To present the use of automated lamellar therapeutic keratoplasty (ALTK) for t he treatment of post-photorefractive keratectomy (PRK) corneal scarring and thi nning with significant residual myopia. Interventional cas...To present the use of automated lamellar therapeutic keratoplasty (ALTK) for t he treatment of post-photorefractive keratectomy (PRK) corneal scarring and thi nning with significant residual myopia. Interventional case report. A patient wi th high myopia of-12 diopters previously underwent PRK that resulted in corneal scarring, myopic regression, moderate loss of best-corrected visual acuity, a residual refractive error of -6.50/-1.00 ×.175 degrees, and a remaining corneal thickness of 300 μm. ALTK was first performed to remove the scar and to augment corneal thickness, and a subsequent laser-assisted in-situ keratomi leusis (LASIK) procedure was performed to correct the residual myopia. ALTK effe ctively removed the corneal scar and augmented the corneal thickness to 639 μm. LASIK effectively treated the residual myopia, resulting in an unaided visual a cuity of 20/25 and a stable refractive error of plano/-0.50 ×40 degrees. The A LTK interface remained clear throughout the follow-up period of 26 months. ALTK may be a reasonable alternative to conventional penetrating keratoplasty in the treatment of post-PRK corneal scarring and thinning, with a moderate loss of b est-corrected visual acuity, and LASIK can be subsequently performed to correct the residual refractive error and achieve an excellent refractive and visual ou tcome.展开更多
Objective: To describe a compressive lamellar surgical technique for treating severe astigmatism in peripheral corneal ectasia. Design: Retrospective, noncomparative, interventional case series. Participants: Four eye...Objective: To describe a compressive lamellar surgical technique for treating severe astigmatism in peripheral corneal ectasia. Design: Retrospective, noncomparative, interventional case series. Participants: Four eyes of 3 patientswith either pellucid or Terrien’ s marginal corneal degeneration were included in this series. Methods: C- shaped lamellar keratoplasty using multiple trephines of different sizes, with deliberate undersizing of the donor graft for a controlled compressive effect, was performed on these patients. Main Outcome Measures: Visual acuity outcome and refraction were measured at different intervals at up to 40 months of follow- up. Results: All eyes achieved Snellen visual acuity of 20/40 or better and stable astigmatism ranging from 0 to- 2.75 diopter cylinder within 6 months, with no recurrence of corneal thinning or peripheral corneal vascularization. Conclusions: Compressive C- shaped lamellar keratoplasty is able to reduce severe corneal astigmatism in peripheral corneal ectasia and can result in good visual and refractive outcomeswith early visual rehabilitation.展开更多
Purpose To describe the presentation and subsequent management of a case of se vere gonococcal keratitis in a young man. Design Case report. Methods A young ma n presented with severe gonococcal keratitis. Topical and...Purpose To describe the presentation and subsequent management of a case of se vere gonococcal keratitis in a young man. Design Case report. Methods A young ma n presented with severe gonococcal keratitis. Topical and systemic antibiotics w ere given with no improvement, and progressive corneal melting was noted. Deep l amellar keratoplasty was performed. The clarity and state of corneal graft and t he postoperative visual acuity were noted. Results At 6 months posttreatment, th e graft was clear, and no recurrence of infection was noticed. Corrected visual acuity was 20/25. Conclusion Deep lamellar keratoplasty should be considered as a therapeutic option in patients with severe gonococcal keratitis that does not respond to antibiotic treatment.展开更多
文摘To present the use of automated lamellar therapeutic keratoplasty (ALTK) for t he treatment of post-photorefractive keratectomy (PRK) corneal scarring and thi nning with significant residual myopia. Interventional case report. A patient wi th high myopia of-12 diopters previously underwent PRK that resulted in corneal scarring, myopic regression, moderate loss of best-corrected visual acuity, a residual refractive error of -6.50/-1.00 ×.175 degrees, and a remaining corneal thickness of 300 μm. ALTK was first performed to remove the scar and to augment corneal thickness, and a subsequent laser-assisted in-situ keratomi leusis (LASIK) procedure was performed to correct the residual myopia. ALTK effe ctively removed the corneal scar and augmented the corneal thickness to 639 μm. LASIK effectively treated the residual myopia, resulting in an unaided visual a cuity of 20/25 and a stable refractive error of plano/-0.50 ×40 degrees. The A LTK interface remained clear throughout the follow-up period of 26 months. ALTK may be a reasonable alternative to conventional penetrating keratoplasty in the treatment of post-PRK corneal scarring and thinning, with a moderate loss of b est-corrected visual acuity, and LASIK can be subsequently performed to correct the residual refractive error and achieve an excellent refractive and visual ou tcome.
文摘Objective: To describe a compressive lamellar surgical technique for treating severe astigmatism in peripheral corneal ectasia. Design: Retrospective, noncomparative, interventional case series. Participants: Four eyes of 3 patientswith either pellucid or Terrien’ s marginal corneal degeneration were included in this series. Methods: C- shaped lamellar keratoplasty using multiple trephines of different sizes, with deliberate undersizing of the donor graft for a controlled compressive effect, was performed on these patients. Main Outcome Measures: Visual acuity outcome and refraction were measured at different intervals at up to 40 months of follow- up. Results: All eyes achieved Snellen visual acuity of 20/40 or better and stable astigmatism ranging from 0 to- 2.75 diopter cylinder within 6 months, with no recurrence of corneal thinning or peripheral corneal vascularization. Conclusions: Compressive C- shaped lamellar keratoplasty is able to reduce severe corneal astigmatism in peripheral corneal ectasia and can result in good visual and refractive outcomeswith early visual rehabilitation.
文摘Purpose To describe the presentation and subsequent management of a case of se vere gonococcal keratitis in a young man. Design Case report. Methods A young ma n presented with severe gonococcal keratitis. Topical and systemic antibiotics w ere given with no improvement, and progressive corneal melting was noted. Deep l amellar keratoplasty was performed. The clarity and state of corneal graft and t he postoperative visual acuity were noted. Results At 6 months posttreatment, th e graft was clear, and no recurrence of infection was noticed. Corrected visual acuity was 20/25. Conclusion Deep lamellar keratoplasty should be considered as a therapeutic option in patients with severe gonococcal keratitis that does not respond to antibiotic treatment.
