Evaluation of intrastromal corneal ring segments for treatment of keratoconus with a mechanical implantation technique

Tunc, Zeki; Helvacıoğlu, Fırat; Şencan, Sadık

doi:10.4103/0301-4738.109519

Cited by 9 publications

(27 citation statements)

References 28 publications

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“…Our results are in agreement with previous studies that reported significant corneal flattening changes after Keraring implantation 18,20,21…”

Section: Discussionsupporting

confidence: 94%

“…They reported a statistically significant reduction in the SE refractive error compared to that observed at the examination before implantation. Tunc et al18 reported a significant reduction in SE refractive error from −6.42±4.69 D preoperatively to −1.26±1.45 D ( P =0.001) at 1 year postoperatively.…”

Section: Discussionmentioning

confidence: 94%

“…Tunc et al18 reported that the mean LogMAR UCVA increased significantly from 1.36±0.64 preoperatively to 0.51±0.28 at 12 months after mechanical Keraring implantation ( P =0.001). The mean preoperative LogMAR BCVA was significantly improved from 0.57±0.29 to 0.23±0.18 at 1 year postoperatively ( P =0.001).…”

Section: Discussionmentioning

confidence: 97%

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Refractive and visual outcomes after Keraring intrastromal corneal ring segment implantation for keratoconus assisted by femtosecond laser at 6 months follow-up

Heikal

Abdelshafy

Soliman

et al. 2016

OPTH

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PurposeWe attempted to evaluate the efficacy of femtosecond laser-assisted intrastromal corneal ring segment implantation in patients with keratoconus (KC).Patients and methodsA retrospective interventional consecutive clinical study was conducted on patients with KC who were treated with femtosecond laser Keraring implantation. All procedures were performed at Ebsar Eye Center in the period from January 5, 2015, to February 28, 2016.ResultsThirty eyes of 20 patients were included in this study. The mean age of patients was 27.43±3.57 years. Eleven patients (55%) were female and nine patients (45%) were male. Keraring segments were successfully implanted in all eyes. There were no complications or need for ring repositioning. The follow-up period was 6 months postoperatively. There was a significant improvement in the mean logarithm of the minimum angle of resolution (LogMAR) of uncorrected visual acuity (UCVA) after Keraring segment implantation from 1.5±0.23 preoperatively to 0.54±0.16 at 6 months postoperatively (P=0.001). The preoperative mean LogMAR of best-corrected visual acuity (BCVA) was 0.85±0.17. At 1 month postoperatively, it was 0.35±0.15; at 3 months postoperatively, it was 0.26±0.11, and at 6 months postoperatively, it was 0.14±0.07 (P=0.001). The mean preoperative maximum keratometric value for 3 mm pupil in diopters (K max) significantly decreased from 55.85±5.44 preoperatively (N=30) to 44.05±1.64 D at 6 months postoperatively (P=0.001). There was a statistically significant reduction in the mean preoperative spherical equivalent from −5.43±1.76 D preoperatively to −2.43±0.95 D at 6 months postoperatively. No statistically significant differences were detected between 1 and 3 months of follow-up regarding the visual and refractive outcomes.ConclusionAnalysis of the outcomes after Keraring ICRS implantation showed a significant postoperative corneal flattening with a subsequent increase in UCVA and BCVA. Using the femtosecond laser for tunnel creation made the procedure easy and fast with an accurate precise depth of implantation and reduced the risk of operative and postoperative complications.

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“…Our results are in agreement with previous studies that reported significant corneal flattening changes after Keraring implantation 18,20,21…”

Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 94%

See 1 more Smart Citation

Refractive and visual outcomes after Keraring intrastromal corneal ring segment implantation for keratoconus assisted by femtosecond laser at 6 months follow-up

Heikal

Abdelshafy

Soliman

et al. 2016

OPTH

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“…74,75 An improvement in the corneal shape manifested as an improvement in inferior-superior corneal symmetry and centralization of the corneal apex has been reported. 67,[76][77][78] However, Alio et al, 79 in their retrospective study with longer follow-up (36-48 months), showed that ICRS implantation is incapable of maintaining the initial corneal flattening effect. In their series, the eyes implanted with ICRS showed a progressive increase in keratometry reading from 6 to 36 months.…”

Section: Momentioning

confidence: 93%

Outcome of Keratoconus Management: Review of the Past 20 Years' Contemporary Treatment Modalities

Mandathara

Stapleton

Willcox

2017

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

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“…This decreases refractive errors and improves corneal surface regularity. Moreover, there is evidence to suggest that implanting an ICRS may delay the requirement for penetrating keratoplasty (7)(8)(9) . There are several commercially available ICRS that vary with regard to curvature, width, and zone of implantation (3) .…”

Section: Introductionmentioning

confidence: 99%

Intrastromal corneal ring segments delay corneal grafting in patients with keratoconus

Beniz¹,

Queiroz²,

Queiroz³

et al. 2016

Arquivos Brasileiros De Oftalmologia

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Approved by the following research ethics committee: Hospital das Clínicas, Universidade Federal de Goiás (219.191). ABSTRACT Purpose:To assess the impact of intrastromal corneal ring segments (ICRS) as a surgical alternative to corneal grafting in patients with keratoconus who were scheduled for a corneal transplant. Methods: This single-surgeon, single-center, retrospective, observational case series study included 19 eyes of 18 patients (mean age, 23.36 ± 6.22 years) with a confirmed diagnosis of keratoconus. These patients were enrolled from the State of Goiás, Brazil corneal graft waiting list. Following extensive pre-operative testing, including the measurement of best-corrected visual acuity (BCVA), applanation tonometry, biomicroscopy, funduscopy, pachymetry, and corneal topography, patients were implanted with Keraring® ICRS. Patients underwent clinical examination at postoperative days 1, 7, 30, 90, and 180 and were examined again 2 years following surgery. Results: At the 2-year cut-off following ICRS implantation (mean follow-up, 28.72 ± 4.71 months), there was a statistically significant improvement in BCVA (logMAR) from 0.59 ± 0.35 preoperatively to 0.35 ± 0.45 postoperatively (p<0.01). Three of 19 eyes (15.8%) still required keratoplasty. In the remaining patients (84.2%), BCVA was managed with spectacles (52.6%) or contact lenses (31.6%). One patient developed infectious keratitis, requiring removal of ICR at the first postoperative visit. Conclusion: ICRS implantation may be a surgical alternative to keratoplasty in patients with keratoconus. This procedure may delay or even eliminate the need for keratoplasty in such patients.

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Evaluation of intrastromal corneal ring segments for treatment of keratoconus with a mechanical implantation technique

Cited by 9 publications

References 28 publications

Refractive and visual outcomes after Keraring intrastromal corneal ring segment implantation for keratoconus assisted by femtosecond laser at 6 months follow-up

Refractive and visual outcomes after Keraring intrastromal corneal ring segment implantation for keratoconus assisted by femtosecond laser at 6 months follow-up

Outcome of Keratoconus Management: Review of the Past 20 Years' Contemporary Treatment Modalities

Intrastromal corneal ring segments delay corneal grafting in patients with keratoconus

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