Intrastromal Corneal Ring Segment Implantation in 409 Paracentral Keratoconic Eyes

Cueto, Luis Fernández-Vega; Lisa, Carlos; Poo-López, Arancha; Madrid-Costa, David; Merayo‐Lloves, Jesús; Alfonso, José F.

doi:10.1097/ico.0000000000000978

Cited by 55 publications

(88 citation statements)

References 21 publications

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“…The ICRSs were implanted following the nomogram used in previous studies. [18][19][20][21] Two experienced surgeons performed all implantation procedures (J.F.A., C.L.) using a femtosecond laser, and using the procedure described in previous studies.…”

Section: Methodsmentioning

confidence: 99%

“…using a femtosecond laser, and using the procedure described in previous studies. [18][19][20][21] Preoperative medication included proparacaine 0.5%, ciprofloxacin 0.3%, and oxybuprocaine ClH 0.2%. The postoperative treatment regimen was a combination of antibiotic (tobramycin, 3 mg/mL) and steroid eye drops (dexamethasone, 1 mg/mL) (Tobradex; Alcon Laboratories, Inc, Fort Worth, TX) 3 times daily for 2 weeks, and the dose was tapered off over the following 2 weeks.…”

Section: Methodsmentioning

confidence: 99%

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Long-Term Follow-up of Intrastromal Corneal Ring Segment Implantation in Pediatric Keratoconus

Alfonso

Fernández-Vega-Cueto

Lisa

et al. 2019

Cornea

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Purpose: To evaluate efficacy, safety, and stability of Ferrara-type intrastromal corneal ring segment (ICRS) implantation for visual rehabilitation in pediatric patients with keratoconus. Methods: This study included patients with keratoconus aged 18 years or younger who had received Ferrara-type ICRS implantation. The uncorrected and corrected distance visual acuities, residual refractive errors, and root mean square for coma-like aberration were recorded preoperatively and at 6 months, 1, 3, and 5 years postoperatively. Results: One hundred eighteen eyes of 88 patients (mean age 16.1 6 1.89; range 10-18) were studied. All patients were examined at a 6-month follow-up after ICRS implantation, and at the 12-, 36-, and 60-month follow-ups, 97, 71, and 23 eyes were evaluated, respectively. Mean uncorrected distance visual acuity (logarithm of minimum angle of resolution) changed from 0.67 6 0.37 preoperatively to 0.37 6 0.30, 6 months after ICRS implantation (P , 0.0001). Mean corrected distance visual acuity increased in turn from 0.19 6 0.15 to 0.10 6 0.12 (P , 0.0001). The percentage of eyes with a refractive cylinder #2.00 D increased from 30.5% before surgery to 70.3% 6 months later, and the root mean square for corneal coma-like aberration showed a statistically significant decrease (P , 0.001). At the follow-up visits, refractive and visual values remained stable compared with those of the 6-month visit. Conclusions: Our long-term results suggest that Ferrara-type ICRS implantation is a safe, effective, and stable procedure for restoring vision in pediatric patients with keratoconus.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Long-Term Follow-up of Intrastromal Corneal Ring Segment Implantation in Pediatric Keratoconus

Alfonso

Fernández-Vega-Cueto

Lisa

et al. 2019

Cornea

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“…ntrastromal corneal ring segments (ICRS) implantation is a surgical procedure used for the treatment of keratoconus, enabling both a therapeutic and refractive improvement. [1][2][3] Both the safety and the refractive efficacy of the implant depend on the correct selection of the implant features and a precise intrastromal surgical implantation. Shallower intrastromal tunnels are associated with complications such as implant exposure due to corneal thinning over the implant, segment migration and extrusion, astigmatism overcorrection, or corneal melting.…”

Section: O R I G I N a L A R T I C L Ementioning

confidence: 99%

Predictability of Tunnel Depth for Intrastromal Corneal Ring Segments Implantation Between Manual and Femtosecond Laser Techniques

Monteiro¹,

Alfonso²,

Franqueira³

et al. 2018

J Refract Surg

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“…Featuring the crucial role of cone location, some other studies evaluated the outcomes in paracentral KC. A longitudinal follow-up study reported significantly improved UDVA and CDVA 6 months after Ferrara ring implantation which remained stable for five years [28,32]. In contrast, a recent study stated a clear conclusion that cone location was not related neither to the visual nor the topographic outcomes [33].…”

Section: Discussionmentioning

confidence: 98%

Evaluation of a Tangential Map-Based Nomogram for Intrastromal Corneal Ring Segments’ Implantation in Keratoconus: One Year Results

Zaky

KhalafAllah

Sarhan

et al. 2020

Journal of Ophthalmology

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is properly cited.Purpose. To evaluate a new tangential map-based nomogram versus the axial map-based nomogram for ICRS in keratoconus. Methods. A prospective case series study including 64 eyes of 64 patients who underwent ICRS implantation. Cone location was determined for each eye with two maps: the axial and the tangential. Appropriate ring selection was determined using two surgical nomograms: axial map-based and tangential map-based. Visual, refractive, and topographic outcomes were assessed before, as well as at 3, 6, and 12 months after ICRS implantation. Results. e cone location, and consequently the ring selection, was significantly different in the two nomograms with a "centralization tendency" in the tangential map. In the axial group, UDVA and CDVA improved from 0.12 ± 0.04 and 0.24 ± 0.08 to 0.28 ± 0.08 and 0.4 ± 0.1, respectively. Similarly, MRSE substantially decreased from − 6.7 ± 3.3 to − 1.2 ± 1.1D at 12 months after the procedure. In the tangential group, UDVA and CDVA improved from 0.09 ± 0.06 and 0.2 ± 0.1 to 0.5 ± 0.2 and 0.7 ± 0.2, respectively. MRSE substantially decreased from − 4.9 ± 1D to − 1.00 ± 1.6D at 12 months after the procedure. e UDVA gain was significantly higher in the tangential group: 0.35 compared to 0.15 at 12 months, P � 0.01 * . Similarly, the gain in the CDVA was 0.4 and 0.15 in the tangential and axial groups, respectively, at 12 months, P � 0.003 * . At 12 months, the tangential map showed superiority in UDVA, CDVA, and MRSE in the peripheral cone location, but not the central and paracentral ones. Conclusion. e tangential map-based nomogram attained better visual and refractive outcomes at 1 year. In addition, the cone location was significantly different between both maps with a centralization tendency in the tangential one.

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Intrastromal Corneal Ring Segment Implantation in 409 Paracentral Keratoconic Eyes

Abstract: The Ferrara-type ICRS implantation is a safe and effective procedure for treating patients with keratoconus that meets the morphological characteristics of the sample under study.

Cited by 55 publications

References 21 publications

Long-Term Follow-up of Intrastromal Corneal Ring Segment Implantation in Pediatric Keratoconus

Long-Term Follow-up of Intrastromal Corneal Ring Segment Implantation in Pediatric Keratoconus

Predictability of Tunnel Depth for Intrastromal Corneal Ring Segments Implantation Between Manual and Femtosecond Laser Techniques

Evaluation of a Tangential Map-Based Nomogram for Intrastromal Corneal Ring Segments’ Implantation in Keratoconus: One Year Results

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