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Adjustment of intrastromal corneal ring segments after unsuccessful implantation in keratoconic eyes

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Monteiro, Tiago and Mendes, José Ferreira and Faria Correira, Fernando and Franqueira, Nuno and Madrid Costa, David and Alfonso, José F. (2018) Adjustment of intrastromal corneal ring segments after unsuccessful implantation in keratoconic eyes. Cornea, 37 (2). pp. 182-188. ISSN 0277-3740

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Official URL: https://doi.org/10.1097/ICO.0000000000001449


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Abstract

Purpose: To evaluate visual, refractive, and corneal topography outcomes in eyes with keratoconus that have undergone exchange/adjustment surgery with a new intrastromal corneal ring segment (ICRS) combination after unsuccessful visual and/or refractive outcomes after primary ICRS surgery. Methods: A retrospective nonrandomized case series was conducted including consecutive eyes of patients with keratoconus that underwent ICRS adjustment after an unsuccessful visual outcome. Patients were divided into 2 groups: group 1 was made up of patients with Intacs ICRSs that were exchanged for the Ferrara ICRS type, and group 2 consisted of patients who maintained the same ICRS type after undergoing ICRS adjustment surgery (change of the arc length or thickness). Uncorrected distance visual acuity, best-corrected distance visual acuity (CDVA), keratometry, asphericity, higher-order aberrations, and corneal regularity indexes (ISV and IHD) (Pentacam HR; OCULUS) were assessed preoperatively and 12 months after each procedure. Results: Twenty-six eyes from 26 patients were included, 8 eyes in group 1 and 18 eyes in group 2. The eyes in both groups improved their CDVA values after ICRS exchange, in group 1 from 0.27 ± 0.11 preoperatively to 0.54 ± 0.17 postoperatively (P = 0.001), and in group 2 from 0.34 ± 0.22 to 0.61 ± 0.15 (P < 0.0001). In both groups, there was also a significant improvement in the refractive cylinder, topographic cylinder, and coma after ICRS adjustment (P < 0.05). Conclusions: ICRS implantation has been shown to be a reversible and adjustable surgical procedure for keratoconus treatment. Good outcomes can be obtained after ICRSs are exchanged. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved


Item Type:Article
Additional Information:

Received June 26, 2017
Received in revised form September 22, 2017
Accepted September 28, 2017

Uncontrolled Keywords:Keratoconus; Intrastromal corneal ring segments; Adjustment
Subjects:Medical sciences > Medicine > Ophtalmology
Medical sciences > Optics > Optometry
Medical sciences > Optics > Physiological optics
ID Code:47328
Deposited On:04 May 2018 10:03
Last Modified:04 May 2018 10:03

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