Evaluation of a new nomogram for Ferrara ring segment implantation in keratoconus
Por:
Fernández J, Peris-Martínez C, Pérez-Rueda A, Hamida Abdelkader SM, Roig-Revert MJ and Piñero DP
Publicada:
18 sep 2021
Ahead of Print:
18 sep 2021
Categoría:
Ophthalmology
Resumen:
AIM: To evaluate the short-term clinical outcomes of Ferrara rings in keratoconus using an optimized nomogram developed after several years of research and retrospective analysis of clinical data.
METHODS: This prospective longitudinal non-comparative clinical trial evaluated 88 eyes of 88 patients (age 1862y) with keratoconus diagnosis from two Spanish centers. Ferrara ring segment (AJL Ophthalmic) implantation was performed in all cases, using the mechanical procedure in 25 eyes (28.4%) and a femtosecond laser-assisted procedure in 63 eyes (71.6%). The ring segments implanted in each case were selected using a new optimized nomogram that considered variables such as anterior corneal asphericity and astigmatism or the discrepancy among astigmatism and coma orientations. Visual, refractive, corneal topographic, aberrometric, and pachymetric changes after surgery were evaluated during a 3-month follow-up.
RESULTS: The implants induced a significant refractive change as well as an improvement in uncorrected (UDVA) and corrected distance visual acuity (CDVA; P< 0.001). Postoperative CDVA of 0.10 logMAR or better was achieved in 28.4% and 46.5% of eyes, respectively. Two eyes (2.3%) lost two or more lines of CDVA whereas a total of 53.5% of eyes gained lines of CDVA. A significant central anterior and posterior corneal flattening was induced (P=0.003), with a significant reduction of anterior (P<0.001) and posterior corneal astigmatisms (P=0.048), and a change in anterior asphericity (P<0.001). Total primary coma (6 mm pupil) change was also statistically significant (preoperative 3.66 +/- 3.04 mu m vs postoperative 2.33 +/- 2.26 mu m, P<0.001). No significant differences were found in the effect of ring segments between cases implanted using the mechanical and femtosecond techniques (P=0.101).
CONCLUSION: The implantation of Ferrara rings based on the nomogram evaluated is safe and effective for promoting a visual rehabilitation in keratoconus, with a relevant control of primary coma aberration.
Filiaciones:
Fernández J:
Department of Ophthalmology (Qvision), Vithas Virgen del Mar Hospital, Almería 04120, Spain
Department of Ophthalmology, Torrecárdenas Hospital Complex, Almería 04009, Spain
:
Cornea and External Diseases Unit, FISABIO-Oftalmología Médica (FOM), Valencia 46015, Spain
Aviño Peris Eye Clinic, Valencia 46001, Spain
Department of Surgery, Ophthalmology, University of Valencia, Valencia 46010, Spain
Pérez-Rueda A:
Department of Ophthalmology, Torrecárdenas Hospital Complex, Almería 04009, Spain
Hamida Abdelkader SM:
Department of Ophthalmology, Torrecárdenas Hospital Complex, Almería 04009, Spain
:
Cornea and External Diseases Unit, FISABIO-Oftalmología Médica (FOM), Valencia 46015, Spain
Department of Surgery, Ophthalmology, University of Valencia, Valencia 46010, Spain
:
Department of Optics, Pharmacology, and Anatomy, University of Alicante, Alicante 03690, Spain
gold, Green Submitted, Green Published
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