Effect of Corneal Collagen Cross-Linking on Corneal Innervation, Corneal Sensitivity, and Tear Function of Patients with Keratoconus

Purpose:
To evaluate the effect of corneal collagen cross-linking (CXL) on corneal innervation, corneal sensitivity, and tear function in patients with keratoconus.

Design:
Prospective, interventional case series.

Participants:
Twenty-four patients with bilateral keratoconus (30 eyes) who presented to the Institute of Vision and Optics, University of Crete, from May 2008 to October 2008.

Methods:
Patients underwent CXL. Confocal microscopic analysis of corneal sub-basal nerve plexus (total nerve length per image), corneal sensitivity (assessed with the Cochet–Bonnet esthesiometer), basic tear secretion (assessed with Schirmer’s I test with anesthesia), and tear film (Read more...)

Genetic testing becoming more reliable in gauging AMD risk factors

BALTIMORE — Although refinements are needed, genetic testing for risk assessment in age-related macular degeneration is gaining momentum, a speaker said here.“We’ve made great leaps in the understanding of the genetic basis behind macular degeneration in less than half a decade,” Ivana K. Kim, MD, said at Macula 2013. “Over 25 genes to date have been reported to influence AMD risk. Identification of these major genetic risk factors has elucidated some potential pathways for therapeutic intervention, namely the complement pathway.”

Flapless all-laser procedure outperforms femto-LASIK for high myopia

HYDERABAD, India — A flapless procedure proved more effective than femto-LASIK in the treatment of high myopia and produced fewer dry eye complaints in a series of patients, according to a presenter here.ReLEx small-incision lenticule extraction uses the VisuMax femtosecond laser (Carl Zeiss Meditec) to carve out a lenticule within the cornea in order to correct refractive errors. No excimer ablation is used, and the lenticule is separated and removed through a small incision.

Transepithelial phototherapeutic keratectomy enhances visual outcomes of collagen cross-linking

HYDERABAD, India — Epithelial removal using transepithelial phototherapeutic keratectomy during corneal collagen cross-linking results in better visual and refractive outcomes compared to mechanical epithelial debridement, according to one surgeon.“It is proved that the epithelium at the keratoconus apex is thinner than in the surrounding area. Transepithelial [phototherapeutic keratectomy] allows the excimer laser, set at 50 µm, to ablate the epithelium but also a few microns of stroma at the apex, smoothening the corneal surface before [cross-linking],” Vardhaman Kankaria, MD, said at the joint meeting of the Asia-Pacific Academy of Ophthalmology (Read more...)