Fabio Grizzi

Long-term follow-up of ultrathin corneas after surface retreatment with phototherapeutic keratectomy.

Purpose: To evaluate visual acuity and long‐term stability after phototherapeutic keratectomy (PTK) in patients with corneal thickness less than 400 μm and cornea‐related vision problems. Setting: Department of Ophthalmology, Istituto Clinico Humanitas, Rozzano−Milan, Italy. Methods: This retrospective study comprised 48 eyes that had PTK for complications after photorefractive keratectomy that removed more than 200 μm of tissue. Phototherapeutic keratectomy was performed with the Nidek EC‐5000 excimer laser with 10 Hz frequency, intraoperative topography, and masking fluid over an ablation diameter of 10.0 mm. The follow‐up was 5 years. The mean preoperative best spectacle‐corrected visual acuity (BSCVA) was 0.2 ± 0.09 (SD) with −2.53 ± 2.34 diopters (D), and the mean pachymetry was 390 ± 38 μm. The efficacy parameters were pachymetry and visual acuity at 1 year and the stability parameters, optical refraction, corneal curvature (calculated as the mean curvature over the entire 3.0 mm and 5.0 mm central zones), and pachymetry from 1 to 5 years. Results: At 1 year, the mean BSCVA was 0.6 ± 0.72 with −2.15 ± 1.67 D and the mean pachymetry, 341 ± 40 μm. At 5 years, the mean BSCVA was 0.7 ± 0.15 with −2.33 ± 1.12 D and the mean pachymetry, 339 ± 48 μm. In all patients, there was an improvement of 4 or more Snellen lines. Statistical evaluation of refraction and corneal curvature values at 1 and 5 years indicated no statistically significant differences. Conclusions: After PTK in eyes with ultrathin corneas, there was significant improvement in BSCVA and long‐term stability of the optical refraction, corneal curvature, and pachymetry. In selected cases, 10.0 mm ablation zone PTK may be an alternative to penetrating keratoplasty, offering long‐term corneal stability.

Immunopathology of Specific Cancers in Males and Females and Immunotherapy of Prostate and Cervical Cancer

Cancer remains one of the most complex diseases affecting humans, and despite the impressive advances that have been made in molecular and cell biology, how cancer cells progress through carcinogenesis and acquire their metastatic ability is still widely debated. Prostate cancer emerges from multiple alterations that induce changes in expression patterns of genes and proteins that function in networks controlling critical molecular and cellular events. Based on the exponential aging of the population and the increasing life expectancy in industrialized Western countries, prostate cancer is becoming a disease of increasing significance. While the incidence of cervical cancer has declined significantly in the USA, ethnic disparities remain in terms of increased mortality and morbidity. Here, it is aimed to review the clinical experiences and results achieved with immunotherapy for treating prostate and cervical cancers, two of the most significant malignancies in human male and females, respectively.

Computer-Aided Estimate and Modelling of the Geometrical Complexity of the Corneal Stroma

Despite the fact that all anatomical forms are characterised by non-polyhedral volumes, rough surfaces and irregular outlines, it has been suggested that sophisticated computer-aided analytical systems based on the Euclidean principles of regularity, smoothness and linearity can be used in human quantitative anatomy. However, the new fractal geometry is a more powerful means of quantifying the spatial complexity of real objects. The present study introduces the surface fractal dimension as a numerical index of the complex architecture of the corneal stroma, and investigates its behaviour during computer-simulated changes in keratocyte density and distribution, and in the heterogeneous composition of the extracellular matrix. We found that the surface fractal dimension depends on keratocyte density and distribution, as well as on the different concentrations of the constituents making up the extracellular matrix. Our results show that the surface fractal dimension could be widely used in ophthalmology not only because of its ability to quantify drug-correlated architectural changes, but also because it can stage corneal stroma alterations and predict disease evolution.