Long-term follow-up of intrastromal corneal ring segments in keratoconus

Torquetti, Leonardo; Berbel, Rodrigo Fabri; Ferrara, Paulo

doi:10.1016/j.jcrs.2009.05.036

Cited by 127 publications

(135 citation statements)

References 25 publications

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“…These results are consistent with those found in the literature, as most of the studies that have been carried out reported a gain of lines in UDVA. 6,7,10,21,27,28 We observed that the most significant increase in the UDVA was found in patients classified as grade plus, where more than 77% gained 1 or more lines of UDVA. Furthermore, in this group of patients we observed the least number of eyes losing 1 or more lines of UDVA (Tables 6 and 7).…”

Section: In This Study We Evaluated the Outcomes Of Icrsmentioning

confidence: 66%

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 Icrsmentioning

confidence: 66%

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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“…29 Segment implantasyonu sonrası görsel ve topografik stabilleşme 6. ayda gelişmekte ve 6. ay ile 5. yıl arasında bir miktar regresyon görülse de bu anlamlı olmamaktadır. [35][36][37] Ancak KİHS implantasyonu ektazinin progresyonunu durduramadığından, progresyonu devam eden hastalıkta implantasyon ile sağlanan düzelme zamanla azalmaktadır. 44 Seçilen segmentin modeli dışında sonuçları etkileyen diğer önemli faktör hastalığın evresidir.…”

Section: Sonuçlarunclassified

Intracorneal Ring Segment Applications: Review

Koç¹

2017

Turkiye Klinikleri J Ophthalmol

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“…In advent of alternative treatments, intrastromal ring implantation have been introduced which improves visual acuity and optical aberrations and also corrects refractive errors and mean keratometric data [7][8][9][10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Aberrometric Outcomes of Intrastromal Corneal Ring Segment (KeraRing 355) Implantation Using PocketMaker Microkeratome in Patients with Keratoconus

Jadidi¹,

Nejat²,

Alishiri³

et al. 2017

J Clin Exp Ophthalmol

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Objective: To evaluate aberrometric changes in corneas with keratoconus implanted with intrastromal corneal ring segment (Keraring 355) during a 3-months follow-up. Design: Prospective, consecutive case seriesMethods: In this interventional study, 22 eyes of 21 keratoconic patients with mean age of 29 ± 6 years who underwent KeraRing 355 intrastromal corneal ring insertion using a Pocket Maker Microkeratome for channel creation and completed at least three months of follow-up were included. Uncorrected visual acuity (UCVA), best spectacle corrected visual acuity (BSCVA), refractive outcome, Orbscan finding and corneal aberrations were assessed.Results: Three months postoperately, Low order aberration (defocus and astigmatism) decreased significantly (P<0.001). No statistically significant changes were detected in total RMS, trefoil, secondary trefoil and coma. Moreover, a statistically significant increase in quatrefoil, secondary coma, spherical aberration and secondary spherical was found. In term of visual outcomes, the mean UCVA (in LogMAR value) improved significantly from 0.75 ± 0.33 to 0.31 ± 0.23 and the mean BSCVA improved (from 0.31 ± 0.16 to 0.19 ± 0.15) (P<0.05). The mean spherical refractive error improved (from -1.37 ± 1.36 to 0.01 ± 2.47) and the mean cylindrical refractive error decreased significantly (from -3.8 ± 1.03 to -2.1 ± 1.27 (P<0.001)). Also, the mean keratometry value decreased from 47.61 ± 2.03 to 42.50 ± 2.76. Conclusion: KeraRing 355 implantation provided significant improvement in low order aberrations but was not effective in high order aberrations (HOA) in low/moderate keratoconus patients. However, UCVA, BCVA, spherical and cylindrical refractive error and keratometry results improved significantly.

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Long-term follow-up of intrastromal corneal ring segments in keratoconus

Abstract: Five years after ICRS implantation, the UDVA and CDVA were improved in eyes with keratoconus. There was significant postoperative corneal flattening that remained stable over the follow-up period.

Cited by 127 publications

References 25 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 Applications: Review

Aberrometric Outcomes of Intrastromal Corneal Ring Segment (KeraRing 355) Implantation Using PocketMaker Microkeratome in Patients with Keratoconus

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