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Sequential intrastromal corneal ring segment and monofocal intraocular lens implantation for keratoconus and cataract: Long-term follow-up

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Alfonso, José F. and Lisa Fernández, Carlos and Fernández-Vega Cueto, Luis and Poo López, Arancha and Madrid Costa, David and Fernández-Vega, Luis (2017) Sequential intrastromal corneal ring segment and monofocal intraocular lens implantation for keratoconus and cataract: Long-term follow-up. Journal of cataract and refractive surgery, 43 (2). pp. 246-254. ISSN 1873-4502

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Official URL: http://dx.doi.org/10.1016/j.jcrs.2016.11.044




Abstract

Purpose: To evaluate the efficacy, safety, predictability, and stability of sequential Ferrara intrastromal corneal ring segment (ICRS) and intraocular lens (IOL) implantation in patients with keratoconus and cataract.
Setting: Fernández-Vega Ophthalmological Institute, Oviedo, Spain.
Design: Retrospective case series.
Methods: This study comprised patients with keratoconus and cataract who had ICRS implantation followed 6 months later by IOL implantation. The uncorrected (UDVA) and corrected (CDVA) distance visual acuities and residual refractive errors, analyzed using vector analysis, were recorded preoperatively, 6 months after ICRS implantation, 6 months after IOL implantation, and 3 years and 5 years thereafter.
Results: Seventy eyes of 47 patients were studied. The mean UDVA was 1.08 logMAR ± 0.24 (SD) preoperatively, 0.95 ± 0.31 logMAR 6 months after ICRS implantation (P = .03), and 0.44 ± 0.29 logMAR 6 months after IOL implantation (P < .0001). The mean CDVA changed from 0.35 ± 0.23 logMAR before surgery to 0.28 ± 0.22 logMAR 6 months after ICRS implantation (P < .0001) and to 0.11 ± 0.16 logMAR 6 months after IOL implantation (P < .0001). The UDVA and CDVA were stable over the period after the second procedure (P > .05). The spherical equivalent (SE) and the refractive cylinder declined steeply after IOL implantation (P < .001) and then were stable (P > .05).
Conclusion: Sequential ICRS and IOL implantation provided good visual and refractive outcomes and was an effective, safe, predictable, and stable procedure for the treatment of patients with keratoconus and cataract.


Item Type:Article
Additional Information:

Received 11 July 2016, Revised 8 November 2016, Accepted 9 November 2016, Available online 31 March 2017.

Uncontrolled Keywords:Keratoconus; Intrastromal corneal rings; Intraocular lens; IOL; Cataract
Subjects:Medical sciences > Medicine > Surgery
Medical sciences > Medicine > Ophtalmology
Medical sciences > Optics > Visual perception
ID Code:47636
Deposited On:21 May 2018 12:15
Last Modified:21 May 2018 12:15

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