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Corneal Defects, Abrasions and Foreign Bodies
Published in Amy-lee Shirodkar, Gwyn Samuel Williams, Bushra Thajudeen, Practical Emergency Ophthalmology Handbook, 2019
Corneal epithelial defects (ED) and corneal foreign bodies (FB) occur as a result of mechanical trauma and need to be examined for in this context, including everting the eyelids. Corneal defects can also be iatrogenic as a result of several surgical procedures: post corneal crosslinking, post laser refractive surgery or superficial keratectomy. In these cases debridement of the epithelium is performed purposefully but also, not uncommonly, can occur iatrogenically after intravitreal injection or cataract surgery – when one mistakenly scratches the eye with a piece of equipment.
Mycotic Keratitis
Published in Mahendra Rai, Marcelo Luís Occhiutto, Mycotic Keratitis, 2019
Mahendra Rai, Avinash P. Ingle, Indarchand Gupta, Pramod Ingle, Priti Paralikar, Marcelo Luís Occhiutto
In addition to pharmacological treatments, surgery and corneal crosslinking are considered as effective approaches in the management of MK. Surgery is generally recommended when a response to the pharmacological agent is poor and there are more chances of spreading of infections. In surgery like periodic debridement, the necrotic, infectious and antigenic portion is removed to develop a favourable environment for pharmacological agents for fast healing (Thomas and Kaliamurthy 2013, Acharya et al. 2017). Similarly, corneal crosslinking has also demonstrated excellent ulcer healing properties, and also showed the overall reduction in inflammation to the anterior chamber, i.e., uvea and iris (hypopyon formation) (Acharya et al. 2017).
Anterior segment inflammation and its association with dry eye parameters following myopic SMILE and FS-LASIK
Published in Annals of Medicine, 2023
Jian Zhao, Yuan Li, Tianyun Yu, Wenhao Wang, Mutsvene Tinashe Emmanuel, Qianwen Gong, Liang Hu
Inflammation is one of the pathogenic factors involved in the vicious cycle of DED [6,7], therefore anterior segment inflammation caused by LVC might be a critical participant in post-LVC DED. Proper evaluation of inflammation may shed some light on the assessment of DED severity, application of anti-inflammatory medication, and improvement in patient satisfaction following LVC. The anterior chamber flare reflects the blood-aqueous barrier integrity during inflammation [8]. Previous studies revealed that flare was sensitive to detect inflammation after LVC and corneal cross-linking [9]. The ocular redness, meanwhile, represents the vasodilatory intensity of the microvasculature in response to inflammation [10]. Limbal hyperemia is more closely related to inflammatory changes in the cornea [11]. However, traditional methods for assessing ocular redness are primarily subjective [12], and it is difficult to grade the limbal and bulbar areas separately. These disadvantages have been overcome by the most recent Keratograph 5 M (Oculus GmbH, Wetzlar, Germany), hence the present study used it for a quantitative assessment of conjunctival hyperemia.
Comparison of topical omega-3 fatty acids with topical sodium hyaluronate after corneal crosslinking : Short term results
Published in Ocular Immunology and Inflammation, 2022
Fevziye Ondes Yilmaz, Burcin Kepez Yildiz, Ugur Tunc, Nilay Kandemir Besek, Yusuf Yildirim, Ahmet Demirok
After the corneal cross-linking procedure, patients were examined daily until the epithelial defect was totally repaired. The ocular surface was painted with a moistened fluoresceined strip, and photographs were taken to capture the area of the epithelial defect using a blue cobalt filter (Topcon DC-3 camera; Topcon Corporation, Tokyo, Japan) (Figure 1b). The area was measured using one of the quantitative analysis tools available (measurement function) on the IMAGEnet program of the Topcon camera system. For investigating the patient’s postoperative comfort, the pain score was assessed and graded using the Wong-Baker FACES Pain Rating Scale12 (0: no pain; 1: discomfort; 2: light pain; 3: moderate pain; 4: intense pain; 5: severe pain). In the first month following the treatment, visual acuity, corneal staining, tear breakup time, and Schirmer’s tests were repeated and the results recorded. Tear meniscus height was measured preoperatively by the same method noted previously and by the same researcher.
Differential Regional Stiffening of Sclera by Collagen Cross-linking
Published in Current Eye Research, 2020
Bola A. Gawargious, Alan Le, Michael Lesgart, Shoaib Ugradar, Joseph L. Demer
Cross-linking using riboflavin and UVA increased YM significantly in all regions of human sclera. The effect was varied topographically, being relatively greater in the equatorial than posterior region (Figure 5). This difference is in part attributable to regional variation in scleral thickness. Consistent with previous studies,23 we found that the average posterior sclera thickness at 1.00 mm to be significantly greater than the equatorial sclera thickness averaging at 0.77 mm. Limited to a fixed tissue depth, UVA illumination therefore cross-linked a greater percentage of the total thickness of the equatorial than posterior sclera, and thus produced a greater increase in relative stiffness. In addition, we found that CXL increases YM significantly more in the lateral than in medial sclera. It should be noted that the irradiance and time of UV exposure were chosen to provide a stronger scleral crosslinking effect than the standard Dresden protocol for corneal cross-linking. Since other dosages of UV exposure were not investigated, specific protocols for in vivo scleral CXL would likely require optimization.