Intrakorneale Ringsegmente beim Keratokonus

El-Husseiny, M; Tsintarakis, Themistoklis; Eppig, Timo; Langenbucher, Achim; Seitz, Berthold

doi:10.1007/s00347-013-2821-2

Cited by 15 publications

(15 citation statements)

References 29 publications

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“…Intraoperative complications are rare, and they are usually related to creating the corneal tunnel, insufficient tunnel depth, asymmetry or decentration, or bowman's layer perforation. 80 , 103 , 104 Corneal neovascularization, keratitis, deposits around ring segment, corneal haze, halos, pain, corneal melting or edema, segment extrusion, visual fluctuation, and photophobia are rare postoperative complications. 88 , 104 , 105 , 106 …”

Section: Methodsmentioning

confidence: 99%

Updates on Managements for Keratoconus

Mohammadpour

Heidari

Hashemi

2018

Journal of Current Ophthalmology

101

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PurposeKeratoconus is a progressive disease of the cornea which can lead to blindness as irregular astigmatism increases. Currently, a variety of methods are available for the treatment of keratoconus, and in certain cases, it may be difficult to choose the most appropriate option. This article reviews available treatment modalities for keratoconus to provide the practitioner with practical and useful information for selecting the most suitable option for each individual patient.MethodsTo review treatment methods for different stages of keratoconus, PubMed (United States National Library of Medicine) and Scopus (Elsevier BV) databases were searched using the keywords “keratoconus”, “contact lens”, “cross-linking”, “Intacs”, “keratoplasty”, “gene therapy”, and “irregular astigmatism”, and related articles were reviewed based on disease assessment parameters and treatment methods.ResultsVarious methods are available for the treatment of keratoconus: eyeglasses and contact lenses in the early stages, cross-linking for stabilizing disease progression, intrastromal corneal ring segments (ICRS) for reducing refractive errors or flattening the cornea, and penetrating keratoplasty (PK) and deep anterior lamellar keratoplasty (DALK), conductive keratoplasty, gene therapy and more recently, bowman layer transplantation (BL transplantation) in advanced stages of the disease. To achieve optimum results, it is essential to choose the best option for each individual patient.ConclusionsA commonality of the reviewed papers was the advancement of novel diagnostic and treatment methods in ophthalmology, which can delay the need for corneal grafting. A better understanding of keratoconus treatment options can help enhance visual rehabilitation and prevent blindness in keratoconus patients.

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Section: Methodsmentioning

confidence: 99%

Updates on Managements for Keratoconus

Mohammadpour

Heidari

Hashemi

2018

Journal of Current Ophthalmology

101

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“…Similarly, data from a study by El-Husseiny et al, which included 20 eyes of 16 patients, revealed that ICRS (Intacs, Addition Technology, Inc, Sunnyvale, CA) provided a viable alternative to early penetrating keratoplasty for patients with keratoconus having a clear central cornea and a history of contact lens intolerance. Specifically, the data revealed that after 6 months of follow-up, the mean uncorrected distance visual acuity improved from 0.07 ± 0.07 preoperatively to 0.6 ± 0.26 postoperatively, whereas mean BCVA changed from 0.4 ± 0.15 preoperatively to 0.9 ± 0.29 postoperatively (20) . Although data from our small study suggests that ICRS may be a surgical alternative to keratoplasty in some patients with keratoconus, longer-term follow-up is required to determine for how long ICRS adequately maintain BCVA and whether patients for whom ICRS implantation was effective will eventually require penetrating ke ratoplasty.…”

Section: Discussionmentioning

confidence: 94%

Intrastromal corneal ring segments delay corneal grafting in patients with keratoconus

Beniz¹,

Queiroz²,

Queiroz³

et al. 2016

Arquivos Brasileiros De Oftalmologia

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Approved by the following research ethics committee: Hospital das Clínicas, Universidade Federal de Goiás (219.191). ABSTRACT Purpose:To assess the impact of intrastromal corneal ring segments (ICRS) as a surgical alternative to corneal grafting in patients with keratoconus who were scheduled for a corneal transplant. Methods: This single-surgeon, single-center, retrospective, observational case series study included 19 eyes of 18 patients (mean age, 23.36 ± 6.22 years) with a confirmed diagnosis of keratoconus. These patients were enrolled from the State of Goiás, Brazil corneal graft waiting list. Following extensive pre-operative testing, including the measurement of best-corrected visual acuity (BCVA), applanation tonometry, biomicroscopy, funduscopy, pachymetry, and corneal topography, patients were implanted with Keraring® ICRS. Patients underwent clinical examination at postoperative days 1, 7, 30, 90, and 180 and were examined again 2 years following surgery. Results: At the 2-year cut-off following ICRS implantation (mean follow-up, 28.72 ± 4.71 months), there was a statistically significant improvement in BCVA (logMAR) from 0.59 ± 0.35 preoperatively to 0.35 ± 0.45 postoperatively (p<0.01). Three of 19 eyes (15.8%) still required keratoplasty. In the remaining patients (84.2%), BCVA was managed with spectacles (52.6%) or contact lenses (31.6%). One patient developed infectious keratitis, requiring removal of ICR at the first postoperative visit. Conclusion: ICRS implantation may be a surgical alternative to keratoplasty in patients with keratoconus. This procedure may delay or even eliminate the need for keratoplasty in such patients.

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“…The thickness, arc length and implantation site is usually defined by proprietary nomograms [25]. In the follow-up of ICRS, AS-OCT is useful for investigating proper placement of the ring segments, especially the distance to DM and/or BL and the epithelium [26]. In these cases, the plastic rings within the cornea will induce artifacts visible as bright stripes parallel to the line of sight.…”

Section: Refractive Surgerymentioning

confidence: 99%

Imaging the Cornea, Anterior Chamber, and Lens in Corneal and Refractive Surgery

Eppig¹,

Mäurer²,

Daas³

et al. 2018

OCT - Applications in Ophthalmology

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Anterior segment OCT (AS-OCT) is an optical and noncontact imaging technology, which has numerous fields of application in the imaging of the cornea, anterior chamber, and the lens. In this chapter, we will present some of the application fields of AS-OCT in corneal, cataract, and refractive surgery. We will emphasize the potential of AS-OCT by several clinical examples including corneal imaging (keratoconus, keratoplasty, and refractive surgery) and intraocular lens imaging after refractive surgery. AS-OCT shows special potential for corneal imaging in case of corneal edema and for postoperative control after Descemet's membrane endothelial keratoplasty (DMEK). The postoperative follow-up of a posterior chamber Collamer lens'ses vault and measuring the anterior chamber angle could be identified as another promising field of application for AS-OCT.

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Intrakorneale Ringsegmente beim Keratokonus

Abstract: The femtosecond laser-assisted INTACS implantation provides a valid alternative to early keratoplasty for keratoconus patients with a clear central cornea and contact lens intolerance. It is a minimally invasive and reliable method for stage-related surgical management of keratoconus.

Cited by 15 publications

References 29 publications

Updates on Managements for Keratoconus

Updates on Managements for Keratoconus

Intrastromal corneal ring segments delay corneal grafting in patients with keratoconus

Imaging the Cornea, Anterior Chamber, and Lens in Corneal and Refractive Surgery

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