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Clinical Advances in Corneal and Refractive Surgery for Keratoconus
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Clinical Advances in Corneal and Refractive Surgery for Keratoconus

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Ophthalmology".

Deadline for manuscript submissions: 30 June 2024 | Viewed by 1598

Special Issue Editors

Prof. Dr. Anna M. Roszkowska

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Guest Editor
1. Ophthalmology Clinic, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
2. Ophthalmology Department, Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, Krakow, Poland
Interests: cornea; corneal imaging; keratoconus; corneal surgery; refractive surgery
Special Issues, Collections and Topics in MDPI journals
Dr. Maciej Kozak

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Guest Editor
Ophthalmology Department, Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, Krakow, Poland
Interests: cornea; keratoconus; keratoplasty; corneal surgery
Dr. Katarzyna Sajak-Hydzik

E-Mail Website
Guest Editor Assistant
Ophthalmology Department, Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, Krakow, Poland
Interests: corneal topography; refractive surgery; keratoconus; laser technology; intracorneal rings

Special Issue Information

Dear Colleagues,

In recent years we have observed an increasing interest for the diagnosis and treatment of keratoconus. The dynamic development of diagnostic and therapeutic methods constantly gives us new tools and opens up opportunities to improve the treatment options in patients with corneal ectasia. New sophisticated diagnostic tools allow us to obtain fast, accurate and detailed results and diagnosis in early stages of ectasia enabling the prompt treatment. In the mean time, new diagnostic possibilities allow precise determination of the severity of disease and consequently the choice of the appropriated treatment method. The therapy aims to maintain or improve visual acuity and the corneal cross-linking (CXL) is actually the most performed procedure to halt the ectasia progression. Nevertheless, in cases with visual impairment, corneal surgery such as lamellar or penetrating keratoplast and refractive surgery are performed to restore the visual acuity. Particularly, refractive procedures aiming to improve the visual acuity in KC are of growing interest. Progress in refractive surgery has enabled the use of treatment protocols based on CXL and surface ablation procedures to improve visual function. CXL performed using different protocols combined with photorefractive keratectomy or implantation of intracorneal rings represents a new approach in the management of corneal ectasia.  At the same time the successful use of femtolasers in corneal surgery both refractive and therapeutic, opened new horizons for keratoconus treatment.

In this special issue we invite authors to submit articles on surgical advances in corneal surgery and refractive procedures performed in different stages of keratoconus. We encourage the authors to share their experience and the results of corneal cross linking protocols and surgical procedures used in keratoconus management. Information contained in this special issue will allow a further exchange of experiences and recommendations for ophthalmologists to optimize the therapy of keratoconus in different stages of this disease.

Prof. Dr. Anna M. Roszkowska
Dr. Maciej Kozak
Guest Editors
Dr. Katarzyna Sajak-Hydzik
Guest Editor Assistant

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • keratoconus
  • corneal collagen cross linking (CXL)
  • corneal surgery
  • keratoplasty
  • refractive surgery

Published Papers (2 papers)

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10 pages, 3878 KiB  
Article
Simultaneous Muraine Sutures and Excimer Laser-Assisted Penetrating Keratoplasty for Acute Keratoconus
by Marie Elisabeth Burghardt, Joana Heinzelmann, Marlene Stein, Anja Viestenz and Arne Viestenz
J. Clin. Med. 2024, 13(13), 3792; https://doi.org/10.3390/jcm13133792 - 28 Jun 2024
Viewed by 137
Abstract
Background: Acute keratoconus (acute KC), which affects approximately 1.6–2.8% of keratoconus (KC) patients, is a pathological condition of the cornea characterized by stromal edema due to entry of aqueous humor through a tear in Descemet’s membrane. Methods: We present a novel combination [...] Read more.
Background: Acute keratoconus (acute KC), which affects approximately 1.6–2.8% of keratoconus (KC) patients, is a pathological condition of the cornea characterized by stromal edema due to entry of aqueous humor through a tear in Descemet’s membrane. Methods: We present a novel combination of surgical procedures that allows swifter visual recovery in a consecutive, retrospective case series. The new surgical procedure for acute KC consists of a combination of Muraine corneal sutures to smooth the corneal curvature and Excimer laser-assisted penetrating keratoplasty and was performed in six acute KC patients from 2019 to 2022 at the Department of Ophthalmology, University Hospital of Martin-Luther-University Halle-Wittenberg (UMH), Germany. We monitored data on preoperative status, operative details, intraoperative and postoperative complications and visual outcomes were analyzed. Results: The mean age was 41.5 ± 13.5 years (3 OD, 3 OS). Neurodermatitis was present in 3 patients (50%). All patients received significant visual benefits from the procedure. Preoperative BCVA was hand motion (logMAR 3.0) in all patients; postoperatively, BCVA improved significantly logMAR 0.03 ± 0.09 [range: 0.2–0.4; p < 0.001, FUP 20+/−10 months). Visual acuity remained stable throughout the roughly biannual follow-ups. One patient developed endothelial graft rejection after 2 years. During the last examination, all eyes had clear grafts and stable curvatures, K1 and K2 being 42.43 ± 4.17 D and 44.95 ± 4.07 D, respectively, and mean corneal astigmatism was 2.61 ± 1.74 D. The thinnest corneal thickness was 519 ± 31 µm. A graft size of 8.0 × 8.1 mm was the most beneficial. Conclusions: in patients with acute KC and hydrops, a penetrating keratoplasty with Muraine corneal sutures is successful in terms of graft clarity and visual outcome. Combining the procedures allows quicker visual recovery. Patients with a history of neurodermatitis should have preoperative and postoperative dermatologic treatment and close follow-up for possible complications. Full article
(This article belongs to the Special Issue Clinical Advances in Corneal and Refractive Surgery for Keratoconus)
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Review

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10 pages, 544 KiB  
Review
Visual Acuity Examination Methodology in Keratoconus
by Magdalena Nandzik, Edward Wylęgała, Adam Wylęgała, Dominika Szkodny, Anna Maria Roszkowska and Ewa Wróblewska-Czajka
J. Clin. Med. 2023, 12(24), 7620; https://doi.org/10.3390/jcm12247620 - 11 Dec 2023
Viewed by 1017
Abstract
Visual acuity is one of the most important parameters for evaluating the vision of patients with keratoconus. This study reviewed 295 articles related to keratoconus published between 2017 and 2022 in which visual acuity was one of the parameters measured. The methodology of [...] Read more.
Visual acuity is one of the most important parameters for evaluating the vision of patients with keratoconus. This study reviewed 295 articles related to keratoconus published between 2017 and 2022 in which visual acuity was one of the parameters measured. The methodology of visual acuity testing in studies on keratoconus was thoroughly analyzed. The analysis showed that the most commonly indicated chart for testing visual acuity papers on keratoconus is the Snellen chart. It was shown that in 150 out of 295 articles, the authors do not describe the methodology for testing visual acuity. What is more, it was also shown that in 68 of the 295 articles which were analyzed, a procedure for converting visual acuity tested with a Snellen chart into a logMAR scale was used. In this review, we discuss the validity and reliability of such conversions. In particular, we show that insufficient description of visual acuity testing methodology and lack of information on the conversion of visual acuity results into the logMAR scale may contribute to the misinterpretation of visual acuity test results. Full article
(This article belongs to the Special Issue Clinical Advances in Corneal and Refractive Surgery for Keratoconus)
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