Five-year long-term outcomes of intrastromal corneal ring segment implantation using the manual technique for keratoconus management

Costa, Jorge Vasco; Monteiro, Tiago; Franqueira, Nuno; Faria-Correia, Fernando; Alfonso, José F.; Vaz, Fernando

doi:10.1097/j.jcrs.0000000000000500

Cited by 5 publications

(10 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…No regression was observed in any visual or topographic parameter during the entire follow-up. Regarding the subgroup analysis, both younger and older patients demonstrated similar and stable results from preoperative to the 5-year visit, except for the minimal change in pachymetry value over time [21].…”

Section: Mednext Journal Of Medical and Health Sciencesmentioning

confidence: 78%

Ferrara ring and the nomogram as the main strategy for correcting keratoconus: a systematic review of clinical findings

Moura¹,

Daher²,

Ferrari³

et al. 2023

MedNEXT

View full text Add to dashboard Cite

Introduction: In the setting of corneal ectasias, keratoconus (KC) is a bilateral and asymmetrical disease that results in progressive thinning and tilting of the cornea, leading to irregular astigmatism and decreased visual acuity. The condition affects all ethnicities and both sexes. KC prevalence and incidence rates are close to between 0.2 and 4790 per 100,000 people and 1.5 and 25 cases per 100,000 person-years, respectively. For surgeons who implant Ferrara rings, the manufacturer has developed an online nomogram aimed at optimizing patient outcomes. Objective: The present study carried out a systematic review to present the main clinical outcomes of keratoconus treatment using the Ferrara ring. Methods: The systematic review rules of the PRISMA Platform were followed. The literature search was carried out from January to February 2023 in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. Scientific articles from the last 15 years were selected. The quality of the studies was based on the GRADE instrument. The risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 60 articles were found, of which only 21 were part of this systematic review, after an eligibility analysis.It was concluded that the insertion of Ferrara rings in keratoconic eyes with previous cross-linking history using the company's nomogram results in significant improvements in visual, refractive, and tomographic results. Corneal densitometry in the anterior layer of the cornea decreases after the implantation of intrastromal corneal ring segments and correlates with corneal keratometry. Over 5 years, Ferrara-type intrastromal corneal ring segment implantation is a safe, effective, and stable procedure for restoring vision in pediatric patients with keratoconus old.

show abstract

Section: Mednext Journal Of Medical and Health Sciencesmentioning

confidence: 78%

Ferrara ring and the nomogram as the main strategy for correcting keratoconus: a systematic review of clinical findings

Moura¹,

Daher²,

Ferrari³

et al. 2023

MedNEXT

View full text Add to dashboard Cite

show abstract

“…5,6 Intrastromal corneal ring segments (ICRS) can decrease irregular astigmatism and corneal higher-order aberrations (HOA), thus improving VA, refraction and keratometry. 7,8 Although the long-term stability of ICRS implantation and its ability to halt the disease progression has been recently described, 9,10 it remains a point of controversy. 11 Recent publications have confirmed the efficacy and safety of different treatment combinations: CXL with excimer corneal ablation, [12][13][14] and ICRS with CXL.…”

Section: Introductionmentioning

confidence: 99%

Comparison of outcomes between cross-linking plus topoguided excimer laser ablation and intrastromal corneal ring segments for keratoconus

Pinheiro

Rosa

Monteiro

et al. 2023

European Journal of Ophthalmology

Self Cite

View full text Add to dashboard Cite

Objective To compare cross-linking (CXL) plus topography-guided photorefractive keratectomy (t-PRK) and intrastromal corneal ring segments (ICRS) in keratoconus patients, at 12 months of follow-up. Methods This was a longitudinal, retrospective multi-center study. We included a referred sample of 154 eyes from 149 patients with grade I-III Amsler-Krümeich keratoconus with insufficient corrected-distance visual acuity (CDVA). In group 1 (CXL plus t-PRK, 87 eyes), another possible indication for surgery was evidence of progression. Group 2 (ICRS, 67 eyes) included only eyes with paracentral keratoconus (thinnest point at the inferotemporal quadrant) with coincident axes, and evidence of stabilization was required. A subgroup analysis was performed regarding the disease topographic phenotype. At 12 months postoperatively, visual, refractive, and topographic outcomes were evaluated. Results Comparison of the outcomes between CXL plus t-PRK (group 1) and ICRS (group 2) showed similar improvements in CDVA (in group 1, CDVA improved 0.18 logMAR, and in group 2 0.12 logMAR, P = .18) and K2 (−2,45 [6.46] D in group 1 and −2.13 [1.67] D in group 2, P = .34) The improvement in cylinder power was greater in group 2 (−2.37 [2.07] D in group 2 versus −1.18 [2.63] D in group 1, P = .003); group 1 had a higher decrease in Kmax (- 3.26 [3.64] versus—1.74 [2.67], P = .001). Conclusions Both CXL plus t-PRK and ICRS were equally effective in improving CDVA and topographic parameters in a similar group of keratoconus patients at 12 months.

show abstract

“…(2) There have been numerous studies (3)(4)(5)(6)(7)(8)(9) confirming the safety and efficacy of Ferrara ICRS implants (AJL, Ophthalmic, Spain) in patients with keratoconus, but few have analyzed the procedure's stability in the short, medium and long term. Most of the studies (10)(11)(12)(13)(14)(15)(16)(17) have reported a maximum follow-up of 5 years, showing evidence of improved visual, refractive, and topographical quality. A number of these studies (11,13,15,17) have concluded that this improvement remains stable at 5 years.…”

Section: Introductionmentioning

confidence: 99%

“…Most of the studies (10)(11)(12)(13)(14)(15)(16)(17) have reported a maximum follow-up of 5 years, showing evidence of improved visual, refractive, and topographical quality. A number of these studies (11,13,15,17) have concluded that this improvement remains stable at 5 years. The study by De Araujo et al (14) corroborated the efficacy of ICRS, but its effect did not remain stable for patients younger than 21 years old.…”

Section: Introductionmentioning

confidence: 99%

Changes in the total corneal refractive power after insertion of intrastromal rings in patients with keratoconus in short, medium and long term

Rodríguez-Gutiérrez¹,

Villa-Collar²,

Díaz-Valle³

et al. 2023

Revista Brasileira De Oftalmologia

View full text Add to dashboard Cite

show abstract

Five-year long-term outcomes of intrastromal corneal ring segment implantation using the manual technique for keratoconus management

Abstract: This retrospective study of 124 eyes concluded that ICRS implantation was a stable, safe, and effective procedure for keratoconus management over a 5-year follow-up period.

Cited by 5 publications

References 25 publications

Ferrara ring and the nomogram as the main strategy for correcting keratoconus: a systematic review of clinical findings

Ferrara ring and the nomogram as the main strategy for correcting keratoconus: a systematic review of clinical findings

Comparison of outcomes between cross-linking plus topoguided excimer laser ablation and intrastromal corneal ring segments for keratoconus

Changes in the total corneal refractive power after insertion of intrastromal rings in patients with keratoconus in short, medium and long term

Contact Info

Product

Resources

About