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non steroidei e/o trattamenti fisici. L'osteoartrosi del ginocchio, la localizzazione più frequente, è una delle principali cause di disabilità nell'anziano (1, 2) e la principale voce di spesa fra le malattie reumatiche (3). Molti pazienti ricorrono a terapie termali, quali i fanghi, anche perché non sempre i farmaci correnti sono privi di effetti collaterali. Il ruolo dei trattamenti termali è discusso (4), anche se nella Consensus italiana sulle raccomandazioni EULAR 2003 per il trattamento della gonartrosi, che non menzionano i trattamenti termali, viene riconosciuto che il punteggio scadente assegnato agli studi sulle terapie termali è dovuto alla insufficienza metodologica di tali studi e non ad evidenze univoche sulla inefficacia della terapia L' osteoartrosi è una affezione a etiopatogenesi eterogenea, nella quale vengono correntemente usati farmaci analgesici o antinfiammatori Reumatismo, 2008; 60(4):282-289 SUMMARY This is an observational study of the mid-long-term results of a single course of phytothermotherapy with grass baths (group A, 54 patients), of a course of usual medical care (group B, 58 patients) and of a course of physiokinesistherapy (FKT, group C, 30 patients) in knee osteoarthritis. For each group of consecutively treated patients we evaluated the Lequesne algo-functional Index, the drug consumption, the frequency of the patient-physician contacts and laboratory or radiological examinations after 10-15 days of treatment and at 3, 6, 9 and 12 months with blind telephonic follow-up.The mean Lequesne-score at basal time was 7. 5±3.3, 11.9±5.3 and 11.0±2.7

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A new technique that allows implanting intracorneal ring-segments (ICRS) from the limbal zone is described. Using a femtosecond laser (FSL), a 360° corneal tunnel is created with an internal diameter of 5.4 mm and an external diameter of 7.0 mm, with a wider area (0.2 mm inner and 0.2 mm outer) in the upper 60° of the tunnel (called landing zone). Next, a 4.36 mm-long corneal-limbal incision was created with the FSL, which connects to the bubbles created in the landing zone. The entire procedure was performed using intraoperative optical coherence tomography (OCT). Once the two incisions were connected using blunt-edged Mac Pherson forceps, the bubbles were released from the surgical plane. The programmed ICRS(s), 6 mm in diameter, are then placed in the corneal tunnel from the limbal incision with the aid of Sinskey forceps. Finally, when the ICRS is in place, the surgery is complete.

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