Table of Contents - WOC 2012

WOC2012 Abstract Book
PO-COR-69
Evaluation of save and efficience of Crosslinking in patients with
keratoconus grade I and grade II
Grupenmacher Leon (1) , Sousa Luciene (1) , Martins Luiz (1) , Bordon Arnaldo (1)
1. Banco de Olhos de Sorocaba
Purpose Evaluate ocular and corneal response of Crosslinking in patients with
Keratoconus grade I and II. Methods Prospective, randomized,clinical trial with
keratoconus patients, who were divided in two groups of treatment: Group
I were used Riboflavin and Group II were used Balanced Saline Solution .
Inclusion criteria were keratoconus up to 52D, with progression in six months
and BCVA (Snellen) of 20/30; thinnest pachimetry of 400µ. They were
submitted to a complete ophthalmologic exam, corneal topography, especular
microscopy and retinal OCT in preoperative and 1, 3, 6, 9, 12 and 24 months
postoperative. Results The preoperative maximum keratometry in group I was
48,4 and the group II was 46,5. The maximum keratometry mean in 9 months
postoperative in group I was 47,8 and in group II was 46,5. The parameters of
points visual acuity without correction preoperative in the group I had the mean
9,6 and group II 7,3. In 24 months after the procedure the group I had 11 points
and the group II 10,1. Conclusion The two groups did not presented evaluation
of the maximum keratometry, during the study. The treatment was efficient and
safe in both groups.
PO-COR-70
Assessment of effectiveness for Trans-Epithelial CXL
Mitsui Iwane (1)
1. Toho University and Mitsui Medical Institute
Instead of usual CXL procedure, trans-epithelial CXL were performed for eight
keratoconus patients after successful Orthokeratology treatment.
Orthokeratology(Ortho-K) is less invasive corneal reshaping therapy to flatten
the corneal curvature with wearing reverse geometry rigid gas permeable
contact lens during sleeping time at night. Corneal reshaping effect of Ortho-K
is considered to happen in the epithelial layer. Histological study already
shows shape change of corneal surface during successful Ortho-K as central
epithelial thinning and mid-peripheral epithelial thickening. If epithelial layer was
removed as usual CXL procedure, Ortho-K effect might be reduced. To avoid
this, theoretically epithelial layer needs to be maintained during CXL procedure.
Results from trans-epithelial CXL for successful cases of keratoconus patients
after Ortho-K were examined in corrected and uncorrected visual acuity,
refractometry, keratometry, corneal curvature, intraocular pressure, and corneal
endothelial cell for more than six months. To absorb riboflavin enough into the
corneal epithelial and stromal layer, alcohol and/or benzalconium solution is
used before UVA irradiation. Corneal thickness was carefully measured during
riboflavin adsorption procedure with several concentrations of alcohol and/or
benzalconium comparing the level of CXL effectiveness.
PO-COR-71
Epithelial Mesenchymal Transition May Cause a Rapid Epithelial
Ingrowth After DSAEK
Hotta Fumika (1) , Eguchi Hiroshi (1) , Miyamoto Tatsuro (1) , Mitamura Yoshinori
(1) (2)
, Matsubara Minoru
1. Ophthalmology, Tokushima University
2. Ophthalmology, Matsubara Eye Clinic
Purpose: To suggest the involvement of epithelial mesenchymal transition
(EMT) in epitheliual ingrowth after Descemet-stripping automated endothelial
keratoplasty (DSAEK)
Methods: A 66 year-old male, who had a bilateral intracapsular cataract
extraction because of unknown uveitis, presented with a visual disturbance
in his left eye. His left visual acuity was (0.06) due to bullous keratopathy. He
underwent a DSAEK concurrent with intraocular lens sulcus fixation on 29th
Jan, 2010. Three air injections into the anterior chamber were applied because
of the adhesion failure of the endothelial graft. On 2nd Mar, the endothelial
graft contracted spontaneously 2 week after the last injection. We performed
2nd DSAEK on 19th Mar, and investigated the extracted endothelial graft
immunohistochemically.
Results: The visual acuity in left eye increased up to (0.2) a month after last
DSAEK. The extracted graft had several-layered squamous cells that were
positive for cytokeratin (AE1/AE2). Both the squamous cells and stroma of
the graft were negative for CD3. Although the basement cells were positive for
both vimentin and CD44, the superficial cells were negative.
Conclusions: This case suggests that a spontaneous contraction of the
endothelial graft can occur after DSAEK. It is possible that EMT cause the
rapid epithelial ingrowth.
500
PO-COR-72
The efficacy of diquafosol sodium ophthalmic solutions after
keratoplasty
Niki Masanori (1) , Eguchi Hiroshi (1) , Mitamura Sayaka (1) , Miyamoto Tatsuro (1) ,
Mitamura Yoshinori (1)
1. Department of Ophthalmology, the University of Tokushima
Purpose: The purpose of this study is to investigate the efficacy of diquafosol
sodium ophthalmic solutions 3% for dry eye patients with keratoplasty.
Methods: Six patients with keratoplasty were recruited in this study at
Tokushima University Hospital, Japan. All patients were treated for dry eye
after suture removal in 12 months postoperatively. The age ranged 46 to 73
year old. Penetrationg keratoplasty were performed on 4 eyes and lamellar
keratoplasty were performed on 2 eyes. Schirmer-I test, tear film break up time
(TFBUT), and fluorescein staining scores (scores) were compared before and
one month after addition of diquafosol sodium ophthalmic solutions 3%. The
clinical courses of corneal grafts after the addition were examined by slit lamp
microscope.
Results: Schirmer-I scores decreased from 4.4-3.6 to 4.0-3.2. TFBUT was
elongated from 1.0-0.7 to 2.4-2.6 second. Scores decreased from 3.5-1.2 to
2.3-1.2. No cases show visual disturbance, increase of intra ocular pressure,
graft rejection, and infection.
Conclusion: Diquafosol sodium ophthalmic solutions 3% is useful for dry eye
patients with keratoplasty.
PO-COR-73
Dual therapy with both diquafosol and hyaluronate sodium
ophthalmic solutions
Toibana Toshi (1) , Eguchi Hiroshi (1) , Mitamura Sayaka (1) , Miyamoto Tatsuro (1) ,
Mitamura Yoshinori (1)
1. Department of Ophthalmology,the University of Tokushima
Purpose: To investigate a dual therapy with both diquafosol and hyaluronate
sodium ophthalmic solutions for dry eye.
Methods: Thirty-one patients, 5 males and 26 females, with dry eye were
recruited in this study at Tokushima University Hospital and Mino Tanaka
Hospital, Japan. Ophthalmic findings of all patients had no significant difference
for 3months during administration of hyaluronate sodium ophthalmic solutions.
The age ranged 46 to 85 year old. Tear secretions and ophthalmic findings by
slit lamp microscope were examined before and one month after the addition
of 3% diquafosol sodium ophthalmic solutions. Schirmer-I test, tear film break
up time (TFBUT), and fluorescein staining scores were compared statistically
by means of Wilcoxon›s signed-rank test.
Results: Schirmer-I scores increased significantly from 4.8±3.7 to 7.7±1.4
(P=0.0001). TFBUT was significantly elongated from 2.2±1.5 to 3.5±2.2
second (P