Evolving techniques in keratoplasty have undoubtedly led to thinner corneal grafts. These newer iterations of keratoplasty aim to reduce graft rejections, improve visual acuity and visual rehabilitation. Each techniqu...Evolving techniques in keratoplasty have undoubtedly led to thinner corneal grafts. These newer iterations of keratoplasty aim to reduce graft rejections, improve visual acuity and visual rehabilitation. Each technique poses its own advantages and disadvantages; the surgeon should select patients suitable for a particular technique while accounting for their surgical competency given the learning curve associated with these newer techniques. Alternatives to corneal transplant may have a role in addressing the shortages of corneal graft, these bioengineered material and medical treatment still need further studies to demonstrate its clinical applicability.展开更多
Orthokeratology is a reversible technique that temporarily changes the curvature of the cornea with the aim of addressing refractive errors. The United States Food and Drug Administration(FDA) granted approval for usi...Orthokeratology is a reversible technique that temporarily changes the curvature of the cornea with the aim of addressing refractive errors. The United States Food and Drug Administration(FDA) granted approval for using reverse geometry contact lenses to correct myopia without any age restriction. Information from the pre-market applications to the FDA was rated as level Ⅱ evidence. Another unapproved use of overnight orthokeratology is for the prevention of myopic progression. Although orthokeratology is advocated to reduce myopic progression, there are limited long-term studies with substantial evidence of its benefits. Much of this evidence comes from non-robust experimental studies using historical or self-selected controls with relative high dropout rates. Although some positive results have been published in temporarily reducing the myopic refractive error and its progression, the use of these lenses can be associated with serious complications such as microbial keratitis. Microbial keratitis is a potentially vision-threatening adverse response associated with contact lens wear. In fact, contact lens wearhas been shown to be the predominant risk factor of microbial keratitis in some developed countries. Most of the published cases on overnight orthokeratology related microbial keratitis occurred in children or adolescents. Parents considering orthokeratology must make an informed decision about its temporary benefit and its potential for permanent loss of vision. The ophthalmic community should be reminded of the potential complications of orthokeratology.展开更多
文摘Evolving techniques in keratoplasty have undoubtedly led to thinner corneal grafts. These newer iterations of keratoplasty aim to reduce graft rejections, improve visual acuity and visual rehabilitation. Each technique poses its own advantages and disadvantages; the surgeon should select patients suitable for a particular technique while accounting for their surgical competency given the learning curve associated with these newer techniques. Alternatives to corneal transplant may have a role in addressing the shortages of corneal graft, these bioengineered material and medical treatment still need further studies to demonstrate its clinical applicability.
文摘Orthokeratology is a reversible technique that temporarily changes the curvature of the cornea with the aim of addressing refractive errors. The United States Food and Drug Administration(FDA) granted approval for using reverse geometry contact lenses to correct myopia without any age restriction. Information from the pre-market applications to the FDA was rated as level Ⅱ evidence. Another unapproved use of overnight orthokeratology is for the prevention of myopic progression. Although orthokeratology is advocated to reduce myopic progression, there are limited long-term studies with substantial evidence of its benefits. Much of this evidence comes from non-robust experimental studies using historical or self-selected controls with relative high dropout rates. Although some positive results have been published in temporarily reducing the myopic refractive error and its progression, the use of these lenses can be associated with serious complications such as microbial keratitis. Microbial keratitis is a potentially vision-threatening adverse response associated with contact lens wear. In fact, contact lens wearhas been shown to be the predominant risk factor of microbial keratitis in some developed countries. Most of the published cases on overnight orthokeratology related microbial keratitis occurred in children or adolescents. Parents considering orthokeratology must make an informed decision about its temporary benefit and its potential for permanent loss of vision. The ophthalmic community should be reminded of the potential complications of orthokeratology.
