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Refractive Surgery - Where are we now?

Chaired by Bita Manzouri.

Outcomes of corneal cross-linking in paediatric patients compared to fellow untreated eyes

This retrospective cohort study evaluated long-term visual, refractive, topographic and safety outcomes of corneal cross-linking (CXL) in patients younger than 18-years-old with keratoconus. The study included all consecutive paediatric patients who underwent epithelium-off CXL treatment for keratoconus at the study...

A case of ipsilateral fourth nerve paresis and Horner’s syndrome

The author presents a single case report of an exceptional association between fourth nerve palsy and ipsilateral Horner’s Syndrome. The case is presented alongside magnetic resonance images (MRI) which reveal a mass in the right cavernous sinus. The 54-year-old woman...

The management of possibly progressive pterygium

A 43-year-old Sudanese male patient is referred by his GP with a fleshy lesion encroaching the nasal cornea for the last six months. History Make note of: risk factors, i.e. UV exposure and ocular irritation - history of living in...

Acute dellen formation post trauma

Corneal dellen are saucer-like thinnings, usually of the peripheral cornea [1]. Dellen formation is thought to be related to localised tear film instability [2], specifically the absence of the mucin component of the tear film. Without the mucin layer, dry...

Q&A: Mr Goel and Mr Loomba on alcohol delamination and phototherapeutic keratectomy (PTK) for the treatment of recurrent corneal erosion syndrome

Recurrent corneal erosion syndrome is a common, recurrent condition caused by abnormal epithelial adhesion to the underlying basal lamina. Spontaneous breakdown of the corneal epithelium can lead to the sudden onset of ocular pain, blurred vision, tearing and photophobia, typically...

Corneal Transplantation

This relatively small book provides a thorough overview of the history of corneal transplantation, an update on the anatomy and physiology of the cornea with particular reference to the components essential to keratoplasty procedures, also graft preparation and storage. There...

Ocular characteristics in Marfan syndrome

Marfan syndrome (MFS) is a genetic disorder with clinical manifestations associated with cardiovascular, ocular and skeletal organ systems. Typical signs are descending aortic root aneurysms, ectopia lentis, tall stature and scoliosis. This observational study looked at the ocular characteristics, visual...

Long-term corneal crosslinking results in paediatric eyes

This prospective longitudinal study examined patients 18 years of age or less with progressive keratoconus, who underwent corneal crosslinking and completed 10 years of follow-up. Crosslinking protocol involved removal of epithelium, 10 minutes of riboflavin soaking, followed by 30 minutes...

Penetrating keratoplasties in infants

This retrospective review looked at endothelial cell counts (ECC) following penetrating keratoplasties (PKP) performed in infants within the first year of their life. One hundred eyes of 71 patients had their first PKP during the study period (1998-2013). In 30%...

LASEK vs. epi-LASIK for myopia: meta-analysis

Previous studies have produced inconsistent conclusions on the relative benefits between LASEK vs. Epi-LASIK. LASEK uses 20% alcohol to separate an epithelial flap from the Bowman membrane. After ablation, the epithelial flap is repositioned onto the cornea. Epi-LASIK creates the...

An uncommon late postoperative complication of combined cataract surgery and intravitreal triamcinolone injection

Case report A 64-year-old female with diabetic maculopathy (DMO) underwent phacoemulsification with intraocular lens (IOL) implantation in her right eye combined with intravitreal triamcinolone (IVTA). Diabetes control was poor with HbA1c (IFCC) of 119mmol/mol and blood sugar level of 27mmol/L....