Clinical Outcomes after Complete Intracorneal Ring Implantation and Corneal Collagen Cross-Linking in an Intrastromal Pocket in One Session for Keratoconus

Studený, Pavel; Krizova, Deli; Stranak, Zbynek

doi:10.1155/2014/568128

Cited by 17 publications

(33 citation statements)

References 24 publications

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“…The formation of the stromal pocket during MyoRing implantation offers the opportunity for simultaneous introduction of 0.1% riboflavin into the pocket followed by UVA irradiation to provide combined treatment for patients with progressive keratoconus [ 5 ]. The results of the combination of CXL with MyoRing implantation with 12 months of follow-up were reported by Studeny et al [ 7 ].…”

Section: Introductionmentioning

confidence: 79%

Complete corneal ring (MyoRing) implantation versus MyoRing implantation combined with corneal collagen crosslinking for keratoconus: 3-year follow-up

et al. 2017

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PurposeTo estimate the effectiveness of complete corneal ring (MyoRing) implantation compared with MyoRing implantation combined with corneal collagen crosslinking (CXL) for keratoconus treatment for 36 months follow-up.DesignRetrospective cohort study.Materials and methodsMyoRing implantation was performed in a series of 78 patients (80 eyes) with keratoconus II–III Amsler classification, of these 39 eyes had MyoRing implantation combined with CXL. Implantation of a MyoRing in the corneal pocket was performed using a PocketMaker microkeratome and corneal intrastromal implantation system. During CXL, riboflavin solution 0.1% was injected into the corneal pocket through the incision tunnel and standard surface UVA irradiation (370 nm, 3 mW/cm2) was then applied from 5-cm distance for 30 min.ResultsSignificant improvements in uncorrected distance visual acuity and corrected distance visual acuity were observed for both groups, which was relatively better 12 months after procedure in MyoRing alone group; however, in 36 months there was no difference between groups. Keratometry was reduced in both groups; after MyoRing implantation for 8.45 D and MyoRing + CXL for 9.43 D, the spherical equivalent decreased from 8.45 to 7.72 D and from 9.43 to 6.25 D, respectively. The cylinder decreased to 3.33 D with MyoRing alone and to 3.31 D with MyoRing + CXL. Corneal thickness remained nearly unchanged (from 433.69 ± 38.76 to 434.21 ± 34.98) in MyoRing group and decreased from baseline (from 426.93 ± 46.58 to 401.24 ± 39.12 µm) in MyoRing + CXL group 36 months postoperatively, which corresponds with pachymetry reduction after conventional CXL.ConclusionBoth MyoRing implantation and MyoRing combined with CXL were effective for treating keratoconus. At 36 months, there were slightly better outcomes in MyoRing + CXL group; however, in MyoRing alone group visual and refractive outcomes were stable overtime.

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Section: Introductionmentioning

confidence: 79%

Complete corneal ring (MyoRing) implantation versus MyoRing implantation combined with corneal collagen crosslinking for keratoconus: 3-year follow-up

et al. 2017

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“…It is therefore possible to combine MyoRing treatment with excimer laser surface ablation without biomechanically harming the cornea. 25 However, it is no longer necessary to combine MyoRing treatment with CXL in progressive keratoconus 26 , 27 because MyoRing implantation alone seems to be sufficient to strengthen the cornea. In contrast to early experiments on complete rings, 28 the design of the MyoRing combines 2 a priori conflicting qualities in one device: it is rigid enough to modify and stabilize the corneal shape according to the refractive needs, and flexible with a shape memory to allow quick, easy, and reversible implantation into the corneal pocket through a small entrance.…”

Section: Discussionmentioning

confidence: 99%

Biomechanics of Corneal Ring Implants

Daxer

2015

Cornea

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Purpose:To evaluate the biomechanics of corneal ring implants by providing a related mathematical theory and biomechanical model for the treatment of myopia and keratoconus.Methods:The spherical dome model considers the inhomogeneity of the tunica of the eye, dimensions of the cornea, lamellar structure of the corneal stroma, and asphericity of the cornea. It is used in this study for calculating a strengthening factor sf for the characterization of different ring-shaped corneal implant designs. The strengthening factor is a measure of the amount of strengthening of the cornea induced by the implant.Results:For ring segments and incomplete rings, sf = 1.0, which indicates that these implants are not able to strengthen the cornea. The intracorneal continuous complete ring (MyoRing) has a strengthening factor of up to sf = 3.2. The MyoRing is, therefore, able to strengthen the cornea significantly.Conclusions:The result of the presented biomechanical analysis of different ring-shaped corneal implant designs can explain the different postoperative clinical results of different implant types in myopia and keratoconus.

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“…Studeny и соавт. использовали комбинацию MyoRing с CXL в группе пациентов (22 глаза) с кератоконусом [8] и отметили улучшение результатов в течение 1 года после операции аналогично нашему исследованию. Nobari и соавт.…”

Section: Discussionunclassified

“…Кросслинкинг роговицы (CXL), предложенный G. Wollensak и соавт. в 2003 г., стал стандартом в лечении прогрессирующего кератоконуса [6], способствуя замедлению и приостановке прогрессирования заболевания [7][8][9]. В настоящее время обе методики часто применяются в сочетании, что повышает эффект лечения кератоконуса и приводит к более высоким функциональным результатам.…”

Section: Introductionunclassified

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MyoRing Implantation in Comparison with MyoRing Implantation Combined with Corneal Collagen Crosslinking for Keratoconus

Kazakbaeva

2019

Oftalʹmologiâ

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Purpose: tо estimate the effectiveness of complete corneal ring (MyoRing) implantation compared with MyoRing implantation combined with corneal collagen crosslinking (CXL) for keratoconus treatment for 36 months follow-up. Patients and Methods. There were 101 patients (124 eyes) with progressing keratoconus aged 18–59 years in the study. Intracorneal rings were implanted in all patients. The patients were divided into 2 groups. MyoRing implantation was performed in a series of 59 patients (76 eyes) with keratoconus II–III Amsler classification, 42 patients (48 eyes) had MyoRing implantation combined with CXL. Implantation of a MyoRing in the corneal pocket was performed using a PocketMaker microkeratome and corneal intrastromal implantation system. Results. Keratometry was reduced in both groups; after MyoRing implantation for 8,45 D and MyoRing combined with CXL for 7,44 D, the spherical equivalent decreased for 7,72 and 6,29 D respectively, after 36 months. The cylinder decreased to 3,33 D with MyoRing alone and to 3,11 D with MyoRing combined with CXL. The smallest corneal thickness remained stable during 36 months after the procedure. There was an improvement in uncorrected and corrected visual acuity, and the difference in the CRF within the period of up to 12 months after the operation. It can be explained by the pseudochase formation in the group with a combined procedure. Conclusion. The implantation of the MyoRing IRC and the combination of MyoRing with CXL showed efficacy and safety in stabilizing keratoconus stabilization, as well as correction of comorbided ametropia 3 years after surgery. Both MyoRing implantation and MyoRing combined with CXL were effective in the stabilization of progressive keratoconus, as well as the correction of ametropia 3 years after surgery. There was no significant difference in MyoRing implantation and its combination with corneal crosslinking in visual and refractive results. The refractive power of the cornea was only one exeption. Long follow-up and randomized prospective studies with a large number of patients are needed.

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Clinical Outcomes after Complete Intracorneal Ring Implantation and Corneal Collagen Cross-Linking in an Intrastromal Pocket in One Session for Keratoconus

Cited by 17 publications

References 24 publications

Complete corneal ring (MyoRing) implantation versus MyoRing implantation combined with corneal collagen crosslinking for keratoconus: 3-year follow-up

Complete corneal ring (MyoRing) implantation versus MyoRing implantation combined with corneal collagen crosslinking for keratoconus: 3-year follow-up

Biomechanics of Corneal Ring Implants

MyoRing Implantation in Comparison with MyoRing Implantation Combined with Corneal Collagen Crosslinking for Keratoconus

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