in the central zone. However, it continues to change even after 18 months in the paracentral zone. The greatest thickening is in the paracentral zone, followed by the central zone.
Purpose: To describe a novel technique of amniotic membrane (AM) patch graft in the management of double chamber treatment after big-bubble deep anterior lamellar keratoplasty (DALK). Case Report: A 35-year-old male patient with advanced keratoconus underwent bigbubble DALK. Manual lamellar dissection was done due to failed big-bubble. First-day postoperative double chamber was detected. Air bubbling and SF6 injection were tried without any success. Double chamber resolved by fixation of AM transplantation patch graft (1 × 1 mm) over the Descemet’s membrane perforation with fibrin glue. Conclusion: Amniotic membrane patch graft can be used in the management of double chamber after DALK not responsive to intracameral gas injection.
Purpose: To investigate the change in anterior, posterior, and net corneal power more than 18 months after photorefractive keratectomy (PRK) by RTVue anterior segment optical coherence tomography (OCT). Setting: Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran. Design: Prospective observational study. Methods: PRK was performed using Technolas TENEO 317 laser platform. Anterior, posterior, and net corneal power was measured by the RTVue-XR anterior segment OCT system with the Pachymetry + Cpwr scan pattern at baseline and months 1, 3, 6, 12, 18, and more than 18 (up to 27) after PRK. Results: Three hundred twenty-six eyes of 163 patients (61 men [37.4%], 102 women [62.6%]; mean age 29.71 years; range 18.5 to 46.5 years) were enrolled in this study. Mean preoperative spherical equivalent was −3.15 ± 1.50 diopter (D) (range −8.37 to −0.62 D). The mean change in net corneal power was 3.052 D, 3.281 D, 3.324 D, 3.114 D, 3.446 D, and 3.972 D at months 1, 3, 6, 12, 18, and more than 18 postoperatively compared with baseline, respectively (P < .001 for all comparisons). The mean change in posterior corneal power at postoperative visits compared with baseline was not statistically significant (P > .1) except for 1 month postoperatively, which increased by 0.13 D (P < .001). Changes in posterior corneal power were not correlated with any of the preoperative clinical and Scheimpflug variables. Conclusions: Posterior corneal power did not change for more than 18 months after PRK, except for an early small increase at 1 month postoperatively.
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