Purpose:To evaluate the clinical outcomes of intrastromal corneal ring segment (ICRS) implantation in patients with keratoconus using a mechanical implantation technique.Materials and Methods:Thirty eyes of 17 patients with keratoconus were enrolled. ICRSs (Keraring) were implanted after dissection of the tunnel using Tunc's specially designed dissector under suction. A complete ophthalmic examination was performed, including uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), spherical equivalent, keratometric readings, inferosuperior asymmetry index (ISAI), and ultrasound pachymetry. All 3-, 6-, and 12-month follow-ups were completed, and statistical analysis was performed.Results:The mean preoperative UDVA for all eyes was 1.36 ± 0.64 logMAR. At 12 months, the mean UDVA was 0.51 ± 0.28 logMAR (P = 0.001), and the mean preoperative CDVA was 0.57 ± 0.29 logMAR, which improved to 0.23 ± 0.18 (P = 0.001) at 1 year. There was a significant reduction in spherical equivalent refractive error from –6.42 ± 4.69 diopters (D) preoperatively to –1.26 ± 1.45 D (P = 0.001) at 1 year. In the same period, the mean K-readings improved from 49.38 ± 3.72 D to 44.43 ± 3.13 D (P = 0.001), and the mean ISAI improved from 7.92 ± 3.12 to 4.21 ± 1.96 (P = 0.003). No significant changes in mean central corneal thickness were observed postoperatively. There were no major complications during and or after surgery.Conclusion:ICRS implantation using a unique mechanical dissection technique is a safe and effective treatment for keratoconus. All parameters improved by the 1-year follow-up.
Torsional phacoemulsification performed with a 45-degree aperture angled tip provided more effective lens removal with a lower CDE and less CCT change than a 30-degree aperture angled tip.
Aim:To evaluate the clinical outcomes of Keraring segment implantation in patients with post- laser-assisted in situ keratomileusis (LASIK) ectasia, using a mechanical implantation technique.Materials and Methods:Twelve eyes of 10 patients with post-LASIK ectasia were enrolled. Intracorneal ring segments (ICRS) were implanted after dissection of the tunnel using Tunc's specially designed dissector under suction. A complete ophthalmic examination was performed, including uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), spherical equivalent, keratometric (K) readings, inferosuperior asymmetry index (ISAI), and ultrasound pachymetry. All 3, 6, and 12-month follow-ups were completed, and statistical analysis was performed.Results:The mean preoperative UDVA for all eyes was 1.28 ± 0.59 logMAR. At 12 months, the mean UDVA was 0.36 ± 0.19 logarithm of the Minimum Angle of Resolution (logMAR) (P=0.002), and the mean preoperative CDVA was 0.58 ± 0.3 logMAR, which improved to 0.15 ± 0.12 (P=0.002) at 1 year. There was a significant reduction in cylindrical refractive and spherical equivalent refractive error from –5.29 ± 2.47 diopters (D) and –5.54 ± 5.04 D preoperatively to –1.47 ± 0.71 D and –0.74 ± 1.07 D (P=0.001, P=0.002), respectively, at 1 year. In the same period, the mean K- readings improved from 47.93 ± 4.84 D to 40.87 ± 2.36 D (P=0.002), and the mean ISAI improved from 5.34 ± 3.05 to 2.37 ± 1.68 (P=0.003). No significant changes in mean central corneal thickness were observed postoperatively. There were no major complications during or after surgery.Conclusion:ICRS implantation using a unique mechanical dissection technique is a safe and effective treatment for post-LASIK ectasia. All parameters showed improvement at 1-year follow-up.
Torsional phacoemulsification performed with 22-degree bent tips provided more effective lens removal than 12-degree bent tips, with a lower UST and CDE.
The results of the histologic evaluation of the decompensated corneas caused by the TASS are compatible with the clinical severity of the disease. In mild cases, the histologic findings were insignificant; however, when the clinical situation deteriorated, histologic findings became increasingly worse.
The Ozil IP torsional mode may provide more effective lens removal than the combined torsional/longitudinal US mode with a lower UST and volume of BSS used.
Fakoemulsifikasyon cerrahisi sonras›nda geliflebilen toksik anterior segment sendromu (TASS) 'nun klinik ve histopatolojik bulgular›n› analiz etmek. Gereç ve Yöntem: Ayn› seansta ayn› cerrah taraf›ndan gerçeklefltirilen sorunsuz fakoemulsifikasyon operasyonlar› son-ras›nda geliflen üç TASS olgusu de¤erlendirildi. Hastalar›n postoperatif 1., 12., 24., 48. saat kontrolleri yap›ld›. Sonraki takipler ihtiyaca göre planland›. Üç olguda da korneal dekompansasyon geliflti. Bir olguya eviserasyon di¤erine ise penetran keratoplasti operasyonu uyguland›. Her iki kornean›n histopatolojik analizi yap›ld›. Sonuçlar: Hastalar 61 ve 73 yafl aral›¤›nda olup, hepsi erkekti. Tüm olgularda a¤r›s›z bulan›k görme, limbustan limbusa korneal ödem ve hipopiyon vard›. Her olguda iris düzensiz dilate ve atrofikti. ‹ki kornean›n histopatolojik incelemesi; endotel hücre tabakas›n›n tamamen yok oldu¤unu gösterdi. Üçüncü olgu ise korneal dekompansasyon ve tedaviye dirençli glokom nedeniyle görmesini kaybetti. Tart›flma: TASS kornea endotel tabakas›n›n tamamen kayb›yla sonuçlanabilen ciddi bir komplikasyondur. Tek kullan›ml›k aletlere geçifl ve/veya aletlerin usule uygun y›kanmas›, TASS komplikasyonunu azaltmak için önem tafl›maktad›r.
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