Risk factors for postlaser refractive surgery corneal ectasia.

PURPOSE OF REVIEW: To summarize newly reported and update previously known risk factors for post laser vision correction (LVC) corneal ectasia. RECENT FINDINGS: Advances in corneal topography and tomography have improved detection of preclinical ectasia-related changes. This has allowed for enhanced screening of surgical candidates. There are also known genetic predispositions for corneal ectasia, and recent genetic analyses have revealed various genes and inflammatory biomolecular markers related to corneal biomechanical integrity. Other models of risk assessment such as finite element biomechanical modeling and artificial intelligence tools have shown promise in detecting more subtle risk factors, such as those related to mechanical strain. SUMMARY: Risk factors for post-LVC corneal ectasia involve both surgery and patient-specific characteristics, such as topographic and tomographic abnormalities, younger age, thinner preoperative corneas, and residual stromal beds, high myopia, and higher percentage tissue altered. Preoperative risk stratification has helped to decrease the incidence of postoperative ectasia, a trend which will likely continue with advancements in analytic tools and better understanding of underlying genetic predispositions.

Acute Corneal Endothelial Graft Rejection With Coinciding COVID-19 Infection.

PURPOSE: To report a case of acute corneal endothelial graft rejection with the concurrent onset of coronavirus disease 2019 (COVID-19) symptoms. METHODS: Case report. RESULTS: A 31-year-old African American woman with a history of asthma, sleep apnea, obesity (body mass index of 40), and bilateral keratoconus was noted to have acute corneal endothelial graft rejection 3 months after uncomplicated penetrating keratoplasty of the left eye. The patient developed dysgeusia and subjective fever on the same day as ocular discomfort, and she was subsequently diagnosed with COVID-19 with only these 2 classic symptoms of the viral infection. CONCLUSIONS: Severe acute respiratory syndrome coronavirus 2 is known to cause conjunctivitis and has demonstrated transmissibility through ocular secretions. Acute immune and inflammatory dysregulations have been seen in cases of COVID-19 through various mechanisms. COVID-19 infection may potentially compromise ocular immune privilege contributing to acute corneal graft rejection.

Penetrating ocular injury from motor vehicle rear-view side-mirror.

PURPOSE: To report a case of penetrating ocular injury due to automobile rear-view side-mirror. OBSERVATIONS: This is a case of a 49-year-old male who developed penetrating eye injury with a full thickness corneal laceration after isolated motor vehicle damage to the rear-view side-mirror. This patient subsequently required surgical repair of the corneal laceration and likely will need further surgical interventions in the future for ocular rehabilitation. CONCLUSIONS AND IMPORTANCE: Our case of rear-view side mirror caused injury and those previously reported highlight an area of opportunity for injury prevention.