At the one-month mark, the SBK and FS-LASIK groups achieved identical surgical satisfaction scores of 98.08, whereas at three years, these scores were 97.09 and 97.10, respectively. (All P-values were greater than 0.05).
At both one month and three years following surgery, SBK and FS-LASIK procedures displayed comparable corneal aberration profiles and patient satisfaction scores.
At one month and three years post-procedure, a comparison of corneal aberrations and patient satisfaction revealed no distinctions between SBK and FS-LASIK techniques.
Analyzing the impact of transepithelial corneal collagen crosslinking (CXL) on corneal ectasia after laser-assisted in situ keratomileusis (LASIK) procedures.
CXL procedures were performed on 18 eyes belonging to a group of 16 patients. Nine of these eyes also underwent LASIK flap lift, utilizing 365 nm wavelength and a power density of 30 mW/cm².
Treatment protocols included either a four-minute pulsed laser, or a transepithelial flap-on procedure, (n=9 eyes; 365 nm, 3 mW/cm^2).
A technique of 30 minutes was used. Postoperative changes in central corneal thickness (CCT), maximum keratometry (Kmax), anterior elevation, posterior elevation, spherical equivalent (SE), logMAR uncorrected distance visual acuity (UDVA), and aberrations were evaluated 12 months after the procedure.
In this investigation, eighteen eyes were observed across sixteen patients (eleven male, five female). teaching of forensic medicine Subsequent to flap-on CXL, Kmax demonstrated a more substantial flattening than was seen after flap-lift CXL, a difference deemed statistically significant (P = 0.014). Endothelial cell density and posterior elevation maintained a consistent level throughout the entire follow-up period. A significant decrease (P < 0.05) in vertical asymmetry index (IVA), keratoconus index (KI), and central keratoconus index (CKI) was seen 12 months following flap-on CXL surgery, in contrast to the absence of statistically significant changes observed in the flap-off CXL group. At the 12-month postoperative mark following flap-lift CXL, a decline in spherical aberrations and the total root mean square was observed, reaching statistical significance (P < 0.05).
Transepithelial collagen crosslinking proved successful in halting the progression of keratectasia, a post-LASIK complication, as evidenced by our study. We suggest employing the flap-on surgical procedure for these instances.
Our study successfully utilized transepithelial collagen crosslinking to prevent the worsening of post-LASIK keratectasia. The flap-on surgical technique is considered the preferred method for these cases.
To scrutinize the efficiency and safety of pediatric accelerated cross-linking (CXL) treatment.
A longitudinal study examining progressive keratoconus (KC) in patients below the age of eighteen. Thirty-nine cases had their sixty-four eyes subjected to the accelerated epithelium-off CXL protocol. Detailed examination notes encompassed visual acuity (VA), slit-lamp findings, refractive error, pentacam keratometry (K) readings, corneal thickness measurements, and the precise location of the thinnest corneal pachymetry. Cases were examined and followed up on days one, five, and one.
, 3
, 6
This item's return is mandated by the conclusion of the twelve-month post-procedure.
The mean values of VA, K, and mean corneal astigmatism displayed a statistically significant improvement (p < 0.00001). Prior to accelerated CXL, the Kmax reading exhibited a range of 555 to 564 diopters (D); 12 months post-procedure, the Kmax reading decreased to a range of 544 to 551 diopters (D), encompassing a pre-op range of 474-704 D and a post-op range of 46-683 D. The progression of the two cases was noteworthy. Persistent haze, coupled with sterile infiltrate, presented as complications.
Pediatric KC benefits from the effective and efficacious nature of accelerated CXL.
The accelerated CXL approach to pediatric keratoconus management is both effective and efficacious, delivering positive outcomes.
Employing an artificial intelligence (AI) model, this research sought to pinpoint and scrutinize clinical and ocular surface risk factors contributing to the progression of keratoconus (KC).
This prospective investigation included a sample of 450 keratoconus (KC) patients. The classification of these patients utilized the random forest (RF) classifier, a model previously applied to investigate longitudinal tomographic parameters in a study that assessed both progression and non-progression. A questionnaire assessed clinical and ocular surface risk factors, encompassing eye rubbing, indoor activity duration, lubricant and immunomodulator topical medication use, computer usage duration, hormonal imbalances, hand sanitizer use, immunoglobulin E (IgE) levels, and vitamin D and B12 levels from blood tests. An AI model was subsequently constructed to evaluate if these risk factors correlated with the future advancement or lack thereof of KC progression. A thorough examination of the area under the curve (AUC) and other metrics was performed.
According to the tomographic AI model, 322 eyes were classified as showing progression, in contrast to 128 eyes, which showed no progression. Clinical risk factors at the first visit successfully predicted progression in 76% of cases exhibiting tomographic progression and no progression in 67% of cases that did not progress radiographically. IgE yielded the largest information gain, trailed by the presence of systemic allergies, the levels of vitamin D, and the action of eye rubbing. LY2157299 TGF-beta inhibitor The AI model for clinical risk factors demonstrated an area under the curve (AUC) of 0.812.
Utilizing AI for patient risk stratification and profiling, considering clinical factors, was demonstrated in this study as essential for impacting the progression of KC eyes and enabling improved management strategies.
This research highlighted the critical role of AI in categorizing and characterizing patient risk based on medical factors, potentially influencing the advancement of keratoconus (KC) and enabling enhanced management.
We aim to dissect the recurring patterns of follow-up care and the explanations for discontinued follow-up in keratoplasty cases within a tertiary eye care facility.
In a single-center setting, a retrospective cross-sectional study was executed. During the investigation, 165 eyes received corneal transplants. Visual acuity measurements pre and post-surgery, recipient demographics, keratoplasty justifications, follow-up duration, and the final graft condition were all included in the collected data regarding recipients and keratoplasty procedures. An essential goal was to evaluate the causative factors behind the attrition of graft recipients. A patient failing to attend any of the following post-operative follow-up visits was considered LTFU: four at two weeks, three at one month, six at one month, twelve at two months, eighteen at two months, twenty-four at three months, and thirty-six at six months. The secondary analysis centered around evaluating best-corrected visual acuity (BCVA) for those patients who had their final follow-up appointment.
At the 6, 12, 18, 24, and 36-month points, follow-up rates for recipients were recorded at 685%, 576%, 479%, 424%, and 352%, respectively. Old age and the distance from the central point were influential in cases of lost follow-up. Completion of follow-up was notably influenced by instances of failed grafts, signaling the need for transplantation, and by those who underwent penetrating keratoplasty for improved vision.
The persistence of difficulties in the follow-up process for corneal transplant patients is a significant concern. Follow-up appointments for elderly patients and those in remote areas should be a top concern.
Suboptimal follow-up care is a widespread issue after corneal transplants. Prioritization of follow-up care should include elderly patients and those who live in distant areas.
Assessment of clinical outcomes in patients undergoing therapeutic penetrating keratoplasty (TPK) for Pythium insidiosum keratitis after treatment with linezolid and azithromycin anti-Pythium therapy (APT).
Retrospectively analyzing medical records for patients with P. insidiosum keratitis, the time frame encompassing May 2016 through December 2019 was considered. oral anticancer medication Patients receiving APT treatment for a minimum duration of 14 days, and who later underwent TPK, were considered for inclusion in the research. A comprehensive record was maintained for demographic attributes, clinical symptoms, microbial characteristics, intraoperative specifics, and post-operative outcomes.
During the study period, a total of 238 cases of Pythium keratitis were observed; 50 of these met the inclusion criteria and were subsequently incorporated. The median of the geometric mean of infiltrates measured 56 mm, having an interquartile range of 40-72 mm. Surgical procedures were preceded by topical APT treatment administered to patients for a median of 35 days, with an interquartile range of 25 to 56 days. Worsening keratitis, at a rate of 82% (41 out of 50 cases), was the most frequent symptom indicative of TPK. Infection recurrence was not observed. Of the 50 eyes examined, 49 (98%) displayed a stable anatomical globe. The middle point in graft survival time fell at 24 months. During a median follow-up of 184 months (IQR 11-26 months), a clear graft was present in 10 eyes (20%), culminating in a median visual acuity of 20/125. The findings suggest a clear graft was linked to the graft size, which was below 10 mm (or 5824, CI1292-416) and showed statistical significance (P = 0.002).
Following APT administration, the anatomical outcomes of TPK procedures are favorable. Survival rates were higher for grafts measuring less than 10 mm.
The anatomical effects of performing TPK after APT administration tend to be positive. The survival of grafts measuring under 10mm was more frequent.
The management of visual outcomes and complications stemming from Descemet stripping endothelial keratoplasty (DSEK) procedures, applied to 256 eyes at a major eye care center in southern India, is the subject of this study.