Refractive and topographic effects of single-segment intrastromal corneal ring segments in eyes with moderate to severe keratoconus and inferior cones

Fahd, Daoud; Alameddine, Raafat; Nasser, Marc; Awwad, Shady T.

doi:10.1016/j.jcrs.2014.10.037

Cited by 31 publications

(22 citation statements)

References 14 publications

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“…Several studies have reported that INTACS is effective in keratoconus 14–20 . Uncorrected distance visual acuity and spherical equivalent can be improved after INTACS implantation 14–20 . However, these reports mainly focused on short-term (less than one year) outcomes.…”

Section: Introductionmentioning

confidence: 99%

Long-term outcome of intrastromal corneal ring segments in keratoconus: Five-year follow up

Kang

Byun

Yoo

et al. 2019

Sci Rep

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To evaluate the effectiveness of intrastromal corneal ring segment (ICRS) use in keratoconus after five years. ICRS has been widely used to correct astigmatism and improve visual acuity in keratoconus. Although the short-term outcome is well known to be effective, long-term outcome has rarely been reported. A retrospective chart review was done. A total of 30 eyes diagnosed with keratoconus and treated with INTACS (Addition Technology, Sunnyvale, CA, USA) were included. Visual acuity, refraction, indices of corneal irregularity, and higher-order aberration were evaluated at preoperative, two months, one year, three years, and five years postoperatively. Uncorrected distance visual acuity (UDVA) and spherical and spherical equivalent were improved (p < 0.05) for three years. However, they worsened (p < 0.05) at five years to preoperative values. On the other hand, corrected distance visual acuity (CDVA) was improved for five years (p < 0.05). Topographic keratometry was flattened, and corneal irregularity indices were improved at five years (all p < 0.05). Coma RMS was improved (p < 0.05) continuously for five years. ICRS has advantages in improving CDVA with topographic stabilization and decreasing coma in keratoconus for five years.

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Section: Introductionmentioning

confidence: 99%

Long-term outcome of intrastromal corneal ring segments in keratoconus: Five-year follow up

Kang

Byun

Yoo

et al. 2019

Sci Rep

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“…1). Removal of duplicates and use of the selection criteria reduced the number of articles reporting the evaluation of ICRS in keratoconus to 95 articles 8,14–16,26…”

Section: Resultsmentioning

confidence: 99%

“…The reference point was a Sinskey hook marking the center of the pupil. Channel depth varied between 70% ( references 14–16, 33, 35, 37, 48-54, 63, 65, 66, 70, 80, 82, 83, 87, 88, 90, 92, 95, 98, 99, 102, 103, 105, 108, 109, 111, 113, 114 ), 75% ( references 26, 27, 34, 39, 41, 42, 45, 58, 60, 64, 71, 79, 110 ), or 80% ( references 8, 29, 30, 32, 33, 43, 47, 54–56, 59, 62, 67–69, 72–…”

Section: Resultsmentioning

confidence: 99%

“…The degree of the channel was determined using nomograms of specific ICRS used or was a 360-degree15,16,26,32,34,36,39,96 tunnel for inserting the segments. Five ICRS were used: Keraring (Mediphacos, Belo Horizonte, Brazil) ( references 8, 16, 27, 28, 31, 32, 36, 41, 42, 47, 54, 55, 58–61, 64, 66, 67, 69, 70, 77, 80, 88, 92, 93, 97–99, 102, 103, 107, 110, 112, 116 ), Ferrara ring (Ferrara Ophthalmics, Belo Horizonte, Brazil) ( references 14, 30, 35, 43, 62, 63, 76, 78, 81, 82, 84, 85, 89, 91, 94, 101, 104 ), Intacs (Addition Technology, Inc., Des Plaines, IL) ( references 16, 26, 33, 37, 39, 40,…”

Section: Resultsmentioning

confidence: 99%

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Efficacy of Different Procedures of Intra-Corneal Ring Segment Implantation in Keratoconus: a Systematic Review and Meta-Analysis

d'Azy

Pereira²,

Chiambaretta

et al. 2019

Trans. Vis. Sci. Tech.

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Purpose To evaluate the efficacy of the functional, keratometric, and refractive postoperative parameters of intracorneal ring segment (ICRS) implantation in keratoconus and its association with collagen cross-linking (CXL), photorefractive keratectomy (PRK), and intraocular lenses (IOLs). Methods We conducted a systematic review and meta-analysis on case series published between 2007 and 2017. Results We included 95 case series with a total of 4560 patients. We included 64 studies of the ICRS procedure, 20 studies of ICRS+CXL, 9 studies of ICRS+CXL+PRK, and 5 studies of ICRS+IOL. We demonstrated an overall improvement of all parameters in all procedures. Cylinder was decreased with an overall effect size (ES) of −1.15 (−1.36 to −0.95; I 2 = 93.7%). Corrected distance visual acuity was improved with an overall ES of 0.89 (0.78 to 1.00; I 2 = 81.9%). Maximal keratometry was decreased with an overall ES of 0.98 (0.85 to 1.11; I 2 = 78.9%). ICRS+IOL is the best procedure to improve spherical equivalent and uncorrected distance visual acuity ( P < 0.05) compared with other procedures. ICRSs versus ICRS+CXL are similar in all parameters except for corrected distance visual acuity. ICRS+CXL+PRK is better than ICRS alone in all parameters except for the correction of spherical equivalent. Conclusions Although the quality and strength of the data are questionable, ICRS implantation is an effective strategy to preserve visual function in keratoconic patients. Particularly, ICRS+CXL+PRK could be a low invasive procedure to propose to young keratoconic patients. Translational Relevance To propose an overview of postoperative parameters on each ICRS procedure on keratoconus.

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“…8 Moderate anatomical abnormality with structural instability (i.e., keratoconus, keratoglobus, pellucid marginal degeneration, or LASIK ectasia), prescription inserts (Intacs, Addition Technology) can be used in an intelligently-applied, asymmetric fashion using different ring combinations (i.e., 0.45 and 0.3), superficial and deep placement, single and paired rings, and incision placement manipulation. 9 The inserts then act as braces in this unstable cornea, first to correct the progress of the abnormality, and second-in a case-specific, customized fashion-to visually focus the rehabilitated cornea and further present it for laser vision surgery to correct astigmatism, which is the most common error with keratoconus that removes the least amount of tissue with the excimer laser. Ocular surface pathologies-such as advanced pterygium, recurrent pterygium, limbal lesions-can be addressed with amniotic membrane reconstruction to clear the pathology on the cornea and rehabilitate the ocular surface to present the cornea for vision corrective surgery once again.…”

Section: Gulani Corneal Scar Classificationmentioning

confidence: 99%

Corneal Scars - A Refractive Surgery !

Gulani¹

2016

DJO

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Refractive and topographic effects of single-segment intrastromal corneal ring segments in eyes with moderate to severe keratoconus and inferior cones

Abstract: No author has a financial or proprietary interest in any material or method mentioned.

Cited by 31 publications

References 14 publications

Long-term outcome of intrastromal corneal ring segments in keratoconus: Five-year follow up

Long-term outcome of intrastromal corneal ring segments in keratoconus: Five-year follow up

Efficacy of Different Procedures of Intra-Corneal Ring Segment Implantation in Keratoconus: a Systematic Review and Meta-Analysis

Corneal Scars - A Refractive Surgery !

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