Characterization of the effect of intracorneal ring segment in corneal ectasia after laser refractive surgery
Por:
Peris-Martínez C, Bueno-Gimeno I, Alvarez-Arana I, Piñero DP and Gené-Sampedro A
Publicada:
1 ene 2020
Ahead of Print:
1 nov 2018
Resumen:
Purpose: To evaluate the visual, refractive, topographic, pachymetric, and biomechanical outcomes after intracorneal ring segment implantation in corneas with post-LASIK ectasia. Methods: Retrospective longitudinal study enrolling 26 eyes of 22 patients with post-LASIK ectasia and undergoing intracorneal ring segment implantation (KeraRing (R), Mediphacos) using a 60-kHz femtosecond laser (IntraLase (R), IntraLase Corp.) for corneal tunnelization. Visual, refractive, anterior, and posterior corneal topographic (Pentacam HR, Oculus), pachymetric, and corneal biomechanical changes (Ocular response Analyzer, Reichert) were evaluated during a 12-month follow-up. Vector analysis of astigmatic changes was performed. Results: A statistically significant reduction of sphere (p = 0.043) was observed at 1 month after surgery, with a significant improvement of uncorrected distance visual acuity associated (p = 0.019). Likewise, a significant reduction of anterior corneal power measurements (p <= 0.014) and steepest posterior keratometric reading (p = 0.006) were observed at 1 month postoperatively, with no significant changes afterwards (p > 0.133). No significant changes were observed in manifest cylinder (p > 0.175), corrected distance visual acuity (p > 0.174), flattest posterior keratometric measurement (p > 0.282), volumetric measurements (p > 0.051), and corneal biomechanical parameters (p > 0.068). Vector analysis revealed an initial trend to overcorrection of astigmatism, with a trend to undercorrection at the end of follow-up and a significant variability in the outcome achieved in each patient. Conclusion: The implantation of KeraRing segments in post-LASIK corneal ectasia generates a significant modification of spherical refraction and a visual improvement due to a central corneal flattening generated. More refined nomograms of implantation in these cases should be developed to achieve a more predictable correction of astigmatism.
Filiaciones:
:
1 FISABIO Oftalmología Médica (FOM), Cornea and External Diseases Unit, Valencia, Spain
2 AviñoPeris Eye Clinic, Valencia, Spain
Bueno-Gimeno I:
3 Department of Optics and Optometry and Vision Sciences, University of Valencia, Valencia, Spain
Alvarez-Arana I:
3 Department of Optics and Optometry and Vision Sciences, University of Valencia, Valencia, Spain
:
4 Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
Gené-Sampedro A:
3 Department of Optics and Optometry and Vision Sciences, University of Valencia, Valencia, Spain
5 Research Institute on Traffic and Road Safety (INTRAS) University of Valencia, Valencia, Spain
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