Outcomes of the Q value-based nomogram in managing pediatric versus adult keratoconus: a prospective interventional study

Iqbal, Mohammed; Hammour, Abdallah; Elsayed, Ahmed; Gad, Ahmed

doi:10.51329/mehdiophthal1473

Cited by 2 publications

(2 citation statements)

References 18 publications

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“…Keratoconus (KCN) is a non-inflammatory, bilateral, asymmetric ocular disease characterized by gradual corneal thinning and steepening, resulting in irregular astigmatism and reduced visual acuity. KCN usually occurs in the second and third decades of life [ 1 , 2 ] . Intracorneal ring segments (ICRSs) have been used in the management of KCN since the 2000s [ 3 ] .…”

Section: Introductionmentioning

confidence: 99%

Corneal densitometry changes after femtosecond laser-assisted intracorneal ring segments implantation in keratoconus

Mounir,

Mohamed Mostafa,

Amer

et al. 2024

Med Hypothesis Discov Innov Ophthalmol

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Background: Intrastromal corneal ring segments are commonly implanted in the corneas of eyes with mild-to-moderate keratoconus; however, changes in corneal densitometry (CD) after implantation are a matter of debate in the current literature. We evaluated the changes in CD 1 and 3 months after femtosecond laser-assisted Keraring implantation. Methods: This retrospective, non-comparative, multicenter, case series study included patients with keratoconus who underwent femtosecond laser-assisted implantation of double segments with 90° and 160° arc lengths or two 160° arc length Keraring segments. Demographic and baseline clinical ophthalmic data were recorded. Corneal topography and tomography data acquired using a Pentacam HR Scheimpflug tomography system (Pentacam High Resolution; Oculus, Wetzlar, Germany) with a best-fit sphere were used as a reference surface. Using the Pentacam HR, CD measurements were acquired over a corneal area of 12 mm in total and at four concentric zones (0–2, 2–6, 6–10, and 10–12 mm) of three corneal stromal depths: 120 micrometers of the anterior corneal stromal layer, 60 micrometers of the posterior corneal stromal layer, and the central layer of stroma lying between these two layers. Results: We included 40 eyes of 40 patients, including 8 (20%) male and 32 (80%) female individuals, with a mean (standard deviation) age of 21.0 (6.4) years. We observed a significant improvement in the topographic values of steep keratometry (K), flat K, maximum K, and corneal astigmatism (all P < 0.05), but not in the mean K, thinnest corneal pachymetry, corneal thickness at the apex, back elevation, or front elevation (all P > 0.05). The mean total anterior, central, and posterior CD differed significantly among the time points, with a significant increase from the preoperative to the 1-month and 3-month postoperative visits (all P < 0.05) and no difference between those of the 1-month and 3-month postoperative visits (all P > 0.05). The mean CD for the anterior layer in the central, paracentral, and mid-peripheral zones, and the central layer in all four zones, differed significantly among time points, with a significant increase from the preoperative to the 1-month and 3-month postoperative visits (all P < 0.05), which remained unchanged from the 1-month to the 3-month postoperative visit (all P < 0.05), except for the central 2–6-mm zone, which decreased significantly from the 1-month to the 3-month postoperative visit (P < 0.001). The CD of the central 10–12-mm zone did not differ significantly in each pairwise comparison (all P > 0.05). In contrast, CD for the posterior layer in the paracentral zone decreased significantly from the preoperative to the 1-month and 3-month postoperative visits but increased, to a lesser extent, from the 1-month to the 3-month postoperative visit (all P < 0.05). Conclusions: Femtosecond laser-assisted Keraring implantation significantly changes CD, with improvement in most topography parameters. Further longitudinal studies with larger sample sizes are required to verify these preliminary findings.

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Section: Introductionmentioning

confidence: 99%

Corneal densitometry changes after femtosecond laser-assisted intracorneal ring segments implantation in keratoconus

Mounir,

Mohamed Mostafa,

Amer

et al. 2024

Med Hypothesis Discov Innov Ophthalmol

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“…Surgical intervention may be considered for progressive KCN or inadequate visual outcomes despite wearing contact lenses [ 12 ] . Collagen crosslinking (CXL) and intracorneal ring segment (ICRS) implantation have been used for over two decades with favorable results and acceptably low complication rates [ 1 , 14 ] .…”

Section: Introductionmentioning

confidence: 99%

Keratoconus: imaging modalities and management

Alqudah

2024

Med Hypothesis Discov Innov Ophthalmol

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Background: Keratoconus (KCN) is characterized by gradual thinning and steepening of the cornea, which can lead to significant vision problems owing to high astigmatism, corneal scarring, or even corneal perforation. The detection of KCN in its early stages is crucial for effective treatment. In this review, we describe current advances in the diagnosis and treatment of KCN. Methods: This narrative review focuses on recent advancements in the diagnosis and treatment of KCN, especially evolving approaches and strategies. To ensure the inclusion of the most recent literature, relevant publications discussing advanced imaging techniques and treatment options for KCN were extensively gathered from the PubMed/MEDLINE and Google Scholar databases. The following index terms and keywords were used for the online search: keratoconus, diagnosis of keratoconus, advances in the diagnosis of keratoconus, topography or tomography, anterior segment optical coherence tomography, treatment of keratoconus, advances in the treatment of keratoconus, collagen crosslinking, intrastromal ring, keratoplasty, and new techniques in keratoconus. Results: Various screening methods such as corneal topography, tomography, anterior segment optical coherence tomography, and assessment of corneal biomechanics have been developed to identify KCN in its early stages. After diagnosis, KCN management focuses on preventing disease progression. Corneal collagen crosslinking is a minimally invasive treatment that can slow or stop the progression of the condition. Recent research has also explored the use of copper sulfate eye drops (IVMED-80) as a noninvasive treatment to prevent the progression of KCN. Current treatment options for visual improvement include scleral lenses, intracorneal ring segments, corneal allogeneic intrastromal ring segments, and deep anterior lamellar keratoplasty. Recently, novel alternative procedures, such as isolated Bowman layer transplantation, either as a corneal stromal inlay or onlay, have demonstrated encouraging outcomes. Artificial intelligence has gained acceptance for providing best practices for the diagnosis and management of KCN, and the science of its application is contentiously debated; however, it may not have been sufficiently developed. Conclusions: Early detection and advancements in screening methods using current imaging modalities have improved diagnosis of KCN. Improvement in the accuracy of current screening or diagnostic tests and comparison of their validities are achievable by well-designed, large-scale, prospective studies. The safety and effectiveness of emerging treatments for KCN are currently being investigated. There is an ongoing need for studies to track progress and evaluate clinicians’ knowledge and practices in treating patients with KCN. Artificial intelligence capabilities in management approach considering the currently available imaging modalities and treatment options would best benefit the patient.

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Outcomes of the Q value-based nomogram in managing pediatric versus adult keratoconus: a prospective interventional study

Cited by 2 publications

References 18 publications

Corneal densitometry changes after femtosecond laser-assisted intracorneal ring segments implantation in keratoconus

Corneal densitometry changes after femtosecond laser-assisted intracorneal ring segments implantation in keratoconus

Keratoconus: imaging modalities and management

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