Clasificación del queratocono basada en fenotipos clínicos. Influencia del astigmatismo congénito en la morfología del queratocono

Sánchez, José F. Alfonso; Fernández, Carlos Lisa; Cueto-Felgueroso, Luis Fernández-Vega; López, Arancha Poo; Costa, David Madrid

doi:10.1016/b978-84-9022-649-0.50021-1

Cited by 5 publications

(1 citation statement)

References 12 publications

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“…Since the recent phenotypic keratoconus (KC) classification described by Alfonso [ 11 ], in which the corneal curvature pattern becomes the most relevant factor in the surgical management of the ectasia, the understanding of the refractive outcome after intracorneal ring segment (ICRS) implantation has evolved considerably. So far, all kinds of phenotypes have been treated with symmetric ICRSs.…”

Section: Introductionmentioning

confidence: 99%

Localized Refractive Changes Induced by Symmetric and Progressive Asymmetric Intracorneal Ring Segments Assessed with a 3D Finite-Element Model

García de Oteyza,

Álvarez de Toledo,

Barraquer

et al. 2023

Bioengineering

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To build a representative 3D finite element model (FEM) for intracorneal ring segment (ICRS) implantation and to investigate localized optical changes induced by different ICRS geometries, a hyperelastic shell FEM was developed to compare the effect of symmetric and progressive asymmetric ICRS designs in a generic healthy and asymmetric keratoconic (KC) cornea. The resulting deformed geometry was assessed in terms of average curvature via a biconic fit, sagittal curvature (K), and optical aberrations via Zernike polynomials. The sagittal curvature map showed a locally restricted flattening interior to the ring (Kmax −11 to −25 dpt) and, in the KC cornea, an additional local steepening on the opposite half of the cornea (Kmax up to +1.9 dpt). Considering the optical aberrations present in the model of the KC cornea, the progressive ICRS corrected vertical coma (−3.42 vs. −3.13 µm); horizontal coma (−0.67 vs. 0.36 µm); and defocus (2.90 vs. 2.75 µm), oblique trefoil (−0.54 vs. −0.08 µm), and oblique secondary astigmatism (0.48 vs. −0.09 µm) aberrations stronger than the symmetric ICRS. Customized ICRS designs inspired by the underlying KC phenotype have the potential to achieve more tailored refractive corrections, particularly in asymmetric keratoconus patterns.

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Section: Introductionmentioning

confidence: 99%

Localized Refractive Changes Induced by Symmetric and Progressive Asymmetric Intracorneal Ring Segments Assessed with a 3D Finite-Element Model

García de Oteyza,

Álvarez de Toledo,

Barraquer

et al. 2023

Bioengineering

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Keratoconus: exploring fundamentals and future perspectives – a comprehensive systematic review

Niazi,

Gatzioufas,

Doroodgar

et al. 2024

Ophthalmol Eye Dis

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Background: New developments in artificial intelligence, particularly with promising results in early detection and management of keratoconus, have favorably altered the natural history of the disease over the last few decades. Features of artificial intelligence in different machine such as anterior segment optical coherence tomography, and femtosecond laser technique have improved safety, precision, effectiveness, and predictability of treatment modalities of keratoconus (from contact lenses to keratoplasty techniques). These options ingrained in artificial intelligence are already underway and allow ophthalmologist to approach disease in the most non-invasive way. Objectives: This study comprehensively describes all of the treatment modalities of keratoconus considering machine learning strategies. Design: A multidimensional comprehensive systematic narrative review. Data sources and methods: A comprehensive search was done in the five main electronic databases (PubMed, Scopus, Web of Science, Embase, and Cochrane), without language and time or type of study restrictions. Afterward, eligible articles were selected by screening the titles and abstracts based on main mesh keywords. For potentially eligible articles, the full text was also reviewed. Results: Artificial intelligence demonstrates promise in keratoconus diagnosis and clinical management, spanning early detection (especially in subclinical cases), preoperative screening, postoperative ectasia prediction after keratorefractive surgery, and guiding surgical decisions. The majority of studies employed a solitary machine learning algorithm, whereas minor studies assessed multiple algorithms that evaluated the association of various keratoconus staging and management strategies. Last but not least, AI has proven effective in guiding the implantation of intracorneal ring segments in keratoconus corneas and predicting surgical outcomes. Conclusion: The efficient and widespread clinical translation of machine learning models in keratoconus management is a crucial goal of potential future approaches to better visual performance in keratoconus patients. Trial registration: The article has been registered through PROSPERO, an international database of prospectively registered systematic reviews, with the ID: CRD42022319338

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Queratocono en edad pediátrica: características clínico-refractivas y evolución. Centro de Especialidades Médicas Fundación Donum, Cuenca, Ecuador, 2015-2018

Rojas-Álvarez¹

2019

Revista Mexicana De Oftalmología

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queratometría media, paquimetría en el punto más delgado y cilindro refractivo, en dos momentos. Se empleó el análisis de varianza (ANOVA) de medidas repetidas para un factor con ajuste del intervalo de confianza por Bonferroni y valor p. Resultados: Se obtuvo un aumento estadísticamente significativo entre el valor promedio de queratometría media de la muestra en el momento del diagnóstico (49.6 D) y el valor promedio de queratometría media a los 3 años de seguimiento (52.4 D) (p = 0.02; α = 0.05); una disminución estadísticamente significativa entre la paquimetría promedio de la muestra en el momento del diagnóstico (482 µm) y la paquimetría promedio de la muestra a los 3 años de seguimiento (459 µm) (p = 0.03; α = 0.05); y un incremento estadísticamente significativo entre el cilindro refractivo promedio de la muestra en el momento del diagnóstico (4.6 D) y el cilindro refractivo promedio de la muestra a los 3 años de seguimiento (5.1 D) (p = 0.01; α = 0.05). Conclusiones: Las modificaciones de queratometría, cilindro refractivo y paquimetría sugieren progresión de la enfermedad en este grupo de edad, en un periodo de 3 años.

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Clasificación del queratocono basada en fenotipos clínicos. Influencia del astigmatismo congénito en la morfología del queratocono

Cited by 5 publications

References 12 publications

Localized Refractive Changes Induced by Symmetric and Progressive Asymmetric Intracorneal Ring Segments Assessed with a 3D Finite-Element Model

Localized Refractive Changes Induced by Symmetric and Progressive Asymmetric Intracorneal Ring Segments Assessed with a 3D Finite-Element Model

Keratoconus: exploring fundamentals and future perspectives – a comprehensive systematic review

Queratocono en edad pediátrica: características clínico-refractivas y evolución. Centro de Especialidades Médicas Fundación Donum, Cuenca, Ecuador, 2015-2018

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