Cornea - ARVO

More documents

Recommendations

Info

ARVO 2013 Annual Meeting Abstracts by Scientific Section/Group - CorneaResults: In both KC corneas, small angle analysis demonstrated adisordered ring of collagen fibril spacing in the peripheralcornea/limbus where an additional equatorial peak was evidentconsistently at ~80 and ~120 nm. This double peak, which indicatestwo populations of fibrils each with a different interfibril spacing,was observed only slightly in the corresponding limbal region of thenormal tissue ~5mm from centre. In addition, both corneasdemonstrated regions of peripheral corneal opacity which appeared tocorrespond with additional high scatter peaks ~140 nm. Wide angleanalysis of the KC peripheral tissue demonstrated unique concentricrings of preferential collagen orientation which were not observed inthe normal corneas.Conclusions: There were clear and evident changes in the cornealultrastructure in both keratoconus specimens. The causes of thechanges are unknown and it is not possible to conclude if they are aresult of keratoconus pathology or have occurred during the periodfollowing corneal implant. However, this is the first demonstration ofstructural changes in the periphery and limbus of the keratoconuscornea.Commercial Relationships: Erin Dooley, None; Steven Gardner,None; Sally Hayes, None; Jonathan Harris, None; Kim Nielsen,None; Jesper Hjortdal, Carl Zeiss Meditec (R); Thomas Sorensen,None; Nicholas Terrill, None; Craig Boote, None; Keith M. Meek,NoneSupport: Medical Reserach CouncilProgram Number: 3134 Poster Board Number: D0069Presentation Time: 8:30 AM - 10:15 AMEvaluate the safety and efectiveness of the AcrySof Phakic Anglesupported intraocular Lens for the correction of high myopiaMireya G. Arellano. Fundacion Hospital Nuestra Señora de la Luz,Distrito Federal, Mexico.Purpose: To evaluate the safety and effectiveness of the AcrySofCachet Phakic angle-supported Intraocular Lens (pIOL) for thecorrection of high myopia.Methods: Retrospective and prospective study including patientswith high myopia who had implantation of the Acrysoft Cachet pIOL(Alcon Laboratories, Inc., Fort Worth, TX). The outcome measuresincluded uncorrected visual acuity (UCVA), best corrected visualacuity (BCVA), endothelial cell density was measured withTOPCON specular microscope SP-2000P (taking 5 measures at thecenter of the cornea and 25 contiguous cells) , contrast sensitivity(SWCT chart) and adverse effects. The statistical study was madewith Wilcoxon test.Results: We included evaluated 14 eyes of 9 patients with ages from22 to 53 years, mean 34.1 years; 66.6% were female and 33.3% male.The mean follow up period was 29 months (range 9 to 38 months),with a mean preoperative spherical equivalent of -14.39, rangingfrom -10.25 to -19.25. The mean postoperative spherical equivalentwas -0.5, ranging from -3.25 to +0.62. The mean postoperativeUCVA was 20/30 (LogMar 0.17) or better and the BCVA 20/25 (logMar 0.098 or better. The contrast sensivity was made with CDVA,considering the low, medium or high spatial frequency, mean spatialfrequencies were 6.28, 5.07 and 3.78 cycle per degree respectively.The change of the mean preoperative endothelial cell density from2763.4 cells to a mean postoperative cell density of 2626.9, wasstatistically significant (p=0.013). Only one patient was steroidhiperreactor, which was normalized after it was suspended. None ofthe patients showed IOP raised in time or other adverse effects.Conclusions: AcrySof Cachet showed an effective alternative for thecorrection of high myopia, it is consistent with other publishedreports of phakic IOLs, where the UCVA and BCVA were excellent.None of the patients had significant adverse effects. Howeverendothelial cell loss over time was statistically significant, which hasbeen attributed to the proximity of anterior chamber pIOL to theendothelium, the surgery itself and physiology decrease with aging.An important variable to consider is that the procedure was made inour Hospital which has residents in training. Additional follow-upwill be necessary to elucidate the long-term effectsCommercial Relationships: Mireya G. Arellano, NoneProgram Number: 3135 Poster Board Number: D0070Presentation Time: 8:30 AM - 10:15 AMPatient Satisfaction and Quality of Vision after Wavefrontguided(WFG) vs. Wavefront-optimized (WFO) Photorefractivekeratectomy (PRK)Denise S. Ryan 1 , Rose K. Sia 1 , Richard D. Stutzman 2 , Joseph F.Pasternak 2 , Lamarr Peppers 1 , Jennifer B. Eaddy 1 , Lorie A. Logan 1 ,Edward W. Trudo 1 , Kraig S. Bower 3 . 1 US Army WarfighterRefractive Surg Research Ctr, Fort Belvoir Community Hospital, FortBelvoir, VA; 2 Ophthalmology, Walter Reed National MilitaryMedical Center, Bethesda, MD; 3 The Wilmer Eye Institute, JohnsHopkins University, Baltimore, MD.Purpose: To compare higher order aberration (HOA) root meansquare (RMS) and patient satisfaction of postoperative vision afterWFG vs. WFO PRK.Methods: Participants randomized to receive WFG PRK (VISX StarS4, Abbott Medical Optics) or WFO PRK (Wavelight AllegrettoWave Eye-Q, Alcon Surgical) underwent testing to determine theirHOA RMS preoperatively and at 6 months (M) postoperatively. RMSHOA were analyzed at four different pupil sizes (4, 5, 6, and 7mm)using Complete Ophthalmic Analysis System (COAS, AbbottMedical Optics). A repeated measures analysis of variance (RM-ANOVA) was used to compare WFG vs. WFO PRK HOA RMS ateach pupil size over time. Participants responded to a questionnairepreoperatively and 6M postoperatively. A Mann-Whitney test wasused to compare patient satisfaction of postoperative vision. A p-value
ARVO 2013 Annual Meeting Abstracts by Scientific Section/Group - CorneaFigure 1. WFG vs. WFO PRK higher order aberrations (HOA) rootmean square (RMS)Response Analyser. Furthermore 30 healthy persons between 20-30years were measured as a control group.Results: There were no significant differences in IOPcc between the4 groups. As DA and DR correlated linearly with CCT, DA and DRwere adjusted to a corneal thickness of 476 µm in all groups.DR in all refractive groups was significantly lower than the controlgroup, but no significant differences were found between therefractive groups (Table 1). LASIK had a significantly lower DA,when compared with SMILE and the control group. There was nosignificant difference in DA between SMILE and the control group(Table 2).Conclusions: The low DR in all refractive groups indicates that laserrefractive surgery results in higher corneal elasticity despite adjustingfor differences in CCT. The significantly lower DA in LASIK couldbe a result of stress-stiffening appearing in untouched collagens. Asmore collagens are left untouched after flap-free laser treatments(SMILE), the stress on each collagen fiber becomes less. A DA moresimilar to the control group may support, that SMILE is a morebiomechanically neutral corneal laser refractive procedure.Table 1. Patient satisfaction and quality of vision questionnaireresults.Commercial Relationships: Denise S. Ryan, None; Rose K. Sia,None; Richard D. Stutzman, None; Joseph F. Pasternak, None;Lamarr Peppers, None; Jennifer B. Eaddy, None; Lorie A. Logan,None; Edward W. Trudo, None; Kraig S. Bower, NoneSupport: Dept of Defense W81XWH-09-2-0018Clinical Trial: NCT01097525Program Number: 3136 Poster Board Number: D0071Presentation Time: 8:30 AM - 10:15 AMComparing the Corneal Biomechanical Stability after LASIK,ReLEx FLEx and ReLEx SMILE with Ultra High Speed Camera(Corvis® ST)Iben Bach Pedersen, Sashia Bak-Nielsen, Anders Ivarsen, JesperHjortdal. Ophthalmology, Aarhus University Hospital, Aarhus,Denmark.Purpose: Laser refractive surgery involves removal of corneal tissue.Modern flap-free laser treatments of the cornea (SMILE) mayweaken the cornea to a lesser extent than flap based treatments (FLExand LASIK). With the new device, Corvis ST from Oculus, it ispossible to measure high-speed pictures of the corneal deformationduring an air-pulse. With the deformation amplitude (DA) and thedeformation radius (DR) at highest concavity, changes in the cornealrigidity after laser refractive surgery may be compared.Methods: Patients treated for high myopia (-9,5 to -4,5 D) more thanone year ago were invited for a follow up examination. Eighty-sevenpatients operated on both eyes participated, and were divided into 3refractive groups:Laser-Assisted In Situ Keratomileusis, LASIK (30 patients)Femtosecond Lenticule Extraction, ReLEx-FLEx (30 patients)Small Incision Lenticule Extraction, ReLEx-SMILE (27 patients)The average uncorrected visual acuity, best corrected visual acuityand IOP was similar in all refractive groups. With Corvis ST, thecentral corneal thickness (CCT), DA and DR was measured, andcorneal corrected IOP (IOPcc) was measured with the OcularTable 1: Mean DR with 95% CI.Table 2: Mean DA with 95% CI.Commercial Relationships: Iben Bach Pedersen, None; SashiaBak-Nielsen, None; Anders Ivarsen, None; Jesper Hjortdal, CarlZeiss Meditec (R)Program Number: 3137 Poster Board Number: D0072Presentation Time: 8:30 AM - 10:15 AMFemtosecond (FS) Laser Techniques to Facilitate Deep AnteriorLamellar Keratoplasty (DALK)Perry S. Binder 1, 2 , Roger F. Steinert 1, 2 , James E. Hill 2 , Michael A.Campos 2 . 1 Gavin Herbert Dept of Ophthal, Univ of California, IrvineCA, San Diego, CA; 2 Abbott Medical Optics Inc., Santa Ana, CA.Purpose: To develop and study femtosecond laser techniques andsettings that facilitate deep stromal resections for DALK.Methods: Three approches in human eye bank eyes were used tocreate smooth beds for DALK using a 150 kHz FS laser: Procedure1) Debulking (N=12) removing 300 µm @ 9.0 mm (3x3 spot/line SL,0.6 µJ) followed by 100 µm resection (2x2 or 3x3 SL, 0.6 µJ);Procedure 2) Deep single or double raster pass (N=3) @ 7.0 mmdiameter, 8x8 SL, 0.3 µJ); Procedure 3) Multiple raster passes usingtwo spiral and then 2 raster patterns using the same patient interface,followed by a raster pattern with a side cut (N= 8) forcing the FSproducedgases to dissect Descemet’s membrane (DM) away fromthe stroma (7.0 mm diameter, 8x8 SL, 900 side cut 1.6 µJ, 2.1 µJraster). The corneas were then fixed in glutaraldehye and prepped forLM, SEM, and TEM.Results: Procedure 1 created a bed as smooth as more superficial FSlaser dissections, but left a significant thickness of posterior stroma inplace. Procedure 2 removed more stroma than #1, but it was not as©2013, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permissionto reproduce any abstract, contact the ARVO Office at arvo@arvo.org.
Page 2 and 3:
ARVO 2013 Annual Meeting Abstracts
Page 4 and 5:
Page 6 and 7:
Page 8 and 9:
Page 10:
Page 13 and 14:
Page 16 and 17:
Page 18 and 19:
Page 20 and 21:
Page 22 and 23:
Page 24 and 25:
Page 26 and 27:
Page 28 and 29:
Page 30 and 31:
Page 32 and 33:
Page 34 and 35:
Page 36 and 37:
Page 38 and 39:
Page 40 and 41:
Page 42 and 43:
Page 44 and 45:
Page 46 and 47:
Page 48 and 49:
Page 50 and 51:
Page 52 and 53:
Page 54 and 55:
Page 56 and 57:
Page 58 and 59:
Page 60 and 61:
Page 62 and 63:
Page 64 and 65:
Page 66 and 67:
Page 68 and 69:
Page 70 and 71:
Page 72 and 73:
Page 74 and 75:
Page 76 and 77:
Page 78 and 79:
Page 80 and 81:
Page 82 and 83:
Page 84 and 85:
Page 86 and 87:
Page 88 and 89:
Page 90 and 91:
Page 92 and 93:
Page 94 and 95:
Page 96 and 97:
Page 98 and 99:
Page 100 and 101:
Page 102 and 103:
Page 104 and 105:
Page 106 and 107:
Page 108 and 109:
Page 110 and 111:
Page 112 and 113:
Page 114 and 115:
Page 116 and 117:
Page 118 and 119:
Page 120 and 121:
Page 122 and 123:
Page 124 and 125:
Page 126 and 127:
Page 128 and 129:
Page 130 and 131:
Page 132 and 133:
Page 134 and 135:
Page 136 and 137:
Page 138 and 139:
Page 140 and 141:
Page 142 and 143:
Page 144 and 145:
Page 146 and 147:
Page 148 and 149:
Page 150 and 151:
Page 152 and 153:
Page 154 and 155:
Page 156 and 157:
Page 158 and 159:
Page 160 and 161:
Page 162 and 163: ARVO 2013 Annual Meeting Abstracts
Page 262 and 263:
Page 264 and 265:
Page 266 and 267:
Page 268 and 269:
Page 270 and 271:
Page 272 and 273:
Page 274 and 275:
Page 276 and 277:
Page 278 and 279:
Page 280 and 281:
Page 282 and 283:
Page 284 and 285:
Page 286 and 287:
Page 288 and 289:
Page 290 and 291:
Page 292 and 293:
Page 294 and 295:
Page 296 and 297:
Page 298 and 299:
Page 300 and 301:
Page 302 and 303:
Page 304 and 305:
Page 306 and 307:
Page 308 and 309:
Page 310 and 311:
Page 312 and 313:
Page 314 and 315:
Page 316 and 317:
Page 318 and 319:
Page 320 and 321:
Page 322 and 323:
Page 324 and 325:
Page 326 and 327:
Page 328 and 329:
Page 330 and 331:
Page 332 and 333:
Page 334 and 335:
Page 336 and 337:
Page 338 and 339:
Page 340 and 341:
Page 342 and 343:
Page 344 and 345:
Page 346 and 347:
Page 348 and 349:
Page 350 and 351:
Page 352 and 353:
Page 354 and 355:
Page 356 and 357:
Page 358 and 359:
Page 360 and 361:
Page 362 and 363:
Page 364 and 365:
Page 366 and 367:
Page 368 and 369:
Page 370 and 371:
Page 372 and 373:
Page 374 and 375:
Page 376 and 377:
Page 378 and 379:
Page 380 and 381:
Page 382 and 383:
show all

Cornea - ARVO

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?