Corneal biomechanical properties in myopic and emmetropic children.

OBJECTIVE: The purpose of this study was to investigate the relationship between corneal biomechanics and ocular morphology in myopic children and adolescents. PATIENTS AND METHODS: The study included 170 right eyes, from 170 patients under the age of 18 years, who underwent a complete ophthalmologic examination, gathering the following data: spherical equivalent (SE) (under pharmacological cycloplegia), biomechanical parameters - corneal hysteresis (CH) and corneal resistance factor (CRF), structural parameters - axial length (AL) and central corneal thickness (CCT). RESULTS: The average age of the patients was 15.26 years old (55.29% girls, 44.70% boys). Out of the 170 eyes, 111 were myopic eyes and 59 were emmetropic. Myopic eyes had a significantly lower CH (p=0.001), CRF (p=0.002) and CCT (p=0.009), and higher AL (p<0.001) than emmetropic eyes. The AL and CCT were significantly higher in myopic males, compared to myopic females (p<0.001 and 0.001). In myopes, we found statistically significant negative correlations between AL and CH (Pearson's r=-0.218), CRF (r=-0.226) and also SE (r=-0.539), and positive between SE and either CH (r=0.193) or CRF (r=0.201). CONCLUSIONS: Corneal biomechanical properties are significantly related to myopia parameters in children.

Assessment of two-year clinical outcomes after keratoconus treatment using two different crosslinking protocols.

OBJECTIVE: This study aims to compare the long-term outcomes of standard corneal collagen crosslinking with accelerated corneal collagen crosslinking (CXL) for progressive keratoconus. PATIENTS AND METHODS: This prospective, comparative study included 79 eyes with progressive keratoconus, which were randomly assigned: 42 eyes received a standard CXL procedure, and 37 eyes were treated with the accelerated CXL protocol. We evaluated the following parameters, before the procedure and 1 month, 6 months, 12 months and 24 months postoperatively: best corrected visual acuity (BCVA), manifest refraction spherical equivalent (MRSE), cylindrical values, corneal dioptric powers on the steepest meridian (Kmax), central corneal thickness (CCT); demarcation line depth (DLD) preoperatively and 1 month after the CXL procedure. RESULTS: The BCVA, MRSE, cylindrical values, Kmax, CCT improved significantly, after both the accelerated and the standard CXL procedure. Throughout the 24-months follow-up, BCVA improvement was achieved sooner in the accelerated group (after 1 month, vs. after 3 months). However, there were no statistically significant differences between the two groups in these aspects. The DLD-to-CCT was significantly greater in the standard group (66% vs. 62%, p = 0.02). CONCLUSIONS: Standard and accelerated CXL are effective in stabilizing keratoconus progression in the long term. In clinical practice, the accelerated protocol has the added benefit of a faster visual recovery, in addition to the known reduced treatment time and increased comfort.

[Posttraumatic hyphema with secondary glaucoma]. / Hifema postcontuziva cu glaucom secundar.

The authors present in detail (symptoms, signs, predisposing factors, complications, treatment) one of the most common signs seen in the eyeball contusion--traumatic hiphema. There are presented concepts for proper treatment of hiphema with secondary glaucoma and for relapsing hiphema.

[Principles of treatment in ocular burns regarding the ocular surface and limbal stem cells]. / Principii de tratament ale arsurilor oculare in lumina conceptului de suprafata oculara si celule stem limbice.

The term ocular surface emphasizes the functional interdependence of the nonkeratinizing epithelium of cornea and conjunctiva. The limbal stem cells are responsible for replacement of corneal epithelium following ocular surface injuries. Over the past decades important advances in the management of chemical injury have occurred based on the application of theories on ocular surface and limbal stem cells.