Anatomical and Visual Effects of the MyoRing Implantation Measured by the ABCD Keratoconus Grading System.

OBJECTIVE: To assess the anatomical changes produced by implantation of the complete intracorneal ring (MyoRing; DIOPTEX, GmbH, Linz, Austria) on the different corneal anatomical layers as measured by the ABCD keratoconus staging system 6 months after operation. METHODS: Seventeen eyes of 17 keratoconic patients implanted with MyoRing using the femtosecond laser were assessed preoperatively and postoperatively. Distance uncorrected visual acuity and distance corrected visual acuity (DCVA), refraction, and Scheimpflug tomography with Pentacam HR were determined for each patient. The 4 ABCD parameters were recorded, which include the anterior and posterior radius of curvature from a 3.0-mm optical zone centered on the thinnest point (TP) (A & B, respectively), the thinnest corneal thickness (C), and DCVA (D). RESULTS: Statistically significant improvement (preoperatively vs. postoperatively) in the DCVA (0.40±0.21 vs. 0.67±0.20 in decimal notation, P=0.001) associated with significant flattening effect was observed in both anterior (6.02±0.40 vs. 7.18±0.54 mm, P<0.001) and posterior (4.49±0.41 vs. 4.66±0.40 mm, P=0.001) radius of curvature. There was no significant change in the corneal thickness at the TP (P=0.981). The largest magnitude of change occurred on the anterior surface as measured by the "A" parameter. The average ABCD keratoconus staging before MyoRing implantation was A4B4C2D2 and changed to A1B4C2D1 6 months after ring implantation. CONCLUSION: Despite the placement of MyoRings in the posterior one-third of the cornea, the greatest changes in curvature occurred on the anterior corneal surface. The ABCD classification and staging system allows for a differential assessment of the different anatomical layers and may prove useful in better understanding of the geometric (structural) and functional changes after MyoRing implantation, as well as with other corneal procedures.

Effects of intracameral cefuroxime on corneal endothelial cell counts and its morphology after cataract surgery.

BACKGROUND: Endophthalmitis is one of the most important complications after cataract surgery and in case event can cause many symptoms, such as severe decrease in eyesight and/or even the loss of vision. Employing methods to reduce this problem is very important. The aim of this study was to evaluate the effect of intracameral cefuroxime after cataract surgery on corneal endothelial cell counts and its morphology. METHODS: In this study, 32 eyes of 30 patients underwent endothelial cell count and morphology assessment by ConfoScan III device before and 1 month after cataract surgery. All patients undertaken cataract surgery by one surgeon and by one method. Intracameral cefuroxime (1 mg/0.1 ml) was used as prophylaxis of postoperative endophthalmitis at the end of operation. RESULTS: In this study, the rate of corneal endothelial cell loss 1 month after cataract surgery was 8.4%, and the rate of endothelial cells polymegathism before and after cataract surgery did not differ statistically. During the follow-up period, there were no cases of endophthalmitis or other complications. CONCLUSION: With regard to the importance of the intracameral cefuroxime in a reduction in the rate of endophthalmitis after cataract surgery and that harmful effects on the endothelial cells were not seen, this method can be considered as a suitable method for endophthalmitis prophylaxis.

Prognostic Investigations of Expression Level of Two Genes FasL and Ki-67 as Independent Prognostic Markers of Human Retinoblastoma.

In this study, expression of FasL and Ki-67 messenger RNA (FasL and Ki-67 mRNA) in human retinoblastoma (HRB) was examined by the immunohistochemistry method and quantitative real-time PCR. Positive expression of Ki-67 in tumor cells was detected in 16 of 30 patients (53.33%), and only 9 (30%) of the tissues from patients with retinoblastoma showed positive staining for FasL. Our results revealed that FasL expression was significantly higher in tumor tissue with invasion compared with the noninvasion form (p = 0.033). Ki-67 expression was markedly increased in tumor tissues with invasion compared with the noninvasion group (p = 0.04), but no significant correlation was found between FasL expression and differentiation (p > 0.05). In addition, Ki-67 expression was strongly linked to differentiation (p < 0.002). Expression of these FasL was correlated with shorter overall survival of patients, but its expression was not significantly associated with overall survival (p = 0.15). The impact of Ki-67 expression on survival in patients was also evaluated. Ki-67 expression level was not found to be significantly associated with shorter survival (Kaplan-Meier; p = 0.09). Univariate analysis revealed that massive choroidal invasion was correlated with poor prognosis. Taken together, the data suggest that massive choroidal invasion is also an important indicator of poor prognosis for HRB.