Small incision lenticule extraction and femtosecond-assisted laser in situ keratomileusis in patients with deep corneal opacity: case series

Abstract

AIM: To report the safety, efficacy, and accuracy of small-incision lenticule extraction (SMILE) or femtosecond-assisted laser in situ keratomileusis (FS-LASIK) for the correction of myopia or myopic astigmatism in patients with deep corneal opacity denoted by anterior segment optical coherence tomography (AS-OCT). METHODS: Four patients with monocular corneal opacity (3 due to mechanical injury, 1 due to a firecracker wound) were recruited and treated with refractive surgery (3 for SMILE, 1 for FS-LASIK combined with limbal relaxing incision (LRI). Preoperative ocular manifestations, surgical details, postoperative visual outcomes, corneal opacity parameters, and corneal topography were analyzed. RESULTS: Preoperatively, spherical diopter ranged from -3.0 D to -4.75 D with cylinder ranging from -0.75 to -5.0 D, and corrected distance visual acuity (CDVA) ranging from 20/25 to 20/20. One eye’s corneal opacity was located in the central zone and three were in the mid-peripheral optical zone. Three patients underwent uneventful SMILE in both eyes, whilst one patient underwent FS-LASIK for high astigmatism in both eyes and LRI in the right eye. CDVA of the eye with corneal opacity ranged from 20/22 to 20/20 one to six weeks postoperatively. Two patients achieved better CDVA and no patients lost Snellen lines. The postoperative diopter was within ±0.75 D for all eyes. Significant edema existed above the corneal opacity in one eye and dissipated soon. No eccentric corneal topography or morphological anomaly of the corneal cap or flap was observed. CONCLUSION: The cases demonstrate that SMILE or FS-LASIK is safe and effective to treat myopic astigmatism combined with deep corneal opacity lesions after comprehensive preoperative evaluation and appropriate candidate selection. FS-LASIK combined with LRI is also sufficient for correcting high astigmatism due to corneal scarring.

Exploring multi-level risk factors and post-war burdens of trachomatous trichiasis among displaced population in Raya Kobo districts, implication for urgent action

“…Consistent with previous studies, finding in central Ethiopia [17] , Southern Ethiopia [23] , and Tanzania [46] demonstrated that at ≥10 km far from the site of a drinking water source for an individual living house, the log-odds of having TT infection was 6.5 (AOR=6.5: 95%CI, 3.9-31.3) times increased as compared with the counter group had been lived <10 km. Individuals who lived near water sources had higher hygiene standards, more personal cleanses, and a lower risk of trachoma infection from flies, which is directly related to the likelihood of developing trachoma and TT infection [3][4][5][6][7] .…”

“…C hlamydia trachomatis is an infectious eye disease caused by Chlamydia trachomatis, an obligate intracellular bacterium that causes follicular conjunctivitis, superficial keratitis, and corneal vascularization, and finally caused scarring [1][2] . Epidemiologically, trachoma is the leading cause of blindness worldwide and transmitted by eye-to-eye contact and eye-seeking flies' contacts [3][4][5][6][7] . Etiologically, trachomatous trichiasis (TT) infection is characterized by severe corneal abrasion, inflammation, and scarring on the tarsal conjunctiva due to insufficient secretion of intravitreal biomarkers by multiple infections in childhood accounted synaptic for neural transmission and finally caused irreversible blindness [3] .…”

“…Epidemiologically, trachoma is the leading cause of blindness worldwide and transmitted by eye-to-eye contact and eye-seeking flies' contacts [3][4][5][6][7] . Etiologically, trachomatous trichiasis (TT) infection is characterized by severe corneal abrasion, inflammation, and scarring on the tarsal conjunctiva due to insufficient secretion of intravitreal biomarkers by multiple infections in childhood accounted synaptic for neural transmission and finally caused irreversible blindness [3] . The eyelid protrusion in miss-segmentally caused repeated blinks and which finally produces florid pans and corneal scarring in the wrong direction [8][9] .…”

“…After an intervention, global antibiotic coverage in 2021 was 44% [13][14] . Globally, 47 countries were identified as active trachomaendemic countries with 157.7 million inhabitants living in public health hazard areas [3,[6][7] . The WHO promotes a multifaceted surgery, antibiotics, facial cleanliness, and environmental improvement (SAFE) method for trachoma prevention, which includes multiple components [4] for reducing the TT burden through antibiotic distribution, TT surgery, and environmental sanitation [4][5][6][7][8][9][10][11][12][13][14][15] .…”