Implantation of a Complete Intrastromal Corneal Ring at 2 Different Stromal Depths in Keratoconus

Jabbarvand, Mahmoud; Hashemi, Hassan; Mohammadpour, Mehrdad; Khojasteh, Hassan; Khodaparast, Mehdi; Hashemian, Hesam

doi:10.1097/ico.0000000000000026

Cited by 19 publications

(11 citation statements)

References 8 publications

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“…The MyoRing [sometimes called intracorneal continuous ring (ICCR)] was used for the patients with keratoconus in several studies with successful visual outcomes. 5 , 6 , 7 , 8 , 9 Our study demonstrated additional information, including improved uncorrected visual acuity and spherical equivalent 6 months after the operation, about effectivity of the procedure. The improvement in the uncorrected visual acuity and spherical equivalent after the procedure was similar to other studies.…”

Section: Discussionsupporting

confidence: 53%

“…The MyoRing is a complete intrastromal ring that has been successfully used in the management of the patients with different grades of keratoconus. 5 , 6 , 7 , 8 , 9 This instrument has been used to treat the corneal ectasia after refractive surgery. 10 , 11 The MyoRing may have some beneficial or adverse effects on the structures in multiple levels of cornea.…”

Section: Introductionmentioning

confidence: 99%

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Confocal biomicroscopic changes of the corneal layers following femtosecond laser-assisted MyoRing implantation in keratoconus

Siatiri

Jabbarvand

Mohammadpour

et al. 2017

Journal of Current Ophthalmology

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PurposeTo evaluate the effect of the femtosecond laser-assisted MyoRing implantation on the confocal biomicroscopic findings in different corneal layers of the patients with keratoconus.MethodsTwelve eyes of 12 patients with mild to moderate keratoconus (keratometry between 48 and 52 diopters) and intolerance to hard contact lens entered the study. All the included patients underwent femtosecond laser-assisted MyoRing (Dioptex GmBH, Linz, Austria) implantation. The confocal biomicroscopy of the cornea was performed for all corneal layers in the center and periphery preoperatively and 3 and 6 months postoperatively. The cell counts and the qualitative findings in each layer of the cornea were compared between preoperative and 3 and 6 months postoperative images.ResultsCompared with preoperative values, the central epithelial and the central and peripheral midstromal cell counts were significantly decreased 6 months after MyoRing implantation (P = 0.015, P = 0.010 and 0.005, respectively). Furthermore, compared with preoperative values, the peripheral posterior stromal cell count was significantly decreased 3 months after MyoRing implantation (P = 0.033). In the qualitative analysis, highly reflective nuclei in the basal epithelium, transient disruption in the subepithelial nerve plexus, increase in the reflectivity of the stromal keratocyte, and normal endothelial cell morphology were seen.ConclusionsOur study demonstrated some findings similar to that reported in intrastromal corneal ring segments (ICRS): decreased central epithelial cell counts, highly reflective nuclei in the basal epithelium, transient disruption in the subepithelial nerve plexus, and normal endothelial cell count and morphology. In addition, a decrease in the central and peripheral midstromal, transient decrease in posterior stromal cell counts, and absence of amorphous depositions were in contrast with the findings reported in ICRS.

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Section: Discussionsupporting

confidence: 53%

Section: Introductionmentioning

confidence: 99%

Confocal biomicroscopic changes of the corneal layers following femtosecond laser-assisted MyoRing implantation in keratoconus

Siatiri

Jabbarvand

Mohammadpour

et al. 2017

Journal of Current Ophthalmology

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“…The ring is implanted into an intrastromal pocket created with either a specified microkeratome PocketMaker (Dioptex GmbH, Austria) [5] or a femtosecond laser [8, 10]. The depth of the corneal pocket has been proposed to be 300 or 250 μ m in the previous studies [5, 11]. The main advantages of a full ring are easy implantation, excellent centration, and the postoperative possibility of adjusting the position of the ring, if necessary [6].…”

Section: Introductionmentioning

confidence: 99%

Clinical Outcomes after Complete Intracorneal Ring Implantation and Corneal Collagen Cross-Linking in an Intrastromal Pocket in One Session for Keratoconus

Studený

Krizova

Stranak

2014

Journal of Ophthalmology

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Purpose. The aim of this work was to evaluate the results after combined surgery implantation of full rings and CXL in one session in a group of patients with keratoconus during a 12-month follow-up. Material and Methods. The study included 22 eyes of 20 keratoconic patients, mean age of 28.41 (from 18 to 50) years. A full ring was inserted and afterwards 0.1% riboflavin solution was injected into the corneal pocket through the incision tunnel. The cornea was irradiated with UV-A light for 30 minutes. Postoperative visits were scheduled for the first week and months 1, 3, 6, 12, and 24 after surgery. Minimal follow-up time was 12 months. Results. The mean UDVA improved by 6 lines from before the operation to 1 year after the operation, the mean CDVA improved by approximately 2.5 lines, and the mean K improved by 3.94 D. Statistically significant reductions of sphere (P < 0.001), cylinder (P = 0.004), and spherical (P < 0.001) equivalents were found 1 month after surgery. Conclusion. The combined surgery MyoRing implantation and CXL seems to be a safe method in the treatment of keratoconus. We noticed an improvement of the refractive error in all of our patients.

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“…8,9 Recently, we reported our results of a complete intracorneal ring (MyoRing) to correct keratoconus. 10,11,21 However, some human studies reported complications of intrastromal inlays, including significant visual loss and scarring, intrastromal epithelial opacification, and unacceptable visual outcomes. 8,20,22 In this animal study, we implanted intracorneal inlays made of hexafocon A in New Zealand white rabbit eyes.…”

Section: Discussionmentioning

confidence: 98%

Histological and Confocal Changes in Rabbit Cornea Produced by an Intrastromal Inlay Made of Hexafocon A

Salamatrad

Jabbarvand

Hashemian

et al. 2015

Cornea

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Implantation of a Complete Intrastromal Corneal Ring at 2 Different Stromal Depths in Keratoconus

Abstract: An implantation depth of 250 μm has comparable outcomes with the previously applied 300-μm implantation depth. It may be appropriate for selected cases of keratoconus with lower pachymetry.

Cited by 19 publications

References 8 publications

Confocal biomicroscopic changes of the corneal layers following femtosecond laser-assisted MyoRing implantation in keratoconus

Confocal biomicroscopic changes of the corneal layers following femtosecond laser-assisted MyoRing implantation in keratoconus

Clinical Outcomes after Complete Intracorneal Ring Implantation and Corneal Collagen Cross-Linking in an Intrastromal Pocket in One Session for Keratoconus

Histological and Confocal Changes in Rabbit Cornea Produced by an Intrastromal Inlay Made of Hexafocon A

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