scholarly journals Intrastromal Corneal Ring Segment Implantation (Keraring 355°) in Patients with Central Keratoconus: 6-Month Follow-Up

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Khosrow Jadidi ◽  
Seyed Aliasghar Mosavi ◽  
Farhad Nejat ◽  
Mostafa Naderi ◽  
Leila Janani ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Invasive Procedure ◽  
Cost Effective ◽  
Corrected Visual Acuity ◽  
Intrastromal Corneal Ring ◽  
Uncorrected Visual Acuity ◽  
Ring Segment ◽  
Efficacy Index ◽  
Preliminary Study

We evaluate the efficacy and safety of Keraring 355° intrastromal corneal ring segment (ICRS) implantation aided by PocketMaker microkeratome for the correction of keratoconus. Patients underwent ICRS insertion using mechanical dissection with PocketMaker microkeratome and completed 6 months of follow-up. Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), refraction, topographic findings, safety, efficacy index, and adverse events were reported for six months postoperatively. We evaluated 15 eyes of 15 patients (12 men) with a mean age of 28.87 ± 6.94 years (range 21–49 years). At final postoperative examination, there was a statistically significant reduction in the spherical equivalent refractive error compared to preoperative measurements (−5.46 ± 1.52 to −2.01 ± 1.63 D,P<0.001). Mean preoperative UCVA (logMAR) before implantation was 0.79 ± 0.48, and postoperative UCVA was 0.28 ± 0.15,P=0.001. Mean preoperative BSCVA (logMAR) before implantation was 0.36 ± 0.21; at final follow-up examination BSCVA was 0.18 ± 0.9,P=0.009. MeanKdecreased from 48.33 to 43.31 D,P<0.001. All patients were satisfied with ICRS implantation; 86.7% were moderately to very happy with the results. No intraoperative or postoperative complications were demonstrated. This preliminary study shows that ICRS (Keraring 355°) implantation is an efficient, cost-effective, and minimally invasive procedure for improving visual acuity in nipple type keratoconic corneas.

scholarly journals Preliminary Results of Femtosecond Laser Assisted Corneal Ring Segment Implantation for Keratoconus

2013 ◽  
Vol 2 (2) ◽  
pp. 47-50
Author(s):  
Vardhaman P Kankariya ◽  
Kemal Ozulken ◽  
Florence Cabot ◽  
Sonia H Yoo
Keyword(s):  
Visual Acuity ◽  
Femtosecond Laser ◽  
Safe Procedure ◽  
K Value ◽  
Preliminary Results ◽  
Corrected Visual Acuity ◽  
Uncorrected Visual Acuity ◽  
Ring Segment ◽  
Preliminary Study

ABSTRACT Purpose To present refractive, visual and topographic outcomes of femtosecond laser assisted intrastromal ring segments (ISRS) implantation. Settings Bascom Palmer Eye Institute, Miami, FL, USA. Materials and methods Nineteen eyes of 15 patients with keratoconus, clear central corneas, and contact lens intolerance had implantation of a symmetrical 0.45 mm Inta cs segment (Addition Technology Inc, California, USA) using 200 kHz femtosecond laser (WaveLight GmbH, Erlangen, Germany). The outcomes of the procedure were evaluated in terms of uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), average keratometry value (K-value) and spheric equivalent (SE). Results Femtosecond laser assisted ISRS implantation could be performed with ease, while no intra- or postoperative complications were encountered. Mean UCVA improved from 0.95 ± 0.39 to 0.66 ± 0.28 logMAR, mean BSCVA improved from 0.46 ± 0.13 to 0.29 ± 0.21 logMAR, mean spherical equivalent considerably reduced from −7.15 ± 4.57 to −4.38 ± 4.07 and K value reduced from 52.39 ± 5.79 to 49.78 ± 6.84 D at the last follow-up. Conclusion Using a 200 kHz femtosecond laser is a safe procedure providing optimal refractive, visual and topographic outcomes in our preliminary study. How to cite this article Ozulken K, Cabot F, Kankariya VP, Yoo SH. Preliminary Results of Femtosecond Laser Assisted Corneal Ring Segment Implantation for Keratoconus. Int J Kerat Ect Cor Dis 2013;2(2):47-50.

scholarly journals Clinical outcomes after intracorneal ring segment implantation for keratoconus management in corneas with mild apical haze

2021 ◽  
Vol 13 ◽  
pp. 251584142110033
Author(s):  
Mohamed Elalfy ◽  
Sundas Maqsood ◽  
Aja Reinhold ◽  
Georgios D. Panos ◽  
Aye Khine ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Therapeutic Option ◽  
Exclusion Criterion ◽  
Queen Victoria ◽  
Corrected Visual Acuity ◽  
Uncorrected Visual Acuity ◽  
Ring Segment ◽  
Corneal Opacities ◽  
Intracorneal Ring Segment

Purpose: The implantation of intracorneal ring segments represents an effective and safe therapeutic option for visual improvement in patients with keratoconus. The presence of corneal opacities is considered an exclusion criterion for this operation. Methods: This is a retrospective cohort study of six eyes of six keratoconus patients at Queen Victoria Hospital, East Grinstead, UK, between January 2012 and December 2016. Femtosecond laser-assisted intracorneal ring segment implantation was performed in six eyes with apical corneal haze. Preoperative and postoperative visual acuity, keratometry readings, as well as corneal pachymetry were compared at 6-month follow-up. Results: Uncorrected visual acuity (UCVA) [LogMAR] improved significantly from median 1.05 [95% confidence interval (CI): 0.83–0.13] preoperatively to 0.9 (95% CI: 0.63–1.00) at 6 months postoperatively ( p = 0.03). Corrected visual acuity (CDVA) also improved significantly from median 0.75 (95% CI: 0.43–1.00) preoperatively to 0.4 (95% CI: 0.23–0.50) at 6 months postoperatively ( p = 0.03). Keratometric readings, K-max (diopters) and K-mean (diopters), decreased significantly from 54.5 and 47.85 preoperatively to 53.45 and 46.42 postoperatively, respectively ( p = 0.03). Corneal pachymetry showed no significant changes postoperatively. Conclusion: The results of this study show that the presence of apical haze should not exclude the implantation of intracorneal ring segments in patients with keratoconus.

scholarly journals Modification of the Intrastromal Ring Position according to Postimplant Visual and Refractive Failure: Report of Two Cases

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Luis Izquierdo ◽  
Josefina A. Mejías Smith ◽  
Jose R. Lievano ◽  
Ramón Sarquis ◽  
Maria A. Henriquez
Keyword(s):  
Visual Acuity ◽  
Postoperative Outcome ◽  
Mean Square ◽  
Corrected Visual Acuity ◽  
Intrastromal Corneal Ring ◽  
Scheimpflug Imaging ◽  
Uncorrected Visual Acuity ◽  
Ring Segment ◽  
One Year ◽  
Ring Position

Objective. The following report presents the adaptation of an existing technique of intrastromal corneal ring (ICRS) implantation enabling repositioning of the ring position postoperatively to manage a refractive failure in two patients with keratoconus. Methods. In two cases, KeraRing and Ferrara nomograms had suggested different ring positions. To manage with the differences between the two nomograms, a longer corneal tunnel was created followed by the classic intervention to move the ring through the initial intrastromal corneal tunnel according to the topographic values. Once the first ring position has failed, the ring segment was repositioned along the longer corneal tunnel according to the postoperative outcome. Results. Significant improvement in both cases was observed in the best corrected visual acuity (BCVA), uncorrected visual acuity (UCVA), and root mean square (RMS) measured with Scheimpflug imaging (Pentacam; Oculus GmBH, Wetzlar, Germany). The participants were followed for one year. Conclusion. In patients with keratoconus which exhibit significant differences between KeraRing and Ferrara nomograms, a longer tunnel should be created to enable repositioning of the ring postoperatively if necessary, to avoid extracting the ring or changing it.

Corneal densitometry in patients with keratoconus undergoing intrastromal Ferrara ring implantation

2021 ◽  
pp. 112067212110206
Author(s):  
Pablo Felipe Rodrigues ◽  
Bernardo Kaplan Moscovici ◽  
Guilherme Ferrara ◽  
Luciano Lamazales ◽  
Marcela Mara Silva Freitas ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Medical Records ◽  
Spherical Equivalent ◽  
Interventional Study ◽  
Data Comparison ◽  
Corneal Densitometry ◽  
Corrected Visual Acuity ◽  
Ring Segment ◽  
The Mean

Objective: Evaluation of central corneal densitometry changes following Ferrara corneal ring segment implantation in patients with keratoconus, especially the correlation between corneal densitometry and keratometry. Methods: Retrospective, non-comparative, interventional study based on the review of medical records of patients diagnosed with keratoconus who underwent Ferrara corneal ring segment implantation. Pre and post-operative corneal densitometry measurements obtained with Pentacam HR (Oculus, Wetzlar, Germany) were analyzed. The follow-up time was 3 months, and data comparison was made, using specific statistical analysis, with the data of 3 months postoperatively. Results: The study sample consisted of 43 eyes of 36 patients. The mean corrected visual acuity improved from 0.82 LogMAR preoperatively (SD ± 0.33) to 0.19 LogMAR (SD ± 0.13) postoperatively. The mean spherical equivalent varied from −4.63 (SD ± 3.94) preoperatively to −2.16 (SD ± 2.63) postoperatively. Asphericity varied from −0.69 (SD ± 0.32) preoperatively to −0.27 (SD ± 0.31) postoperatively. The mean maximum K was 54.01D (SD ± 3.38) preoperatively and 51.50D (SD ± 2.90) postoperatively. The mean anterior densitometric value was 18.26 (SD ± 2.03) preoperatively and 17.66 (SD ± 1.84) postoperatively. Conclusion: Corneal densitometry is an interesting technology that should be studied in keratoconus patients. Our results suggest that the corneal densitometry in the cornea’s anterior layer reduces after ICRS implantation and correlates with corneal keratometry. Further studies should be performed to increase the knowledge in this field.

Outcomes of a 320-degree intrastromal corneal ring segment implantation for keratoconus: Results of a 6-month follow-up

2018 ◽  
Vol 30 (1) ◽  
pp. 139-146 ◽  
Author(s):  
Guilherme Andrade do Nascimento Rocha ◽  
Paulo Ferrara de Almeida Cunha ◽  
Leonardo Torquetti Costa ◽  
Luciene Barbosa de Sousa
Keyword(s):  
Visual Acuity ◽  
Spherical Equivalent ◽  
Distance Visual Acuity ◽  
Uncorrected Distance Visual Acuity ◽  
Intrastromal Corneal Ring ◽  
Corrected Distance Visual Acuity ◽  
Ring Segment ◽  
The Mean ◽  
Corneal Tomography

Importance: This study shows that a newer long-arc length intrastromal corneal ring segment is efficient and safe for keratoconus treatment. Background: To evaluate visual, tomographic results and complications of a 320-degree intrastromal corneal ring segment implantation with the femtosecond laser for keratoconus treatment. Design: A prospective, nonrandomized, and interventional study. Participants: A total of 34 eyes of 31 patients diagnosed with keratoconus were enrolled. Methods: Patients were divided into two groups based on the strategy used for 320-degree intrastromal corneal ring segment thickness selection. In one group, this selection was based on spherical equivalent (SE group) and in the other on the mean asphericity (Q group). The uncorrected and corrected distance visual acuities, spherical equivalent, K1, K2, Km, Kmax, and mean asphericity ( Q) on corneal tomography were evaluated preoperatively and at 3 and 6 months postoperatively. For astigmatism improvement, we analyzed the corneal tomographic vectorial astigmatism change preoperatively and at 6 months postoperatively. The mean follow-up period was 6.63 ± 0.96 months. Results: The mean uncorrected distance visual acuity and corrected distance visual acuity improved with a significant spherical equivalent improvement ( p < 0.05), with no differences between the 320-degree intrastromal corneal ring segment groups. All corneal tomographic parameters improved significantly ( p < 0.05) between the preoperative and postoperative intervals, with a significant better performance when we used spherical equivalent for the 320-degree intrastromal corneal ring segment thickness selection. Finally, the mean vectorial corneal tomographic astigmatism significantly improved after 6 months, again with no differences between groups. Conclusion: This study suggests that implanting a 320-degree intrastromal corneal ring segment is a safe and effective procedure for treating patients with keratoconus. It also suggests that for thickness selection spherical equivalent is the better strategy.

scholarly journals Outcomes of a Single-Segment Intrastromal Corneal Ring in Early Keratoconus Versus Early Pellucid Marginal Degeneration

2021 ◽  
Author(s):  
Seyed Javad Hashemian ◽  
Parya Abdolalizadeh ◽  
Leila Ghiasian ◽  
Hossein Aghaei ◽  
Ali Hadavandkhani ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Femtosecond Laser ◽  
Early Stage ◽  
Interventional Study ◽  
Short Term ◽  
Single Segment ◽  
Corrected Visual Acuity ◽  
Intrastromal Corneal Ring ◽  
Ring Segment ◽  
Outpatient Center

Abstract Purpose: To determine the effect of a single-segment intrastromal corneal ring segment (ICRS;Intacs-SK) on early keratoconus (KCN) or pellucid marginal degeneration (PMD).Methods: It is a prospective interventional study. One-hundred-twenty-four eyes (99 patients) with KCN and 36 eyes (26 patients) with PMD at early stage (the maximum keratometric reading less than 55 diopters) were included to ICRS implantation using femtosecond laser at a tertiary university-based hospital and a private outpatient center. The uncorrected distance and spectacle-corrected visual acuity (UDVA and SCDVA), manifest spherical and cylindrical refractions, and keratometry indices were measured preoperatively and postoperatively, 1 week, 2 and 6 months.Results: One week after surgery, significant improvements were observed in UDVA, SCDVA, cylinder and keratometry readings of both KCN and PMD groups (all P<0.05) with no significant changes afterwards. No significant change occurred in the sphere refraction of PMD group (P=0.10) in contrast to KCN group (P<0.001). Corneal irregularity of KCN group in central 3 and 5 mm zones increased at 1 week (both P<0.001) and then continued to decrease up to 6 months. However, the corneal irregularity of PMD group had significant reduction only at 1 week in 5-mm zone (P=0.02) and 2 months in 3-mm zone (P=0.01) postoperatively. The final efficacy indexes were 1.44±0.71 and 0.87±0.40 in KCN and PMD groups, respectively. Conclusion: Visual acuity and keratometry values reached stability at 1 week, after one-segment Intacs-SK implantation in KCN and PMD groups. The short-term efficacy of the procedure was more in early KCN compared to early PMD.

scholarly journals Explantation and Rotation of Intracorneal Ring Segments with the Support of Femtosecond Laser: An Asymmetrical Version

2013 ◽  
Vol 2 (1) ◽  
pp. 40-42
Author(s):  
E Levinger ◽  
S Levinger ◽  
A Hirsh
Keyword(s):  
Visual Acuity ◽  
Femtosecond Laser ◽  
Lower Segment ◽  
Medical Optics ◽  
Corrected Visual Acuity ◽  
Body Sensation ◽  
Uncorrected Visual Acuity ◽  
The Right ◽  
Visual Results

ABSTRACT Purpose To report a 25-year-old man who presented with advance keratoconus in the right eye with uncorrected visual acuity (UCVA) of 0.2 and best spectacle-corrected visual acuity (BSCVA) of 0.33 with +0.50 −9.25 × 45°. Materials and methods Clinical examination and corneal topography revealed grade III keratoconus in the right eye. Intracorneal ring segments (INTACS SK; Addition Technology, Des Plaines, IL) were implanted without surgical complications at 400 µm, with the 450 µm segments implanted superiorly and inferiorly using the femtosecond laser (Intralase®, Advanced Medical Optics, Inc, Abbott Park, IL). Results For 3 months postoperatively, BSCVA remained at 0.5 with plano −4.50 × 25°. The patient was complaining of foreign body sensation in the upper part of the eye and glare asking the surgeon to remove the two segments. The superior segment was removed and the lower segment was rotated 30° counter clockwise. Three months later, UCVA was 0.67 and remained stable for 24 months of follow-up. Conclusion This report shows that implanting the thicker segment inferiorly provides better visual results. How to cite this article Levinger E, Levinger S, Hirsh A. Explantation and Rotation of Intracorneal Ring Segments with the Support of Femtosecond Laser: An Asymmetrical Version. Int J Kerat Ect Cor Dis 2013;2(1):40-42.

scholarly journals Two-stage treatment of ametropia in patients with keratoconus and cataracts

2021 ◽  
Vol 6 (6-1) ◽  
pp. 204-213
Author(s):  
M. M. Bikbov ◽  
O. I. Orenburkina ◽  
A. E. Babushkin ◽  
I. F. Nuriev
Keyword(s):  
Visual Acuity ◽  
Rotational Stability ◽  
Posterior Chamber ◽  
Two Stage ◽  
Intrastromal Corneal Ring ◽  
Uncorrected Visual Acuity ◽  
Posterior Chamber Intraocular Lens ◽  
The Russian Federation ◽  
Stage 1

Keratoconus (KC) is a progressive degenerative corneal disease, leads to the aberration of biomechanical and optical properties and thinning of the cornea, causes astigmatism and decreases visual acuity.Materials and methods. 33 patients (35 eyes) with stages II–III of non-progressive keratoconus and concomitant cataracts of various stages of maturity were operated on. The average age of the patients was 46.5 ± 2.7 (41–63) years old. The operations were performed according to our proposed two-stage method of treating ametropia in patients with KC and cataracts (Patent of the Russian Federation No. 2748634 of 28.05.2021). The first stage was the implantation of FERRARA intrastromal corneal ring segments (ICRS) with thickness from 150 to 350 μm. To correct residual refractive error in 5–7 months after stage 1, patients underwent stage 2: cloudy lens was removed and replaced with toric posterior chamber intraocular lens (TIOL) – AcrySof IQ Toric (Alcon, USA), T-fl ex Toric RayOne (Rayner, UK).Results and discussion. After stage 1 of the operation (ICRS implantation), the uncorrected visual acuity (NCVA) was 0.2 ± 0.03, the best corrected visual acuity (BCVA) was 0.4 ± 0.02. In 1 month after stage 2 (phacoemulsifi cation + TIOL) NCVA was 0.64 ± 0.11 and BCVA was 0.74 ± 0.12. During the entire follow-up period after the surgery visual functions, refraction, and rotational stability of TIOL were stable.Conclusions. Conducting a two-stage surgical intervention in patients with keratoconus and cataracts allows to stop the progression of the disease and effectively correct the ametropia concomitant with keratoconus.

Clinical effectiveness of intrastromal corneal ring segments among keratoconus patients

2020 ◽  
Vol 1 (3) ◽  
pp. 140-144
Author(s):  
Abdullhamid Alghamdi ◽  
Keyword(s):  
Visual Acuity ◽  
Femtosecond Laser ◽  
Surgical Intervention ◽  
Clinical Effectiveness ◽  
Ophthalmic Examination ◽  
Visual Outcomes ◽  
Intrastromal Corneal Ring ◽  
Uncorrected Visual Acuity ◽  
The Mean

AIM: To evaluate the clinical effectiveness of intrastromal corneal ring segments (ICRS) among the patients suffering from keratoconus. METHODS: A retrospective and non-comparative interventional design had been utilized on the basis of postoperative follow-up among 56 keratoconus patients. Visual acuity was significantly assessed during complete ophthalmic examination of the patients. The femtosecond laser had been used to create the corneal tunnels in 15 eyes; whereas, the corneal tunnels were created in 72 eyes mechanically. RESULTS: The ranges and standard deviations had been used to obtain results. It had been revealed through ophthalmic assessment that the mean preoperative uncorrected visual acuity observed was 1.38±0.37 logarithm of Minimal Angle of Resolution. Moreover, a significant improvement was observed postoperatively in visual acuity by 0.58±0.32 during the 4th month. The improvement was also witnessed in the 16th month by 0.48±0.30. CONCLUSION: The implantation of ICRS is an efficient and effective surgical intervention for the treatment of keratoconus. Thus, identified intervention seems to be associated with appropriate visual outcomes and safety after the development of femtosecond as well as mechanical tunnels.

scholarly journals Implantable Collamer Lens for Correction of Refractive Errors in Patients with Keratoconus following Collagen Cross-Linking: One Year Follow-up

2014 ◽  
Vol 3 (1) ◽  
pp. 29-35 ◽  
Author(s):  
Hassenien Safa Shuber
Keyword(s):  
Visual Acuity ◽  
Cross Linking ◽  
Refractive Errors ◽  
Implantable Collamer Lens ◽  
Uncorrected Visual Acuity ◽  
Efficacy Index ◽  
The Mean ◽  
One Year ◽  
Collagen Cross Linking

ABSTRACT Objective The purpose of this study is to assess the predictability, safety, efficacy and stability of correction of refractive errors in patients with keratoconus using Visian implantable collamer lens (ICL) following collagen cross-linking. Materials and methods This prospective, non-comparative study evaluated 20 eyes of 14 patients with keratoconus subjected to implantation of intraocular collamer lens at least 1 year following collagen cross-linking and stable refraction. Mean preoperative myopia was −8.43 ± 5.13 Diopters (D) (–3.5 to −20.0D and mean cylinder was −2.19 ± 1.28D (0.0 to −4.5D). The preoperative spherical equivalent (SE) was −9.52 ± 5.33D (–3.75 to −21.25D). During the 12 months follow-up, uncorrected visual acuity, best corrected visual acuity, refraction, intraocular pressure and vaulting are measured. Results At 12 months postoperatively, 90% of eye had refractive cylinder of <1.0D with (p = 0.003) and 20 (100%) eyes was within ±0.75D of sphere at 1 year (r2 = 0.99) and (p = 0.0085). The mean postoperative BCVA in decimal was 0.498 ± 0.232, while the mean preoperative BCVA was 0.484 ± 0.285. The safety index at 12 months was 1.02. The mean postoperative UCVA in decimal was 0.498 ± 0.232 and the mean preoperative BCVA is 0.484 ± 0.29 and the efficacy index at 12 months was 1.01. Conclusion Implantation of Visian Intraocular collamer lens is predictable, safe and effective way to correct refractive error in patients with keratoconus following collagen cross-linking. How to cite this article Shuber HS. Implantable Collamer Lens for Correction of Refractive Errors in Patients with Keratoconus following Collagen Cross-Linking: One Year Follow-up. Int J Kerat Ect Cor Dis 2014;3(1):29-35.

Sign in / Sign up

Export Citation Format

Share Document