BackgroundThe purpose of this study was to evaluate the visual outcome of photorefractive keratectomy (PRK) in patients with mild to moderate stable keratoconus and to assess the risk of progression of the disease after the excimer laser procedure.MethodsIn this prospective study, carried out at the Clemenceau Medical Center, an affiliate of Johns Hopkins International, in Beirut, Lebanon, 119 eyes from 72 patients with grade 1–2 keratoconus (Amsler–Krumeich classification) underwent PRK. Forty-seven patients had both eyes treated and 25 patients had one eye treated. The procedure was done using the Wavelight Eye Q Excimer laser. Uncorrected and best-corrected visual acuity, corneal topography, and pachymetry were assessed before the procedure and 3, 6, 12, 36, and 60 months after the procedure.ResultsMean uncorrected visual acuity showed a statistically significant improvement (P < 0.05) at one, 3, and 5 years follow-up. One hundred and seventeen eyes (98.3%) showed no progression while two eyes (1.7%) showed progression of the disease at 5 years follow-up, as documented by corneal topography and pachymetry. These two eyes were treated with corneal collagen crosslinking.ConclusionPRK in mild to moderate keratoconus is a safe and effective procedure for improving uncorrected vision in patients with mild refractive errors. However, close follow-up of patients is needed to detect any progression of the disease. Longer follow-up is needed to assess the overall effect of this procedure on progression of the disease.

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Purpose Strabismus and nystagmus are often reported in congenital glaucoma ( CG), but few data are available. This study aims at describing clinical features of oculomotor disorders associated with congenital glaucoma. Methods A retrospective study was led in a service of Pediatric Ophthalmology of the South of France taking for reference the registers of the children operated for primitive CG between 2008 and 2013. We registered the caracteristics of cross‐eyed infringement, the nystagmus, refractive data and amblyopia. Tests of chi ² or exact tests of Fisher were used for the category‐specific variables and the tests of Mann‐Whitney for the quantitative variables. Results 47 children were included.2 children presented an unilateral CG. 25%(12 children) presented a strabismus ;4 had a convergent deviation (33 %) and 8 an exotropia(66 %).4 children (8 % ) had a nystagmus, and all of them had a low best corrected visual acuteness(BCVA)(BCVA lower than 0,6 LogMAR). We find an average spherical equivalent (SE) more important in myopia in the cross‐eyed population (average SE ‐1.75 D) with regard to the non strabismic population (average SE ‐0.35 D). Regarding nystagmic patients, we find a much more important average SE in myopia (average SE ‐7.8 D) with regard to the non‐strabismic population (average SE ‐0.35 D)( p: 0.016). A statistically significant link exists between amblyopia and nystagmus occurency (p Fischer: 0.013). Conclusion Most of the children taken in care for primitive CG and presenting a deviation had a visual acuteness decreased in our study. The nystagmus seems to appear for BCVA lower than 0,6 LogMAR. This amblyopia seems to have both organic origin but also refractive origin.

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