Keratoconus and mitral valve prolapse.

PURPOSE: To investigate the prevalence of keratoconus in patients with mitral valve prolapse (MVP). METHODS: Videokeratography was performed in 36 patients (72 eyes) with an echocardiographic diagnosis of MVP, and were compared with 25 controls. All participants underwent slit-lamp examination and completed a medical questionnaire about joint hypermobility, arthralgia, asthma, and allergic reactions. RESULTS: Keratoconus was found in eight eyes (11. 1%) (P =.056) of eight patients (22.2%) (P =.049) in the MVP group and in one eye (2%) of one patient (4%) in the control group. The keratoconus was unilateral and asymptomatic in all cases. Conjunctival papillae were statistical significant higher in the MVP group (P =.015). A statistically significant intergroup difference existed in the presence of an allergic reaction (P =.001), but not in arthralgia, hypermobility of joints, or asthma. CONCLUSION: A borderline important association of MVP with keratoconus and with allergy exists. Patients with mitral valve prolapse complaining of poor vision should be suspected of having keratoconus.

Corneal topographic changes after retinal and vitreous surgery.

PURPOSE: To investigate the topographic changes in the cornea after retinal and vitreous operations. DESIGN: Observational prospective case series. PARTICIPANTS: The study population included 46 patients after vitreoretinal surgery: 11 underwent pneumatic retinopexy, 10 underwent vitrectomy, and 25 underwent scleral buckling procedure. METHODS: The corneal topography was measured by videokeratography with the absolute program and evaluated statistically by a quantitative comparative method, which was developed for this study, for the whole and the central cornea. MAIN OUTCOME MEASURES: The corneal topographic changes were measured in diopters (D), evaluating and comparing the preoperative and postoperative measurements. RESULTS: None of the operative procedures changed the shape of the whole cornea. Vitrectomy induced radial steepening of the central cornea 1.2 to 1.6 D, corresponding to the scleral sutures. Central steepening (average, 2.2 D) was also noted in the first week after circular buckling, but it flattened (average, 1.4 D) after 1 to 3 months. When an additional radial or circumferential buckling element was added to the circular buckle, steepening of the entire cornea and radial steepening of the central cornea (average, 0.6-0.8 D) occurred in the first week and flattened or returned to baseline after 1 to 3 months. There was no correlation between the location of the additional buckling element and the corneal topographic change. CONCLUSIONS: Corneal videokeratography is a useful tool for evaluating the postoperative corneal curvature. It showed that vitreoretinal surgery alters the shape of the cornea when buckling or scleral sutures are used, but pneumatic retinopexy does not.