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GCABASHE NONKULULEKOM, MOODLEY VANESSARAQUEL, HANSRAJ REKHA. Prevalence and clinical profile of keratoconus in patients presenting at a provincial hospital in KwaZulu, Natal, South Africa: A case study. J Public Health Afr 2023; 14:2356. [PMID: 37942062 PMCID: PMC10628798 DOI: 10.4081/jphia.2023.2356] [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: 10/18/2022] [Accepted: 12/16/2022] [Indexed: 11/10/2023] Open
Abstract
Keratoconus (KC) is a progressive, asymmetrical corneal disease, characterized by stromal thinning that leads to distortion, causing vision loss. The visual loss is secondary to corneal scarring, irregular astigmatism, and myopia. The prevalence of KC has been reported to differ in different parts of the world. The study aimed to determine the prevalence and profile of patients with KC presenting to a provincial hospital in KwaZulu-Natal, South Africa. A retrospective study design was used to review 412 clinical records of patients attending the McCord Provincial Eye Hospital (MPEH) during a five-year period (2016-2020). Data on age, race, refraction, clinical profile, treatment plan, and diagnosis were ascertained. The prevalence of KC in MPEH was found to be 13.7% with a mean age of 24.7±7.94 years. Black African and females had a higher frequency of KC compared to males and other ethnic groups. Most of the patients presented with a severe stage of KC and referral was the most common management. Central corneal thinning and Munson's sign were the most prevalent clinical signs. There was no statistically significant difference between the worse and better eye when comparing the clinical signs. The prevalence and clinical profile of patients with KC in this study was similar to that reported by previous studies and more in Blacks and females. Population based epidemiological studies are needed to determine the prevalence of KC in South Africa to enable early clinical interventions.
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Affiliation(s)
- NONKULULEKO M. GCABASHE
- Discipline of Optometry, School of Health Science, University of KwaZulu-Natal, Durban, South Africa
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Doctor K, Vunnava KP, Shroff R, Kaweri L, Lalgudi VG, Gupta K, Kundu G. Simplifying and understanding various topographic indices for keratoconus using Scheimpflug based topographers. Indian J Ophthalmol 2021; 68:2732-2743. [PMID: 33229649 PMCID: PMC7856941 DOI: 10.4103/ijo.ijo_2111_20] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Keratoconus (KC) is a progressive ectatic corneal disorder. There are multiple topographic devices and their varied indices used for diagnosis, detecting progression, and deciding management. It is important to understand the repeatablility, intra- test variabililty, and comparability amongst various topographic devices. The Scheimpflug camera-based devices, such as the Pentacam (Oculus, Wetzlar, Germany), Galilei (Ziemer, Biel, Switzerland), and Sirius (Costruzione Strumenti Oftalmici, Florence, Italy) are known to assist in the detection of early keratoconus and subclinical keratoconus. This article reviews the various Scheimpflug camera-based devices in depth, addressing their different indices, diagnostic accuracy, repeatability, and agreement and identifying the strongest parameter of each device. It will guide the practicing clinician by giving practical tips for decision making in the diagnosis and management of keratoconus.
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Affiliation(s)
| | | | - Rushad Shroff
- Cornea, Refractive Surgery and Cataract Services, Shroff Eye Centre, New Delhi, India
| | - Luci Kaweri
- Cataract and Refractive Surgery Services, Narayana Nethralaya Eye Institute, Bengaluru, Karnataka, India
| | | | - Krati Gupta
- Cornea and Refractive Surgery Services, Narayana Nethralaya Eye Institute, Bengaluru, Karnataka, India
| | - Gairik Kundu
- Cornea and Refractive Surgery Services, Narayana Nethralaya Eye Institute, Bengaluru, Karnataka, India
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Kankariya VP, Dube AB, Grentzelos MA, Kontadakis GA, Diakonis VF, Petrelli M, Kymionis GD. Corneal cross-linking (CXL) combined with refractive surgery for the comprehensive management of keratoconus: CXL plus. Indian J Ophthalmol 2020; 68:2757-2772. [PMID: 33229651 PMCID: PMC7856931 DOI: 10.4103/ijo.ijo_1841_20] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
The past two decades have witnessed an unprecedented evolution in the management of keratoconus that demands a holistic approach comprising of inhibiting the ectatic progression as well as visual rehabilitation. The advent of corneal cross-linking (CXL) in the late 1990s resulted in long-term stabilization of the ectatic cornea along with limited reduction in corneal steepening and regularization of corneal curvature. However, CXL as a standalone procedure does not suffice in rehabilitating the functional vision especially in patients who are unwilling or intolerant towards contact lenses. The concept of “CXL plus” was proposed which incorporates adjunctive use of refractive procedures with CXL in order to overcome the optical inefficiency due to corneal irregularity, decrease the irregular astigmatism, correct the residual refractive error and improve functional visual outcome in keratoconus. Several refractive procedures such as conductive keratoplasty (CK), photorefractive keratectomy (PRK), transepithelial phototherapeutic keratectomy (t-PTK), intrastromal corneal ring segments (ICRS) implantation, phakic intraocular lens (PIOL) implantation and multiple other techniques have been combined with CXL to optimize and enhance the CXL outcome. This review aimed to summarize the different protocols of CXL plus, provide guidelines for selection of the optimum CXL plus technique and aid in decision-making for the comprehensive management of cases with primary keratoconus in addition to discussing the future and scope for innovations in the existing treatment protocols.
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Affiliation(s)
| | - Ankita B Dube
- Asian Eye Hospital and Laser Institute, Pune, Maharashtra, India
| | - Michael A Grentzelos
- Asian Eye Hospital and Laser Institute, Pune, Maharashtra, India; Department of Ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, Lausanne, Switzerland
| | - George A Kontadakis
- Laboratory of Vision and Optics, Medical School, University of Crete, Heraklion, Greece
| | | | - Myrsini Petrelli
- Department of Ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, Lausanne, Switzerland
| | - George D Kymionis
- Department of Ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, Lausanne, Switzerland
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Deshpande K, Shroff R, Biswas P, Kapur K, Shetty N, Koshy AS, Khamar P. Phakic intraocular lens: Getting the right size. Indian J Ophthalmol 2020; 68:2880-2887. [PMID: 33229663 PMCID: PMC7856930 DOI: 10.4103/ijo.ijo_2326_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Phakic intraocular lenses (IOL) are a boon for patients who want spectacle independence but are unable to get refractive correction through laser platforms due to high refractive error or certain corneal contraindications. Phakic IOL's (PIOL) have their own set of complications and challenges, the most important being getting the sizing right. This paper attempts to solve the problem of accurate sizing of PIOL's. Parameters needed for calculating the ideal size of PIOL's have been studied in a step by step manner using all possible tools depending upon the availability and preference of the surgeon. The pros and cons of using a particular tool for measurements have been highlighted along with illustrative case examples to help surgeons who are starting PIOL implantation surgery.
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Affiliation(s)
- Kalyaani Deshpande
- Department of Cataract and Refractive Surgery, Mumbai Eye, Brain and Spine Clinic, Mumbai, Maharashtra, India
| | - Rushad Shroff
- Department of Cataract, Cornea, and Refractive Surgery, Shroff Eye Centre, New Delhi, India
| | - Partha Biswas
- Department of Cataract and Refractive Surgery, Director, B B Eye Foundation, Kolkata, West Bengal, India
| | - Kamal Kapur
- Department of Cataract and Refractive Surgery, Director, Sharp Sight Laser Centre Pvt Ltd, New Delhi, India
| | - Naren Shetty
- Department of Cataract and Refractive Surgery, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Ann Sarah Koshy
- Department of Cataract and Refractive Surgery, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Pooja Khamar
- Department of Cataract and Refractive Surgery, Narayana Nethralaya, Bengaluru, Karnataka, India
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Averich VV, Avetisov KS, Alkhumidi K, Avetisov SE. [Phacosurgery features in keratoconus]. Vestn Oftalmol 2020; 136:296-300. [PMID: 33063980 DOI: 10.17116/oftalma2020136052296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The review summarizes the results of surgical treatment of cataracts in patients with keratoconus. The major challenges of phacosurgery in keratoconus are associated with intraocular lens (IOL) power calculation, choice of the most appropriate IOL model and additional interventions required to stabilize keratectasia and reduce corneal irregularity.
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Affiliation(s)
- V V Averich
- Research Institute of Eye Diseases, Moscow, Russia
| | - K S Avetisov
- Research Institute of Eye Diseases, Moscow, Russia
| | - K Alkhumidi
- Research Institute of Eye Diseases, Moscow, Russia
| | - S E Avetisov
- Research Institute of Eye Diseases, Moscow, Russia.,I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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Arej N, Chanbour W, Zaarour K, Amro M, El-Rami H, Harb F, Jarade E. Management of cataract in keratoconus: early visual outcomes of different treatment modalities. Int J Ophthalmol 2019; 12:1654-1658. [PMID: 31637205 DOI: 10.18240/ijo.2019.10.21] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 04/08/2019] [Indexed: 11/23/2022] Open
Abstract
A review of 31 eyes with keratoconus who developed cataract and underwent phacoemulsification. Visual acuities were measured 1mo postoperatively. Six eyes with a history of good corrected distance visual acuity (CDVA) and a similar refractive and topographic astigmatic axis were implanted with toric intraocular lenses (IOLs). The mean postoperative uncorrected distance visual acuity (UDVA) was 0.2 logMAR with a spherical equivalent (SE): 0.75D. Eleven eyes with a history of good CDVA and different refractive and topographic axis were implanted with monofocal IOL+/-Toric implantable collamer lenses to treat anisometropia and ametropia; mean UDVA was 0.25 logMAR with a mean SE: -0.51 D postoperatively. Six eyes with poor CDVA were first treated with intra-corneal ring segments, followed by phacoemulsification, the mean postoperative UDVA was 0.82 logMAR with an SE: 0.22 D. Eight eyes had advanced ectesia and received combined phacoemulsification and penetrating keratoplasty. Our approach is efficient in addressing ametropia after cataract surgery in keratoconic eyes.
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Affiliation(s)
- Nicolas Arej
- Department of Ophthalmology, Faculty of Medicine, Saint-Joseph University of Beirut, Beirut 11-5208, Lebanon.,Beirut Eye & ENT Specialist Hospital, Beirut 116-5311, Lebanon
| | - Wassef Chanbour
- Beirut Eye & ENT Specialist Hospital, Beirut 116-5311, Lebanon.,Department of Ophthalmology, Faculty of Medicine, Lebanese University, Beirut 14-6573, Lebanon
| | - Karen Zaarour
- Department of Ophthalmology, Faculty of Medicine, Saint-Joseph University of Beirut, Beirut 11-5208, Lebanon.,Beirut Eye & ENT Specialist Hospital, Beirut 116-5311, Lebanon
| | - Mazen Amro
- Beirut Eye & ENT Specialist Hospital, Beirut 116-5311, Lebanon.,Department of Ophthalmology, Faculty of Medicine, Lebanese University, Beirut 14-6573, Lebanon
| | - Hala El-Rami
- Beirut Eye & ENT Specialist Hospital, Beirut 116-5311, Lebanon
| | - Fadi Harb
- Beirut Eye & ENT Specialist Hospital, Beirut 116-5311, Lebanon
| | - Elias Jarade
- Department of Ophthalmology, Faculty of Medicine, Saint-Joseph University of Beirut, Beirut 11-5208, Lebanon.,Beirut Eye & ENT Specialist Hospital, Beirut 116-5311, Lebanon.,Department of Ophthalmology, Faculty of Medicine, Lebanese University, Beirut 14-6573, Lebanon.,Mediclinic Dubai Mall, Dubai 282890, United Arab Emirates
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Ramin S, Sangin Abadi A, Doroodgar F, Esmaeili M, Niazi F, Niazi S, Alinia C, Golestani Y, Taj Abadi R. Comparison of Visual, Refractive and Aberration Measurements of INTACS versus Toric ICL Lens Implantation; A Four-year Follow-up. MEDICAL HYPOTHESIS, DISCOVERY & INNOVATION OPHTHALMOLOGY JOURNAL 2018; 7:32-39. [PMID: 29644243 PMCID: PMC5887605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
This study was performed to evaluate the visual, refractive, and aberration measurement results of 2 implants, including Intacs Intracorneal Ring Segments (ICRS) and phakic Toric Implantable Collamer Lens (TICL), in patients with moderate Keratoconus (KCN). In this retrospective cross-sectional study, 30 patients with KCN with a mean age of 29.83 years were included in 2 groups, including the Intacs Intracorneal Ring Segments (ICRS) group and the phakic Toric Implantable Collamer Lens (TICL) group. Preoperative data as well as 6-month, 1-, 2-, 3- and 4-year follow-up data after the operation were collected and analyzed with the SPSS software (ver. 23.0, SPSS, Inc., Chicago, IL), using the paired t-test, independent t-test, repeated measures Analysis of Variance (ANOVA), and one-way ANOVA. This study included 30 patients with KCN with a mean age of 29.83 years and range of 25 to 35 years, including 17 males with a mean age of 30.11 years and 13 female with a mean age of 29.25 years. Except for preoperative Uncorrected Distance Visual Acuity (UCDVA), Spherical Equivalent (SE) and astigmatism, there was a significant difference between the 2 groups regarding other variables. The TICL group had a significantly better UCDVA and Best Corrected Distance Visual Acuity (BCDVA) in all post-operative follow-ups, and SE and astigmatism values were significantly lower in all post-operative follow-ups when compared with the ICRS group. There was a significant reduction in corneal and total coma as well as internal trefoil aberrations (P<0.01, P<0.01, and P=0.014, respectively) in the ICRS group, and TICL led to a significant reduction in internal trefoil aberration with P<0.03. Comparison of the 2 groups revealed a significant difference in corneal spherical (P<0.01) and total coma (P=0.02) aberrations and no significant differences in other HOA. Both ICRS and TICL are useful in patients with moderate KCN. However, TICL appears to have more stable and predictable vision results.
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Affiliation(s)
- Shahrokh Ramin
- Faculty of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | | | - Mehrdad Esmaeili
- Faculty of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Faizollah Niazi
- Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sana Niazi
- Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Cyrus Alinia
- Department of Public Health, Urmia University of Medical Sciences, Urmia, West Azerbaijan, Iran
| | - Yaser Golestani
- Faculty of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Taj Abadi
- Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Doroodgar F, Niazi F, Sanginabadi A, Niazi S, Baradaran-Rafii A, Alinia C, Azargashb E, Ghoreishi M. 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). BMJ Open Ophthalmol 2017; 2:e000090. [PMID: 29354720 PMCID: PMC5721648 DOI: 10.1136/bmjophth-2017-000090] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 07/28/2017] [Accepted: 08/24/2017] [Indexed: 11/23/2022] Open
Abstract
Aims To 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). Methods Forty 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. Results At 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. Conclusion The results from this standardised clinical investigation support TICL implantation from clinical and optical viewpoints in patients with stable keratoconus. Trial registration number NCT02833649, Pre-results
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Affiliation(s)
- Farideh Doroodgar
- Ophthalmology Department, Eye Research Center Tehran University of Medical Sciences, Tehran, Tehran, Iran
| | - Feazollah Niazi
- Shahid Beheshti University of Medical Sciences and Health Services , Chamran Highway, Daneshjoo Street, Tehran, Iran, Thran, Tehran, Iran
| | - Azad Sanginabadi
- Ophthalmology Department, Eye Research Center Tehran University of Medical Sciences, Tehran, Tehran, Iran
| | - Sana Niazi
- Shahid Beheshti University of Medical Sciences and Health Services , Chamran Highway, Daneshjoo Street, Tehran, Iran, Tehran, Tehran, Iran
| | - Alireza Baradaran-Rafii
- Shahid Beheshti University of Medical Sciences and Health Services , Chamran Highway, Daneshjoo Street, Tehran, Iran, Tehran, Tehran, Iran
| | - Cyrus Alinia
- Department of Public Health, Urmia University of Medical Sciences, Urmia, West Azerbaijan, Iran
| | - Eznollah Azargashb
- Shahid Beheshti University of Medical Sciences and Health Services , Chamran Highway, Daneshjoo Street, Tehran, Iran, Tehran, Tehran, Iran
| | - Mohammad Ghoreishi
- Ophthalmology Department, Isfahan University of Medical Sciences, Isfahan, Isfahan, Iran
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Prakash G, Avadhani K, Kalliath J, Srivastava D. Implantable collamer lens in a case of corneal scar with anisometropic amblyopia in an adult: an expanded indication. BMJ Case Rep 2015; 2015:bcr-2014-208862. [PMID: 25743868 DOI: 10.1136/bcr-2014-208862] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 35-year-old man, a unilateral high myope with corneal scarring, presented for evaluation. He had a stromal scar that started temporally, traversed along the pupillary zone partially and extended across the horizontal diameter of the cornea. The Descemet's membrane appeared intact even though the scar was extending into deep stroma towards the nasal end, as seen in the optical coherence tomography image. The patient had an uncorrected distance visual acuity (UDVA) of 4/60 OD, which improved with a refraction of -9.0 DS/-1.50 DC at 15 to 6/18p and 6/6p OS. He underwent an uneventful toric implantable collamer lens (ICL) implantation of -15.0 D/-2.0 D at 102 after preoperative yttrium-aluminium-garnet (YAG) laser iridotomy in the right eye. The postoperative UDVA and corrected distance visual acuity for the right eye were 6/12 and 6/9p (with a refraction of +0.50 D/-0.50 D at 85), respectively. The corneal scar and topography were stable. This case reports an expanded indication for toric ICL in cases with corneal scar/opacity but good spectacle corrected visual acuity.
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Affiliation(s)
- Gaurav Prakash
- Department of Cornea and Refractive Surgery Services, NMC Eye Care, NMC Specialty Hospital, Abu Dhabi, UAE
| | | | - Jay Kalliath
- NMC Eye Care, NMC Specialty Hospital, Abu Dhabi, UAE
| | - Dhruv Srivastava
- Department of Cornea and Refractive Surgery Services, NMC Eye Care, NMC Specialty Hospital, Abu Dhabi, UAE
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Shetty R, Kaweri L, Pahuja N, Nagaraja H, Wadia K, Jayadev C, Nuijts R, Arora V. Current review and a simplified "five-point management algorithm" for keratoconus. Indian J Ophthalmol 2015; 63:46-53. [PMID: 25686063 PMCID: PMC4363958 DOI: 10.4103/0301-4738.151468] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2014] [Accepted: 01/26/2015] [Indexed: 11/04/2022] Open
Abstract
Keratoconus is a slowly progressive, noninflammatory ectatic corneal disease characterized by changes in corneal collagen structure and organization. Though the etiology remains unknown, novel techniques are continuously emerging for the diagnosis and management of the disease. Demographical parameters are known to affect the rate of progression of the disease. Common methods of vision correction for keratoconus range from spectacles and rigid gas-permeable contact lenses to other specialized lenses such as piggyback, Rose-K or Boston scleral lenses. Corneal collagen cross-linking is effective in stabilizing the progression of the disease. Intra-corneal ring segments can improve vision by flattening the cornea in patients with mild to moderate keratoconus. Topography-guided custom ablation treatment betters the quality of vision by correcting the refractive error and improving the contact lens fit. In advanced keratoconus with corneal scarring, lamellar or full thickness penetrating keratoplasty will be the treatment of choice. With such a wide spectrum of alternatives available, it is necessary to choose the best possible treatment option for each patient. Based on a brief review of the literature and our own studies we have designed a five-point management algorithm for the treatment of keratoconus.
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Affiliation(s)
- Rohit Shetty
- Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bengaluru, India
| | - Luci Kaweri
- Department of Cataract and Refractive Lens Surgery, Narayana Nethralaya, Bengaluru, India
| | - Natasha Pahuja
- Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bengaluru, India
| | - Harsha Nagaraja
- Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bengaluru, India
| | - Kareeshma Wadia
- Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bengaluru, India
| | - Chaitra Jayadev
- Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bengaluru, India
| | - Rudy Nuijts
- Department of Ophthalmology, Maastricht University Medical Center, Netherlands
| | - Vishal Arora
- Department of Cataract and Refractive Lens Surgery, Narayana Nethralaya, Bengaluru, India
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Price MO, Price FW. Evaluation of the toric implantable collamer lens for simultaneous treatment of myopia and astigmatism. Expert Rev Med Devices 2014; 12:25-39. [PMID: 25418502 DOI: 10.1586/17434440.2015.984685] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Myopic astigmatism is a prevalent condition that can be treated with spectacles, contact lenses, or laser refractive surgery. However, these treatment options have functional limitations at higher levels of refractive error. The toric implantable collamer lens is designed to treat a broad range of refractive error, generally up to -18 diopters with +1 to +6 diopters of astigmatism. Approval for a more limited treatment range of up to 15 diopters of myopia with +1 to +4 diopters of astigmatism is being sought in the US, where this device has not yet received marketing approval. Surgical correction of high-myopic astigmatism can be life-altering and allow people to participate in activities that were not previously feasible because of visual limitations. The toric implantable collamer lens is implanted behind the iris and in front of the natural crystalline lens. With earlier lens designs, it was necessary to create an iridectomy or iridotomy to prevent pupillary block. The newest toric implantable collamer lens model has a small central hole that is not visually noticeable. This eliminates the need to create a hole in the iris, thereby enhancing the safety of the procedure.
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Affiliation(s)
- Marianne O Price
- Cornea Research Foundation of America, 9002 N. Meridian St, Suite 212, Indianapolis, IN 46260, USA
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