Keratoconus: exploring fundamentals and future perspectives – a comprehensive systematic review

Niazi, Sana; Gatzioufas, Zisis; Doroodgar, Farideh; Findl, Oliver; Baradaran-Rafii, Alireza; Liechty, Jacob; Moshirfar, Majid

doi:10.1177/25158414241232258

Cited by 4 publications

(1 citation statement)

References 166 publications

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“…The introduction of FSL techniques has undoubtedly facilitated and enhanced surgical outcomes. Nevertheless, it is widely acknowledged that during the docking process, alignment of astigmatism marking lines may sometimes be compromised, posing challenges to achieving precise alignment [ 15 ]. This discrepancy may result in the postoperative axis not aligning with the planned or pre-programmed axis.…”

Section: Discussionmentioning

confidence: 99%

A new technique to implant intracorneal ring-segments from the perilimbal region: one-year prospective pilot study report

Albertazzi,

Rocha-de-Lossada,

Zaldivar

2024

BMC Ophthalmol

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Background Recently a new surgical technique for intracorneal ring-segments (ICRS) assisted by femtosecond laser (FSL) called ByLimB was developed, involving the creation of the incision from a paralimbic region. This study aims to evaluate the safety and efficacy of the ByLimb technique following one year of follow-up. Methods A prospective, single-center study was conducted at the Zaldivar Institute in Buenos Aires, Argentina. Keratoconus patients with indication for ICRS-FSL assisted procedure, operated with the ByLimb technique were included. By using the ByLimb technique, the ICRS are placed without affecting the tunnel’s roof, and the end of the ICRS is always away from the incision area. Visual acuity, topographic astigmatism, and the occurrence of complications were evaluated. Safety index was the main outcome and efficacy indes was a complimentary outcome. Results A total of 17 eyes completed the 12-month follow-up period. The safety index was 1.10 (mean postoperative corrected distance visual acuity (CDVA) in decimal: 0.76/preoperative CDVA: 0.69), while the efficacy index was 0.89 (mean postoperative uncorrected distance visual acuity UDVA in decimal: 0.62/preoperative CDVA: 0.69). Mean preoperative astigmatism was 5.3 ± 2.3, decreasing twelve months after surgery at 2.1 ± 1.2 (p < 0.001). No eye loss lines of vision and no intraoperative complications were observed. During the first month after surgery, an improper positioning of the ICRS based on topographic assessment was detected in five cases. A second procedure was performed, which consisted of opening the incision and introducing a Sinsky hook, through which the ICRS was mobilized and placed in its correct position. No incisional alterations, signs of infection, anterior segment anomalies, or fundus alterations were observed. Conclusion FSL-assisted ICRS implantation through the perilimbal region has demonstrated an adequate safety index one year post-surgery. Additionally, this technique has facilitated accurate realignment of ICRS during secondary surgical interventions within one-month post-surgery. While the current findings are promising, continued follow-up of these cases is warranted.

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Section: Discussionmentioning

confidence: 99%

A new technique to implant intracorneal ring-segments from the perilimbal region: one-year prospective pilot study report

Albertazzi,

Rocha-de-Lossada,

Zaldivar

2024

BMC Ophthalmol

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Evaluation of Responses to Questions About Keratoconus Using ChatGPT-4.0, Google Gemini and Microsoft Copilot: A Comparative Study of Large Language Models on Keratoconus

Demir

2024

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

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Objectives: Large language models (LLMs) are increasingly being used today and are becoming increasingly important for providing accurate clinical information to patients and physicians. This study aimed to evaluate the effectiveness of generative pre-trained transforme-4.0 (ChatGPT-4.0), Google Gemini, and Microsoft Copilot LLMs in responding to patient questions regarding keratoconus. Methods: The LLMs' responses to the 25 most common questions about keratoconus asked by real-life patients were blindly rated by two ophthalmologists using a 5-point Likert scale. In addition, the DISCERN scale was used to evaluate the responses of the language models in terms of reliability, and the Flesch reading ease and Flesch–Kincaid grade level indices were used to determine readability. Results: ChatGPT-4.0 provided more detailed and accurate answers to patients' questions about keratoconus than Google Gemini and Microsoft Copilot, with 92% of the answers belonging to the “agree” or “strongly agree” categories. Significant differences were observed between all three LLMs on the Likert scale (P<0.001). Conclusions: Although the answers of ChatGPT-4.0 to questions about keratoconus were more complex for patients than those of other language programs, the information provided was reliable and accurate.

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Quantifying choroidal and retinal thicknesses variations via optical coherence tomography in different stages of pediatric keratoconus

Mohammadi,

Masihpour,

Feghhi

et al. 2024

BMC Ophthalmol

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Purpose Keratoconus (KCN) is characterized by corneal thinning and bulging, leading to vision impairment. Assessing choroidal thickness (CT) in pediatric KCN ( pKCN) patients can provide insights for better understanding and managing the disease. CT may serve as a potential indicator of disease activity in KCN patients. This study aims to evaluate CT and retinal thickness (RT) in different stages of pKCN patients and compare the findings with an age-matched control group. Methods and patients This cross-sectional study included patients under 18 years old who met specific criteria. CT and RT was measured in all subjects using an optical coherence tomography device (Spectralis OCT, version 6.0, Heidelberg Engineering, Germany) with enhanced depth imaging mode, without pupil dilation. Mean CT and RT in pKCN was compared with healthy subjects and assessed among different disease grades using the ABCD grading method. Results The study included 125 eyes (66 patients) in the pKCN group and 42 control eyes (21 individuals). Grade 2 KCN showed the highest prevalence at 26.4% ( N = 33), while grades 3 and 1 had prevalence rates of 24% ( N = 30). CT in all specified areas (all P -values < 0.001), as well as RT in the subfoveal area ( P -value < 0.001) and 1500 μm nasal to the fovea ( P -value = 0.025), were significantly greater in the pKCN group compared to controls. Furthermore, CT and RT differed significantly among the pKCN grades ( P -values < 0.001). Conclusion CT was found to be elevated in pKCN patients, similar to adult KCN cases. CT could potentially serve as a clinical marker for disease activity in pKCN; however, further studies are needed.

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Keratoconus: exploring fundamentals and future perspectives – a comprehensive systematic review

Cited by 4 publications

References 166 publications

A new technique to implant intracorneal ring-segments from the perilimbal region: one-year prospective pilot study report

A new technique to implant intracorneal ring-segments from the perilimbal region: one-year prospective pilot study report

Evaluation of Responses to Questions About Keratoconus Using ChatGPT-4.0, Google Gemini and Microsoft Copilot: A Comparative Study of Large Language Models on Keratoconus

Quantifying choroidal and retinal thicknesses variations via optical coherence tomography in different stages of pediatric keratoconus

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