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Purpose: To present choroidal and macular thickness measurements in pediatric patients with keratoconus and to evaluate a possible correlation between anterior and posterior segment parameters. Methods: 50 eyes of 50 patients and 50 eyes of 50 age-matched controls were included in this cross-sectional comparative study. The participants underwent ophthalmologic examination including; refraction, visual acuity, biomicroscopy, corneal topography and optical coherence tomography. The choroidal thickness (CT) was measured at subfoveal area and at 500 microns intervals to the nasal and temporal to the fovea up to 1500 microns. Results: The mean age of the patients and controls were 12.4 ± 1.9 and 12.0 ± 2.1 years. The mean thinnest corneal pachimetry was 456 ± 57 μm, the mean central macular thickness (CMT) was 258 ± 24 μm and the mean subfoveal choroidal thickness was 342 ± 30 μm for the patients. There was no significant difference between the patients and controls in regards of CMT and CT at any measured points (p > 0.05 for all). There was no correlation between anterior segment parameters and CMT. There was no correlation between anterior segment parameters and subfoveal choroidal thickness. Conclusions: We may conclude that keratoconus does not affect the CMT and CT of pediatric keratoconus patients, and we may propose that we do not need a correction for this group of patients when we need to evaluate the CMT and CT. Keywords: Choroidal thickness, Keratoconus, Macular thickness, Optical cohorence tomography

Purpose. To evaluate and compare corneal backscatter from anterior stroma between small incision lenticule extraction (SMILE) and femtosecond laser-assisted LASIK (femto-LASIK).Methods. A cohort of 60 eyes of 30 patients was randomized to receive SMILE in one eye and femto-LASIK in the fellow eye. In vivo confocal microscopy was performed at 1 week and 1, 3, and 6 months after surgery. The main outcome measurements were maximum backscattered intensity and the depth from which it was measured, the backscattered light intensity 30 μm below Bowman’s membrane at the flap interface and 150 μm below the superficial epithelium, and the number of refractive particles at the flap interface.Results. The mean backscattered light intensity (LI) at all measured depths and the maximum backscattered LI were higher in the SMILE group than the femto-LASIK group at all postoperative visits. LI differences at 1 week and 1- and 3-month visits were statistically significant (P<0,05). LI differences at 6 months were not statistically significant. There was no difference in the number of refractive particles at the flap interface between the groups at any visit.Conclusions. SMILE results in increased backscattered LI in the anterior stroma when compared with femto-LASIK were evaluated.

Ahmet Demirok,1 Alper Agca,2 Engin Bilge Ozgurhan,2 Ercument Bozkurt,2 Ugur Celik,2 Ali Demircan,2 Nimet Burcu Guleryuz,2 Kadir Ilker Cankaya,2 Omer Faruk Yilmaz3 1Department of Ophthalmology, Medeniyet University, Istanbul, Turkey; 2Beyoglu Eye Training and Research Hospital, Istanbul, Turkey, 3Private Practice, Istanbul, Turkey Aims: To report our initial experience with femtosecond lenticule extraction (FLEX) compared with femtosecond laser-assisted in situ keratomileusis (LASIK). Settings and design: This was a prospective pilot study carried out at the Refractive Surgery Department of the Beyoglu Eye Training and Research Hospital, Istanbul, Turkey. Materials and methods: Surgery was performed on both eyes of 14 consecutive patients with myopia or myopic astigmatism. Patients underwent FLEX in one eye and femtosecond LASIK (FemtoLASIK) in the other eye. The primary outcome was based on uncorrected distance visual acuity, corrected distance visual acuity, and spherical equivalent of the subjective manifest refraction, at 1 week, 1 month, and 6 months postsurgery. Statistical analyses were performed using PAWS Statistics 18. Unpaired Student’s t-test was used to compare the groups. Results: During the last follow-up visit (6 months postsurgery), the mean spherical was −0.37 ± 0.60 diopters (D) (range −1.00 to 0.50) (P < 0.001) and −0.25 ± 0.41 D (range −0.88 to 0.12 D) (P < 0.001) in the FLEX and FemtoLASIK eyes, respectively. The spherical was within ± 0.50 D of the intended correction in ten (72%) of the FLEX eyes and 12 (86%) of the FemtoLASIK eyes (P > 0.05). No complications occurred during surgery or the postoperative period. Conclusion: FLEX is a safe, effective, and predictable procedure for surgical correction of myopia. Refractive results were stabilized within the first postoperative week, and visual acuities were stabilized within the first month, comparable to FemtoLASIK. Keywords: FLEX, femtosecond laser-assisted in situ keratomileusis