Current review and a simplified "five-point management algorithm" for keratoconus

Shetty, Rohit; Kaweri, Luci; Pahuja, Natasha; Nagaraja, Harsha; Wadia, Kareeshma; Jayadev, Chaitra; Nuijts, Rudy M.M.A.; Arora, Vishal

doi:10.4103/0301-4738.151468

Cited by 52 publications

(24 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[ 22 ] KC has also been found to be associated with several autoimmune and allergic eye diseases and several factors that contribute to the risk of progression. [ 23 24 ] In the current study, we demonstrate increased inflammatory factors on the ocular surface which would contribute toward KC and its progression. The knowledge regarding the role of inflammatory factors including cytokines, chemokines, cell adhesion molecules and certain growth factors in influencing the extracellular remodeling is well known.…”

Section: Discussionmentioning

confidence: 54%

Altered tear inflammatory profile in Indian keratoconus patients - The 2015 Col Rangachari Award paper

Shetty

Deshmukh

Ghosh

et al. 2017

Indian J Ophthalmol

Self Cite

View full text Add to dashboard Cite

Purpose:Conventionally, keratoconus (KC) has been considered a noninflammatory corneal ectatic disorder. Recent evidence suggests a possible role of inflammation in the pathogenesis of KC. Hence, we analyzed the levels of inflammatory factors in the tear fluid of Indian KC patients.Methods:Tear fluid samples were collected from age- and sex-matched healthy controls and KC patients (with different grades). The levels of the inflammatory factors in tears were analyzed using cytometric bead array (Human Soluble Protein Flex Set System, BD Biosciences) for levels of interleukin-1α (IL-1α), IL-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-9, IL-10, IL-12p70, IL-23p40, IL-13, IL-17A, IL-17F, IL-21, interferon-α (IFNα), IFNγ, tumor necrosis factor-α, CCL2/monocyte chemotactic protein-1, CCL4/macrophage inflammatory protein-1β (MIP-1β), MIP-1α, CCL5/RANTES, CXCL10/IP10, ICAM1, CD62E, vascular endothelial growth factor and transforming growth factor β.Results:An increase in Kmax and Kmean, and a decrease in central corneal thickness was observed with increasing grades of KC. Tear analysis showed that most of the tear soluble factors, including cytokines, chemokines, growth factors and cell adhesion molecules were significantly elevated in the KC patients compared to the controls.Conclusion:Our findings suggest that inflammatory factors associated with KC may play a role in its pathogenesis. This opens the potential to explore anti-inflammatory strategies to either halt or delay the progression of KC.

show abstract

Section: Discussionmentioning

confidence: 54%

Altered tear inflammatory profile in Indian keratoconus patients - The 2015 Col Rangachari Award paper

Shetty

Deshmukh

Ghosh

et al. 2017

Indian J Ophthalmol

Self Cite

View full text Add to dashboard Cite

show abstract

“…Despite being described for a long time, irregular cornea management remains a challenge for eye care practitioners [ 53 ] and new technologies are applied to develop tools and algorithms that assist decision making to reduce the total number of trial lenses and visits to the clinic [ 54 – 59 ] or choose the best management—from glasses to surgery—for a particular patient [ 60 ].…”

Section: Resultsmentioning

confidence: 99%

Nonsurgical Procedures for Keratoconus Management

Rico-del-Viejo

García-Montero

Hernández-Verdejo

et al. 2017

Journal of Ophthalmology

View full text Add to dashboard Cite

Objectives To describe the past 20 years' correction modalities for keratoconus and their visual outcomes and possible complications. Methods A review of the published literature related to the visual outcomes and possible complications in the context of keratoconus management using nonsurgical procedures for the last 20 years (glasses and contact lenses) was performed. Original articles that reported the outcome of any correction modalities of keratoconus management were reviewed. Results The most nonsurgical procedure used on keratoconus management is the contact lens fitting. Soft contact lenses and soft toric contact lenses, rigid gas-permeable contact lenses, piggyback contact lens system, hybrid contact lenses, and scleral and corneoscleral contact lenses form the contemporary range of available lens types for keratoconus management with contact lenses. All of them try to restore the vision, improve the quality of life, and delay surgical procedures in patients with this disease. Complications are derived from the intolerance of using contact lens, and the use of each depends on keratoconus severity. Conclusions In the context of nonsurgical procedures, the use of contact lenses for the management of keratoconic patients represents a good alternative to restore vision and improve the quality of live in this population.

show abstract

“… 2 3 Essential to each treatment is timing and applying the appropriate intervention method to each patient. 4 The implantation of a phakic intraocular lens into the posterior chamber, as demonstrated by clinical observations, can be a desirable alternative to visual defects resulting from refractive errors in the state of keratoconus. 5 The STAAR Surgical Visian ICL is an intraocular implant manufactured from a propriety hydroxylethylmethacrylate/porcine collagen-based biocompatible polymer material.…”

Section: Introductionmentioning

confidence: 99%

Comparative analysis of the visual performance after implantation of the toric implantable collamer lens in stable keratoconus: a 4-year follow-up after sequential procedure (CXL+TICL implantation)

et al. 2017

View full text Add to dashboard Cite

AimsTo report on 4-year postoperative visual performance with the toric implantable collamer lens (TICL) for stable keratoconus after sequential procedure (corneal collagen crosslinking plus TICL implantation).MethodsForty eyes of 24 patients with stable keratoconus with myopia between 0.00 and −18.00 dioptres (D) and astigmatism between 1.25 and 8.00 D were evaluated in this prospective interventional study (https://clinicaltrials.gov/ct2/show/NCT02833649). We evaluated refraction, visual outcomes, astigmatic changes analysed by Alpins vector, contrast sensitivity, aberrometry, modulation transfer functions (MTFs), defocus curve, and operative and postoperative complications.ResultsAt 4-year follow-up, 45% had 20/20 vision or better and 100% had 20/40 or better uncorrected visual acuity (UCVA). Vector analysis of refractive astigmatism shows that the surgically induced astigmatism (SIA) (3.20±1.46 D) was not significantly different from the target induced astigmatism (TIA) (3.14±1.42 D) (p=0.620). At 4 years postoperatively, none of the eyes showed a decrease in UCVA, in contrast to 24 eyes in which UCVA was increased by ≥1 lines, with contrast sensitivity and improvement in total aberrations and MTF value at 5 per degree (*p=0.004) after TICL implantation. The cumulative 4-year corneal endothelial cell loss was ≤5%. No patients reported dissatisfaction. At the end of follow-up, the vault was 658±54.33m (range, 500–711) and the intraocular pressure was 11.7±2.08 mm Hg. Occurrences of glare and night-driving troubles diminished after TICL surgery.ConclusionThe results from this standardised clinical investigation support TICL implantation from clinical and optical viewpoints in patients with stable keratoconus.Trial registration numberNCT02833649, Pre-results

show abstract

Current review and a simplified "five-point management algorithm" for keratoconus

Cited by 52 publications

References 45 publications

Altered tear inflammatory profile in Indian keratoconus patients - The 2015 Col Rangachari Award paper

Altered tear inflammatory profile in Indian keratoconus patients - The 2015 Col Rangachari Award paper

Nonsurgical Procedures for Keratoconus Management

Comparative analysis of the visual performance after implantation of the toric implantable collamer lens in stable keratoconus: a 4-year follow-up after sequential procedure (CXL+TICL implantation)

Contact Info

Product

Resources

About