Use of Acular LS in the Pain Management of Keratoconus: A Pilot Study

Yu, Jessica; Gundel, Ralph E.

doi:10.1097/opx.0b013e3181c75170

Cited by 7 publications

(8 citation statements)

References 12 publications

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“…57 After consideration of the current evidence, it appears to be inappropriate to describe KC as a noninflammatory disease. 4,5 Given the wide range of inflammatory processes that can be associated with KC (Table 1), it may be more appropriate to at least classify KC as a quasi-inflammatory (inflammatoryrelated) disease until the implications of the inflammatory processes involved are better understood. It can be difficult to distinguish primary disease mechanisms from secondary inflammatory or degenerative effects.…”

Section: Discussionmentioning

confidence: 99%

“…Nonsteroidal antiinflammatory drugs like ketorolac tromethamine have been used to manage allergic conjunctivitis and for pain control after certain refractive surgeries. 5 Ketorolac tromethamine use with KC patients in a masked study did not appreciably improve ocular comfort. 45 Topical nonsteroidal anti-inflammatory drug use has been associated with corneal melts 46 and the thinner KC cornea may be at greater risk for this complication.…”

Section: The Possibility Of Anti-inflammatory Therapies In the Managementioning

confidence: 98%

“…3 Such results suggest that KC cannot be defined as a noninflammatory disorder and that the pathogenesis of KC progression may involve chronic inflammatory events. 4,5 This review of the literature considers the implications of a wide range of inflammatory activity for the pathogenesis of KC and the associated possibility of new anti-inflammatory therapeutic approaches in its management and further addresses the question, from a clinical perspective, as to whether KC can continue to be classified as a noninflammatory disease.…”

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confidence: 99%

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Inflammation and Keratoconus

McMonnies¹

2015

Optometry and Vision Science

113

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Keratoconus (KC) has been traditionally classified as a noninflammatory disease. Barring loss of function, the other classic signs of inflammation (heat, redness, swelling, pain) are not usually obvious or even apparent in KC. This clinical perspective examines the evidence and implications of numerous inflammatory processes that have been recognized in the tears of KC patients as well as some inflammation relevant differences found in the KC cornea. The roles of inflammation in corneal trauma attributed to eye rubbing and/or contact lens wear are examined as is the significance of atopy, allergic disease, dry eye disease, degradative enzyme activity, wound healing, reduced anti-inflammatory capacity, and ultraviolet irradiation. It is possible that any comorbidity that is inflammatory in nature may add synergistically to other forms of KC-related inflammation and exacerbate its pathogenetic processes. For example, some features of inflammation in ocular rosacea and associated corneal thinning and distortion could have some possible relevance to KC. An analogy is drawn with osteoarthritis, which also involves significant inflammatory processes but, like KC, does not meet all the classic criteria for an inflammatory disease. Classifying KC as quasi-inflammatory (inflammatory-related) rather than a noninflammatory disease appears to be more appropriate and may help focus attention on the possibility of developing effective anti-inflammatory therapies for its management.

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Section: Discussionmentioning

confidence: 99%

Section: The Possibility Of Anti-inflammatory Therapies In the Managementioning

confidence: 98%

mentioning

confidence: 99%

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Inflammation and Keratoconus

McMonnies¹

2015

Optometry and Vision Science

113

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“…Although various new therapies have been developed [29][30][31][32][33][34][35][36][37][38][39][40], contact lenses remain the most effective means for achieving good vision in such eyes. If the keratoconic cornea becomes too scarred or too steep to tolerate a contact lens, corneal transplantation is indicated.…”

Section: Discussionmentioning

confidence: 99%

Bevel toric multicurve rigid gas-permeable lens for keratoconus

2012

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“…Although keratoconus was historically considered as a noninflammatory condition, recent researchers revealed increased levels of inflammatory mediators in tears of keratoconus patients without clinical signs of inflammation [ 7 ]. Hence, it has been suggested that keratoconus should not be classified as a noninflammatory disorder and even that the pathogenesis of keratoconus progression could include chronic inflammatory events [ 8 , 9 ]. It should be noted that contact lens wear is intrinsically inflammatory [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Surgical Options for the Refractive Correction of Keratoconus: Myth or Reality

Fernández-Vega-Cueto

Romano

Zaldivar

et al. 2017

Journal of Ophthalmology

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Keratoconus provides a decrease of quality of life to the patients who suffer from it. The treatment used as well as the method to correct the refractive error of these patients may influence on the impact of the disease on their quality of life. The purpose of this review is to describe the evidence about the conservative surgical treatment for keratoconus aiming to therapeutic and refractive effect. The visual rehabilitation for keratoconic corneas requires addressing three concerns: halting the ectatic process, improving corneal shape, and minimizing the residual refractive error. Cross-linking can halt the disease progression, intrastromal corneal ring segments can improve the corneal shape and hence the visual quality and reduce the refractive error, PRK can correct mild-moderate refractive error, and intraocular lenses can correct from low to high refractive error associated with keratoconus. Any of these surgical options can be performed alone or combined with the other techniques depending on what the case requires. Although it could be considered that the surgical option for the refracto-therapeutic treatment of the keratoconus is a reality, controlled, randomized studies with larger cohorts and longer follow-up periods are needed to determine which refractive procedure and/or sequence are most suitable for each case.

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Use of Acular LS in the Pain Management of Keratoconus: A Pilot Study

Abstract: There was no conclusive result as to the efficacy of the ketorolac tromethamine 0.4% vs. the artificial tear solution in the pain management of keratoconus. This could be attributed to a number of physiological and situational factors, as well as small sample size.

Cited by 7 publications

References 12 publications

Inflammation and Keratoconus

Inflammation and Keratoconus

Bevel toric multicurve rigid gas-permeable lens for keratoconus

Surgical Options for the Refractive Correction of Keratoconus: Myth or Reality

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