Entity

Time filter

Source Type


Buzzonetti L.,Bambino Gesu IRCCS Childrens Hospital | Buzzonetti L.,Catholic University | Petrocelli G.,Bambino Gesu IRCCS Childrens Hospital | Valente P.,Bambino Gesu IRCCS Childrens Hospital | And 3 more authors.
Cornea | Year: 2015

Purpose: To report the results 15 months after transepithelial corneal cross-linking by iontophoresis of riboflavin performed in pediatric patients affected by keratoconus. Methods: Fourteen eyes of 14 pediatric patients [mean age 13 6 2.4 (SD) years; range, 10-18 years] were treated. Riboflavin solution was administered by iontophoresis for 5 minutes, and then UVA irradiation (10 mW/cm2) was performed for 9 minutes. The corrected distance visual acuity measured as decimal number, spherical equivalent, refractive astigmatism, simulated K, corneal coma, spherical aberration, and high-order aberrations for 5.0-mm pupil and the thinnest point were measured preoperatively and 3, 6, 12, and 15 months postoperatively. The endothelial cell density was evaluated. The paired Student t test was used to compare data during the follow-up. Results: Fifteen months after the procedure, the corrected distance visual acuity improved from 0.7 6 1.7 to 0.8 6 1.8 (P = 0.005). Spherical equivalent and refractive astigmatism as well as topographic and aberrometric data did not show significant changes. Also, the mean thinnest point and the endothelial cell density remained unchanged. The optical coherence tomography showed a nonhomogeneous but deep hyperreflective band with a fading effect extending through the anterior 180 mm of the cornea. No side effects were recorded. Conclusions: Transepithelial collagen cross-linking by iontophoresis, unlike other transepithelial techniques, seems to halt pediatric keratoconus progression over 15 months. However, we did not record significant improvement in higher-order aberrations and topographic indices. © 2015 Wolters Kluwer Health, Inc. All rights reserved. Source


Buzzonetti L.,Bambino Gesu IRCCS Childrens Hospital | Buzzonetti L.,Catholic University | Petrocelli G.,Bambino Gesu IRCCS Childrens Hospital | Valente P.,Bambino Gesu IRCCS Childrens Hospital | And 4 more authors.
Journal of Refractive Surgery | Year: 2015

PURPOSE: To describe the big-bubble full femtosecond laser-assisted (BBFF) technique, which could be helpful in standardizing the big-bubble technique in deep anterior lamellar keratoplasty (DALK). METHODS: Ten eyes of 10 consecutive patients affected by keratoconus underwent the BBFF technique using the 150-kHz IntraLase femtosecond laser (Intra-Lase FS Laser; Abbott Medical Optics, Inc., Santa Ana, CA). A 9-mm diameter metal mask with a single fissure 0.7 mm wide oriented at the 12-o'clock position was positioned into the cone, over the laser glass. The laser performed a ring lamellar cut (internal diameter = 3 mm; external diameter = 8 mm) 100 μm above the thinnest point, with the photodisruption effectively occurring only in the corneal stroma corresponding to the fissure to create a deep stromal channel; subsequently, an anterior side cut created an arcuate incision, from the corneal surface to the deep stromal channel on the mask's opening site. The mask was removed and the laser performed a full lamellar cut 200 μm above the thinnest point to create a lamella. After the removal of the lamella, the air needle was inserted into the stromal channel and air was injected to achieve a big bubble. RESULTS: The big bubble was achieved in 9 eyes (all type 1 bubbles) and all procedures were completed as DALK. CONCLUSIONS: Preliminary results suggest that the BBFF technique could help in standardizing the bigbubble technique in DALK, reducing the "learning curve" for surgeons who approach this technique and the risks of intraoperative complications. Copyright © SLACK Incorporated. Source


Rossi F.,CNR Institute of Neuroscience | Tatini F.,CNR Institute of Neuroscience | Pini R.,CNR Institute of Neuroscience | Valente P.,Bambino Gesu IRCCS Childrens Hospital | And 6 more authors.
Progress in Biomedical Optics and Imaging - Proceedings of SPIE | Year: 2015

Laser assisted keratoplasty is nowadays largely used to perform minimally invasive surgery and partial thickness keratoplasty [1-3]. The use of the femtosecond laser enables to perform a customized surgery, solving the specific problem of the single patient, designing new graft profiles and partial thickness keratoplasty (PTK). The common characteristics of the PTKs and that make them eligible respect to the standard penetrating keratoplasty, are: the preservation of eyeball integrity, a reduced risk of graft rejection, a controlled postoperative astigmatism. On the other hand, the optimal surgical results after these PTKs are related to a correct comprehension of the deep stroma layers morphology, which can help in the identification of the correct cleavage plane during surgeries. In the last years some studies were published, giving new insights about the posterior stroma morphology in adult subjects [4,5]. In this work we present a study performed on two groups of tissues: one group is from 20 adult subjects aged 59 ± 18 y.o., and the other group is from 15 young subjects, aged 12±5 y.o. The samples were from tissues not suitable for transplant in patients. Confocal microscopy and Environmental Scanning Electron Microscopy (ESEM) were used for the analysis of the deep stroma. The preliminary results of this analysis show the main differences in between young and adult tissues, enabling to improve the knowledge of the morphology and of the biomechanical properties of human cornea, in order to improve the surgical results in partial thickness keratoplasty. © 2015 SPIE. Source


Tatini F.,CNR Institute of Applied Physics Nello Carrara | Rossi F.,CNR Institute of Applied Physics Nello Carrara | Canovetti A.,Nuovo Ospedale Santo Stefano | Malandrini A.,Nuovo Ospedale Santo Stefano | And 5 more authors.
IET Conference Publications | Year: 2015

Laser assisted keratoplasty is largely used to perform minimally invasive surgery and partial thickness keratoplasty (PTK) [1-3], which can be performed through several different techniques. Such approaches are eligible with respect to the standard penetrating keratoplasty and would benefit a major comprehension of the deep stroma layers morphology, which would be crucial in identifying the correct cleavage planes. In the last years some studies were published, giving new insights about the posterior stroma morphology in adult subjects [4,5]. In this work, confocal microscopy was performed in order to investigate relevant parameters, such as different collagen types distribution. The results of this analysis show some differences in between young and adult tissues and suggest a different pattern of localization of collagen VI and I. Our results indicate the necessity of further analysing the differences between young and adult corneas and between healthy and pathological samples. Our results also suggest a developmental process in the formation of the newly identified Dua's layer, whose presence is proposed to be exploited in order to safely perform deep anterior lamellar keratoplasty (DALK) [6]. Source


Leonardi M.,11 Health | Sattin D.,11 Health | Giovannetti A.M.,11 Health | Pagani M.,11 Health | And 9 more authors.
International Journal of Rehabilitation Research | Year: 2012

Children in a vegetative state (VS) and a minimally conscious state (MCS) experience severe limitations as a consequence of nervous system deficits and require consistent environmental support. However, disability in VS and MCS children has never been described following a model that accounts for the presence of the symptoms, limitations and the support required. Therefore, the aim of this paper is to describe the functioning and disability of children in VS and MCS using the International Classification of Functioning, Disability and Health - version for Children and Youth (ICF-CY). VS and MCS children were enrolled in postacute settings and at home. ICF-CY questionnaires were filled in using information available from clinical documentation, direct observation and from children's parents. ICF-CY categories were considered as relevant if used in at least one-third of the children. In total, 36 children and adolescents (22 in VS, 25 males) were enrolled. The majority developed VS and MCS following a nontraumatic event; the mean age was 114.8 months and the mean duration of condition was 50.1 months. A total of 94 ICF-CY categories were reported as relevant: 26 were from body functions, mostly from mental functions and mobility chapters; nine from body structures, 32 from activities and participation, mostly from learning, mobility and self-care chapters; and 27 from environmental factors. The use of ICF-CY enables to obtain a specific profile of functioning for each child that can be coupled with known issues, such as loss of brain functions and provision of life-sustaining interventions. © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins. Source

Discover hidden collaborations