Résumé
Purpose: Outcome of topography?guided excimer laser ablation in conjunction with accelerated, high?fluence cross?linking in corneal ecstatic disease using the NIDEK CXIII equipped with CATz algorithm from the FinalFit software棓Bharat Protocol.� Methods: Retrospective case record review of 30 eyes of 17 patients of stage 1?3 keratoconus who underwent the procedure was performed. Data collected were for visual acuity, distortion?induced eye pain, and keratometry. Pachymetry, lower order and higher order aberrations, spherical aberrations, and topographic cylinder were documented from by Scheimpflug imaging (Pentacam 70700: Oculus, Wetzlar, Germany). Results: At a minimum follow?up of 6 months (range 6.2� months), there was significant improvement in UCVA (P < 0.00001), BCVA (P = 0.0061), decrease in Kmax (P = 0.0349), Ksteep (P < 0.0411), Kflat (P = 0.0099), and pachymetry (P = 0.0001). Significant improvement was also seen in distortion?induced eye pain (27/30 to 2/30; P < 0.00001). A more than two?line improvement in UCVA and BCVA was seen in 23/30 and 17/30 cases, respectively. Ectasia was stabilized in all cases at the last follow?up, and no complications were seen. Conclusions: The 揃harat� Protocol to arrest keratectasia progression and improve corneal regularity is a safe and efficacious alternative as a keratoconus management option. This is the first such study on Nidek Platform for the same.
Résumé
Purpose: To assess Photo Activated Chromophore for Infective Keratitis?Cross Linking (PACK?CXL) and its efficacy as a treatment modality in managing microbial keratitis. Methods: Single Centre prospective interventional study in infectious keratitis. A total of eleven patients were taken who had corneal thickness (CT) more than 400?m. PACK?CXL was performed according to Dresden’s protocol. The response was assessed by slit lamp examination, BCVA and AS?OCT at the time of complete healing. Results: The mean visual acuity at presentation was 1.207logMAR (0.3?3) which improved to mean value of 0.53logMAR (0.3?1). Mean time taken for complete epithelization was 17.45 days (14? 30 days) and that for complete healing was 33.72 days (21? 60 days). Mean CT at the baseline was 650.5± 108?m which reduced on consecutive follow up visits. There was reduction in the symptoms in nine patients except in two. One case reported increase in symptoms with worsening increase in endoexudates and hypopyon, and the other developed drug toxicity due to topical medications. Conclusion: Patients who underwent PACK?CXL showed good and early healing, good remodelling of cornea and improved visual acuity. The recalcitrant cases became responders to the same medications after PACK?CXL. Thus, PACK?CXL works well for both fungal and bacterial keratitis
Résumé
@#With a new therapy of keratoconus in recent years-corneal cross-linking, the pediatric keratoconus have characterized by corneal dilatation, central thinning, protrusion and conical shape in the children' eyes. By analyzing the epidemiological characteristics of keratoconus and the current methods of treating pediatric keratcoconus, this paper discusses the role of different CXL protocols in the clinical application of pediatric keratcoconus, thus providing some help for the choice of clinical treatment methods.