Skip to main content
Top
Published in: International Ophthalmology 11/2020

01-11-2020 | Original Paper

Visual, refractive and topographic outcomes of progressive thickness intrastromal corneal ring segments for keratoconic eyes

Authors: Efekan Coşkunseven, Renato Ambrósio Jr., Adriana Smorádková, Francisco Sánchez León, Onurcan Sahin, Isilay Kavadarli, Mirko R. Jankov II

Published in: International Ophthalmology | Issue 11/2020

Login to get access

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.

Results

In this retrospective case series, 58 eyes of 53 keratoconus patients were included with a follow-up 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 best-corrected 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.
Literature
2.
go back to reference Coskunseven E, Sharma DP, Grentzelos MA et al (2017) Four-stage procedure for keratoconus: ICRS implantation, corneal cross-linking, toric phakic intraocular lens implantation, and topography-guided photorefractive keratectomy. J Refract Surg 33:683–689CrossRef Coskunseven E, Sharma DP, Grentzelos MA et al (2017) Four-stage procedure for keratoconus: ICRS implantation, corneal cross-linking, toric phakic intraocular lens implantation, and topography-guided photorefractive keratectomy. J Refract Surg 33:683–689CrossRef
3.
go back to reference Alio JL, Shabayek MH, Artola A (2006) Intracorneal ring segments for keratoconus correction: long-term follow-up. J Cataract Refract Surg 32:978–985CrossRef Alio JL, Shabayek MH, Artola A (2006) Intracorneal ring segments for keratoconus correction: long-term follow-up. J Cataract Refract Surg 32:978–985CrossRef
4.
go back to reference Park SE, Tseng M, Lee JK (2019) Effectiveness of intracorneal ring segments for keratoconus. Curr Opin Ophthalmol 30(4):220–228CrossRef Park SE, Tseng M, Lee JK (2019) Effectiveness of intracorneal ring segments for keratoconus. Curr Opin Ophthalmol 30(4):220–228CrossRef
5.
go back to reference Alfonso JF (2014) Clasificación del queratocono basada en fenotipos clínicos. Influencia del astigmatismo congénito en la morfología del queratocono. del Buey Sayas MÁ, Peris Martínez C (eds) Biomecánica y arquitectura corneal. Monografías SECOIR. Elsevier Alfonso JF (2014) Clasificación del queratocono basada en fenotipos clínicos. Influencia del astigmatismo congénito en la morfología del queratocono. del Buey Sayas MÁ, Peris Martínez C (eds) Biomecánica y arquitectura corneal. Monografías SECOIR. Elsevier
7.
go back to reference Kang MJ, Byun YS, Yoo YS et al (2019) Long-term outcome of intrastromal corneal ring segments in keratoconus: five-year follow up. Sci Rep 9–315 Kang MJ, Byun YS, Yoo YS et al (2019) Long-term outcome of intrastromal corneal ring segments in keratoconus: five-year follow up. Sci Rep 9–315
8.
go back to reference Coskunseven E, Kymionis GD, Tsiklis NS et al (2008) One-year results of intrastromal corneal ring segment implantation (KeraRing) using femtosecond laser in patients with keratoconus. Am J Ophthalmol 145(5):775–779CrossRef Coskunseven E, Kymionis GD, Tsiklis NS et al (2008) One-year results of intrastromal corneal ring segment implantation (KeraRing) using femtosecond laser in patients with keratoconus. Am J Ophthalmol 145(5):775–779CrossRef
9.
go back to reference Kymionis GD, Siganos CS, Tsiklis NS et al (2007) Long-term follow-up of intacs in keratoconus. Am J Ophthalmol 143:236–244CrossRef Kymionis GD, Siganos CS, Tsiklis NS et al (2007) Long-term follow-up of intacs in keratoconus. Am J Ophthalmol 143:236–244CrossRef
10.
go back to reference Patel S, Marshall J, Fitzke FW (1995) Model for deriving the optical performance of the myopic eye corrected with an intracorneal ring. J Refract Surg 11:248–309CrossRef Patel S, Marshall J, Fitzke FW (1995) Model for deriving the optical performance of the myopic eye corrected with an intracorneal ring. J Refract Surg 11:248–309CrossRef
11.
go back to reference Coskunseven E, Kymionis GD, Grentzelos MA (2010) INTACS followed by KeraRing intrastromal corneal ring segment implantation for keratoconus. J Refract Surg 26:371–374CrossRef Coskunseven E, Kymionis GD, Grentzelos MA (2010) INTACS followed by KeraRing intrastromal corneal ring segment implantation for keratoconus. J Refract Surg 26:371–374CrossRef
12.
go back to reference Pinero DP, Alió JL, El Kady B et al (2010) Corneal aberrometric and refractive performance of 2 intrastromal corneal ring segment models in early and moderate ectatic disease. J Cataract Refract Surg 36:102–109CrossRef Pinero DP, Alió JL, El Kady B et al (2010) Corneal aberrometric and refractive performance of 2 intrastromal corneal ring segment models in early and moderate ectatic disease. J Cataract Refract Surg 36:102–109CrossRef
13.
go back to reference Alio JL, Artola A, Hassanein A et al (2005) One or 2 intacs segments for the correction of keratoconus. J Cataract Refract Surg 31:943–953CrossRef Alio JL, Artola A, Hassanein A et al (2005) One or 2 intacs segments for the correction of keratoconus. J Cataract Refract Surg 31:943–953CrossRef
14.
go back to reference Siganos D, Ferrara P, Chatzinikolas K et al (2002) Ferrara intrastromal corneal rings for the correction of keratoconus. J Cataract Refract Surg 28:1947–1951CrossRef Siganos D, Ferrara P, Chatzinikolas K et al (2002) Ferrara intrastromal corneal rings for the correction of keratoconus. J Cataract Refract Surg 28:1947–1951CrossRef
15.
go back to reference Kwitko S, Severo NS (2004) Ferrara intracorneal ring segments for keratoconus. J Cataract Refract Surg 30:812–820CrossRef Kwitko S, Severo NS (2004) Ferrara intracorneal ring segments for keratoconus. J Cataract Refract Surg 30:812–820CrossRef
16.
go back to reference Rabinowitz YS (2013) INTACS for keratoconus and ectasia after LASIK. Int Ophthalmol Clin 53:27–39CrossRef Rabinowitz YS (2013) INTACS for keratoconus and ectasia after LASIK. Int Ophthalmol Clin 53:27–39CrossRef
17.
go back to reference Miranda D, Sartori M, Francesconi C et al (2003) Ferrara intrastromal corneal ring segments for severe keratoconus. J Refract Surg 19(6):645–653PubMed Miranda D, Sartori M, Francesconi C et al (2003) Ferrara intrastromal corneal ring segments for severe keratoconus. J Refract Surg 19(6):645–653PubMed
19.
go back to reference Salomão MQ, Guerra M, Ramos F et al (2013) Accuracy of topometric indices for distinguishing between keratoconic and normal corneas. Int J Keratoconus Ectatic Corneal Dis 108–112 Salomão MQ, Guerra M, Ramos F et al (2013) Accuracy of topometric indices for distinguishing between keratoconic and normal corneas. Int J Keratoconus Ectatic Corneal Dis 108–112
20.
go back to reference Kanellopoulos A, Asimellis G (2013) Revisiting keratoconus diagnosis and progression classification based on evaluation of corneal asymmetry indices, derived from Scheimpflug imaging in keratoconic and suspect cases. Clin Ophthalmol 1539–1548 Kanellopoulos A, Asimellis G (2013) Revisiting keratoconus diagnosis and progression classification based on evaluation of corneal asymmetry indices, derived from Scheimpflug imaging in keratoconic and suspect cases. Clin Ophthalmol 1539–1548
21.
go back to reference Gomes JA, Tan D, Rapuano CJ et al (2015) Global consensus on keratoconus and ectatic diseases. Cornea 34:359–369CrossRef Gomes JA, Tan D, Rapuano CJ et al (2015) Global consensus on keratoconus and ectatic diseases. Cornea 34:359–369CrossRef
Metadata
Title
Visual, refractive and topographic outcomes of progressive thickness intrastromal corneal ring segments for keratoconic eyes
Authors
Efekan Coşkunseven
Renato Ambrósio Jr.
Adriana Smorádková
Francisco Sánchez León
Onurcan Sahin
Isilay Kavadarli
Mirko R. Jankov II
Publication date
01-11-2020
Publisher
Springer Netherlands
Published in
International Ophthalmology / Issue 11/2020
Print ISSN: 0165-5701
Electronic ISSN: 1573-2630
DOI
https://doi.org/10.1007/s10792-020-01467-5

Other articles of this Issue 11/2020

International Ophthalmology 11/2020 Go to the issue