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R Suarez - One of the best experts on this subject based on the ideXlab platform.
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one year follow up of toric intraocular lens implantation in Forme Fruste keratoconus
Journal of Cataract and Refractive Surgery, 2009Co-Authors: Alejandro Navas, R SuarezAbstract:We present 2 cases of toric intraocular lens implantation for keratoconus: A 55-year-old man with Forme Fruste keratoconus with a preoperative uncorrected distance visual acuity (UDVA) of 20/800 and a refraction of −6.50−3.00×135 and a 46-year-old man with a claw-shaped topographic pattern, a family history of keratoconus, and a UDVA of 20/800 with a refraction of −5.00−3.00×85. The refraction had been stable for at least 5 years in both patients. Phacoemulsification and implantation of an acrylic toric IOL were uneventful. One year postoperatively, the UDVA was 20/25 in both cases, with a refraction of −0.25−0.50×140 and 0.25−0.50×60, respectively. No progression and no IOL rotation were observed. Toric IOLs may provide excellent outcomes in patients with stable and nonprogressive corneal ectasia.
Alejandro Navas - One of the best experts on this subject based on the ideXlab platform.
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Multifocal toric intraocular lens implantation for Forme Fruste and stable keratoconus.
Journal of Refractive Surgery, 2014Co-Authors: Margarita Montano, Karla P López-dorantes, Arturo Ramirez-miranda, Enrique O Graue-hernandez, Alejandro NavasAbstract:PURPOSE To describe the results of multifocal toric intraocular lens implantation in two patients (one with Forme Fruste keratoconus and the other with frank but stable keratoconus). METHODS A 50-year-old woman with Forme Fruste keratoconus and positive family history of keratoconus and a 42-year-old man with frank keratoconus underwent corneal collagen cross-linking. Uncorrected distance visual acuity was 20/800 in the right eye and 20/400 in the left eye and 20/400 in the right eye and 20/100 in the left eye, respectively. Refractive lens exchange was perFormed using multifocal toric intraocular lenses in both cases. RESULTS After phacoemulsification, uncorrected distance visual acuity, corrected distance visual acuity, binocular uncorrected distance visual acuity was 20/25 and 20/30 in cases 1 and 2, respectively, and residual refraction was within 0.5 diopters of emmetropia in both cases. Patients were subjectively satisfied. CONCLUSIONS Presbyopic treatment options are scarce for patients with keratoconus and multifocal toric intraocular lenses may be useful in selected cases.
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one year follow up of toric intraocular lens implantation in Forme Fruste keratoconus
Journal of Cataract and Refractive Surgery, 2009Co-Authors: Alejandro Navas, R SuarezAbstract:We present 2 cases of toric intraocular lens implantation for keratoconus: A 55-year-old man with Forme Fruste keratoconus with a preoperative uncorrected distance visual acuity (UDVA) of 20/800 and a refraction of −6.50−3.00×135 and a 46-year-old man with a claw-shaped topographic pattern, a family history of keratoconus, and a UDVA of 20/800 with a refraction of −5.00−3.00×85. The refraction had been stable for at least 5 years in both patients. Phacoemulsification and implantation of an acrylic toric IOL were uneventful. One year postoperatively, the UDVA was 20/25 in both cases, with a refraction of −0.25−0.50×140 and 0.25−0.50×60, respectively. No progression and no IOL rotation were observed. Toric IOLs may provide excellent outcomes in patients with stable and nonprogressive corneal ectasia.
Damien Gatinel - One of the best experts on this subject based on the ideXlab platform.
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Combining Placido and Corneal Wavefront Data for the Detection of Forme Fruste Keratoconus.
Journal of Refractive Surgery, 2016Co-Authors: Alain Saad, Damien GatinelAbstract:PURPOSE To evaluate the accuracy of a new objective method based on Placido disk-derived data for the detection of eyes at risk of ectasia. METHODS One hundred nineteen eyes of 176 patients were included and separated into two groups, normal and Forme Fruste keratoconus (FFKC), using automated corneal classification software. Normal eyes (n = 114) were classified as negative for keratoconus and keratoconus suspect and had undergone LASIK with unremarkable follow-up for 4 years. The FFKC group was composed of 62 topographically normal eyes of patients with keratoconus in the fellow eye. Anterior topographic parameters, obtained from specular topography using Placido-based indices and corneal wavefront Zernike coefficients, were compared between groups. Receiver operating characteristic (ROC) curves were used to identify cut-off points in discriminating between keratoconic and normal eyes. Validation was perFormed on an external group of eyes. RESULTS A discriminant function was built combining four corneal wavefront variables and four Placido variables. The area under the receiver operating characteristic was 0.970 with this eight-variable model. The validation of this function had 63% sensitivity for detecting FFKC and 100% sensitivity for detecting keratoconus, with a specificity of 82%. CONCLUSIONS Indices generated from corneal wavefront and Placido measurements can assist in identifying early or mild forms of keratoconus undetected by a Placido-based neural network program. [J Refract Surg. 2016;32(8):510-516.].
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Validation of an Objective Scoring System for Forme Fruste Keratoconus Detection and Post-LASIK Ectasia Risk Assessment in Asian Eyes.
Cornea, 2015Co-Authors: Cordelia Chan, Marcus Ang, Alain Saad, Daniel Chua, Margarita Mejia, Li Lim, Damien GatinelAbstract:Purpose:To investigate the efficacy of the SCORE Analyzer (Bausch+Lomb TechnoLas, Germany) in detecting Forme Fruste keratoconus (FFKC) in Asian eyes and validate its usefulness as a risk assessment system for post–laser in situ keratomileusis (LASIK) keratectasia.Methods:We retrospectively evaluate
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Evaluation of total and corneal wavefront high order aberrations for the detection of Forme Fruste keratoconus.
Investigative Opthalmology & Visual Science, 2012Co-Authors: Alain Saad, Damien GatinelAbstract:PURPOSE To investigate the application of anterior corneal and ocular aberrations in detecting mildly ectatic corneas. METHODS This study retrospectively reviewed the data of 220 eyes separated into three groups by the NIDEK Corneal Navigator System automated corneal classification software: normal (N) (n = 123); Forme Fruste keratoconus (N topography with contralateral KC) (n = 34); and KC (n = 63). Anterior corneal and ocular aberrations were obtained with the optical path difference scan and compared using a Kruskal-Wallis test. Evaluation of these data to discriminate between the three groups was assessed using a Receiver-Operating Characteristic curve analysis. RESULTS Corneal and ocular tilt, vertical coma, and trefoil were significantly different in the FFKC as compared with the N group. The discriminant functions between the FFKC and the N group, and between the KC and the N group reached an area under the receiver operating characteristic curve of 0.98 and 0.96, respectively. CONCLUSION Indices generated from corneal and ocular wavefront can identify very mild forms of ectasia that may be undetected by Placido-based neural network programs.
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Topographic and Tomographic Properties of Forme Fruste Keratoconus Corneas
Investigative Opthalmology & Visual Science, 2010Co-Authors: Alain Saad, Damien GatinelAbstract:PURPOSE. To investigate the efficacy of topography and tomography indices combined in discriminant functions to detect mild ectatic corneas. METHODS. The authors retrospectively reviewed the data of 143 eyes separated into three groups by the Corneal Navigator OPD scanning system (Nidek, Gamagori, Japan): normal (N; LASIK surgery with a 2-year follow-up; n 72), Forme Fruste keratoconus (N topography with contralateral KC; FFKC; n 40), and KC (n 31). Topography and tomography indices, corneal thickness spatial profile (CTSP), and anterior and posterior curvature spatial profiles were obtained with the Orbscan IIz (Bausch & Lomb Surgical, Rochester, NY). The percentage of thickness increase (PTI) from the thinnest point to the periphery, the percentage of variation of anterior (PVAK), and posterior curvature were calculated and compared by Kruskal-Wallis test. The usefulness of these data to discriminate among the three groups was assessed by receiver operating characteristic (ROC) curve analysis. RESULTS. Posterior elevation of the thinnest point (TP), all positions of CTSP, PTI for all distances from the TP, and PVAK from a 5- to 7-mm distance from the TP were significantly different in the FFKC compared with the N group. The discriminant functions between the FFKC and the N groups and between the KC and the N groups reached an area under the ROC curve of 0.98 and 0.99, respectively. PTI indices and maximum posterior central elevation were the most important contributors to the discriminant function. CONCLUSIONS. Indices generated from corneal thickness and curvature measurements over the entire cornea centered on the TP can identify very mild forms of ectasia undetected by a Placido-based neural network program. (Invest Ophthalmol Vis Sci. 2010;51:5546‐5555) DOI:10.1167/iovs.10-5369
George Asimellis - One of the best experts on this subject based on the ideXlab platform.
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Forme Fruste Keratoconus Imaging and Validation via Novel Multi-Spot Reflection Topography
Case Reports in Ophthalmology, 2013Co-Authors: Anastasios John Kanellopoulos, George AsimellisAbstract:Background/Aims: This case report aims to evaluate safety, efficacy and applicability of anterior surface imaging in a patient with Forme Fruste keratoconus (FFKC) based on a novel multi-spot, multicolor light-emitting-diode (LED) tear film-reflection imaging technology Case Description: A 45-year-old male patient, clinically diagnosed with FFKC, with highly asymmetric manifestation between his eyes, was subjected to the multicolor-spot reflection topography. We investigated elevation and sagittal curvature maps comparatively with the multicolor-spot reflection topographer, a Placido topographer and a Scheimpflug imaging system. For the right eye, steep and flat keratometry values were 41.92 and 41.05 D with the multicolor spot-reflection topographer, 42.30 and 42.08 D with the Placido, and 41.95 and 41.19 D with the Scheimpflug system. For the left eye, steep and flat keratometry values were 41.86 and 41.19 D with the multicolor spot-reflection topographer, 42.06 and 41.66 D with the Placido topographer, and 41.96 and 41.66 D with the Scheimpflug camera. Average repeatability of the keratometry measurements was ±0.35 D for the multicolor spot-reflection topographer, ±0.30 D for the Placido, and ±0.25 D for the Scheimpflug camera. Very good agreement between the instruments was demonstrated on the elevation and curvature maps. Conclusion: The ease of use and the comparable results offered by the multicolor spotreflection topographer, in comparison to established Placido and Scheimpflug imaging, as well as the increased predictability that may be offered by the multicolor spot-reflection topographer, may hold promise for wider clinical application, such as screening of young
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Forme Fruste Keratoconus Imaging and Validation via Novel Multi-Spot Reflection Topography
Karger Publishers, 2013Co-Authors: Anastasios John Kanellopoulos, George AsimellisAbstract:Background/Aims: This case report aims to evaluate safety, efficacy and applicability of anterior surface imaging in a patient with Forme Fruste keratoconus (FFKC) based on a novel multi-spot, multicolor light-emitting-diode (LED) tear film-reflection imaging technology Case Description: A 45-year-old male patient, clinically diagnosed with FFKC, with highly asymmetric manifestation between his eyes, was subjected to the multicolor-spot reflection topography. We investigated elevation and sagittal curvature maps comparatively with the multicolor-spot reflection topographer, a Placido topographer and a Scheimpflug imaging system. For the right eye, steep and flat keratometry values were 41.92 and 41.05 D with the multicolor spot-reflection topographer, 42.30 and 42.08 D with the Placido, and 41.95 and 41.19 D with the Scheimpflug system. For the left eye, steep and flat keratometry values were 41.86 and 41.19 D with the multicolor spot-reflection topographer, 42.06 and 41.66 D with the Placido topographer, and 41.96 and 41.66 D with the Scheimpflug camera. Average repeatability of the keratometry measurements was ±0.35 D for the multicolor spot-reflection topographer, ±0.30 D for the Placido, and ±0.25 D for the Scheimpflug camera. Very good agreement between the instruments was demonstrated on the elevation and curvature maps. Conclusion: The ease of use and the comparable results offered by the multicolor spot-reflection topographer, in comparison to established Placido and Scheimpflug imaging, as well as the increased predictability that may be offered by the multicolor spot-reflection topographer, may hold promise for wider clinical application, such as screening of young adults for early keratoconus and, in a much wider perspective, potential candidates for laser corneal refractive surgery
Kemal Ozulken - One of the best experts on this subject based on the ideXlab platform.
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In-vivo corneal biomechanical analysis of unilateral keratoconus.
International journal of ophthalmology, 2015Co-Authors: Orhan Ayar, Orkun Muftuoglu, Mehmet Cuneyt Ozmen, Mehmet Orcun Akdemir, Mustafa Koc, Kemal OzulkenAbstract:AIM To evaluate and compare corneal biomechanical findings measured by ocular response analyzer, topographic and pachymetric findings in patients with unilateral keratoconus patients and healthy controls. METHODS This is an observational, case-control study. Patients with keratoconus in one eye and Forme Fruste keratoconus in the fellow eye were compared with sex and age matched with controls healthy subjects. All subjects were evaluated with rotating scheimpflug imaging system. The receiver-operating-characteristic curves were analyzed to evaluate the sensitivity and specificity of the parameters. RESULTS Twenty-seven patients with keratoconus in one eye and Forme Fruste keratoconus in the fellow eye were compared with 40 eyes of 40 normal subjects. Corneal hysteresis (CH) was 8.0±1.7 mm Hg in keratoconus group, 8.3±1.6 mm Hg in Forme Fruste keratoconus group, and 9.8±1.6 mm Hg in control groups (P=0.54 between keratoconus and Forme Fruste keratoconus groups, P
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Posterior corneal elevation and back difference corneal elevation in diagnosing Forme Fruste keratoconus in the fellow eyes of unilateral keratoconus patients.
Journal of Cataract & Refractive Surgery, 2013Co-Authors: Orkun Muftuoglu, Orhan Ayar, Kemal Ozulken, Erhan Özyol, Arsen AkinciAbstract:Purpose To evaluate posterior corneal elevation and back difference corneal elevation in patients with keratoconus in 1 eye and Forme Fruste keratoconus in the fellow eye. Setting Kudret Eye Hospital, Ankara, Turkey. Design Case-control study. Methods This study retrospectively reviewed patients with keratoconus in 1 eye and Forme Fruste keratoconus in the fellow eye and eyes of normal subjects. All subjects were evaluated with a rotating Scheimpflug imaging system (Pentacam), including sagittal and tangential anterior curve analysis, keratometry, and posterior elevation. The back difference elevation values were extrapolated from the difference maps of the Belin-Ambrosio enhanced ectasia display of the Scheimpflug system. The receiver operating characteristic (ROC) curves were analyzed to evaluate the sensitivity and specificity of the parameters. Results The corneal power, pachymetric progression index, and posterior corneal elevation (posterior elevation and back difference elevation) measurements were statistically significantly higher in eyes with keratoconus or Forme Fruste keratoconus than in eyes of normal control subjects ( P Conclusions Back difference elevation was better than posterior elevation in diagnosing Forme Fruste keratoconus. However, as sole parameters, both had limited sensitivity and specificity to differentiate between Forme Fruste keratoconus eyes and normal control eyes. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned.