Changes in Higher-Order Aberrations After Phototherapeutic Keratectomy for Subepithelial Corneal Infiltrates After Epidemic Keratoconjunctivitis

Yıldız, Burçin Kepez; Urvasizoglu, Semih; Yıldırım, Yusuf; Ağca, Alper; Beşek, Nilay Kandemir; Fazıl, Korhan; Eriş, Erdem; Aygıt, Ebru Demet; Taşkapili, Mühittin; Demirok, Ahmet

doi:10.1097/ico.0000000000001296

Cited by 10 publications

(5 citation statements)

References 22 publications

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“…27 Finally, a reduction of both the refractive defect and total higher-order aberrations was obtained, avoiding secondary astigmatism, as described by other authors. 12 Yıldırım et al evaluated the long-term visual and refractive outcomes of wavefront-guided transepithelial photorefractive keratectomy with mitomycin-C (MMC) for the treatment of corneal opacities secondary to adenoviral EKC. 28 No infiltrate recurrence was observed and the treatment was effective for the purpose of visual rehabilitation.…”

Section: Discussionmentioning

confidence: 99%

“…These opacities may lead to an irregular cornea, subepithelial opacities that decrease visual acuity and quality of vision, due to high astigmatism, photophobia, glare, halos, and higher-order aberrations (HOAs), that can persist for months and even years. 2 , 12 Histopathologic studies of affected cornea samples have shown lymphocytic infiltrates and fibroblasts, without the presence of virus-like particles, restricted to the superficial stroma, Bowman layer, and epithelium. 13 Adenovirus stromal keratitis is thought to represent a delayed hypersensitivity immune response to viral antigens in the corneal stroma.…”

Section: Discussionmentioning

confidence: 99%

“… 27 Finally, a reduction of both the refractive defect and total higher-order aberrations was obtained, avoiding secondary astigmatism, as described by other authors. 12 …”

Section: Discussionmentioning

confidence: 99%

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Topography-Guided Transepithelial Photorefractive Keratectomy for the Treatment of Persistent and Visually-Significant Adenoviral Corneal Infiltrates

Spadea¹,

Genova²,

Battagliola³

et al. 2023

TCRM

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To evaluate visual and refractive outcomes of customized photorefractive keratectomy (PRK) in subjects with persistent subepithelial corneal opacities secondary to adenoviral epidemic keratoconjunctivitis (EKC). Patients and Methods: Prospective study, which recruited patients with persistent and visually-significant post-EKC corneal opacities unresponsive to prolonged topical therapy (6 months or more). Outcome measures: uncorrected and best-corrected distance visual acuity, subjective refractive astigmatism, keratometric astigmatism, spherical equivalent, minimum corneal thickness, and corneal morphological irregularity index. Subjects were followed for 12 months post-treatment. Results: Eighteen eyes of 18 patients aged between 32 and 75 years treated with topography-guided transepithelial PRK with iRes excimer laser (iVIS Technologies, Taranto, Italy) from June 2020 to July 2021. After 12 months, the mean UDVA improved from 1.0 ±0.00LogMAR pre-op to 0.15±0.154LogMAR, and the mean CDVA improved from 0.4±0.41LogMAR pre-op to 0.0±0.00LogMAR. With respect to UDVA, all treated eyes (100%) showed an improvement of 6 ETDRS lines or more and with respect to CDVA, 9 out of 18 eyes (50%) showed an improvement of 6 ETDRS lines or more. The mean ablation depth was 54.7±5.9μm. A statistically significant improvement was observed in all topographic indices. No infiltrate recurrence, post-treatment corneal haze, ocular hypertension or other side effects were observed throughout the follow-up period. Conclusion: Topography-guided PRK could be considered an effective and safe treatment option to improve visual acuity in patients affected by persistent and visually-significant subepithelial corneal infiltrates caused by EKC.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Topography-Guided Transepithelial Photorefractive Keratectomy for the Treatment of Persistent and Visually-Significant Adenoviral Corneal Infiltrates

Spadea¹,

Genova²,

Battagliola³

et al. 2023

TCRM

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“…EKC is one of the most common eye infections worldwide [10–13]. The clinical presentation of EKC is rather similar to the different adenovirus-type infections [11].…”

Section: Discussionmentioning

confidence: 99%

A 8-year retrospective clinical analysis of 272 patients of epidemic Keratoconjunctivitis in Beijing, China

et al. 2019

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BackgroundEpidemic keratoconjunctivitis (EKC) is one of the most common eye infections worldwide. The analysis of clinical manifestations in different age groups help better know the disease. This study aims to provide more detailed analysis of 272 cases of EKC in 8 years, describe the differences of the clinical features among different age groups, and establish new clinical grading criteria.Methods272 individuals were reviewed (2011–2019) in Beijing China. All the patients were classified into 3 grades according to the new grading criteria. The typical clinical signs of EKC and the photographs of the multiple subepithelial corneal infiltrates (MSI) were collected and analyzed. The number of 3 grades among and within different age groups were compared. The incidence of the typical signs among and within different age groups were compared. The proportion of each region of the cornea involved by MSI were compared.ResultsNo significant differences were detected among the 4 groups in terms of the number of mild, moderate and severe cases, no matter in all-patients analysis (P = 0.271) nor in acute-phase-patients analysis (P = 0.203). The proportion of the severe cases was the highest among all patients (P = 0.000). Among the incidence of the typical signs, corneal involvement was the most common accounting for 69.8% (P<0.05). The probability of central region involvement was significantly higher than that of pericentral region involvement (P = 0.015) and peripheral region involvement (P = 0.000).ConclusionsAppropriate attention should be paid on EKC, because of the considerable proportion of severe cases, the high incidence of corneal lesion, and the high incidence of central region involvement of MSI.

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“…96 Furthermore, a decrease in coma, secondary astigmatism, and total higher-order aberrations have been noted after PTK for SEIs in adenoviral keratoconjunctivitis. 97…”

Section: Surgical Managementmentioning

confidence: 99%

<p>Management of Adenoviral Keratoconjunctivitis: Challenges and Solutions</p>

Labib¹,

Minhas²,

Chigbu³

2020

OPTH

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Human adenovirus (HAdV) is the most common cause of infectious conjunctivitis, accounting for up to 75% of all conjunctivitis cases and affecting people of all ages and demographics. In addition to ocular complications, it can cause systemic infections in the form of gastroenteritis, respiratory disease, and dissemination in immunocompromised individuals. HAdV causes lytic infection of the mucoepithelial cells of the conjunctiva and cornea, as well as latent infection of lymphoid and adenoid cells. Epidemic keratoconjunctivitis (EKC) is the most severe ocular manifestation of HAdV infection, in which the presence of subepithelial infiltrates (SEIs) in the cornea is a hallmark feature of corneal involvement. SEIs have the tendency to recur and may lead to long-term visual disability. HAdV persistence and dissemination are linked to sporadic outbreaks of adenoviral keratoconjunctivitis. There is no FDA-approved antiviral for treating adenoviral keratoconjunctivitis, and as such, solutions should be proffered to handle the challenges associated with viral persistence and dissemination. Several treatment modalities have been investigated, both systemically and locally, to not only mitigate symptoms but reduce the course of the infection and prevent the risk of long-term complications. These options include systemic and topical antivirals, in-office povidone-iodine irrigation (PVI), immunoglobulin-based therapy, antiinflammatory therapy, and immunotherapy. More recently, combination PVI/dexamethasone ophthalmic formulations have shown favorable outcomes and were well tolerated in clinical trials for the treatment of EKC. Possible, future treatment considerations include sialic acid analogs, cold atmospheric plasma, N-chlorotaurine, and benzalkonium chloride. Continued investigation and evaluation of treatment are warranted to reduce the economic burden and potential long-term visual debilitation in affected patients. This review will focus on how persistence and dissemination of HAdV pose a significant challenge to the management of adenoviral keratoconjunctivitis. Furthermore, current and future trends in prophylactic and therapeutic modalities for adenoviral keratoconjunctivitis will be discussed.

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Changes in Higher-Order Aberrations After Phototherapeutic Keratectomy for Subepithelial Corneal Infiltrates After Epidemic Keratoconjunctivitis

Abstract: PTK is an effective method for treating corneal opacity after epidemic keratoconjunctivitis, which yields significant improvements in both VA and visual quality.

Cited by 10 publications

References 22 publications

Topography-Guided Transepithelial Photorefractive Keratectomy for the Treatment of Persistent and Visually-Significant Adenoviral Corneal Infiltrates

Topography-Guided Transepithelial Photorefractive Keratectomy for the Treatment of Persistent and Visually-Significant Adenoviral Corneal Infiltrates

A 8-year retrospective clinical analysis of 272 patients of epidemic Keratoconjunctivitis in Beijing, China

<p>Management of Adenoviral Keratoconjunctivitis: Challenges and Solutions</p>

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