Combined Rotating Ultra-High-Resolution Spectral Domain OCT and Scheimpflug Imaging for In Vivo Corneal Optical Biopsy.

PURPOSE: This article introduces the Pentacam® Cornea OCT (optical coherence tomography). This advanced corneal imaging system combines rotating ultra-high-resolution spectral domain OCT with sub- 2-micron axial resolution and Scheimpflug photography. The purpose of this study is to present the first experience with the instrument and its potential for corneal diagnostics, including optical biopsy. METHODS: In this prospective study, the Pentacam® Cornea OCT was used to image the corneas of seven patients. The novel wide-angle pericentric scan system enables optimal OCT imaging performance for the corneal layer structure over the entire width of the cornea, including the limbal regions. A detailed analysis of the resulting images assessed the synergism between the OCT and Scheimpflug photography. RESULTS: The Pentacam® Cornea OCT demonstrated significantly improved image resolution and ability to individualize corneal layers with high quality. There is a synergism between the OCT high-definition signal to individualize details on the cornea and Scheimpflug photography to detect and quantify corneal scattering. The noncontact exam was proven safe, user-friendly, and effective for enabling optical biopsy. CONCLUSIONS: Pentacam® Cornea OCT is an advancement in corneal imaging technology. The ultra-high-resolution spectral domain OCT and Scheimpflug photography provide unprecedented detail and resolution, enabling optical biopsy and improving the understanding of corneal pathology. Further studies are necessary to compare and analyze the tomographic reconstructions of the cornea with the different wavelengths, which may provide helpful information for diagnosing and managing corneal diseases.

Topical Losartan for Treating Corneal Fibrosis (Haze): First Clinical Experience.

PURPOSE: To report the first clinical experience with topical losartan for treating a case of severe corneal haze after complicated laser in situ keratomileusis (LASIK). METHODS: A 36-year-old woman presented with corneal haze in the left eye after femtosecond laser-assisted LASIK. The left eye had flap dislocation and significant striae, which had been re-lifted. Uncorrected distance visual acuity (UDVA) was 20/200 and corrected distance visual acuity was 20/30 in the left eye at the first presentation, 52 days after the first procedure. A dense layer of subepithelial opacity (haze) was noted in the left cornea. The patient elected to start the off-label treatment with topical losartan 0.8 mg/mL six times per day. RESULTS: Four and one-half months after initiating topical losartan, UDVA improved to 20/30 and CDVA improved to 20/25 in the left eye. A significant reduction of corneal haze was observed at the slit lamp and using Scheimpflug corneal tomography (Pentacam AXL; Oculus Optikgeräte GmbH) and anterior segment optical coherence tomography (Revo NX 130; Optopol). CONCLUSIONS: Losartan is an inhibitor of transforming growth factor-ß signaling. Topical treatment is promising to treat corneal haze formation after corneal injuries, chemical burns, and surgeries. Further clinical studies are needed to optimize losartan dosages and treatment durations. [J Refract Surg. 2022;38(11):741-746.].