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Elgin U, Simsek M, Sen E, Hondur G, Bayraktar S, Acar A. The comparison of corneal densitometry in cases with glaucoma following childhood cataract surgery and juvenile glaucoma. Int Ophthalmol 2024; 44:64. [PMID: 38347316 PMCID: PMC10861629 DOI: 10.1007/s10792-024-03004-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 10/19/2023] [Indexed: 02/15/2024]
Abstract
PURPOSE To compare the corneal densitometry (CD) in pediatric cases with glaucoma following childhood cataract surgery and juvenile open-angle glaucoma (JOAG). METHODS This prospective comparative study involved 13 eyes with JOAG, 12 eyes with pseudophakic glaucoma, 13 eyes with aphakic glaucoma, and 15 control subjects. Pentacam HR Scheimpflug corneal topography was employed to evaluate corneal thickness (CCT) and CD values. RESULTS The mean intraocular pressure (IOP) and CCT were significantly higher in aphakic glaucoma cases than the other groups (p = 0.001). In aphakic eyes, the mean CD values were higher in most of the anterior, center, and posterior layers of 0-2 mm, 2-6 mm, 6-10 mm, and total zones (p < 0.001 for all). In pseudophakic eyes, the mean CD values were statistically similar with that of aphakic eyes and higher than that of JOAG and control eyes in all layers of 0-2 mm zone and in anterior layer of 10-12 mm and anterior and total layers of 2-6 mm zones (p < 0.05 for all). The CD values demonstrated significant correlations with CCT values in both aphakic and pseudophakic eyes. However, a significant correlation of CD values with IOP was only demonstrated in aphakic eyes (p = 0.01 for all). CONCLUSION The probable effects of childhood cataract surgery especially aphakia might cause corneal backscatter of light and increased CD in all layers in all zones of the cornea. Increased CD values and its correlation with CCT and IOP in aphakic glaucoma eyes may be of importance in clinical management.
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Affiliation(s)
- Ufuk Elgin
- Ulucanlar Eye Education and Research Hospital, University of Health Sciences, Ulucanlar Caddesi No:59, 06240, Altindag Ankara, Turkey
| | - Mert Simsek
- Ulucanlar Eye Education and Research Hospital, University of Health Sciences, Ulucanlar Caddesi No:59, 06240, Altindag Ankara, Turkey
| | - Emine Sen
- Ulucanlar Eye Education and Research Hospital, University of Health Sciences, Ulucanlar Caddesi No:59, 06240, Altindag Ankara, Turkey
| | - Gozde Hondur
- Ulucanlar Eye Education and Research Hospital, University of Health Sciences, Ulucanlar Caddesi No:59, 06240, Altindag Ankara, Turkey.
| | - Serdar Bayraktar
- Ulucanlar Eye Education and Research Hospital, University of Health Sciences, Ulucanlar Caddesi No:59, 06240, Altindag Ankara, Turkey
| | - Atakan Acar
- Ulucanlar Eye Education and Research Hospital, University of Health Sciences, Ulucanlar Caddesi No:59, 06240, Altindag Ankara, Turkey
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Alanazi R, Esporcatte LPG, White L, Salomão MQ, Lopes BT, Ambrósio R, Abass A. Investigation of How Corneal Densitometry Artefacts Affect the Imaging of Normal and Keratoconic Corneas. Bioengineering (Basel) 2024; 11:148. [PMID: 38391634 PMCID: PMC10886353 DOI: 10.3390/bioengineering11020148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 01/27/2024] [Accepted: 01/29/2024] [Indexed: 02/24/2024] Open
Abstract
PURPOSE To investigate corneal densitometry artefacts found in Pentacam Scheimpflug scans and their potential effect on assessing keratoconic (KC) corneas compared to normal (N) corneas. METHODS The current study utilises Pentacam data of 458 N eyes, aged 35.6 ± 15.8 (range 10-87), referred to as the "N group", and 314 KC eyes, aged 31.6 ± 10.8 (range 10-72), referred to as the "KC group", where densitometry data were extracted and analysed via a custom-built MATLAB code. Radial summations of the densitometry were calculated at diameters ranging from 0.5 mm to 5.0 mm. The minimum normalised radial summation of densitometry (NRSD) value and angle were determined at each diameter and then linked. KC cone locations and areas of pathology were determined, and a comparison between N and KC groups was carried out both within the averaged area of pathology and over the corneal surface. RESULTS Joining minimum NRSD trajectory points marked a clear distortion line pointing to the nasal-superior direction at 65° from the nasal meridian. The findings were found to be independent of eye laterality or ocular condition. Consistency was detected in the right and left eyes among both the N and KC groups. The location of the KC cone centre and the area of pathology were determined, and the densitometry output was compared both within the area of pathology and over the whole cornea. When the average densitometry was compared between N and KC eyes within the KC area of pathology, the N group recorded a 16.37 ± 3.15 normalised grey-scale unit (NGSU), and the KC group recorded 17.74 ± 3.4 NGSU (p = 0.0001). However, when the whole cornea was considered, the N group recorded 16.71 ± 5.5 NGSU, and the KC group recorded 15.72 ± 3.98 NGSU (p = 0.0467). A weak correlation was found between the Bad D index and NGSU when the whole measured cornea was considered (R = -0.01); however, a better correlation was recorded within the KC area of pathology (R = 0.21). CONCLUSIONS Nasal-superior artefacts are observed in the densitometry Pentacam maps, and analysis shows no significant differences in their appearance between N or KC corneas. When analysing KC corneas, it was found that the cone positions are mostly on the temporal-inferior side of the cornea, opposite to the densitometry artefact NRSD trajectory. The analysis suggests that the corneal densitometry artefacts do not interfere with the KC area of pathology as it reaches its extreme in the opposite direction; therefore, weighting the densitometry map to increase the contribution of the inferior-temporal cornea and decreasing that of the superior-nasal area would improve the classification or identification of KC if densitometry is to be used as a KC metric.
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Affiliation(s)
- Rami Alanazi
- Department of Materials, Design and Manufacturing Engineering, School of Engineering, University of Liverpool, Liverpool L69 3GH, UK
| | - Louise Pellegrino Gomes Esporcatte
- Rio de Janeiro Corneal Tomography and Biomechanics Study Group, Rio de Janeiro 20520-050, Brazil
- Instituto de Olhos Renato Ambrósio, Rio de Janeiro 20520-050, Brazil
- Department of Ophthalmology, Federal University of São Paulo, São Paulo 04017-030, Brazil
| | - Lynn White
- Research and Development Department, LWVision, Leicester LE18 1DF, UK
| | - Marcella Q Salomão
- Rio de Janeiro Corneal Tomography and Biomechanics Study Group, Rio de Janeiro 20520-050, Brazil
- Instituto de Olhos Renato Ambrósio, Rio de Janeiro 20520-050, Brazil
- Department of Ophthalmology, Federal University of São Paulo, São Paulo 04017-030, Brazil
- Instituto Benjamin Constant, Rio de Janeiro 22290-255, Brazil
| | - Bernardo T Lopes
- Rio de Janeiro Corneal Tomography and Biomechanics Study Group, Rio de Janeiro 20520-050, Brazil
- Department of Ophthalmology, Federal University of São Paulo, São Paulo 04017-030, Brazil
- Ophthalmology Eye Clinic, Alder Hey Children's NHS Foundation Trust, Liverpool L12 2AP, UK
| | - Renato Ambrósio
- Instituto de Olhos Renato Ambrósio, Rio de Janeiro 20520-050, Brazil
- Department of Ophthalmology, Federal University of São Paulo, São Paulo 04017-030, Brazil
- Department of Ophthalmology, Federal University the State of Rio de Janeiro, Rio de Janeiro 22290-240, Brazil
- Brazilian Study Group of Artificial Intelligence and Corneal Analysis-BrAIN, Rio de Janeiro & Maceió, Rio de Janeiro 20520-050, Brazil
| | - Ahmed Abass
- Department of Materials, Design and Manufacturing Engineering, School of Engineering, University of Liverpool, Liverpool L69 3GH, UK
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Lavy I, Erdinest N, Corredores J, Wajnsztajn D, Smadja D. Evaluating the efficacy of Rho kinase inhibitor eye drops in the management of corneal edema: A single-center retrospective cohort study. Taiwan J Ophthalmol 2024; 14:88-94. [PMID: 38654998 PMCID: PMC11034687 DOI: 10.4103/tjo.tjo-d-23-00169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 01/10/2024] [Indexed: 04/26/2024] Open
Abstract
PURPOSE This study aimed to evaluate the efficacy of ripasudil in managing various corneal edema conditions. MATERIALS AND METHODS This single-center retrospective analysis was conducted at Hadassah Medical Center and involved 16 patients with 17 eyes. Patients were selected based on diagnostic criteria, primarily corneal edema. The conditions were as follows, listed by frequency: postcataract surgery (31.25%), postpenetrating keratoplasty (25%), post-Descemet's membrane endothelial keratoplasty (18.75%), Fuchs' endothelial corneal dystrophy (12.5%), status post-Ahmed glaucoma valve (6.25%), and status posttrabeculectomy (6.25%). The treatment regimen involved topical administration of ripasudil hydrochloride hydrate (Glanatec® 0.4%), administered three times a day or tailored to condition severity. Efficacy was assessed using pre- and posttreatment measurements of best-corrected visual acuity (BCVA), central corneal thickness (CCT), and endothelial cell count (ECC), along with slit-lamp and optical coherence tomography examinations. RESULTS The average duration of ripasudil treatment was approximately 4.9 ± 2.2 months. Significant improvements were observed in BCVA, changing from a pretreatment value of 1.106 ± 0.817 logMAR to a posttreatment value of 0.56 ± 0.57 logMAR (P = 0.0308). CCT also showed a significant reduction, from 619.50 ± 56.36 μm pretreatment to 572.5 ± 75.48 μm posttreatment (P = 0.0479). ECC showed a marginal but not statistically significant increase, from 849.00 ± 570.72 cells/mm² pretreatment to 874.75 ± 625.59 cells/mm² posttreatment (P = 0.9010). CONCLUSION The study provides robust evidence supporting the use of ripasudil in managing corneal edema. Significant improvements in key ocular metrics such as BCVA and CCT were observed, enhancing the overall quality of life for patients suffering from various forms of corneal edema.
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Affiliation(s)
- Itay Lavy
- Department of Ophthalmology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Nir Erdinest
- Department of Ophthalmology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Jamel Corredores
- Department of Ophthalmology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Denise Wajnsztajn
- Department of Ophthalmology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - David Smadja
- Department of Ophthalmology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
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Briceno-Lopez C, Burguera-Giménez N, García-Domene MC, Díez-Ajenjo MA, Peris-Martínez C, Luque MJ. Corneal Edema after Cataract Surgery. J Clin Med 2023; 12:6751. [PMID: 37959216 PMCID: PMC10647590 DOI: 10.3390/jcm12216751] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/17/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023] Open
Abstract
This systematic review investigates the prevalence and underlying causes of corneal edema following cataract surgery employing manual phacoemulsification. A comprehensive search encompassing databases such as PubMed, Embase, ProQuest, Cochrane Library, and Scopus was conducted, focusing on variables encompassing cataract surgery and corneal edema. Two independent reviewers systematically extracted pertinent data from 103 articles, consisting of 62 theoretical studies and 41 clinical trials. These studies delved into various aspects related to corneal edema after cataract surgery, including endothelial cell loss, pachymetry measurements, visual performance, surgical techniques, supplies, medications, and assessments of endothelial and epithelial barriers. This review, encompassing an extensive analysis of 3060 records, revealed significant correlations between corneal edema and endothelial cell loss during phacoemulsification surgery. Factors such as patient age, cataract grade, and mechanical stress were identified as contributors to endothelial cell loss. Furthermore, pachymetry and optical coherence tomography emerged as valuable diagnostic tools for assessing corneal edema. In conclusion, this systematic review underscores the link between corneal edema and endothelial cell loss in manual phacoemulsification cataract surgery. It highlights the relevance of factors like patient demographics and diagnostic modalities. However, further research is essential to unravel the complexities of refractive changes and the underlying mechanisms.
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Affiliation(s)
- Celeste Briceno-Lopez
- Department of Optics and Optometry and Vision Sciences, Faculty of Physics, Universitat de València, Dr. Moliner 50, E-46100 Burjassot, Spain; (N.B.-G.); (M.C.G.-D.); (M.A.D.-A.); (M.J.L.)
- Cátedra Alcon—FOM—UVEG, Universitat de València, Dr. Moliner 50, E-46100 Burjassot, Spain
| | - Neus Burguera-Giménez
- Department of Optics and Optometry and Vision Sciences, Faculty of Physics, Universitat de València, Dr. Moliner 50, E-46100 Burjassot, Spain; (N.B.-G.); (M.C.G.-D.); (M.A.D.-A.); (M.J.L.)
- Cátedra Alcon—FOM—UVEG, Universitat de València, Dr. Moliner 50, E-46100 Burjassot, Spain
| | - M. Carmen García-Domene
- Department of Optics and Optometry and Vision Sciences, Faculty of Physics, Universitat de València, Dr. Moliner 50, E-46100 Burjassot, Spain; (N.B.-G.); (M.C.G.-D.); (M.A.D.-A.); (M.J.L.)
- Cátedra Alcon—FOM—UVEG, Universitat de València, Dr. Moliner 50, E-46100 Burjassot, Spain
| | - M. Amparo Díez-Ajenjo
- Department of Optics and Optometry and Vision Sciences, Faculty of Physics, Universitat de València, Dr. Moliner 50, E-46100 Burjassot, Spain; (N.B.-G.); (M.C.G.-D.); (M.A.D.-A.); (M.J.L.)
- Cátedra Alcon—FOM—UVEG, Universitat de València, Dr. Moliner 50, E-46100 Burjassot, Spain
| | - Cristina Peris-Martínez
- Anterior Segment and Cornea and External Eye Diseases Unit, Fundación de Oftalmología Médica, Av. Pío Baroja 12, E-46015 Valencia, Spain;
- Surgery Department, Faculty of Medicine, Universitat de València, Av. Blasco Ibáñez 15, E-46010 Valencia, Spain
| | - M. José Luque
- Department of Optics and Optometry and Vision Sciences, Faculty of Physics, Universitat de València, Dr. Moliner 50, E-46100 Burjassot, Spain; (N.B.-G.); (M.C.G.-D.); (M.A.D.-A.); (M.J.L.)
- Cátedra Alcon—FOM—UVEG, Universitat de València, Dr. Moliner 50, E-46100 Burjassot, Spain
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Miażdżyk M, Consejo A, Iskander DR. OCT based corneal densitometry: the confounding effect of epithelial speckle. BIOMEDICAL OPTICS EXPRESS 2023; 14:3871-3880. [PMID: 37799674 PMCID: PMC10549732 DOI: 10.1364/boe.489054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 06/06/2023] [Accepted: 06/12/2023] [Indexed: 10/07/2023]
Abstract
Corneal densitometry is a clinically validated method for objectively assessing the transparency of stroma. The technique is currently dominated by Scheimpflug technology. Still, optical coherence tomography (OCT), in which examination of the statistical properties of corneal speckle is undertaken, has also been considered to assess corneal densitometry. In-vivo, the stroma is observed via the epithelium. However, the effect of this external layer on stromal densitometry has not been considered as yet. This study aims to quantify the influence of epithelium integrity on corneal OCT densitometry. OCT images from eleven freshly enucleated porcine eyes before and after epithelial debridement were used. OCT densitometry was investigated at different stromal depths using four metrics of speckle statistics. Results indicate that there exist statistically significant differences in speckle statistics for a given stromal depth depending on the presence or absence of the epithelium. The estimation error in speckle statistics can reach over 20% depending on the stromal depth. The anterior stroma densitometry values are the ones most affected by epithelial integrity. In conclusion, if OCT densitometry stromal parameters are to be considered in absolute terms, it is essential to consider the confounding effect of the epithelial layer in the analysis.
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Affiliation(s)
- Maria Miażdżyk
- Department of Biomedical Engineering,
Wroclaw University of Science and Technology, Wybrzeze Wyspianskiego 27, 50-370 Wroclaw, Poland
| | - Alejandra Consejo
- Department of Applied Physics, University of Zaragoza, Zaragoza, Spain
- Aragon Institute for Engineering Research (I3A), University of Zaragoza, Zaragoza, Spain
| | - D. Robert Iskander
- Department of Biomedical Engineering,
Wroclaw University of Science and Technology, Wybrzeze Wyspianskiego 27, 50-370 Wroclaw, Poland
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Zhang J, Zhang L, Hu H, Sun L, He W, Zhang Z, Wang J, Nie D, Liu X. The influence of pterygium on corneal densitometry evaluated using the Oculus Pentacam system. Front Med (Lausanne) 2023; 10:1184318. [PMID: 37396900 PMCID: PMC10310544 DOI: 10.3389/fmed.2023.1184318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 05/30/2023] [Indexed: 07/04/2023] Open
Abstract
Purpose To assess the effect of pterygium on corneal densitometry (CD) values. Methods One hundred and nine patients (155 eyes) with primary pterygium were divided into a severe pterygium group (79 eyes) and a mild-to-moderate pterygium group (76 eyes) according to pterygium severity. Among them, 63 patients had monocular pterygium; and 25 patients (38 eyes) underwent pterygium excision combined with conjunctival autograft follow-up. A Pentacam anterior segment analyzer was used to obtain the CD values and corneal morphological parameters, including central corneal thickness (CCT), flat-axis keratometry (K1), steep-axis keratometry (K2), corneal astigmatism, irregular astigmatism, and spherical aberration. CD was subdivided into four concentric radial regions based on corneal diameter and three layers according to depth. Results CD values at 0-12 mm of the anterior 120 μm layer, 0-10 mm of the center layer and full thickness, and 2-6 mm of the posterior 60 μm layer were significantly higher in eyes affected by pterygium than in the contralateral unaffected eyes (all P < 0.05). CD values were significantly higher in the severe pterygium group than in the mild to moderate pterygium group (all P < 0.05). Corneal astigmatism, irregular astigmatism, K1, K2, CCT, and spherical aberration correlated with CD values in eyes with pterygium (all P < 0.05). CD values at 6-10, 0-12 mm in the anterior 120 μm layer and full thickness, 10-12 and 0-12 mm in the center layer were significantly decreased 1 month after pterygium surgery compared with those before surgery (all P < 0.05). Conclusion Patients with pterygium had increased CD values, particularly in the anterior and central layers. CD values were correlated with pterygium severity grading and corneal parameters. Pterygium surgery partially reduced the CD values.
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Affiliation(s)
- Jing Zhang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Liyun Zhang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
- Shenzhen Key Laboratory of Ophthalmology, Shenzhen Eye Hospital, Postgraduate Training Base of Jinzhou Medical University, Shenzhen, Guangdong, China
| | - Huiling Hu
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Liangnan Sun
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Wenling He
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Zhe Zhang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Jiantao Wang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Danyao Nie
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Xinhua Liu
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
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Liu X, Shao Y, Lin H, Liu C, Shen J, Zhang L, Bi Y. Corneal densitometry: an innovative method to quantitatively evaluate corneal changes after phacovitrectomy. BMC Ophthalmol 2023; 23:87. [PMID: 36879221 PMCID: PMC9987054 DOI: 10.1186/s12886-023-02818-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 02/15/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND To quantitatively investigate corneal changes and the correlation between corneal densitometry (CD) and endothelial parameters after phacovitrectomy. METHODS Thirty-eight eyes with idiopathic full-thickness macular holes (iFTMHs) and cataracts underwent phacovitrectomy. Examinations were conducted at baseline and Day 1, Day 7, Month 1, and Month 3 postoperatively. CD and central corneal thickness (CCT) were measured using Pentacam. Corneal endothelial cell density (ECD), coefficient of variation (CV), and hexagonality (HEX) were measured using specular microscopy. RESULTS ECD and HEX significantly decreased after surgery and the change in HEX occurred prior to CV. CCT increased immediately after surgery and recovered 3 months postoperatively. CD values increased significantly 1 day after surgery and then gradually decreased. For CD in the 0-2 mm zone, it took 1 month to recover in the central and posterior layers and 3 months in the anterior and total layers. For CD in the 2-6 mm zone, the central layer recovered at Day 7, the anterior and total layers recovered at 1 month, and the posterior layer did not recover until 3 months postoperatively. The CD within all layers in the 0-2 mm zone was positively correlated with CCT. Posterior CD in the 0-2 mm zone was negatively correlated with ECD and HEX. CONCLUSIONS CD is not only correlated with CCT, ECD, and HEX but also reflects the state of the whole cornea and each layer. CD can be an objective, rapid, and noninvasive tool that reflects corneal health and undetectable edema and monitors the process of lesion repair. TRIAL REGISTRATION This study was registered with the Chinese Clinical Trial Registry (31/10/2021, ChiCTR2100052554).
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Affiliation(s)
- Xin Liu
- Department of Ophthalmology, Tongji Hospital, School of Medicine, Tongji University, No. 389, Xincun Road, Putuo District, Shanghai, 200000, China.,Department of Ophthalmology, Guizhou Provincial People's Hospital, Guiyang, Guizhou, China
| | - Yuting Shao
- Department of Ophthalmology, Tongji Hospital, School of Medicine, Tongji University, No. 389, Xincun Road, Putuo District, Shanghai, 200000, China
| | - Hui Lin
- Department of Ophthalmology, Tongji Hospital, School of Medicine, Tongji University, No. 389, Xincun Road, Putuo District, Shanghai, 200000, China
| | - Chunyu Liu
- Department of Ophthalmology, Tongji Hospital, School of Medicine, Tongji University, No. 389, Xincun Road, Putuo District, Shanghai, 200000, China
| | - Jiaqi Shen
- Department of Ophthalmology, Tongji Hospital, School of Medicine, Tongji University, No. 389, Xincun Road, Putuo District, Shanghai, 200000, China
| | - Li Zhang
- Department of Ophthalmology, Tongji Hospital, School of Medicine, Tongji University, No. 389, Xincun Road, Putuo District, Shanghai, 200000, China.
| | - Yanlong Bi
- Department of Ophthalmology, Tongji Hospital, School of Medicine, Tongji University, No. 389, Xincun Road, Putuo District, Shanghai, 200000, China. .,Tongji Eye Institute, School of Medicine, Tongji University, Shanghai, China.
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Changes in corneal thickness, corneal volume, and densitometry after long-term orthokeratology wear. Cont Lens Anterior Eye 2023; 46:101703. [PMID: 35550858 DOI: 10.1016/j.clae.2022.101703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 04/23/2022] [Accepted: 04/29/2022] [Indexed: 01/18/2023]
Abstract
PURPOSE To investigate changes in the corneal volume, corneal densitometry and pachymetry of young myopes wearing over-night orthokeratology (OK) contact lenses. METHODS The medical records of 28 right eyes of young myopes wearing OK between 2013 and 2018 were reviewed retrospectively. The baseline refractive error, best corrected visual acuities at baseline and uncorrected visual acuity at the most recent visit were recorded. Corneal volume of the central 10 mm cornea; densitometry at central, nasal and temporal cornea; and pachymetry along the horizontal and vertical meridians were collected from the Pentacam® HR at baseline, after one night of lens wear, and at the latest visit. RESULTS The mean age of subjects was 12.03 ± 3.80 years at the time of OK lens fitting and wore OK overnight for a mean duration of 666 days (range 206-1736 days). The baseline spherical equivalent refractive error was -3.03 ± 1.56 D (range -1.00 to -6.00 D). The corneal volume increased significantly after OK wear (p = 0.001). Corneal densitometry increased after OK wear, but the change did not reach statistical significance (p = 0.113). Pachymetry in the central cornea did not change significantly across all visits (p > 0.05) but increased significantly in the mid-peripheral regions of the cornea. Baseline refractive error was not found to be correlated with the changes in corneal volume, corneal densitometry, or pachymetry. CONCLUSION The increase in corneal volume and densitometry and no significant change in the central corneal thickness may indicate the presence of corneal oedema from long-term OK wear. The baseline refraction was not correlated with the changes in corneal volume, densitometry or pachymetry.
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Bitton K, Zéboulon P, Ghazal W, Rizk M, Elahi S, Gatinel D. Deep Learning Model for the Detection of Corneal Edema Before Descemet Membrane Endothelial Keratoplasty on Optical Coherence Tomography Images. Transl Vis Sci Technol 2022; 11:19. [PMID: 36583911 PMCID: PMC9807180 DOI: 10.1167/tvst.11.12.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Purpose Descemet membrane endothelial keratoplasty (DMEK) is the preferred method for treating corneal endothelial dysfunction, such as Fuchs endothelial corneal dystrophy (FECD). The surgical indication is based on the patients' symptoms and the presence of corneal edema. We developed an automated tool based on deep learning to detect edema in corneal optical coherence tomography images. This study aimed to evaluate this approach in edema detection before Descemet membrane endothelial keratoplasty surgery, for patients with or without FECD. Methods We used our previously described model allowing to classify each pixel in the corneal optical coherence tomography images as "normal" or "edema." We included 1992 images of normal and preoperative edematous corneas. We calculated the edema fraction (EF), defined as the ratio between the number of pixels labeled as "edema," and those representing the cornea for each patient. Differential central corneal thickness (DCCT), defined as the difference in central corneal thickness before and 6 months after surgery, was used to quantify preoperative edema. AUC of EF for the edema detection was calculated for Several DCCT thresholds and a value of 20 µm was selected to define significant edema as it provided the highest area under the curve value. Results The area under the curve of the receiver operating characteristic curve for EF for the detection of 20 µm of DCCT was 0.97 for all patients, 0.96 for Fuchs and normal only and 0.99 for non-FECD and normal patients. The optimal EF threshold was 0.143 for all patients and patients with FECD. Conclusions Our model is capable of objectively detecting minimal corneal edema before Descemet membrane endothelial keratoplasty surgery. Translational Relevance Deep learning can help to interpret optical coherence tomography scans and aid the surgeon in decision-making.
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Affiliation(s)
- Karen Bitton
- Department of Ophthalmology, Rothschild Foundation Hospital, Paris, France
| | - Pierre Zéboulon
- Department of Ophthalmology, Rothschild Foundation Hospital, Paris, France
| | - Wassim Ghazal
- Department of Ophthalmology, Rothschild Foundation Hospital, Paris, France
| | - Maria Rizk
- Department of Ophthalmology, Rothschild Foundation Hospital, Paris, France
| | - Sina Elahi
- Department of Ophthalmology, Rothschild Foundation Hospital, Paris, France
| | - Damien Gatinel
- Department of Ophthalmology, Rothschild Foundation Hospital, Paris, France
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Balıkçı AT, Ulutaş HG, Akacı O. Evaluation of corneal and lens densitometry with Pentacam HR in children with Nephrotic Syndrome: A controlled, prospective study. Photodiagnosis Photodyn Ther 2022; 40:103184. [PMID: 36602067 DOI: 10.1016/j.pdpdt.2022.103184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 10/14/2022] [Accepted: 10/28/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND This study aimed to compare the corneal and lens densitometry values between children with Nephrotic Syndrome (NS) and healthy individuals. METHODS This cross-sectional comparative study included 23 patients with NS and 26 healthy controls. Corneal topographic and corneal and lens densitometric values were measured using Pentacam HR. Densitometry measurements in different layers were analyzed and compared between groups. Correlations between steroid cumulative dose, age at diagnosis of the disease, duration of disease, number of relapses, and patients' densitometries values were evaluated. RESULTS The measurements of the keratometry, horizontal white-to-white, and iridocorneal angle values were significantly different between groups (p < 0.05). The 0-2 mm and 2-6 mm anterior corneal densitometry values were significantly higher in NS patients. (p = 0.009 and p = 0.033, respectively). The lens densitometry values of all zones were higher in the eyes with NS but there was no statistically significant difference from the healthy control eyes (p > 0.05). There was a positive strong correlation between the cumulative steroid dose and the posterior lens zone densitometry, a positive weak correlation between the number of attacks and anterior corneal densitometry, and between disease duration and central corneal densitometry and average lens density. CONCLUSION In eyes with NS, changes occur in corneal and lens densitometry in correlation with disease duration, number of attacks, and cumulative steroid dose. Significant density changes were detected especially in the anterior cornea and central 0-6 mm area.
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Affiliation(s)
- Ayşe Tüfekçi Balıkçı
- Department of Ophthalmology, University of Health Sciences, Ankara Training and Research Hospital, Ankara, Turkey.
| | - Hafize Gökben Ulutaş
- Department of Ophthalmology, University of Health Sciences, Bursa Yüksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Okan Akacı
- Department of Pediatric Nephrology Clinic, University of Health Sciences, Bursa Yüksek Ihtisas Training and Research Hospital, Bursa, Turkey
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11
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Díez-Ajenjo MA, Luque-Cobija MJ, Peris-Martínez C, Ortí-Navarro S, García-Domene MC. Refractive changes and visual quality in patients with corneal edema after cataract surgery. BMC Ophthalmol 2022; 22:242. [PMID: 35655163 PMCID: PMC9164413 DOI: 10.1186/s12886-022-02452-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 05/12/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND To assess visual quality and stabilization of refractive changes in corneal edema patients after cataract surgery, using visual acuity (VA) and contrast sensitivity measurements. METHODS Sixty-one eyes were analysed, twenty-three with and thirty-eight without corneal edema. Uncorrected and corrected distance VA (UDVA and CDVA) were determined with an EDTRS chart, the contrast sensitivity function (CSF) under photopic and mesopic illumination conditions with a CVS-1000e chart, clinical refraction, and corneal topography. Measurements were taken preoperatively, 1-2 days, 1 and 3-months after surgery. Clinical refraction was converted to vector notation (M, J0, J45) and SPSS v26.0 was used for data analysis. RESULTS An improvement of VA was observed through the postoperative period; changes between visits were significant for CDVA in both groups and for UDVA in the edema sample. Significant astigmatic changes (J0,J45) between visits were not observed, but M values showed a hyperopic tendency in the edema group and a myopic shift in the control group that did not change between visits, with statistically significant differences between groups. Controls had significantly better contrast sensitivity at high spatial frequencies. Under mesopic conditions, global contrast sensitivity losses were observed in the edema group, which improved between visits in the middle frequency range. CONCLUSION Corneal edema patients had a significant reduction of CDVA, and frequency-selective sensitivity losses that evidence a visual quality loss. Clinical refraction may improve visual quality, but in edema patients these losses are related to corneal changes, which did not change at three months after surgery.
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Affiliation(s)
- Mª Amparo Díez-Ajenjo
- FISABIO Oftalmología Médica (FOM), Bifurcación Pío Baroja-General Avilés, s/n. E46015, Valencia, Spain
- Optics, Optometry and Visual Sciences Department, Physics Faculty, University of Valencia, Av Dr. Moliner, 50, E 46100, Burjassot, Valencia, Spain
| | - Mª José Luque-Cobija
- FISABIO Oftalmología Médica (FOM), Bifurcación Pío Baroja-General Avilés, s/n. E46015, Valencia, Spain
- Optics, Optometry and Visual Sciences Department, Physics Faculty, University of Valencia, Av Dr. Moliner, 50, E 46100, Burjassot, Valencia, Spain
- Cátedra Alcon-FISABIO-UVEG, Valencia, Spain
| | - Cristina Peris-Martínez
- FISABIO Oftalmología Médica (FOM), Bifurcación Pío Baroja-General Avilés, s/n. E46015, Valencia, Spain
- Cátedra Alcon-FISABIO-UVEG, Valencia, Spain
- Surgery Department, University of Valencia, Av Blasco Ibáñez 15, 46010, Valencia, Spain
| | - Susana Ortí-Navarro
- Optics, Optometry and Visual Sciences Department, Physics Faculty, University of Valencia, Av Dr. Moliner, 50, E 46100, Burjassot, Valencia, Spain.
| | - Mª Carmen García-Domene
- FISABIO Oftalmología Médica (FOM), Bifurcación Pío Baroja-General Avilés, s/n. E46015, Valencia, Spain
- Optics, Optometry and Visual Sciences Department, Physics Faculty, University of Valencia, Av Dr. Moliner, 50, E 46100, Burjassot, Valencia, Spain
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12
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Zhao L, Jing L, Li J, Du X. Changes in corneal densitometry after long-term orthokeratology for myopia and short-term discontinuation. PLoS One 2022; 17:e0263121. [PMID: 35120161 PMCID: PMC8815901 DOI: 10.1371/journal.pone.0263121] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 01/12/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose
To quantify changes in corneal densitometry after long-term orthokeratology treatment in myopic children and to analyze the reversibility one month after discontinuation.
Methods
Seventy-four myopic subjects aged 8–16 years, who wore orthokeratology lenses for two years, were divided into relatively steep- (lens movement within 1.0–1.5 mm, thirty-six participants) and flat-fitting groups (lens movement within 1.5–2.0 mm, thirty-eight participants). Based on refractive errors, they were divided into low and moderate myopia groups (thirty-seven participants in each group). Corneal densitometry was performed using Pentacam (Oculus Optikgeräte GmbH, Wetzlar, Germany) at each follow-up timepoint. Repeated-measures analysis of variance was used to compare the parameters before and after orthokeratology.
Results
The corneal densitometry values over the 0–10 mm diameter area increased from 12.84±1.38 grayscale units (GSU) at baseline to 13.59±1.42 GSU after three-month orthokeratology (P = .001) and reached 14.92±1.45 GSU at two years (P < .001). An increase in densitometry began at one month (P = .001) over the 0–2 mm annulus compared with that at three months over the 2–6 mm and 6–10 mm zones (P = .002,.014). The densitometry values significantly increased at three months in the relatively steep-fitting group (P = .003) and at one year in the relatively flat-fitting group (P = .001). After discontinuation of orthokeratology for one month, the values showed no significant decrease.
Conclusions
Long-term orthokeratology treatment causes a small but statistically significant increase in corneal densitometry values. During the first year, the onset of these changes was related to the fitting mode. Corneal densitometry values showed no significant reduction after one-month discontinuation.
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Affiliation(s)
- Lianghui Zhao
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
- Weifang Medical University, Weifang, China
| | - Lili Jing
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
| | - Jie Li
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
| | - Xianli Du
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
- * E-mail:
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13
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Erdinest N, London N, Levinger N, Lavy I. Therapeutic contact lens for Fuchs endothelial corneal dystrophy: Monitoring with Scheimpflug tomopraphy. Am J Ophthalmol Case Rep 2021; 25:101242. [PMID: 34950806 PMCID: PMC8671105 DOI: 10.1016/j.ajoc.2021.101242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 07/14/2021] [Accepted: 12/06/2021] [Indexed: 11/29/2022] Open
Abstract
Purpose This case report demonstrates the effectiveness of a combined unique soft contact lens design and hypertonic saline at reducing corneal edema symptoms. In addition, this case shows that using tomographic data is invaluable for detecting and monitoring of these presentations. Observations A 61 year old patient diagnosed with Fuchs endothelial corneal dystrophy (FECD) presented with complaints over the past year of intermittent blurry, foggy vision upon awakening and glare while driving. Slit lamp examination showed no signs of corneal edema. Data acquired from the Scheimpflug tomographer revealed subclinical signs, including increased corneal thickness, displacement of the thinnest point of the cornea, focal posterior depression, elevated densinometry, "camel's back" sign, irregular isopachs, and a plane slope of pachymetry progression in both eyes. The patient was fit with Therapeutic Hyper-CL™ soft contact lenses for eight days extended wear and instilled 5% sodium chloride six times a day. Visual acuity improved in the right and left eye from 0.5(-2) and 0.5(+1) to 0.4(+2) and 0.3(-1), respectively. Corneal thickness at the thinnest point decreased from 650μm to 632μm-632μm and 604μm in the right and left eye respectively and a significant decrease in total densinometry was noted from 34.7 to 33.8 standardized grayscale units (GSU) to 23.1 and 24 GSU, in the right and left eye respectively. The patient reported a decrease in symptoms and his 8-item Contact Lens Dry Eye Questionnaire (CLDEQ-8) score was 19 after treatment. Conclusions and importance Treatment for one week with Therapeutic Hyper-CL™ soft contact lenses combined with 5% sodium chloride decreased corneal edema signs and symptoms. Tomographic data facilitated diagnosis and monitoring of improvement.
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Affiliation(s)
- Nir Erdinest
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Israel
| | | | - Nadav Levinger
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Israel.,Department of Ophthalmology, Enaim Refractive Surgery Center, Jerusalem, Israel
| | - Itay Lavy
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Israel
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14
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Zéboulon P, Ghazal W, Gatinel D. Corneal Edema Visualization With Optical Coherence Tomography Using Deep Learning: Proof of Concept. Cornea 2021; 40:1267-1275. [PMID: 33410639 DOI: 10.1097/ico.0000000000002640] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 11/09/2020] [Indexed: 12/23/2022]
Abstract
PURPOSE Optical coherence tomography (OCT) is essential for the diagnosis and follow-up of corneal edema, but assessment can be challenging in minimal or localized edema. The objective was to develop and validate a novel automated tool to detect and visualize corneal edema with OCT. METHODS We trained a convolutional neural network to classify each pixel in the corneal OCT images as "normal" or "edema" and to generate colored heat maps of the result. The development set included 199 OCT images of normal and edematous corneas. We validated the model's performance on 607 images of normal and edematous corneas of various conditions. The main outcome measure was the edema fraction (EF), defined as the ratio between the number of pixels labeled as edema and those representing the cornea for each scan. Overall accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve were determined to evaluate the model's performance. RESULTS Mean EF was 0.0087 ± 0.01 in the normal scans and 0.805 ± 0.26 in the edema scans (P < 0.0001). Area under the receiver operating characteristic curve for EF in the diagnosis of corneal edema in individual scans was 0.994. The optimal threshold for distinguishing normal from edematous corneas was 6.8%, with an accuracy of 98.7%, sensitivity of 96.4%, and specificity of 100%. CONCLUSIONS The model accurately detected corneal edema and distinguished between normal and edematous cornea OCT scans while providing colored heat maps of edema presence.
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Affiliation(s)
- Pierre Zéboulon
- Department of Ophthalmology, Rothschild Foundation, Paris, France ; and
| | - Wassim Ghazal
- Department of Ophthalmology, Rothschild Foundation, Paris, France ; and
| | - Damien Gatinel
- Department of Ophthalmology, Rothschild Foundation, Paris, France ; and
- CEROC (Center of Expertise and Research in Optics for Clinicians)
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15
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Hsieh TH, Yu HJ, Yang IH, Ho RW, Hsiao YT, Fang PC, Kuo MT. Simultaneously Monitoring Whole Corneal Injury with Corneal Optical Density and Thickness in Patients Undergoing Cataract Surgery. Diagnostics (Basel) 2021; 11:diagnostics11091639. [PMID: 34573979 PMCID: PMC8471687 DOI: 10.3390/diagnostics11091639] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 09/02/2021] [Accepted: 09/03/2021] [Indexed: 02/05/2023] Open
Abstract
To pursue the least corneal implication during cataract surgery, this study aimed to monitor corneal wound injury after cataract surgery with a novel method. The prospective cohort study involved thirty-two patients, who were assessed by a Scheimpflug tomography AxL® (Oculus GmbH, Wetzlar, Germany) via the following two kinds of indices: whole corneal optical density (COD) and corneal thickness (CT), two weeks before and one month after cataract surgery. The results of the COD revealed that corneal annuli 0.0–2.0 mm and 2.0–6.0 mm, and the average and maximal values at the incisional site significantly increased postoperatively. Also, the anterior and central stroma of 0.0–2.0 mm, and all three depths of 2.0–6.0 mm, increased remarkably after the operation. For the CT, all ranges of diameters plus incisional sites showed significant increases postoperatively. Furthermore, we analyzed the differences (delta) of COD and CT between pre- and post-operation, and found significant correlations between the delta of COD and the delta of CT, regarding annuli 0.0–2.0 mm, 2.0–6.0 mm, and 6.0–10.0 mm, but no correlation at the incisional site, with either average density or maximal density, was detected. We concluded that whole COD and CT, especially at the central zones of the cornea (annulus < 6 mm), are both valuable parameters in the assessment of corneal damage post-cataract surgery, and are independent indices at the incisional site.
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Affiliation(s)
- Tzu-Han Hsieh
- Department of Medical Education, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City 83301, Taiwan;
| | - Hun-Ju Yu
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City 83301, Taiwan; (H.-J.Y.); (I.-H.Y.); (R.-W.H.); (Y.-T.H.)
| | - I-Hui Yang
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City 83301, Taiwan; (H.-J.Y.); (I.-H.Y.); (R.-W.H.); (Y.-T.H.)
| | - Ren-Wen Ho
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City 83301, Taiwan; (H.-J.Y.); (I.-H.Y.); (R.-W.H.); (Y.-T.H.)
| | - Yu-Ting Hsiao
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City 83301, Taiwan; (H.-J.Y.); (I.-H.Y.); (R.-W.H.); (Y.-T.H.)
| | - Po-Chiung Fang
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City 83301, Taiwan; (H.-J.Y.); (I.-H.Y.); (R.-W.H.); (Y.-T.H.)
- Correspondence: (P.-C.F.); (M.-T.K.)
| | - Ming-Tse Kuo
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City 83301, Taiwan; (H.-J.Y.); (I.-H.Y.); (R.-W.H.); (Y.-T.H.)
- Correspondence: (P.-C.F.); (M.-T.K.)
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16
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Zhao J, Yang W, Zhao J, Shen Y, Sun L, Han T, Wang X, Yao P, Zhou X. A four-year observation of corneal densitometry after implantable collamer lens V4c implantation. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:536. [PMID: 33987234 DOI: 10.21037/atm-20-6628] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background To observe the changes in corneal densitometry (CD) with a Pentacam after implantable collamer lens (ICL) V4c implantation in myopia patients, and to investigate potential influencing factors. Methods We reviewed 65 eyes of 33 patients (mean age, 29.08±5.54 years) with myopia or myopic astigmatism who underwent ICL V4c implantation. Clinic parameters and Pentacam images of corneal topography and CD were obtained pre- and postoperatively. Results After an average of 52±2.2 months follow-up, the efficacy and safety indexes assessed at the last follow-up were 1.03±0.18 and 1.21±0.21, respectively. Except in the central annular zone of 0-2 mm, the CD values increased significantly at postoperative day 1 and decreased significantly until postoperative 1 year (P<0.05). The increase in CD values at different annular zones at postoperative day 1 was ranked as: 0-2 mm <2-6 mm < 6-10 mm. No significant difference was observed in corneal density at 1 week, 1 month, and 1-year follow-up when compared with the preoperative value (P>0.05). The CD value at 4 years follow-up increased significantly and correlated positively with age and preoperative uncorrected distance visual acuity, and negatively with preoperative spherical equivalent and intraocular pressure (IOP) (P<0.05). Conclusions ICL V4c implantation demonstrated safety and efficacy for myopia correction. The CD value increased at 4 years postoperatively and correlated with age, preoperative spherical equivalent, uncorrected distance visual acuity, and IOP.
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Affiliation(s)
- Jing Zhao
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Wen Yang
- Department of Ophthalmology, The Third People's Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, Chengdu, China
| | - Jiao Zhao
- Department of Ophthalmology, People's Hospital of Leshan, Leshan, China
| | - Yang Shen
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Ling Sun
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Tian Han
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xiaoying Wang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Peijun Yao
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xingtao Zhou
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
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17
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Elmekawey H, Abdelaziz M, El Baradey M, Kotb M. Epithelial Remodeling Following Phacoemulsification in Diabetic Patients Using Anterior-Segment Optical Coherence Tomography: A Comparative Study. Clin Ophthalmol 2020; 14:2515-2523. [PMID: 32921979 PMCID: PMC7457868 DOI: 10.2147/opth.s266464] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 07/27/2020] [Indexed: 11/26/2022] Open
Abstract
Purpose To compare the effect of phacoemulsification on corneal epithelial thickness in diabetic and nondiabetic cataract patients. Methods Fifty eyes with cataracts were enrolled in a prospective comparative interventional study. They were divided into two groups: group A (diabetics) and group B (nondiabetics) and underwent uneventful phacoemulsification. Epithelial thickness was assessed in the central, paracentral, and peripheral cornea on the first day and at 1 week, 1 month, and 3 months postoperatively using spectral-domain ocular coherence tomography. Results A significant increase in the first-day postoperative central epithelial thickness was noticed in both groups (57.16±3.5 µm and 55.96±2.81 µm in groups A and B, respectively), with increased baseline epithelial thickness of 3.8±2.1 µm and 3.4±2.14 µm in groups A and B, respectively (P<0.001). A significant decrease in epithelial thickness was noticed in both groups after 1 week (−2.40±3.1 µm and −2.76±2.71 µm in group A and B, respectively). No further significant change was noticed in the nondiabetic group at 1 month; however, significant reductions in for central epithelial thickness were found in the diabetic group up to the first month (−0.80±1.9 µm, P=0.05). Central corneal thickness followed the same pattern of change as the epithelium. A nonsignificant delay in visual acuity improvement was noticed in diabetic patients. Conclusion Phacoemulsification induces a temporary increase in corneal and epithelial thickness that should resolve by the first week postoperatively. However, diabetic patients had slower epithelial recovery that took up to 1 month, which could be reflected in delayed visual recovery with no effect on the final visual outcome.
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Affiliation(s)
- Hany Elmekawey
- Ophthalmology, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Magda Abdelaziz
- Ophthalmology, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohamed El Baradey
- Ophthalmology, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohamed Kotb
- Ophthalmology, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
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18
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Phacoemulsification in the Setting of Corneal Endotheliopathies: A Review. Int Ophthalmol Clin 2020; 60:71-89. [PMID: 32576725 DOI: 10.1097/iio.0000000000000315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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19
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20
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Chen X, Shen Y, Xu H, Wang X, Zhou X. One-year natural course of corneal densitometry in high myopic patients after implantation of an implantable collamer lens (model V4c). BMC Ophthalmol 2020; 20:50. [PMID: 32050942 PMCID: PMC7017626 DOI: 10.1186/s12886-020-1320-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 01/17/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Corneal densitometry, which is also known as corneal backscattering, is a surrogate measure of corneal clarity. The purpose of the study was to investigate the changes in corneal densitometry (CD) after implanting an implantable collamer lens (ICL-V4c). METHOD Twenty-six high myopic patients (aged 29.3 ± 6.6 years, 6 males and 20 females) who underwent ICL-V4c implantation were enrolled. Intraocular pressure (IOP), corneal topography, corneal densitometry, uncorrected distance visual acuity (UCDVA), manifest refraction, and best corrected distance visual acuity (BCDVA) were evaluated pre-operatively and at 1 day, 1 week, and 1, 3, 6, and 12 months post-operatively. Endothelial cell density (ECD) was measured pre-operatively and at 3, 6, and 12 months post-operatively. The efficacy index (mean post-operative UCDVA / mean pre-operative BCDVA) and the safety index (mean post-operative BCDVA / mean pre-operative BCDVA) were evaluated at 1 month, 3 months, 6 months and 12 months post-operatively. RESULTS Over the annular diameters of 0-2 mm, the pre-operative densitometry values of the anterior layer, central layer, posterior layer, and total layer were 20.1 ± 2.8, 11.8 ± 1.1, 10.5 ± 0.9 and 14.1 ± 1.5, respectively. From pre-operatively to post-operative Month 12, the values changed insignificantly (P = 0.177, P = 0.153, P = 0.543 and P = 0.207, respectively). Over the annular diameters of 2-6 mm, the pre-operative mean densitometry values were 17.9 ± 2.2, 10.5 ± 0.9, and 12.6 ± 1.2, respectively. From pre-operatively to post-operative Month 12, the values decreased to 16.5 ± 2.1, 10.0 ± 0.9, and 11.9 ± 1.2, respectively, which were similar to the pre-operative values (all P > 0.05) but significantly lower than the values obtained at post-operative Day 1 (P = 0.013, P = 0.002 and P = 0.010, respectively). The densitometry value of the posterior layer over the annular diameters of 2 to 6 mm remained unchanged (from 9.4 ± 0.7 to 9.1 ± 0.7) over time (P = 0.372). The efficacy and safety indices assessed at 12 months post-operatively were 1.04 ± 0.27 and 1.19 ± 0.23, respectively. The changes in IOP and ECD values were statistically insignificant (P = 0.896 and P = 0.968, respectively). CONCLUSION ICL-V4c implantation may be safe and efficient for high ametropia correction. The corneal densitometry values obtained over the annulus of 0-6 mm increased slightly from before the operation to post-operative Day 1 and then decreased gradually, which indicates that ICL-V4c implantation may not compromise corneal clarity.
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Affiliation(s)
- Xun Chen
- The Eye and ENT Hospital of Fudan University, 19 Baoqing Road, Xuhui District, Shanghai, Zip code: 200031, China.,NHC Key Lab of Myopia (Fudan University), Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Yang Shen
- The Eye and ENT Hospital of Fudan University, 19 Baoqing Road, Xuhui District, Shanghai, Zip code: 200031, China.,NHC Key Lab of Myopia (Fudan University), Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Haipeng Xu
- The Eye and ENT Hospital of Fudan University, 19 Baoqing Road, Xuhui District, Shanghai, Zip code: 200031, China.,NHC Key Lab of Myopia (Fudan University), Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xiaoying Wang
- The Eye and ENT Hospital of Fudan University, 19 Baoqing Road, Xuhui District, Shanghai, Zip code: 200031, China. .,NHC Key Lab of Myopia (Fudan University), Shanghai, China. .,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China.
| | - Xingtao Zhou
- The Eye and ENT Hospital of Fudan University, 19 Baoqing Road, Xuhui District, Shanghai, Zip code: 200031, China.,NHC Key Lab of Myopia (Fudan University), Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
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21
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Mounir A, Zidan OF, Awny I, Mostafa EM. A Case of Artificial Snow Foam induced Corneal Endotheliitis Followed up by Scheimpflug Densitometry. MEDICAL HYPOTHESIS, DISCOVERY & INNOVATION OPHTHALMOLOGY JOURNAL 2019; 8:64-68. [PMID: 31263714 PMCID: PMC6592304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The aim was to present a rare case of artificial snow foam induced corneal endotheliitis followed up by Scheimpflug Densitometry. A 15-year-old male complained of redness, tearing and reduced vision in the left eye after artificial snow foam entered his left eye 4 days before the presentation. Slit lamp examination of the same eye showed ciliary injection with corneal edema with no epithelial defect and endothelial lesion measuring 3 × 4 millimeters (mm) with large keratic precipitates (KP). Examining the left eye by the Scheimpflug densitometry of the Sirius device (CSO, Florence, Italy) showed plaque on the back of the cornea. Aqueous tab Polymerase chain reaction analysis (PCR) results for the affected eye had negative results for viral infection. Improvement of ocular symptoms occurred after treatment with topical steroid therapy. Scheimpflug densitometry showed disappearance of the saw-tooth protrusions on the back of the cornea with decreased reflectivity. Corneal endotheliitis can be triggered by chemical ocular trauma. The Scheimpflug densitometry examination may be a useful noninvasive method for reaching a clinical diagnosis of corneal endotheliitis and monitoring treatment effectiveness.
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Affiliation(s)
- Amr Mounir
- Department of Ophthalmology, Sohag Faculty of Medicine, Sohag University, Sohag, Egypt
| | | | - Islam Awny
- Department of Ophthalmology, Sohag Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Engy Mohamed Mostafa
- Department of Ophthalmology, Sohag Faculty of Medicine, Sohag University, Sohag, Egypt
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22
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Kim B, Mun S, Kim J, Yang Y, Moon J, Chung Y. Short-term Clinical Outcomes of Small Incision Lenticule Extraction for Correction of Myopia Patients with Corneal Opacity. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2019. [DOI: 10.3341/jkos.2019.60.8.719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Buki Kim
- Onnuri Smile Eye Clinic, Seoul, Korea
| | | | - Jisun Kim
- Onnuri Smile Eye Clinic, Seoul, Korea
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