Purpose: To evaluate the safety and efficacy of femtosecond laser-assisted MyoRing implantation with concurrent corneal collagen crosslinking (CXL) compared to MyoRing alone for the treatment of progressive keratoconus. Methods: A total of 60 patients were enrolled in this randomized controlled trial. The patients were randomly allocated into two groups. In the first group, MyoRing was implanted, while in the second, it was inserted in the corneal stroma using the same technique, along with simultaneous CXL. Visual, refractive, topographic, and abberometric outcomes were measured preoperatively and at every postoperative visit. Results: Data of 47 patients were available at the end of the study; 28 in the MyoRing group and 19 in the MyoRing + CXL group. The mean uncorrected distance visual acuity (UDVA) improved from 0.79 ± 0.39 logMAR to 0.52 ± 0.31 logMAR (P < 0.05) in the MyoRing + CXL group and from 0.65 ± 0.38 logMAR to 0.62 ± 0.23 logMAR (P = 0.70) in the MyoRing group. CDVA changed from 0.33 ± 0.19 logMAR to 0.25 ± 0.16 logMAR (P = 0.10) in the MyoRing + CXL group and 0.32 ± 0.22 logMAR to 0.33 ± 0.17 logMAR (P > 0.5) in the MyoRing group. The mean keratometry (Km) decreased from 47.5 ± 2.7 D to 43.8 ± 3.2 D (P < 0.001) in the MyoRing group and 49.3 ± 3.4 D to 45.1 ± 3.0 D (P < 0.001) in the MyoRing + CXL group. Besides, horizontal coma was significantly lower in the MyoRing + CXL group (P = 0.022). Conclusion: MyoRing insertion combined with CXL is a safe and effective method for the treatment of keratoconus. The visual and topographic outcomes were comparable to that for MyoRing insertion after 10 months; however, horizontal coma was significantly lower in the MyoRing + CXL group.
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Background and Importance: Liponeurocytoma is a rare tumor of the CNS. Some of its prominent features include low neuronal proliferation with foci of lipomatous differentiation. So far, 70 reports on cases of brain liponeurocytoma have been published. Most of them were located in the cerebellar hemisphere, but only 7 cases of primary Cerebellopontine Angle (CPA) liponeurocytoma have been reported. Case Presentation: We presented a 27-year-old woman with a 6-month progressive headache and dizziness. More recently, she developed progressive hearing loss and ataxia. Pre-operative MRI of the brain demonstrated a heterogeneous solid extra-axial lesion in the right CPA with hydrocephalus. The operation was performed via the retro sigmoid approach. Histopathological diagnosis was confirmed as liponeurocytoma. No radiotherapy was performed. The patient was followed up for two years. There were no signs of recurrence. Conclusion: Liponeurocytoma is a rare tumor. In most of the cases, it is presented in the cerebellum, and the CPA as the primary location of this tumor is extremely uncommon. Typically, surgery is the treatment of choice for these lesions. If the tumor is subtotal, radiotherapy after operation and resection can also be advantageous.
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