Visual, refractive and topographic outcomes of progressive thickness intrastromal corneal ring segments for keratoconic
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ORIGINAL PAPER
Visual, refractive and topographic outcomes of progressive thickness intrastromal corneal ring segments for keratoconic eyes Efekan Cos¸ kunseven . Renato Ambro´sio Jr. . Adriana Smora´dkova´ . Francisco Sa´nchez Leo´n . Onurcan Sahin . Isilay Kavadarli . Mirko R. Jankov II
Received: 25 February 2020 / Accepted: 3 June 2020 Ó Springer Nature B.V. 2020
Abstract Purpose To evaluate one-year visual, refractive, and topographic outcomes of 58 eyes of 53 keratoconus patients who underwent surgery with a progressive thickness intrastromal corneal ring segment (ICRS). Methods This multi-center, retrospective, observational study evaluates the one-year effects of progressive thickness ICRS implanted in keratoconus patients meeting the inclusion criteria. One or two progressive ICRS were implanted in the selected eyes after creating an intrastromal tunnel with a femtosecond laser. Pre- and postoperative uncorrected distance visual acuity, best-corrected distance visual acuity, manifest refraction (both spherical equivalent and cylindrical refractions), corneal astigmatism, maximum keratometry, corneal thickness, and corneal topography measurements and indices were evaluated.
E. Cos¸ kunseven (&) O. Sahin I. Kavadarli Dunyagoz World Eye Hospital, Istanbul, Turkey e-mail: [email protected] R. Ambro´sio Jr. VisareRIO, Rio De Janeiro, Brazil A. Smora´dkova´ NeoVı´zia ocˇna´ klinika, Bratislava, Slovakia F. Sa´nchez Leo´n Novavision Laser Center, Naucalpan, Mexico M. R. Jankov II LaserFocus, Belgrade, Serbia
Results In this retrospective case series, 58 eyes of 53 keratoconus patients were included with a followup of 12 months. The mean age was 30.89 ± 11.90 years. There were improvements postoperatively in mean values of visual acuities, both uncorrected from 0.71 (preoperatively) to 0.28 (log MAR), and bestcorrected from 0.28 to 0.10 (log MAR), mean cylindrical refraction from - 2.35 ± 1.51 to - 4.15 ± 2.23 D, and mean spherical equivalent from - 2.10 ± 2.25 to - 4.64 ± 3.2 D. There was also a reduction in maximal keratometry from 54.21 D preoperatively to 50.93 D postoperatively. Conclusion The implantation of the progressive thickness ICRS is an effective and safe method to improve the vision of keratoconic eyes. Corneal stability was maintained at the 12-month mark. Keywords Intrastromal corneal ring segments Keratoconus Progressive thickness intrastromal corneal ring segments ICRS
Introduction Keratoconus is a progressive, corneal ectatic disease that has an estimated prevalence of 265 cases per 100,000 [1]. It is characterized by corneal thinning that leads to irregular astigmatism as well as a decrease in visual acuity and optical quality. There are several surgical therapeutic options to slow or halt the disease
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Int Ophthalmol
progression or to correct visual disturbances such as intrastromal corneal ring segment (ICRS) implantation, corneal cross-linking (CXL), toric phakic intraocular lens implantation, topography-gui
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