RESUMEN
BACKGROUND: To examine the 12-month clinical and refractive outcomes of PRK performed with a UV all-solid-state laser. METHODS: The study included healthy patients with myopia and/or compound myopic astigmatism enrolled for refractive surgery and treated with PRK using a 210 nm wavelength, 2 kHz repetition rate, UV all-solid-state laser (LaserSoft, Katana Technologies GmbH, Kleinmachnow, Germany). All subjects were examined at baseline and after 1, 3, 6, and 12 months after the treatment with a slit lamp, refraction, visual acuity assessment (logMAR chart), tonometry, ophthalmoscopy, and corneal tomography with a Scheimpflug camera. The outcome measures considered were uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, central corneal thickness, and transparency. The efficacy, safety, predictability, and stability were determined. RESULTS: The study included 34 eyes of 19 patients. The mean UDVA changed from 1.20 ± 0.43 to -0.05 ± 0.10 logMAR at 12 months, and the mean CDVA changed from -0.03 ± 0.06 to -0.06 ± 0.09 logMAR, respectively. The mean spherical equivalent (SE) changed from -4.90 ± 2.12 D to -0.01 ± 0.40 D and was within ±0.50 D of the intended correction in 91% of eyes and within ±1.00 D in 97% of eyes at 12 months. No eyes lost lines of visual acuity, and 64% of eyes gained one or more lines. CONCLUSIONS: PRK with the 210 nm wavelength, 2 kHz repetition rate, all-solid-state laser LaserSoft system proved to have good visual, refractive, and clinical outcomes after the follow-up at 12 months. The emerging gas-free, solid-state technology might be considered a valid alternative for the gas operating lasers for corneal refractive surgery.
RESUMEN
PURPOSE: To report the clinical and confocal findings of a unique case of combined Phialemonium curvatum and Acanthamoeba keratitis and to highlight the role of the prompt diagnosis and specific medical treatment in preserving visual function. METHODS: A case report and literature review. RESULTS: A 54-year-old woman presented with a 3-day history of visual impairment, photophobia, and ocular pain in her right eye. Her best corrected visual acuity was 0.4 Logarithm of the Minimum Angle of Resolution scale, and the slit-lamp examination showed whitish corneal stromal infiltrate with satellite lesions. In vivo confocal microscopy evidenced Acanthamoeba cysts and fungal hyphae that resulted P. curvatum in the culture examination. The intensive medical treatment was started with topical 0.02% polyhexamethylene biguanide, voriconazole 1%, and moxifloxacin hydrochloride 0.5%. Progressive improvement of clinical and confocal pictures was registered with a complete recovery of visual function after 1 month. CONCLUSIONS: This is the first case report of combined P. curvatum and Acanthamoeba keratitis. The fast diagnosis with in vivo confocal microscopy allowed early and intensive specific treatment with recovery of corneal infection.
