Mycotic Keratitis
Mahendra Rai, Marcelo Luís Occhiutto in Mycotic Keratitis, 2019
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).
Corneal Defects, Abrasions and Foreign Bodies
Amy-lee Shirodkar, Gwyn Samuel Williams, Bushra Thajudeen in 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.
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.
Progressive corneal ectatic disease in pregnancy
Published in Clinical and Experimental Optometry, 2021
Devanshi Jani, James McKelvie, Stuti L Misra
Corneal cross-linking is the treatment of choice for progressive keratoconus and iatrogenic keratectasia and is effective in arresting progression in most patients. Clinical trials often exclude pregnant and breastfeeding women to avoid the requirement of systemic therapy and general anaesthesia should complications occur, and the unknown risks to the foetus.12–14 Epithelium-off cross-linking is associated with complications such as corneal haze, corneal oedema, striae, keratitis, corneal ulceration, delayed re-epithelialisation, temporary visual blur, severe post-operative pain and corneal melting.15 A transepithelial approach (epithelium-on) has been developed to enhance recovery and reduce the risk of complications related to epithelium removal.16
Screening for Keratoconus in a High-Risk Adolescent Population
Published in Ophthalmic Epidemiology, 2021
Brian K. Armstrong, Scott D. Smith, Ivana Romac Coc, Prateek Agarwal, Najah Mustapha, Samuel Navon
We have found the prevalence of KC in the Emirati adolescent population aged 10 to 19 years to be 2.7%. Based on the lower limits of our estimated 95% confidence intervals, the prevalences of KC and KC suspect are likely to be at least 1.2% and 15.7%, respectively. We identified subjects who need corneal crosslinking based on their current status and a larger number of subjects who require monitoring and early intervention if progression occurs. Without screening, individuals with KC would almost certainly present at later stages of disease requiring additional interventions, such as hard contact lenses, corneal rings, and/or corneal transplantation for visual rehabilitation.
Related Knowledge Centers
- Cornea
- Corneal Topography
- Microscopy
- Ultraviolet
- Riboflavin
- Keratoconus
- Pellucid Marginal Degeneration
- Post-Lasik Ectasia
- Cochrane Library
- Stroma of Cornea