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Purpose: To assess and compare preoperative refractive, aberrometric, topographic, and contrast sensitivity (CS) measurements with postoperative values after corneal collagen cross-linking (CXL) in patients with progressive keratoconus. Methods: Twenty-two eyes of 11 patients with keratoconus were enrolled in this prospective study. Uncorrected distance visual acuity (UDVA), best spectacle corrected visual acuity (BSCVA), CS, and higher order aberrations (HOAs) were evaluated at baseline and 1, 3, 6, and 8 months after surgery. Results: The mean total HOAs of the included patients were 2.24, 2.34, 2.28, 2.17, and 2.03 before and 1, 3, 6, and 8 months after CXL, respectively. A significant reduction in corneal HOAs including vertical coma, vertical and horizontal trefoil and spherical aberration was observed 6 and 8 months after CXL. UDVA and BSCVA improved significantly in all patients who completed the follow-up period (P = 0.001). Although mean CS declined significantly 1 month postoperatively, it improved significantly after 3, 6, and 8 months (P<0.001). Maximum keratometry was significantly lower 8 months postoperatively compared to the preoperative value. (P = 0.006). Conclusions: CXL seems to improve UCVA, BSCVA, and CS and reduce most corneal HOAs in progressive forms of keratoconus. [ABSTRACT FROM AUTHOR]

Purpose: To report an interesting case of concomitant bilateral Terrien's marginal degeneration-like corneal ectasia and posterior polymorphous corneal dystrophy in a young man with quiescent rheumatoid arthritis. Case Report: A 24-year-old man with history of rheumatoid arthritis presented with bilateral decreased vision since four years ago. Slit lamp examination revealed bilateral circumferential peripheral corneal thinning and bulging with vascularization and lipid deposition in addition to band-like lesions in descemet's membrane. Previous records revealed no gross corneal abnormalities up to 4 years ago. Corneal lesions were compatible with bilateral circumferential Terrien's marginal degeneration concomitant with posterior polymorphous dystrophy. Conclusion: To our knowledge, this is the first report of concomitant bilateral Terrien's marginal degeneration with peripheral corneal ectasia and posterior polymorphous dystrophy in a patient with rheumatoid arthritis. Bilateral circumferential involvement, younger age at presentation and total peripheral corneal ectasia as observed in this case are not typical for classic Terrien's marginal degeneration. [ABSTRACT FROM AUTHOR]

Herein we describe a technique for management of large inadvertent full-thickness trephination during deep anterior lamellar keratoplasty using the big-bubble technique without converting to penetrating keratoplasty. First, the anterior chamber is formed with an ophthalmic viscosurgical device (OVD). Then, the full-thickness wound is secured with one X-type 10-0 nylon suture. A 27-gauge needle is attached to a 2 mlair-filled syringe and inserted into the corneal stroma in the meridian opposite to the site of full-thickness trephination. Air is gently injected to produce a limited area of "big-bubble" detaching Descemet's membrane (DM) from the corneal stroma. The "big bubble" is slowly expanded with injection of OVD. Finally, the recipient stroma is removed, the donor lenticule is placed and the DM tear is secured with one full thickness 10-0 nylon suture. [ABSTRACT FROM AUTHOR]