Publication: Función visual en pacientes con queratocono pre y post implantación de anillos intraestromales y posterior adaptación de lentes de contacto
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2015-05-19
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Universidad Complutense de Madrid, Servicio de Publicaciones
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Abstract
"OBJETIVOS": Analizar y comparar los cambios en la función visual en ojos con queratocono, pre y post implantación de anillos intraestromales(ICRS) Keraring® y la posterior adaptación de lentes de contacto hidrofílicas tóricas(LHT). "METODOS": Los ojos fueron evaluados en condiciones mesópicas(0,1-0,2 cd/m2) y fotópicas(85 cd/m2). Las agudezas visuales compensadas de alto (AVC-AC) y bajo (AVC-BC) contraste fueron medidas con la carta de Bailey-Lovie y la sensibilidad al contraste (SC) con la carta de Pelli-Robson. La adaptación de las LHT se estableció según la AVC-AC como satisfactoria (≤0,2 logMAR) o insatisfactoria (>0,2). Los pacientes en el grupo insatisfactorio fueron readaptados con sistema piggy-back (PB). "RESULTADOS": Fueron evaluados 12 ojos con estadio I de queratocono, 21 con estadio II, y 14 con estadio III (clasificación de Amsler-Krumeich). El incremento medio (logMAR) debido a la cirugía en la AVC-AC fotópica fue de 0,16 ± 0,20(P<0,00001), la AVC-BC fotópica de 0,14 ± 0,26(P=0,0005), la AVC-AC mesópica de 0,10 ± 0,26(P=0,03) y la CS fotópica (un. Log.) de 0,09 ± 0,22(P=0,005). No hubo diferencia entre estadios. No fueron significativos los cambios en la AVC-BC mesópica o la CS mesópica para ningún estadio. El straylight se incrementó en los ojos con estadio III. La adaptación de LHT fue satisfactoria en el 75%, 66.66% y el 0% de los ojos implantados con ICRS con estadios I a III respectivamente. La AVC-AC en gafas fue 1,5 líneas logMAR mayor y la potencia corneal media 3.62D más baja en el grupo satisfactorio con LHT. La adaptación de PB consiguió una AVC-AC ≤0,2 logMAR en todos los casos. El straylight no cambió. "CONCLUSIONES": La suma de la cirugía y la adaptación de lentes de contacto mejoró la función visual fotópica y mesópica en AVC-AC, AVC-BC y SC. No hubo cambio en el straylight. La integridad epitelial se mantuvo estable.
"PURPOSE": To analyze and compare the changes in visual function in different stages of keratoconus before and after Keraring® intrastromal corneal ring segment (ICRS) implantation and subsequently after hydrophilic soft contact lens (LHT) fitting. "METHODS": Keratoconic eyes were evaluated under mesopic (0.1-0.2 cd/m2) and photopic (85 cd/m2) conditions. LogMAR high-contrast (AVC-AC) and low-contrast (AVC-BC) corrected distance visual acuity were assessed using the Bailey-Lovie test and logarithmic contrast sensitivity (SC) using the Pelli-Robson test. The outcome of LHT fitting was defined according to AVC-AC as successful (≤0.2 logMAR) or unsuccessful (>0.2 logMAR). Patients in the unsuccessful group were refitted with a piggy-back (PB) system. "RESULTS": The study evaluated 12 eyes with stage I keratoconus, 21 eyes with stage II, and 14 eyes with stage III according Amsler-Krumeich classification. The mean increase (logMAR) by the surgery in photopic AVC-AC was 0.16 ± 0.20 (P<0.00001). Photopic AVC-BC increased by a mean of 0.14 ± 0.26 (P=0.0005), mesopic AVC-AC by a mean of 0.10 ± 0.26 (P=0.03) and photopic CS (log.units) by a mean of 0.09 ± 0.22 (P=0.005). There were no significant differences between stages. Surgery did not affect the mean changes in mesopic AVC-BC or mesopic CS for any stage. Straylight increased in eyes with stage III. LHT fitting was successful in 75%, 66.66% and 0% of the ICRS implanted eyes with stages I–III keratoconus, respectively. Spectacle AVC-AC was 1.5 logMAR lines better and mean corneal power was 3.62D lower in the successful LHT group. PB refitting achieved a AVC-AC ≤0.2 logMAR in all cases. Straylight did not change. "CONCLUSIONS": The sum total of the ICRS implantation and the contact lens fitting improved the photopic and mesopic visual function in AVC-AC, AVC-BC and SC. There was no change in straylight. Epithelial integrity remained stable after both treatments.
"PURPOSE": To analyze and compare the changes in visual function in different stages of keratoconus before and after Keraring® intrastromal corneal ring segment (ICRS) implantation and subsequently after hydrophilic soft contact lens (LHT) fitting. "METHODS": Keratoconic eyes were evaluated under mesopic (0.1-0.2 cd/m2) and photopic (85 cd/m2) conditions. LogMAR high-contrast (AVC-AC) and low-contrast (AVC-BC) corrected distance visual acuity were assessed using the Bailey-Lovie test and logarithmic contrast sensitivity (SC) using the Pelli-Robson test. The outcome of LHT fitting was defined according to AVC-AC as successful (≤0.2 logMAR) or unsuccessful (>0.2 logMAR). Patients in the unsuccessful group were refitted with a piggy-back (PB) system. "RESULTS": The study evaluated 12 eyes with stage I keratoconus, 21 eyes with stage II, and 14 eyes with stage III according Amsler-Krumeich classification. The mean increase (logMAR) by the surgery in photopic AVC-AC was 0.16 ± 0.20 (P<0.00001). Photopic AVC-BC increased by a mean of 0.14 ± 0.26 (P=0.0005), mesopic AVC-AC by a mean of 0.10 ± 0.26 (P=0.03) and photopic CS (log.units) by a mean of 0.09 ± 0.22 (P=0.005). There were no significant differences between stages. Surgery did not affect the mean changes in mesopic AVC-BC or mesopic CS for any stage. Straylight increased in eyes with stage III. LHT fitting was successful in 75%, 66.66% and 0% of the ICRS implanted eyes with stages I–III keratoconus, respectively. Spectacle AVC-AC was 1.5 logMAR lines better and mean corneal power was 3.62D lower in the successful LHT group. PB refitting achieved a AVC-AC ≤0.2 logMAR in all cases. Straylight did not change. "CONCLUSIONS": The sum total of the ICRS implantation and the contact lens fitting improved the photopic and mesopic visual function in AVC-AC, AVC-BC and SC. There was no change in straylight. Epithelial integrity remained stable after both treatments.
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Óptica y Optometría, Departamento de Óptica II, leída el 21-11-2014