Intrastromal Corneal Ring Segment Explantation in Patients With Keratoconus: Causes, Technique, and Outcomes

Chhadva, Priyanka; Yeşilırmak, Nilüfer; Cabot, Florence; Yoo, Sonia H.

doi:10.3928/1081597x-20150521-05

Cited by 20 publications

(22 citation statements)

References 22 publications

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“…Ring segments have the disadvantage of resulting in a long-term postoperative loss of visual acuity 9, 10. MyoRing implantation, by contrast, stabilizes the corneal thickness even in previously progressive cases, as several reports indicate 11, 12, 13.…”

Section: Discussionmentioning

confidence: 99%

Long-term results of MyoRing treatment of keratoconus

Daxer

Ettl

Hörantner

2017

Journal of Optometry

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PurposeTo study long-term results of MyoRing treatment of keratoconus.MethodsRetrospective study of MyoRing implantation into a corneal pocket for keratoconus.ResultsCorneal thickness at the thinnest point remained unchanged, SIM K's, manifest sphere and cylinder were significantly improved at the first follow-up 9 months postoperatively and remained stable until the last follow-up about 5 years after surgery. Uncorrected and corrected distance visual acuity (UDVA, CDVA) were significantly improved at the first follow-up 9 months postoperatively and were further ameliorated until the last follow-up about 5 years after surgery.ConclusionThe treatment was safe and effective with continuing improvement of visual acuity during the 5 years after surgery.

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Section: Discussionmentioning

confidence: 99%

Long-term results of MyoRing treatment of keratoconus

Daxer

Ettl

Hörantner

2017

Journal of Optometry

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“… 16 – 18 In contrast to the clinical data obtained after MyoRing implantation for keratoconus, the clinical data after ICRS implantation do not indicate stopping disease progression. 19 , 20 So far, only corneal cross-linking (CXL) has been shown to stop progression of the disease, yet without achieving visual rehabilitation. 21 – 23 The strengthening factor of CXL in humans was reported to be approximately 4.5.…”

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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“…Так, есть данные об увеличении НКОЗ в 93 % случаев, снижении рефракции роговицы в центре во всех случаях, сохранении стабильности эффекта в течение 5 лет у всех пациентов с кератоконусом [12]. В то же время в других работах указано, что эффект действия РС не столь продолжителен и может исчезать при сроке 2 и более лет после операции, что отмечено в 80 % случаев [13][14][15] литература/rEfErEnCEs…”

Section: результаты и обсуждениеunclassified

Bandage Therapeutic-Optical Keratoplasty in Keratoconus Patients after Intrastromal Corneal Segments Implantation

Осипян¹,

Sheludchenko²,

Юсеф³

et al. 2019

Oftalʹmologiâ

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Purpose — to evaluate the functional results of bandage therapeutic-optical keratoplasty (BTOK) in keratoconus eyes after implantation of intrastromal corneal ring segments (CRS). Material and methods. The study included 18 patients with stage II and III keratoconus (as per Amsler-Krumeich classification) who had underwent implantation of CRS with unsatisfactory long-term outcomes. The patients were divided into two groups. The first group consisted of 7 patients (7 eyes) of 27 ± 3 years old with had past history of CRS implantation followed by the absence of predicted improvement of visual acuity during the observation period of up to 18 months. The second group included 11 patients (11 eyes) who had visual acuity improvements after CRS implantation, but had regression in the long-term follow-up of 2 to 5 years. The surgical algorithm consisted of two steps: first, all 18 patients had the intrastromal ring segments removed; second, 3 months later they underwent BTOK. Outcomes. After the removal of CRS, patients of both groups showed improvements in central corneal refraction, their visual acuity decreased to 0.07 ± 0.02 and 0.09 ± 0.04, respectively. The 36 months follow-up after BTOK revealed significant improvements in visual acuity — up to 0.48 ± 0.04 and 0.54 ± 0.11, respectively — in all patients in both group due to marked flattening of the cornea in the optical zone. Conclusion. Bandage therapeutic-optical keratoplasty allows treatment of patients with complicated or who had unsatisfactory results after implantation of intrastromal ring segments. The surgery leads to stabilization of keratectasia in keratoconus patients and significantly increases uncorrected visual acuity.

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Intrastromal Corneal Ring Segment Explantation in Patients With Keratoconus: Causes, Technique, and Outcomes

Abstract: This study demonstrates the visual and structural outcomes that returned to near baseline after Intacs explantation in keratoconic eyes.

Cited by 20 publications

References 22 publications

Long-term results of MyoRing treatment of keratoconus

Long-term results of MyoRing treatment of keratoconus

Biomechanics of Corneal Ring Implants

Bandage Therapeutic-Optical Keratoplasty in Keratoconus Patients after Intrastromal Corneal Segments Implantation

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