Changes in Corneal Keratometry Readings after Corneal Collagen Cross-Linking Using Alcohol in Keratoconus Patients

PURPOSE: To evaluate the changes in corneal keratometry (K) readings after corneal collagen cross- linking (CXL) using 20% alcohol in primary keratoconus and keratectasia after refractive surgery. METHODS: Twelve eyes of 10 patients with primary keratoconus and 3 eyes of 3 patients with keratectasia after refractive surgery were included in the present study. Best-corrected visual acuity (BCVA) and mean K, corneal astigmatism by corneal topography, and mean K, corneal astigmatism, and spherical equivalent (SE) by auto refractometer were evaluated at baseline, and 6 months postoperatively. Eight eyes of 7 patients were also evaluated 1 year postoperatively. RESULTS: Mean BCVA improved from log MAR 0.66 +/- 0.50 to log MAR 0.55 +/- 0.58 (p = 0.100) at 6 month after CXL. In corneal topography, mean K significantly decreased from 50.04 +/- 5.88 D to 49.18 +/- 6.15 D (p = 0.019), and corneal astigmatism slightly decreased from 5.33 +/- 4.47 D to 5.29 +/- 4.88 D (p = 0.755) at 6 months after CXL. According to the auto refractometer, mean K significantly decreased from 48.53 +/- 5.94 D to 47.95 +/- 5.79 D (p = 0.038), corneal astigmatism significantly decreased from 3.95 +/- 2.54 D to 3.52 +/- 2.40 D (p = 0.010), and SE significantly decreased from -6.25 +/- 3.45 D to -5.40 +/- 2.91 D (p = 0.037) at 6 months after CXL. Significant mean K and corneal astigmatism decreases in topography were also observed at 1 year after CXL. Complications related to CXL were not observed. CONCLUSIONS: CXL using 20% alcohol appears to be a safe and promising treatment modality with less corneal stromal damage in progressive primary keratoconus and keratectasia after refractive surgery.

A Case of Primary Eyelid Peripheral T-Cell Lymphoma, Not Otherwise Specified

PURPOSE: To report a case of primary peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS), of the eyelid. METHODS: A 48-year-old healthy male patient presented with a mass on the upper lid of 2 months in duration. The lesion was reddish, well-demarcated, oval shaped, and measured approximately 8 x 4 mm. The mass did not respond to incisional drainage and intra-lesional triamcinolone. An excisional biopsy for diagnosis was performed. RESULTS: On microscopic examination, a localized dense lymphocytic infiltration was observed in the subepithelial area, and cytologic atypia was observed under high power. On immunohistochemical examination, tumor cells were positive for CD3 but negative for CD20, CD30, CD56, k-light chain immunoglobulin, lambda-light chain immunoglobulin, and increased Ki-67 activity was noted. A histopathological diagnosis of PTCL-NOS was made. CONCLUSIONS: PTCL-NOS, which rarely occurs on the eyelids, commonly accompanies generalized lymphadenopathy and "B symptoms" such as fever and weight loss. Herein, the authors report a case of PTCL-NOS of the eyelid presenting as a rapidly growing solid mass in an otherwise healthy patient.