Excimer laser photorefractive keratectomy for low to moderate myopia using a 5.0 mm treatment zone and no transitional zone: 16-year follow-up.

PURPOSE: To evaluate the safety and efficacy of photorefractive keratectomy (PRK) 16 years postoperatively. SETTING: Refractive Laser Suite, Mater Private Hospital, Dublin, Ireland. DESIGN: Cohort study. METHODS: Myopic PRK was performed using the UV200 excimer laser with a 5.0 mm ablation zone. The following were evaluated in patients returning 16 years postoperatively: refractive stability, refractive predictability, corrected visual acuity, corneal haze, and subjective patient symptoms (eg, glare, halos). RESULTS: Most of the 120 eyes (80 patients) were followed for 2 years or more; 23 patients (39 eyes) were followed for 16 years. Preoperatively, the spherical equivalent (SE) ranged from -1.75 to -7.25 diopters (D) and astigmatism from 0.00 to 1.50 D. At 2 years, the mean SE was -0.25 D and at 16 years, -0.58 D. Overall, 31 eyes (79.5%) were within ± 1.00 D of emmetropia, with 6 eyes (15.4%) between 1.00 D and 2.00 D and 2 eyes (5.1%) between 2.00 D and 3.00 D. The final uncorrected distance visual acuity was 20/20 or better in 27 eyes (69.2%) and 20/30 or better in 36 eyes (92.3%). Eight eyes (20.5%) lost 1 line of corrected distance visual acuity. Four eyes (10.3%) had visible haze and 7 eyes (17.9%) had hemosiderin. All patients stated they would have the procedure again. CONCLUSION: Photorefractive keratectomy was safe and effective in the treatment of myopia up to -7.00 D, and all patients reported being satisfied. There appeared to be slight regression over the follow-up period. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.

Central corneal thickness and its relationship to intraocular pressure in mucopolysaccararidoses-1 following bone marrow transplantation.

PURPOSE: To examine the ocular findings in mucopolysaccaridoses-1 (MPS-1) and the relationship between intraocular pressure (IOP) and central corneal thickness following bone marrow transplantation. SETTING: clinical practice. SUBJECTS: 23 subjects with MPS-1 following bone marrow transplantation were examined. OBSERVATION PROCEDURES: age, sex, visual acuity, presence of strabismus, refractive error, fundus examination, intraocular pressure, and central corneal thickness were assessed for each individual. MAIN OUTCOME MEASURE: correlation of central corneal thickness with intraocular pressure. Only the right eye was used in correlations. RESULTS: Forty-six eyes of 23 subjects were examined. All subjects had been treated with successful bone marrow transplantation with mean follow-up of 8.5 years. Ages ranged from 17 months to 19 years (SD 5.03). Of the subjects, 60.8% were female; 85.5% were hyperopic; 8.6% had best-corrected visual acuity of >/=6/12; 34.5% had best-corrected visual acuity of <6/12 and >6/36 with 56.9% <6/36; 30% had strabismus. IOP ranged from 13 to 41 mm Hg with four children on antiglaucoma therapy. Central corneal thickness ranged from 484 microm to 705 microm and was moderately correlated with measured IOP in the right eye (r = 0.56). Corneal opacification moderately correlated with central corneal thickness (r = 0.57). Seventy percent had a normal disk evaluation; 30% had abnormal disk cupping. CONCLUSION: This is the first large case series of MPS-1 subjects demonstrating a correlation between measured IOP and central corneal thickness. All subjects had corneal opacification moderately correlating with corneal pachymetry.

Characterization of optical coherence topography findings in Kenny-Caffey syndrome.

An unusual congenital syndrome was first reported in 1966 by Kenny and Linarelli, who described two patients with dwarfism, cortical thickening of the long bones, transient hypocalcemia, and normal intelligence,(1) the radiological features in the condition being reported by Caffey.(2) The constellation of dwarfism, medullary stenosis, transient hypocalcemia, and ophthalmologic abnormalities has been classically recognized as Kenny-Caffey syndrome with additional manifestations ranging from hypoplastic nails, persistent neutropenia, abnormal T-cell function, and neonatal liver disease.(3) Ocular findings range from uncomplicated nanophthalmos with hypermetropia to extreme pseudopapilloedema, vascular tortuosity, and macular crowding. Other reported ophthalmic findings include bilateral band keratopathy,(4) bilateral optic atrophy,(5) and myelinated nerve fibers.(6) We report two cases of Kenny-Caffey syndrome with an ellipsoid macular fold orientated horizontally involving the fovea and document this unusual feature with optical coherence topography (OCT).