Intracorneal ring segment implantation for the management of keratoconus: Safety and efficacy

Zare, Mohammad; Hashemi, Hassan; Salari, M R

doi:10.1016/j.jcrs.2007.06.055

Cited by 157 publications

(157 citation statements)

References 27 publications

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“…[19][20][21] Most of the published studies analyzing the effectiveness of ICRS implantation for the treatment of keratoconus agree that there is a significant flattening of the central cornea after the procedure. [4][5][6][7][8][22][23][24][25] Our results confirm that finding, as we found a statistically significant reduction in the keratometry readings in all grades of keratoconus. We observed that the largest reduction in mean keratometry was found in those cases with the most severe disease.…”

Section: In This Study We Evaluated the Outcomes Of Icrssupporting

confidence: 91%

“…There are several publications in the literature showing that ICRS implantation in keratoconus eyes results in an improvement of the CDVA. 4,5,8,11,[20][21][22][23][24]29 However, in the present study, patients with the milder form of the disease (patients classified as grade I) showed a statistically significant decrease in the CDVA. This might be related to the fact that in those investigations, the analysis of the outcomes regarding CDVA was performed evaluating all the population under study as a whole, without considering the degree of visual impairment.…”

Section: In This Study We Evaluated the Outcomes Of Icrscontrasting

confidence: 78%

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Outcome Analysis of Intracorneal Ring Segments for the Treatment of Keratoconus Based on Visual, Refractive, and Aberrometric Impairment

Vega-Estrada

Alió

Brenner

et al. 2013

American Journal of Ophthalmology

116

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PURPOSE: To analyze the outcomes of intracorneal ring segment (ICRS) implantation for the treatment of keratoconus based on preoperative visual impairment. DESIGN: Multicenter, retrospective, nonrandomized study.METHODS: A total of 611 eyes of 361 keratoconic patients were evaluated. Subjects were classified according to their preoperative corrected distance visual acuity (CDVA) into 5 different groups: grade I, CDVA of 0.90 or better; grade II, CDVA equal to or better than 0.60 and worse than 0.90; grade III, CDVA equal to or better than 0.40 and worse than 0.60; grade IV, CDVA equal to or better than 0.20 and worse than 0.40; and grade plus, CDVA worse than 0.20. Success and failure indices were defined based on visual, refractive, corneal topographic, and aberrometric data and evaluated in each group 6 months after ICRS implantation.RESULTS: Significant improvement after the procedure was observed regarding uncorrected distance visual acuity in all grades (P < .05). CDVA significantly decreased in grade I (P < .01) but significantly increased in all other grades (P < .05). A total of 37.9% of patients with preoperative CDVA 0.6 or better gained 1 or more lines of CDVA, whereas 82.8% of patients with preoperative CDVA 0.4 or worse gained 1 or more lines of CDVA (P < .01). Spherical equivalent and keratometry readings showed a significant reduction in all grades (P £ .02). Corneal higher-order aberrations did not change after the procedure (P ‡ .05).CONCLUSIONS: Based on preoperative visual impairment, ICRS implantation provides significantly better results in patients with a severe form of the disease. K ERATOCONUS IS AN ECTATIC DEBILITATING corneal disorder characterized by a progressive corneal thinning that results in corneal protrusion, irregular astigmatism, and decreased vision. 1 A variety of options have been described for the management of this pathologic condition, such as rigid gas-permeable contact lenses, 2 corneal collagen cross-linking, 3 intracorneal ring segment implantation, 4-11 or keratoplasty. 12 In a number of studies intracorneal ring segments (ICRS) have been demonstrated to be effective in improving visual acuity and reducing the refractive error and the mean keratometry in selected cases of keratoconic eyes. 4-11 Such a positive therapeutic effect is considered to be based on the induction of a remodeling of the corneal anterior and posterior surface's topography, which improves the optical quality of the cornea and reduces the optical aberrations, with consequent improvement in best-corrected visual acuity. [4][5][6][7][8][9][10][11] Although in the healthy cornea, the sectorial arcuate addition to the corneal local volume caused by these implants at the corneal midperiphery induces a flattening of the central cornea in an arc-shortening effect, with the consequence of a decrease in myopic spherical equivalent attributable to the overall reduction in the optical power of the cornea, 13 such corneal modeling effect may be different in structurally abnormal corneas such as in keratoco...

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Section: In This Study We Evaluated the Outcomes Of Icrssupporting

confidence: 91%

Section: In This Study We Evaluated the Outcomes Of Icrscontrasting

confidence: 78%

Outcome Analysis of Intracorneal Ring Segments for the Treatment of Keratoconus Based on Visual, Refractive, and Aberrometric Impairment

Vega-Estrada

Alió

Brenner

et al. 2013

American Journal of Ophthalmology

116

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“…So, in good cases an important flattening in the central cornea was confirmed as described by others. [8][9][10][11][12][24][25][26][27][28] Instead, for group B only K 2 had a significant decrease.…”

Section: Discussionmentioning

confidence: 91%

Intracorneal Ring Segment in Keratoconus: A Model to Predict Visual Changes Induced by the Surgery

Peña-García

Vega-Estrada

Barraquer

et al. 2012

Invest. Ophthalmol. Vis. Sci.

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“…27,30 Bazı cerrahlar ise implantasyon kolaylığı açısından dik aksa bakmaksızın insizyonun temporal bölgeden yapıl-masını önermektedirler. 31,32 İnsizyon bölgesinin sonuçlar üzerindeki etkisini karşılaştırmalı olarak değerlendiren çalışma mevcut değildir. Benzer şe-kilde tünel genişliği hakkında da görüş birliği mevcut değildir.…”

Section: Cerrahi̇ Planlamaunclassified

“…Amsler-Krumeich keratokonus sınıflamasına göre; sonuçlar evre 1 ve 2'de evre 3'e göre daha iyidir. 31,45 Evre 4'te ise segment implantasyonunun faydası çok sınırlıdır, hatta bazı yayınlara göre görme kaybına yol açmaktadır. 46 Progresyonu durmuş hastalıkta yaşın sonuçlar üzerindeki etkisi minimaldir.…”

Section: Sonuçlarunclassified

Intracorneal Ring Segment Applications: Review

Koç¹

2017

Turkiye Klinikleri J Ophthalmol

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Intracorneal ring segment implantation for the management of keratoconus: Safety and efficacy

Abstract: Intacs implantation appeared to be effective in improving UCVA and BSCVA in patients with mild to moderate keratoconus and contact-lens intolerance.

Cited by 157 publications

References 27 publications

Outcome Analysis of Intracorneal Ring Segments for the Treatment of Keratoconus Based on Visual, Refractive, and Aberrometric Impairment

Outcome Analysis of Intracorneal Ring Segments for the Treatment of Keratoconus Based on Visual, Refractive, and Aberrometric Impairment

Intracorneal Ring Segment in Keratoconus: A Model to Predict Visual Changes Induced by the Surgery

Intracorneal Ring Segment Applications: Review

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