In this study, failed graft has gradually become the leading indication for PK, whereas most other studies have reported PBK as the leading indication. Unlike many other studies, Fuchs dystrophy was a common indication for PK.

We report the first 2 cases of bacterial keratitis resistant to fourth-generation fluoroquinolones after laser in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK). The first patient had Pseudomonas aeruginosa keratitis after PRK despite treatment with moxifloxacin. The second patient was on gatifloxacin post-LASIK when she had methicillin-resistant Staphylococcus aureus (MRSA) keratitis diagnosed. In both cases, culture susceptibilities showed isolates resistant to moxifloxacin and gatifloxacin, and treatment with topical aminoglycosides and surgical intervention was necessary to effect a cure. These cases show the potential limitations in the coverage of these antibiotics.

Two novel biodendrimer adhesives successfully sealed and secured LASIK flaps. These adhesives may prove to be an effective alternative for treating LASIK flap complications such as epithelial ingrowth or flap dislocation.

We report 2 patients with stable keratoconus and high myopia who benefited from implantation of an iris-supported phakic intraocular lens (Verisyse, AMO) for correction of their refractive error. Both patients had a postoperative uncorrected visual acuity of 20/40. Endothelial cell density showed at most a 4% decrease, and no evidence of keratoconus progression was witnessed. The use of the Verisyse lens may be beneficial for certain keratoconic patients as an alternative step between rigid gas-permeable lenses and penetrating keratoplasty.

PurposeTo compare and analyze the differences in visual outcomes between Visx iDesign Advanced WaveScan Studio™ System, Alcon Wavelight Allegro Topolyzer and Nidek EC-5000 using Final Fit™ Custom Ablation Treatment Software from the submitted summary of safety and effectiveness of the US Food and Drug Administration (FDA) data.MethodsIn this retrospective comparative study, 334 eyes from Visx iDesign, 212 eyes from Alcon Contour, and 135 eyes from Nidek CATz platforms were analyzed for primary and secondary visual outcomes. These outcomes were compared via side-by-side graphical and tabular representation of the FDA data. Statistical significance was calculated when appropriate to assess differences. A P-value <0.05 was considered statistically significant.ResultsThe mean postoperative uncorrected distance visual acuity (UDVA) at 12 months was 20/19.25±8.76, 20/16.59±5.94, and 20/19.17±4.46 for Visx iDesign, Alcon Contoura, and Nidek CATz, respectively. In at least 90% of treated eyes at 3 months and 12 months, all three lasers showed either no change or a gain of corrected distance visual acuity (CDVA). Mesopic contrast sensitivity at 6 months showed a clinically significant increase of 41.3%, 25.1%, and 10.6% for eyes using Visx iDesign, Alcon Contoura, and Nidek CATz, respectively. Photopic contrast sensitivity at 6 months showed a clinically significant increase of 19.2%, 31.9%, and 10.6% for eyes using Visx iDesign, Alcon Contoura, and Nidek CATz, respectively.ConclusionFDA data for the three platforms shows all three were excellent with respect to efficacy, safety, accuracy, and stability. However, there are some differences between the platforms with certain outcome measurements. Overall, patients using all three lasers showed significant improvements in primary and secondary visual outcomes after LASIK surgery.

Patients with mild corneal guttata and a family history of Fuchs' dystrophy are prone to transient corneal edema, loss of BSCVA, endothelial cell loss, and myopic regression after uneventful LASIK for correction of myopia and myopic astigmatism.

There was a statistically significant difference in posterior corneal elevation between before LASIK enhancement and after LASIK enhancement. However, the change in posterior corneal elevation was much smaller than previously reported values and below the sensitivity of the Pentacam topographer.

The purpose of the study was to investigate the management of recurrent corneal erosion syndrome (RES). A retrospective case series design was employed in which all RES cases presenting to the Duke University Eye Center from 1995 to 2002 were included. In total, 364 episodes of RES occurred in 261 patients during the study period. Of this 61% of patients were female (P < .001), average age was 46.0 years, and etiologies included trauma (51.3%), anterior basement membrane dystrophy (29.1%), other etiologies (10.3%) and unknown (9.2%). Treatments included conservative therapy (83.2%), anterior stromal puncture (ASP)(12.6%) and phototherapeutic keratectomy (PTK)(4.1%). Recurrence by treatment was 31.0% for conservative therapy, 23.9% for ASP and 26.7% for PTK. Subjects treated with ASP and PTK had failed prior treatment efforts. Conclusions include that RES was commonly associated with trauma and the female gender, and that one-third of conservatively treated episodes and one-quarter of surgically treated episodes (ASP or PTK) recurred.