bluuebunny/crossref_metadata_2025_split huggingface dataset:
Keratoconus patterns and intrastromal segments
Authors: BARRAQUER RI , ALFONSO J , MURTA J 
Published: August 2012

AbstractPurpose Intrastromal corneal segments (ICS) are a popular alternative for the treatment of keratoconus. However, its variability makes difficult a simple approach to ICS implantation. The SA.ANA classification of ICS implant modalities was developed to enable comparability between case series, with implications on the best ICS combinations for the different keratoconus patterns.Methods A multicenter database was established including ICS implanted during the 2004 to 2011 period. Based on 1097 cases, a simple classification of ICS implantation modalities was devised using 2 basic criteria: symmetry and axiality, whose combination results in 4 major types. The observed series was fitted into this framework.Results 2 equal ICS facing each other define symmetrical (S) implantation. Asymmetrical (A) means only 1 or 2 different ICS. Axial (A) implants are those placed with their center at the flatter astigmatism axis, while non‐axial (NA) refers to those at an axis differing ≥30º from that of astigmatism. This results in 4 main types (SA, AA, SNA, ANA), while the asymmetric types can include 1 or 2 ICS (AA1, AA2, ANA1, ANA2). The most frequent modality was asymmetrical‐axial (AA) totaling almost 70% of the implants. Symmetric‐axial (SA) represent about 10%. The non‐axial groups account for the remaining minority (20%).Conclusion The SAANA classification employs simple criteria for a comprehensive description of the ICS implantation types. Identifying these types is a prerequisite for a meaningful comparison of the clinical results. This classification is also useful as a guideline to select the best ICS combinations for a particular keratoconus case. While axial implantation constitutes 80% of the cases, the non‐axial types may address special problems as non‐coincident astigmatism & coma.
Commercial interest
Cross linking for keratoconus ‐ clinical results comparing epithelium removal versus no removal
Authors: CAPOROSSI ALDO , MAZZOTTA C , PARADISO AL 
Published: August 2012

AbstractPurpose Comparative prospective mid‐term 24 months functional analysis after Epi‐off and Epi‐on Riboflavin UV A corneal cross‐linking (CXL) in patients affected by progressive keratoconus (KC).Methods Functional analysis comprised 30 eyes of 24 patients (15 ‐ 26 years) treated by epi‐on trans‐epithelial CXL procedure and 30 eyes of 24 patients (10 ‐ 26 years) treated by standard epi‐off CXL. Therapy was performed according to the Siena protocol by using the Vega CBM (Caporossi‐Baiocchi‐Mazzotta) X linker (CSO, Florence, Italy) at Siena University.Results At 24 months follow‐up patients showed a mean gain in UCVA of +0.2, +Snellen lines in the epi‐off group while in the epi‐on group after a mean improvement of 1 Snellen Line at 3 months, uncorrected visual acuity gradually returned to baseline. BSCVA gained by a mean of +0.2 Snellen lines in the epi‐off procedure while in the epi‐on patients no significant improvement was recorded at 24 moths follow‐up. Kmax was reduced by a mean value of −0.6D, and Coma values improved by a mean of −0.45 μm in the epi‐off group. No significant variation in K readings and coma values were recorded in the epi‐on treatment.Conclusion Epi‐off CXL showed a constant improvement of functional data while the epi‐on procedure showed a relative instability with a regression of functional outcomes returning to baseline at 24 months of follow‐up. In patients with progressive keratoconus under 26 years with corneal thickness over 400 microns epi‐off cross‐linking should be the first choice therapy. According to actual limitations epi‐on procedure should be reserved in patients over 26 years with low KC progression or in patients with thinnest point under 400 microns.
Assessment of dry eye after LASIK by real‐time measurement of higher order aberrations variation
Authors: GICQUEL JJ , DJABAROUTI M , ZAKARI W , BREMOND‐GIGNAC D , PISELLA PJ 
Published: August 2012

AbstractPurpose To evaluate tear break‐up time (BUT) with real‐time (RT) higher order wavefront aberrations (HOA) measurements in myopic patients after Laser‐Assisted In Situ Keratomileusis (LASIK) surgery.Methods HOA up to the sixth order for a 4‐mm pupil were measured in 20 normal subjects (Group 1) and in 20 myopic patients, with no history of dry eye (DE), before and after LASIK surgery (Group 2), using the IRX3 (Imagine Eyes, Orsay, France) Hartmann‐Shack (H‐S) aberrometer. The HOA measurements were performed (in triplicate) with a new dedicated software, once every second for up to 20 seconds. HOA variations were compared with the BUT by the conventional fluorescein method (CFM).Results Twenty percent of the patients from Group 2 were complaining from DE symptoms. There was an excellent correlation between the HOA variation and the BUT recorded by the CFM in both groups. Reproducibility of the HOA measurements in all subjects and patients was excellent. BUT was significantly decreased (P<0.005) in 30% of the patients in Group 2 when compared to the normal tests subjects (Group 1).Conclusion HS aberrometry is a non invasive method that has been used for the last decade for the assessment of the quality of vision, in patients undergoing refractive surgery and cataract or clear lens extraction. Studying the HOA variation is a new interesting method for evaluating both the quality vision and the BUT in patients after LASIK surgery.
Pathogenetic evaluation of the ocular surface drug correction in patients before LASIK
Authors: SERGEEVA M , KOVALEVSKAYA M , CHERNIKOVA I 
Published: August 2012

AbstractPurpose Development and evaluation of the method of optimizing the ocular surface before the refractive intervention.Methods Overall, 485 patients were enrolled in this case‐control study. Assessed the ocular surface, tear film and tear production before and after optimization of preoperative LASIK patients in 4 groups. Group 1 (A) ‐ high myopia ‐ (97), aged 18 to 35 years, group 2 (B) ‐ medium myopia – (145), aged 18 to 35 years, group 3 (C) ‐ myopia medium or high – (73), older than 35 years, group 4 (D) ‐ hypermetropia medium or high ‐ (49), older than 35 years. The criteria for preoperative drug correction of refractive surgery to the stage were the following diagnostic blocks: clinical data in diagnosis of dry eye and corneal status, corneal thickness, the definition of clinical refraction, including patient age, antioxidant and immune activity of tears.Results The use of a preparation containing hydroxypropylguar and sorbitol in groups A and D, and a preparation containing hydroxyproylguar in groups B and C before LASIK reduces the number of complications refractive surgery.Conclusion The correlation between the choice of ocular surface drug correction and the evaluation of the Norn, Lipkof, cornea vital coloring tests, cornea thickness (mm), the type of refractive error and degree of change (and its degree of myopia), the patient's age (35 and older than 35 years of age), antioxidant and immune activity of tears (the concentration of peroxyredoxin 6 (PRDX6), the presence or absence of gamma globulin).
Secreted frizzled proteins in control and keratoconus (KC) tears and corneas
Authors: MADIGAN MC , YOU JJ , WEN L , HODGES C , ROUFAS A , MCAVOY JW , SUTTON G 
Published: August 2012

AbstractPurpose To investigate the expression and distribution of Wnt pathway antagonists, secreted frizzled‐related proteins (SFRPs), in tears and corneas from control and keratoconus (KC) patients.Methods Immunofluorescence and confocal microscopy were used to examine the expression patterns of SFRP1, 2, 3, and 5 in paraffin sections of KC (n=11) and control (n=7) corneas. A custom SFRP1 ELISA was developed and used to quantify SFRP1 concentration in basal tear samples collected from KC (n=10) and control patients (n=10). The percentage SFRP1 of total tear protein concentration (%SFRP1) was calculated and compared between KC and control groups.Results Immunofluorescence showed heterogeneous epithelial SFRP1 expression in all KC corneas compared to low expression in controls. SFRP3 and SFRP5 showed unique patterns of immunolabelling. SFRP3 was localised to epithelial cell membranes and limbal vessels in control corneas; cell membrane and cytoplasmic immunolabelling, and increased expression centrally, was seen in KC. SFRP5 was expressed strongly in the corneal stroma (KC and control). SFRP2 immunoreactivity not obvious in either control or KC corneas. ELISA results showed that tear SFRP1 levels were lower in KC compared to control tears.Conclusion The pathogenesis of KC remains poorly understood. Our current study shows that SFRP1, 2, 3 and 5 are differentially expressed in control and KC corneas, consistent with previous work, suggesting Wnt signalling involvement in KC. The decreased levels of KC tear SFRP1 contrasts with increased expression in KC corneal epithelium, and may suggest KC‐associated differences in tear secretion or tear protein breakdown. Funded in part by Sydney Eye Hospital Foundation
Diagnostic ability for glaucoma of imaging technologies based on optic nerve head parameters
Authors: GIL ARRIBAS L , ARA M , FERRERAS A , SATUE M , BAMBO M , FERRANDEZ B 
Published: August 2012

AbstractPurpose To assess the ability of optic nerve head (ONH) parameters measured with 2 different imaging technologies to discriminate between normal and glaucoma patients with visual field losses.Methods Sixty‐seven normal eyes and 43 glaucoma patients were consecutive and prospectively selected. Participants were classified depending on the results of standard automated perimetry (SAP) and intraocular pressure. All of them underwent a comprehensive ophthalmic examination, at least 2 reliable SAP tests, and imaging of the ONH with the Heidelberg Retina Tomograph 3 (HRT; Heidelberg Engineering, Heidelberg, Germany) and with Cirrus OCT (Carl Zeiss Meditec, Dublin, Ca). Only one eye per subject was randomly included in the statistical analysis. The areas under the receiver operating characteristic curve (AUCs) were plotted and sensitivity‐specificity pairs compared.Results The mean age was 55.713.6 years for the normal group and 59.16.2 years for the glaucoma group (p=0.133). The mean deviation of SAP was ‐0.71.2 dB and ‐5.96.1 dB (p<0.001) for the normal and glaucoma groups, respectively. The largest AUCs were observed for the rim area of Cirrus (0.954; 95% confidence interval [CI]: 0.919‐0.989), and the vertical cup/disk ratio of HRT3 (0.924; 95% CI: 0.890‐0.959). There was not a significant difference between them. Sensitivity at 85% fixed specificity was 86% for the rim area of Cirrus and 83.7% for the cup/disk area ratio of HRT3.Conclusion ONH parameters measured with spectral‐domain OCT and HRT3 have similar diagnostic performance. OCT, however, does not require prior manual outlining of disc boundaries, reducing the dependency on operator skill.
Biomechanical response of lamina cribrosa and prelaminar tissue to an acute induced IOP elevati
Authors: GIZZI C , CELLINI M , CAMPOS EC 
Published: August 2012

AbstractPurpose We decided to investigate the effects of an acute induced IOP elevation on the prelaminar tissue and on the lamina cribrosa in glaucomatous eyes and in healthy eyes by means of an high resolution Spectral Domain (SD) OCT.Methods We enrolled 10 patients (mean age 70.2 years) affected by primary open angle glaucoma (POAG) and 10 healthy subjects (mean age 70.8 years) as controls. All the subjects were scanned with a SD‐OCT with real‐time eye tracking at baseline and in the same exact position during IOP elevation performed with an ophthalmodynamometer. The IOP was measured with a Tono‐Pen at baseline and during IOP elevation. The SD‐OCT images acquired were processed with a computer graphical suite to determine the prelaminar tissue displacement (PTD) and the laminar displacement in the two groups. An analysis of variance was used for evaluating group differences considering statistically significant a P < 0.05.Results Baseline IOP was significantly different in the two groups, with higher values in patients compared to controls: 18.9(4.3) vs. 15.7(2.6) mmHg (P<0.037). Mean PTD was significantly lower in glaucomatous eyes compared to healthy eyes: 6.8(13.7) vs. 20.8(17.5) micron (P<0.039); whereas LD was similar in the two groups: ‐0.5(3.7) vs. 0.2(2.0) micron (P=0.366), and not statistically different from 0 (P=0.366).Conclusion The study shows that an acute induced elevation of IOP does not induce a detectable movement of the lamina cribrosa anterior surface both in glaucomatous and healthy eyes.On the other hand the displacement of the prelaminar tissue is lower in patients with POAG than in controls.
Advanced open angle glaucoma with controlled intraocular pressure and cataract: one‐year predictive model of glaucoma progression after surgical treatment.
Authors: LIASKA A , PAPAKONSTANTINOU D , THEODOSIADIS P , CHATZISTEPHANOU K 
Published: August 2012

AbstractPurpose To identify the predictive factors of midterm postoperative course in patients with visually significant cataract and advanced open angle glaucoma with intraocular pressure controlled on topical medications.Methods 55 patients with visually significant cataract and advanced open angle glaucoma (visual field Mean Deviation (MD)≤‐12dB) and intraocular pressure(IOP)≤21mmHg on topical medications were prospectively studied(longitudinal data analysis).32 patients undergone phacoemulsification alone versus 23 patients undergoing combined phaco‐trabeculectomy. Main outcome measures: IOP(mmHg), visual acuity(VA)(logMAR), MD(dB), number of antiglaucoma medications needed postoperatively. Follow‐up 1 year.Results The combined surgery provided more IOP reduction (‐5.76(‐7 to ‐4.5) mmHg) (p<0.001) and allowed the reduction of antiglaucoma medications postop by 2.2(2.7 to 1.8) (p<0.001). VA improvement was more by the time elapsed (p=0.014) and preoperative MD (p=0.006) and less by the presence of relative afferent pupillary defect(RAPD)(p<0.001). The MD change was related to the preoperative MD (p<0.001) while Cup‐Disc Ratio had a negative effect on postoperative MD change (p=0.001). The presence of RAPD reduced the MD change (p=0.052) while patients with pseudoexfoliation syndrome and women showed improvement in their MD postoperatively (p=0.038 and p=0.021, respectively).Conclusion type of operation is the main predictive factor of the IOP change and number of antiglaucoma medication reduction. VA improvement is related to severe damage of the optic nerve and visual field change is related to the degree of glaucomatous damage of the optic nerve.
STARfloTM, a new suprachoroidal drainage implant for glaucoma: 3 months clinical results
Authors: POURJAVAN S , COLLIGNON N , DE GROOT V , GEENS P , MAGINNESS M , MARSHALL A , ROY C , ALVAREZ M 
Published: August 2012

AbstractPurpose STARfloTM is a silicone implant for IOP reduction in POAG. STARfloTM is made with STAR® Biomaterial, a flexible tissue‐friendly, micro‐porous structure designed to reduce fibrotic response and maximize long‐term performance. The safety and performance endpoints of the study were; 1. Feasibility of STARfloTM device implantation; 2. Incidence of device and procedure related‐complication and unanticipated adverse device effects; 3. Reduction in IOP; 4. Reduction in number of glaucoma medications.Methods 4 patients with advanced POAG and preop IOP>21 mmHg underwent STARfloTM implantation in suprachoroidal space. Outcome measures were IOP, biomicroscopy, ophthalmoscopy and the number of anti‐glaucomatous drugs on D1, W1, M1 and M3 postop.Results Mean preop IOP was 37.0±8.4 mmHg and mean preop glaucoma medication was 2.5±1 intake/day. 1m postop (4 cases), mean IOP decreased to 21.8±9.7 mmHg (38.4% reduction/patient) and mean glaucoma medication decreased to 1.0±1.2 intake/day. At 3 m (3 cases), mean IOP was 25±11.3 mmHg (33.1% reduction/patient) and mean glaucoma medication was 1±1 intake/day. No adverse events were reported during or immediately postop and no device‐related serious adverse events were reported during follow‐up. Early complications were: transient hypotony for 2 cases, transient choroidal hemorrhage in 1 case, transient abnormal macula in 1 case. In 3 cases, bleb disappeared at month 1, and in 1 case it disappeared at month 3. 1 patient, with posttraumatic COAG, was dropped 4 m after implantation.Conclusion Early results for STARflo met the safety and performance endpoints of study. STARflo reduces IOP in refractory glaucoma,
Commercial interest
Marginally controlled open angle glaucoma and cataract: sequential (1st phacoemulsification,2nd trabeculectomy) versus combined (phacotrabeculectomy) surgery
Authors: LIASKA A , ANDRIANOPOULOU K 
Published: August 2012

AbstractPurpose glaucoma patients with borderline controlled intraocular pressure (IOP) may benefit from cataract surgery alone. However it is possible that these patients may need glaucoma surgery at some point in the future. Furthermore the risk of postoperative IOP spikes and the inconvenience of two operations (sequential) should be weighed against the complexity of the combined operation. The purpose of the study is to compare the results of phacotrabeculectomy with trabeculectomy in clear corneal incision pseudophacic eyes.Methods retrospective study of 31 patients with visually significant cataract and open angle glaucoma with IOP 22‐25 mmHg on topical medications. The patients were assigned to either surgical treatment according to their glaucoma severity. 20 patients underwent combined phacotrabeculectomy (two‐sites) and 11 patients underwent sequential (1st phacoemulsification(temporal clear corneal incision with intraocular lens implantation), 2nd trabeculectomy). Antimetabolites and adjustable sutures were used in all glaucoma operations. IOP measurements were recorded. Follow up time was 6‐18 months (median 12 months).Results the effect of type of surgical treatment on postoperative IOPs was not statistically significant. Combined phacotrabeculectomy resulted in higher IOPs by 0.97(95% Confidence Interval [‐1.6 3.59]) mmHg (p=0.47) versus sequential surgery.Conclusion in patients with clinically significant cataract and glaucoma with borderline control of IOP the choice of combined (phacotrabeculectomy) versus sequential (1st phaco, 2nd trabeculectomy) surgery can be done according to the severity of glaucoma and based on surgeon’s preference and experience.
Local recurrence after uveal melanoma protontherapy: prognostic consequences
Authors: CAUJOLLE JP , PAOLI V , CHAMOREY E , MASCHI C , HANNOUN‐LEVI JM 
Published: August 2012

AbstractPurpose To study the prognosis of the different types of uveal melanoma recurrences treated by proton beam therapyMethods This retrospective study analyzed 61 cases of uveal melanoma local recurrence on a total of 1102 patients treated with protontherapy between June 1991 and December 2010. Survival rates have been determined by using Kaplan‐Meier curves. Prognostic factors have been evaluated by using Log‐rank test or Cox model.Results Our local recurrence rate was 5.5%. These recurrences were divided into: 25 patients with marginal recurrences, 18 global recurrences, 12 far recurrences and 6 extra‐scleral extensions. 4 factors have been identified as statistically significant risk factor of local recurrence in univariate analysis: large tumoral diameter, weak tumoral volume, weak ratio of tumoral volume over eyeball volume and safety margin inferior to 1 mm. In the local recurrence free population, the overall survival rate was 59.8% at 15 years and the specific survival rate was 80.9% at 15 years. In the local recurrence population, the overall survival rate was 34.5% at 15 years and the specific survival rate was 55% at 15 years. Kaplan‐Meier survival curves have shown a better prognosis for marginal recurrences compared to the other recurrences.Conclusion Survival rate of marginal recurrences is highly superior to the other recurrences. The type of recurrence is an important clinical prognostic value to know.
Lethal metastatic ciliary body melanoma without hepatic disease in a young girl
Authors: GRANGE JD , MONTEIRO S , BENTALEB Z 
Published: August 2012

AbstractPurpose To illustrate a case report of rapid metastatic death due to a ciliary body melanoma in a a young female of 19 years of age, with no hepatic metastatic disease.Methods A young algerian girl was send for conservative treatment for a ciliary body tumor of the left eye on the 19th of march 2012.This eye was blind, with a white cataract.Rubeosis iridis was present on the whole iris surface with total angle closure ,ocular pressure was 41 mm and US showed a temporal ciliary body tumor of 3.5 mm in height and 10 mm in diameter .Results An enucleation was performed on March 20th , but the patient had to be hospitalized on the same afternoon in Intensive Care Unit for drainage of bilateral pleural effusion, purely inflammatory .Full Body CT Scan has shown brain secondary foci of 3 and 5 mm on both frontal lobes.A nodular lesion of 7 mm was also present on the Fowler lung lobe.The liver was not invaded but massive mesenteric necrotic lesions with peritoneal effusion were found. Surgical biopsy of the mesenteric lesions was done in the General Surgery Unit on March 22nd showing melanoma cells.In the same time the ocular pathologists diagnosis was an epithelioid ciliary body melanoma of 10x10 mm. On April 3rd a pleurodesis was created with pleural biopsies in the Thoracic Surgery Unit.Mesothelial pleural hyperplasia without malignancy sign was diagnosed.A chemotherapy with Muphoran has been advised by oncologists and begun soon after she returned in her country where she died at the end of May .Conclusion Death by metastatic disease can also occur without detectable hepatic lesions by US or CT Scan in case of severe ciliary body melanoma.The mechanism of responsible mesenteric lesions for death in the hepatic vicinity has to be explained.
Fine needle aspiration biopsy in uveal melanoma : the Curie experience
Authors: DESJARDINS L , LEVY C , LUMBROSO‐LEROUIC L , CASSOUX N , SASTRE X , ASSELAIN B , PLANCHER C , COUTURIER J 
Published: August 2012

AbstractPurpose In order to posssibly include uveal melanoma patients in a randomized trial on adjuvant therapy by Fotemustine we have started in 2009 to propose fine needle aspiration biopsy for genetic studies during clip or plaque positioningMethods Biopsies were proposed to patients with uveal melanomas of more than 5 mm in thickness.we have used transcleral or transvitreal biopsies depending on the location of the tumor with 25 or 23 gauge needles. Histoacryl glue was used after transcleral biopsies and cryotherapy for transvitreal biopsies.Patients signed an inform consentResults 108 biopsies were performed between January 2009 and april 2012; 6 patients had transient vitreal hemorrhages ( much more frequent with transvitreal p<0,0001))but no other side effects was observed. A sufficient quantity of DNA for CGH array was present in76% of cases, using whole genome amplification in 60% of cases. The quality of the specimen was strongly correlated with the presence of tumor cells’ p<0, 0001). 28, 7% of patients were classified as high genomic risk. No correlation was found between location and size of the tumor or any other clinical factor and the biopsy success rateConclusion fine needle aspiration biopsy is a safe procedure to allow genetic testing in uveal melanoma patients