Intrastromal corneal ring segment implantation with the femtosecond laser in a post-keratoplasty patient with recurrent keratoconus

Coşkunseven, Efekan; Kymionis, George D.; Talu, Haluk; Aslan, Ebru; Diakonis, Vasilios F.; Bouzoukis, Dimitrios I; Pallikaris, Ioannis G.

doi:10.1016/j.jcrs.2007.05.042

Cited by 20 publications

(12 citation statements)

References 7 publications

(7 reference statements)

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“…To our knowledge, there is only 1 report in the literature of ICRS implantation in these cases, and it is of a single case with a follow-up of 10 months. 34 In conclusion, our results indicate that ICRS implantation is a safe option to correct high astigmatism after PKP and that is yields good visual, refractive, and topographic outcomes. Future prospective studies with more patients and a longer follow-up are needed to confirm the safety and effectiveness of ICRS for high astigmatism after keratoplasty.…”

Section: Discussionsupporting

confidence: 51%

Intrastromal corneal ring segment implantation for high astigmatism after penetrating keratoplasty

Arriola‐Villalobos¹,

Díaz-Valle²,

Güell³

et al. 2009

Journal of Cataract and Refractive Surgery

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PURPOSE: To evaluate the safety and efficacy of intracorneal ring segments (ICRS) for high astigmatism after penetrating keratoplasty (PKP). SETTING:METHODS: This retrospective noncomparative study comprised eyes with high post-PKP astigmatism (>4.00 diopters [D]), contact lens intolerance, and a minimum follow-up of 24 months who had ICRS (Kerarings) implantation by mechanical stromal dissection. Corrected distance visual acuity (CDVA), refractive astigmatism, spherical equivalent (SE), surgically induced astigmatism (SIA), central corneal curvature, topographic corneal astigmatism, average corneal power, and complications were assessed. RESULTS:The mean CDVA was statistically significantly better postoperatively (0.23 G 0.21) than preoperatively (0.98 G 0.27) (P Z .007); no eye lost CDVA. The mean refractive astigmatism decreased from 6.17 G 1.12 D to 4.04 G 1.67 D (P Z .068) and the mean SE from À3.17 G 5.48 D to À0.12 G 2.40 D (P Z .34). The mean SIA was 4.55 G 2.83 D. The mean central corneal curvature decreased from 46.28 G 1.73 D to 42.09 G 3.20 D (P<.01); the mean topographic corneal astigmatism, from 7.07 G 2.52 D to 4.48 G 2.00 D (P<.05) and the mean average corneal power from 45.92 G 1.59 D to 41.88 G 3.37 D (P<.01); all decreases were statistically significant. One patient developed deep vascularization in the lower temporal stromal channel that resolved after ICRS removal. One patient reported significant night halos.CONCLUSION: Implantation of ICRS for high post-PKP astigmatism reduced corneal curvature and topographic astigmatism, significantly improving CDVA.

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Section: Discussionsupporting

confidence: 51%

Intrastromal corneal ring segment implantation for high astigmatism after penetrating keratoplasty

Arriola‐Villalobos¹,

Díaz-Valle²,

Güell³

et al. 2009

Journal of Cataract and Refractive Surgery

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“…[25][26][27] In a case report, Coskunseven et al 25 advocate the use of ICRS, a minimally invasive procedure, to correct high astigmatism after PKP. According to Coskunseven et al, eyes with thin corneal grafts and recurrent keratoconus are unsuitable for laser refractive corrections because of the possibility of postoperative complications.…”

Section: Discussionmentioning

confidence: 99%

Intrastromal corneal ring segment implantation to correct astigmatism after penetrating keratoplasty

Coscarelli

Ferrara

Alfonso

et al. 2012

Journal of Cataract and Refractive Surgery

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“…Keraring is an efficient method for keratoconus correction, as it significantly decreases the SE by decreasing both the spherical and cylindrical components [10]. It also significantly decreases the keratometric values (K max , K min , and K average ) and significantly increases both the UCVA and BSCVA as well as improving the corneal topography [10-12]. When dealing with an irregular "asymmetrical" corneal surface, asymmetrical implantation provides better results by unequal flattening of the two opposite hemimeridians, as previously reported [7,8].…”

Section: Discussionmentioning

confidence: 99%

Sequential Intrastromal Corneal Ring Implantation and Cataract Surgery in a Severe Keratoconus Patient with Cataract

Lee¹,

Kwon²,

Koh³

2012

Korean J Ophthalmol

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A 49-year-old man with an uncorrected visual acuity (UCVA) of 20 / 1000, a best spectacle-corrected visual acuity (BSCVA) of 20 / 400, keratometric readings of K1 = 59.88 × 82° / K2 = 45.88 × 172°, and an inferior steepening that was consistent with keratoconus in his left eye was treated with clear-cornea phacoemulsification and an intraocular lens (IOL) implantation after insertion of keraring intrastromal corneal ring segments for severe keratoconus and cataract. An asymmetrical pair of kerarings was implanted with the assistance of a femtosecond laser in September 2008; the one segment was 250 µm and the other was 150 µm and both were placed at 70°. Three months after the kerarings were implanted, clear-cornea phacoemulsification and IOL implantation were performed on the left eye. After surgery, both the UCVA and the BSCVA of the left eye improved by eight lines. Postoperative central keratometry showed a decrease of 7.35 diopters in the left eye. Both the postoperative refraction (-0.75 -0.75 × 60°) and the keratometric reading (K1 = 50.05 × 93° / K2 = 48.83 × 3°) remained stable one month following the procedures. Thus, the sequential order of intrastromal corneal rings implantation and cataract surgery can be considered as a treatment option in patients with severe keratoconus and cataract.

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Intrastromal corneal ring segment implantation with the femtosecond laser in a post-keratoplasty patient with recurrent keratoconus

Cited by 20 publications

References 7 publications

Intrastromal corneal ring segment implantation for high astigmatism after penetrating keratoplasty

Intrastromal corneal ring segment implantation for high astigmatism after penetrating keratoplasty

Intrastromal corneal ring segment implantation to correct astigmatism after penetrating keratoplasty

Sequential Intrastromal Corneal Ring Implantation and Cataract Surgery in a Severe Keratoconus Patient with Cataract

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