Visian Toric ICL Implantation after Intracorneal Ring Segments Implantation and Corneal Collagen Crosslinking in Keratoconus

Dirani, Ali; Fadlallah, Ali; Khoueir, Ziad; Antoun, Joëlle; Cherfan, George; Jarade, Elias

doi:10.5301/ejo.5000384

Cited by 25 publications

(26 citation statements)

References 20 publications

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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%

“…Finally, when the optical zone was 7 mm,83,102,108,109 the inner diameter was 7 mm and the outer diameter was 8.2 mm. One or two rings were inserted depending on the keratoconus grade in 44 studies ( references 8, 14, 26–30, 32, 41, 49–51, 53–55, 59–61, 67, 68, 75–77, 80, 82, 84, 85, 87–89, 92–94, 96, 97, 102, 103, 107, 109, 110, 112, 116 ). In 20 studies, only one ring was systematically set up ( references 15, 34–37, 39, 40, 43, 44, 46, 48, 52, 56, 57, 63, 66, 70, 71, 78, 95 ).…”

Section: Resultsmentioning

confidence: 99%

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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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“…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%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

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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“…23 Implantation of toric ICL in keratoconus patients has been evaluated even for the residual refractive error after Intacs implantation and CXL, suggesting that ICL can serve as a good treatment option for the residual refractive error in such patients. 24,25 In another study conducted on 16 eyes with keratoconus ICL implantation after CXL, results were observed to be fairly stable even after long-term follow-up of 3 years, with no significant endothelial cell loss. The mean Snellen decimal CDVA improved from 0.56 ± (p < 0.0001).…”

Section: Icl In Keratoconusmentioning

confidence: 96%

Implantable Contact Lenses in Keratoconus

Gupta¹

2016

International Journal of Keratoconus and Ectatic Corneal Diseases

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Keratoconus is a progressive inherited disorder with varying economic and social consequences. Varying modalities of visual rehabilitation such as spectacles, contact lenses, surgical treatment in the form of corneal collagen cross-linking to arrest progression, and surface refractive procedures such as photorefractive keratectomy, implantation of phakic intraocular lenses (IOLs), or Intacs have been undertaken with varying results. This

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“…The authors also concluded that the 3-step procedure was safe, effective, and predictable in the treatment of selected cases of keratoconus. Dirani et al [ 135 ] retrospectively examined the results of this triple procedure in 11 eyes with moderate to severe keratoconus. They also found that the UDVA, CDVA, and refractive error improved significantly after toric PC pIOl implantation.…”

Section: Combined Proceduresmentioning

confidence: 99%

Surgical Options for the Refractive Correction of Keratoconus: Myth or Reality

Fernández-Vega-Cueto

Romano

Zaldivar

et al. 2017

Journal of Ophthalmology

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Keratoconus provides a decrease of quality of life to the patients who suffer from it. The treatment used as well as the method to correct the refractive error of these patients may influence on the impact of the disease on their quality of life. The purpose of this review is to describe the evidence about the conservative surgical treatment for keratoconus aiming to therapeutic and refractive effect. The visual rehabilitation for keratoconic corneas requires addressing three concerns: halting the ectatic process, improving corneal shape, and minimizing the residual refractive error. Cross-linking can halt the disease progression, intrastromal corneal ring segments can improve the corneal shape and hence the visual quality and reduce the refractive error, PRK can correct mild-moderate refractive error, and intraocular lenses can correct from low to high refractive error associated with keratoconus. Any of these surgical options can be performed alone or combined with the other techniques depending on what the case requires. Although it could be considered that the surgical option for the refracto-therapeutic treatment of the keratoconus is a reality, controlled, randomized studies with larger cohorts and longer follow-up periods are needed to determine which refractive procedure and/or sequence are most suitable for each case.

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Visian Toric ICL Implantation after Intracorneal Ring Segments Implantation and Corneal Collagen Crosslinking in Keratoconus

Abstract: Toric ICL implantation after sequential ICRS implantation and CXL is an effective and safe option for correcting high residual refractive error and improving visual acuity in patients with moderate to severe keratoconus.

Cited by 25 publications

References 20 publications

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

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

Implantable Contact Lenses in Keratoconus

Surgical Options for the Refractive Correction of Keratoconus: Myth or Reality

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