Keratoconus progression after intrastromal corneal ring segment implantation according to age: 5-year follow-up cohort s
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ORIGINAL PAPER
Keratoconus progression after intrastromal corneal ring segment implantation according to age: 5-year follow-up cohort study Bruno Schneider de Araujo Sergio Kwitko
. Leticia Kubo . Diane Ruschel Marinho .
Received: 25 February 2020 / Accepted: 3 June 2020 Springer Nature B.V. 2020
Abstract Background/aims Intrastromal corneal ring segments (ICRS) have been found to be useful in correcting keratoconus by decreasing irregular astigmatism, thereby potentially improving visual acuity. However, its long-term effects in keratoconus progression are not completely understood, mainly concerning the effects of age on ICRS implantation results. This study aimed to evaluate long-term effects of ICRS implantation according to age at implantation. Methods We conducted a longitudinal retrospective study, where we evaluated patients with keratoconus who underwent ICRS implantation between 2004 and 2012. Results We evaluated 34 eyes for 5 years postoperatively. The mean age of the 21 men and 7 women was 20.59 ± 4.65 years. Best spectacle-corrected
visual acuity (BSCVA) improved from 0.32 ± 0.19 in the preoperative period to 0.46 ± 0.27 6 months post-operatively. After up to 5 years of follow-up, there was no significant difference in mean visual acuity of the group. As expected, there was a significant decrease in keratometric values after corneal ring implantation, which remained stable over the 5-year follow-up. Among the 34 cases analysed, nine (26%) showed signs of disease progression. In eight of the nine documented progression cases, patients were 21 years old or younger, revealing that these patients were sevenfold more likely to progress than those aged over 21 years. Conclusion In our series of cases, ICRS implantation was shown to be an excellent treatment to reduce corneal curvature and improve visual acuity at all ages, but it did not stabilize the disease, especially in young patients with more aggressive forms of the keratoconus.
B. S. de Araujo (&) D. R. Marinho S. Kwitko OftalmoCentro, Private Clinic, Porto Alegre, Av. Coronel Lucas de Oliveira, 505/709, 90440-011 Porto Alegre, RS, Brazil e-mail: [email protected]
Keywords Keratoconus Intrastromal corneal ring Progression Cornea ectasia
B. S. de Araujo D. R. Marinho S. Kwitko Department of Ophthalmology and Otolaryngology, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil L. Kubo School of Medicine, Universidade Luterana do Brasil (ULBRA), Canoas, RS, Brazil
Introduction Keratoconus is a noninflammatory ectatic corneal disorder that manifests later on in the disease process and involves central corneal thinning, corneal protrusion and progressive irregular astigmatism [1].
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Classically the disease starts in puberty and progresses throughout the third and fourth decades of life [2]. The frequency of keratoconus in the general population depends on geographical area and screening method, varying from 0.1 to 2.3% or more [3,
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