Keratoconus correction using a new model of intrastromal corneal ring segments

Israel, Marina; Yousif, Mohamed Omar; Na, Osman; Nashed, Marina; Abdelfattah, Nizar Saleh

doi:10.1016/j.jcrs.2015.11.044

Cited by 16 publications

(22 citation statements)

References 16 publications

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“…Visual outcomes in our study are comparable or superior to all prior studies. Israel reported improved UCVA and CDVA from 0.02 to 0.06 to 0.16 and 0.32 respectively, and a reduction of spherical error from − 9.5 to − 0.5D [35]. Yousif and Said reported better visual and topographic outcomes with MyoRing and 320°rings compared symmetric ring segments.…”

Section: Discussionmentioning

confidence: 95%

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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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Section: Discussionmentioning

confidence: 95%

“…e first study was conducted in Egypt by Israel and her colleagues who reported the outcomes for 4 types of rings: 160, 210, 320, and 355 [35]. After that, Yousif and Said compared 3 types of rings: 2 symmetric 160°ring segments, 320°rings, and MyoRing [34].…”

Section: Discussionmentioning

confidence: 99%

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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“…1). Removal of duplicates and use of the selection criteria reduced the number of articles reporting the evaluation of ICRS in keratoconus to 95 articles 8,14–16,26…”

Section: Resultsmentioning

confidence: 99%

“…The reference point was a Sinskey hook marking the center of the pupil. Channel depth varied between 70% ( references 14–16, 33, 35, 37, 48-54, 63, 65, 66, 70, 80, 82, 83, 87, 88, 90, 92, 95, 98, 99, 102, 103, 105, 108, 109, 111, 113, 114 ), 75% ( references 26, 27, 34, 39, 41, 42, 45, 58, 60, 64, 71, 79, 110 ), or 80% ( references 8, 29, 30, 32, 33, 43, 47, 54–56, 59, 62, 67–69, 72–…”

Section: Resultsmentioning

confidence: 99%

Efficacy of Different Procedures of Intra-Corneal Ring Segment Implantation in Keratoconus: a Systematic Review and Meta-Analysis

d'Azy

Pereira²,

Chiambaretta

et al. 2019

Trans. Vis. Sci. Tech.

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Purpose To evaluate the efficacy of the functional, keratometric, and refractive postoperative parameters of intracorneal ring segment (ICRS) implantation in keratoconus and its association with collagen cross-linking (CXL), photorefractive keratectomy (PRK), and intraocular lenses (IOLs). Methods We conducted a systematic review and meta-analysis on case series published between 2007 and 2017. Results We included 95 case series with a total of 4560 patients. We included 64 studies of the ICRS procedure, 20 studies of ICRS+CXL, 9 studies of ICRS+CXL+PRK, and 5 studies of ICRS+IOL. We demonstrated an overall improvement of all parameters in all procedures. Cylinder was decreased with an overall effect size (ES) of −1.15 (−1.36 to −0.95; I 2 = 93.7%). Corrected distance visual acuity was improved with an overall ES of 0.89 (0.78 to 1.00; I 2 = 81.9%). Maximal keratometry was decreased with an overall ES of 0.98 (0.85 to 1.11; I 2 = 78.9%). ICRS+IOL is the best procedure to improve spherical equivalent and uncorrected distance visual acuity ( P < 0.05) compared with other procedures. ICRSs versus ICRS+CXL are similar in all parameters except for corrected distance visual acuity. ICRS+CXL+PRK is better than ICRS alone in all parameters except for the correction of spherical equivalent. Conclusions Although the quality and strength of the data are questionable, ICRS implantation is an effective strategy to preserve visual function in keratoconic patients. Particularly, ICRS+CXL+PRK could be a low invasive procedure to propose to young keratoconic patients. Translational Relevance To propose an overview of postoperative parameters on each ICRS procedure on keratoconus.

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“…ICRS corrects corneal ectasia via shortening the cone length, causing corneal flattening to the periphery [ 127 ]. Improvements in the refractive power, topographic measurements, and optical quality have been reported postoperatively, with an increase in contact lens tolerability [ 127 – 129 ]. Complications, such as segment extrusion, segment migration, or shadow effects, have been found to be rare among patients [ 127 ].…”

Section: Histopathological Abnormalities In Kcmentioning

confidence: 99%

Molecular and Histopathological Changes Associated with Keratoconus

Khaled

Helwa

Drewry

et al. 2017

BioMed Research International

112

101

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Keratoconus (KC) is a corneal thinning disorder that leads to loss of visual acuity through ectasia, opacity, and irregular astigmatism. It is one of the leading indicators for corneal transplantation in the Western countries. KC usually starts at puberty and progresses until the third or fourth decade; however its progression differs among patients. In the keratoconic cornea, all layers except the endothelium have been shown to have histopathological structural changes. Despite numerous studies in the last several decades, the mechanisms of KC development and progression remain unclear. Both genetic and environmental factors may contribute to the pathogenesis of KC. Many previous articles have reviewed the genetic aspects of KC, but in this review we summarize the histopathological features of different layers of cornea and discuss the differentially expressed proteins in the KC-affected cornea. This summary will help emphasize the major molecular defects in KC and identify additional research areas related to KC, potentially opening up possibilities for novel methods of KC prevention and therapeutic intervention.

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Keratoconus correction using a new model of intrastromal corneal ring segments

Abstract: The ICRS provided topographic and visual improvement in keratoconus and post-LASIK keratectasia. Variance in surgical outcomes with manual versus femtosecond tunneling and the effect of different ring sizes are yet to be studied.

Cited by 16 publications

References 16 publications

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

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

Efficacy of Different Procedures of Intra-Corneal Ring Segment Implantation in Keratoconus: a Systematic Review and Meta-Analysis

Molecular and Histopathological Changes Associated with Keratoconus

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