Clinical and Topographical Corneal Changes after Keraring Implantation in Keratoconus Patients

Mirzaei Mohamad, Najafi Amin, Shahraki Kurosh, Taheri Nazli, Mirzaei Samira

Abstract


Introduction: Keratoconus is a progressive, non-inflammatory, bilateral, ecstatic disease of the cornea that is characterized by corneal steepening which progresses to irregular conical shape, with subsequent irregular astigmatism and decreased visual acuity. In early stages of disease, spectacles or RGP lenses are the main treatment. At advanced stages, when these treatment options fail to correct visual acuity, surgical procedures such as penetrating keratoplasty or lamellar keratoplasty are required.

METHODS: Keraring segments were placed in 30 eyes of 21 keratoconus patients. The mean follow-up time was 6.2 months. All patients underwent a complete ocular examination and corneal topography which was obtained by Pentacam (Oculus Pentacam®, USA). Improvement in uncorrected visual acuity (UCVA), best spectacle corrected visual acuity, refraction and topographic changes including keratometry, maximum anterior and posterior elevation, central corneal thickness and thinnest point thickness and location were evaluated.

RESULTS: No intraoperative or postoperative complications occurred in any of the patients. ICRS implantation significantly improved UCVA (P=0.005) and BSCVA (P=0.000). Mean Spherical equivalent significantly reduced from -6.66±3.52 to -4.42±3.20 (p=0.000). A clinically significant reduction in mean keratometry (p=0.000), Max Ant Elevation (P=0.024) and Max Post Elevation (P=0.002) were recorded. No clinically significant changes in central corneal thickness, thinnest point thickness and thinnest point location were observed.

Conclusion: With mean follow-up of 6.2 months, Keraring segments implantation caused significant clinical improvement in UCVA, BCVA Refractive Error and Keratometric findings of the most keratoconic patients.

 

Keywords: keratoconus; ICRS; Keraring


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References


Espandar, L. and J. Meyer (2010). "Keratoconus: overview and update on treatment." Middle East Afr J Ophthalmol 17(1): 15-20.

de Freitas Santos Paranhos, J., et al. (2011). "Visual perception changes and optical stability after intracorneal ring segment implantation: comparison between 3 months and 1 year after surgery." Clin Ophthalmol 5: 1057-1062.

Hashemi, H., et al. (2013). "Efficacy of intacs intrastromal corneal ring segment relative to depth of insertion evaluated with anterior segment optical coherence tomography." Middle East Afr J Ophthalmol 20(3): 234-238.

Vazirani, J. and S. Basu (2013). "Keratoconus: current perspectives." Clin Ophthalmol 7: 2019-2030.

Siganos, C. S., et al. (2003). "Management of keratoconus with Intacs." Am J Ophthalmol 135(1): 64-70.

Colin, J., et al. (2001). "INTACS inserts for treating keratoconus: one-year results." Ophthalmology 108(8): 1409-1414.

Pinero, D. P., et al. (2010). "Modeling the intracorneal ring segment effect in keratoconus using refractive, keratometric, and corneal aberrometric data." Invest Ophthalmol Vis Sci 51(11): 5583-5591.

.Kymionis, G. D., et al. (2007). "Long-term follow-up of Intacs in keratoconus." Am J Ophthalmol 143(2): 236-244.

Shabayek, M. H. and J. L. Alio (2007). "Intrastromal corneal ring segment implantation by femtosecond laser for keratoconus correction." Ophthalmology 114(9): 1643-1652.

Ertan, A. and J. Colin (2007). "Intracorneal rings for keratoconus and keratectasia." J Cataract Refract Surg 33(7): 1303-1314.

Ganesh, S., et al. (2013). "Intrastromal corneal ring segments for management of keratoconus." Indian J Ophthalmol 61(8): 451-455.

Colin, J., et al. (2000). "Correcting keratoconus with intracorneal rings." J Cataract Refract Surg 26(8): 1117-1122.

Tunc Z, Deveci N, Sener B, Bahcecioglu H. Anneaux intracornee´ns (Intacs) pour le traitement de l’astigmatisme asyme´trique du ke´ratoco ˆ ne: recul de plus de deux ans. J Fr Ophtalmol 2003; 26:824–830.

Colin J. European clinical evaluation: Use of Intacs for the treatment of keratoconus. J Cataract Refract Surg 2006;32:747-55.

Torquetti L, Berbel RF, Ferrara P. Long-term follow-up of intrastromal corneal ring segments in keratoconus. J Cataract Refract Surg 2009;35:1768-73.

Pinero, D. P., et al. (2009). "Refractive and aberrometric outcomes of intracorneal ring segments for keratoconus: mechanical versus femtosecond-assisted procedures." Ophthalmology 116(9): 1675-1687.

Sogutlu, E., et al. (2012). "Elevation changes of central posterior corneal surface after intracorneal ring segment implantation in keratoconus." Cornea 31(4): 387-395.

Turner T. What corneal topography can tell you about corneal shape. In: MacRae S, Krueger R, Applegate RA, eds. Customized Corneal Ablation: The Quest for Supervision. Thorofare, NJ: Slack Inc; 2001:221–227.

Rapuano CJ, Sugar A, Koch DD, et al. Intrastromal corneal ring segments for low myopia: a report by the American Academy of Ophthalmology. Ophthalmology 2001;108:1922– 1928.

Schanzlin Dj, Abbot Rl, Asbell PA, et al. Two-year outcomes of intrastromal corneal ring segments for the correction of myopia. Ophthalmology 2001;108:1688 –1694.

Schanzlin DJ, Asbell PA, Burris TE, Durrie DS. The intrastromal corneal ring segments. Phase II results for the correction of myopia. Ophthalmology 1997;104:1067–1078.

Guell JL. Are intracorneal rings still useful in refractive surgery? Curr Opin Ophthalmol 2005;16:260 –265.

Siganos CS, Kymionis GD, Kartakis N, et al. Management of keratoconus with Intacs. Am J Ophthalmol 2003;135:64 –70.

Boxer Wachler BS, Christie JP, Chandra NS, et al. Intacs for keratoconus. Ophthalmology 2003;110:1031– 40.

Sharma M, Boxer Wachler BS. Comparison of single-segment and double-segment Intacs for keratoconus and post- LASIK ectasia. Am J Ophthalmol 2006;141:891– 895.

Alio, J. L., et al. (2006). "Analysis of results related to good and bad outcomes of Intacs implantation for keratoconus correction." J Cataract Refract Surg 32(5): 756-761.

Alio JL, Shabayek MH, Artola A. Intracorneal ring segments for keratoconus correction: long-term follow-up. J Cataract

Refract Surg 2006;32:978 –985

Kymionis GD, Siganos CS, Kounis G, et al. Management of post-LASIK corneal ectasia with Intacs inserts: one-year results. Arch Ophthalmol 2003;121:322–326.

Kymionis GD, Tsiklis NS, Pallikaris AI, et al. Long-term follow-up of Intacs for post-LASIK corneal ectasia. Ophthalmology 2006;113(11) Forthcoming.

Siganos CS, Kymionis GD, Astyrakakis N, Pallikaris IG. Management of corneal ectasia after laser in situ keratomileusis with INTACS. J Refract Surg 2002;18:43– 46.

Alio J, Salem T, Artola A, Osman A. Intracorneal rings to correct corneal ectasia after laser in situ keratomileusis.

Saelens, I. E., et al. (2011). "Refractive, topographic, and visual outcomes of same-day corneal cross-linking with Ferrara intracorneal ring segments in patients with progressive keratoconus." Cornea 30(12): 1406-1408.


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