Simultaneous intratunnel cross-linking with intrastromal corneal ring segment implantation versus simultaneous epithelium-off cross-linking with intrastromal corneal ring segment implantation for keratoconus management

Mohamed Hosny, Moustafa Nour, Sarah Azzam, Mohsen Salem, Esraa El-Mayah Department of Ophthalmology, Cairo University, Giza, Egypt Purpose: The purpose of this study is to compare the efficacy of intratunnel cross-linking combined with intrastromal corneal ring segment (ICRS) implantation versus c...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Hosny M, Nour M, Azzam S, Salem M, El-Mayah E
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	Keratoconus cross linking intra tunnel epi-off ICRS Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/612d7b1f4455458fb35d0aeb85c81e3b
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:612d7b1f4455458fb35d0aeb85c81e3b
record_format	dspace
spelling	oai:doaj.org-article:612d7b1f4455458fb35d0aeb85c81e3b2021-12-02T02:29:33ZSimultaneous intratunnel cross-linking with intrastromal corneal ring segment implantation versus simultaneous epithelium-off cross-linking with intrastromal corneal ring segment implantation for keratoconus management1177-5483https://doaj.org/article/612d7b1f4455458fb35d0aeb85c81e3b2018-01-01T00:00:00Zhttps://www.dovepress.com/simultaneous-intratunnel-cross-linking-with-intrastromal-corneal-ring--peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Mohamed Hosny, Moustafa Nour, Sarah Azzam, Mohsen Salem, Esraa El-Mayah Department of Ophthalmology, Cairo University, Giza, Egypt Purpose: The purpose of this study is to compare the efficacy of intratunnel cross-linking combined with intrastromal corneal ring segment (ICRS) implantation versus combined epithelium-off (epi-off) cross-linking and ICRS implantation for the management of keratoconus.Methods: Our study included 20 eyes of 12 patients with moderate-to-severe keratoconus. Group A included 10 eyes that underwent simultaneous ICRS implantation with intratunnel cross-linking. Group B included 10 eyes that underwent simultaneous ICRS implantation with epi-off cross-linking. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest sphere and cylinder, mean and maximum keratometric readings, corneal thickness at pachy apex and thinnest location, as well as corneal hysteresis (CH) and corneal resistance factor (CRF) were compared preoperatively and at 6 months postoperatively.Results: The mean UDVA and CDVA improved significantly in both groups with a statistically nonsignificant difference between the groups (P=0.798 and 0.126, respectively). The manifest cylinder decreased significantly in both groups, while the manifest sphere decreased significantly in Group A but nonsignificantly in Group B with a statistically nonsignificant difference between the groups (P=0.773 and 0.111, respectively). Both techniques led to significant flattening of the cornea and a significant decrease of Km and Kmax with a statistically nonsignificant difference between the groups (P=0.312 and 0.857, respectively). There was a statistically significant decrease in CH in both groups postoperatively; however, there was a statistically nonsignificant increase in CRF after both techniques with a statistically nonsignificant difference between the groups in the mean change of CH and CRF (P=0.633 and 0.313, respectively). No intraoperative or postoperative complications were observed in both groups.Conclusion: Both techniques improved the visual and refractive outcomes in cases of moderate and severe keratoconus with no statistically significant difference between the groups; however, simultaneous intratunnel cross-linking and ICRS implantation showed early visual rehabilitation due to the absence of epithelial defect. Keywords: keratoconus, cross-linking, intratunnel, epi-off, ICRSHosny MNour MAzzam SSalem MEl-Mayah EDove Medical PressarticleKeratoconuscross linkingintra tunnelepi-offICRSOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 12, Pp 147-152 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Keratoconus cross linking intra tunnel epi-off ICRS Ophthalmology RE1-994
spellingShingle	Keratoconus cross linking intra tunnel epi-off ICRS Ophthalmology RE1-994 Hosny M Nour M Azzam S Salem M El-Mayah E Simultaneous intratunnel cross-linking with intrastromal corneal ring segment implantation versus simultaneous epithelium-off cross-linking with intrastromal corneal ring segment implantation for keratoconus management
description	Mohamed Hosny, Moustafa Nour, Sarah Azzam, Mohsen Salem, Esraa El-Mayah Department of Ophthalmology, Cairo University, Giza, Egypt Purpose: The purpose of this study is to compare the efficacy of intratunnel cross-linking combined with intrastromal corneal ring segment (ICRS) implantation versus combined epithelium-off (epi-off) cross-linking and ICRS implantation for the management of keratoconus.Methods: Our study included 20 eyes of 12 patients with moderate-to-severe keratoconus. Group A included 10 eyes that underwent simultaneous ICRS implantation with intratunnel cross-linking. Group B included 10 eyes that underwent simultaneous ICRS implantation with epi-off cross-linking. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest sphere and cylinder, mean and maximum keratometric readings, corneal thickness at pachy apex and thinnest location, as well as corneal hysteresis (CH) and corneal resistance factor (CRF) were compared preoperatively and at 6 months postoperatively.Results: The mean UDVA and CDVA improved significantly in both groups with a statistically nonsignificant difference between the groups (P=0.798 and 0.126, respectively). The manifest cylinder decreased significantly in both groups, while the manifest sphere decreased significantly in Group A but nonsignificantly in Group B with a statistically nonsignificant difference between the groups (P=0.773 and 0.111, respectively). Both techniques led to significant flattening of the cornea and a significant decrease of Km and Kmax with a statistically nonsignificant difference between the groups (P=0.312 and 0.857, respectively). There was a statistically significant decrease in CH in both groups postoperatively; however, there was a statistically nonsignificant increase in CRF after both techniques with a statistically nonsignificant difference between the groups in the mean change of CH and CRF (P=0.633 and 0.313, respectively). No intraoperative or postoperative complications were observed in both groups.Conclusion: Both techniques improved the visual and refractive outcomes in cases of moderate and severe keratoconus with no statistically significant difference between the groups; however, simultaneous intratunnel cross-linking and ICRS implantation showed early visual rehabilitation due to the absence of epithelial defect. Keywords: keratoconus, cross-linking, intratunnel, epi-off, ICRS
format	article
author	Hosny M Nour M Azzam S Salem M El-Mayah E
author_facet	Hosny M Nour M Azzam S Salem M El-Mayah E
author_sort	Hosny M
title	Simultaneous intratunnel cross-linking with intrastromal corneal ring segment implantation versus simultaneous epithelium-off cross-linking with intrastromal corneal ring segment implantation for keratoconus management
title_short	Simultaneous intratunnel cross-linking with intrastromal corneal ring segment implantation versus simultaneous epithelium-off cross-linking with intrastromal corneal ring segment implantation for keratoconus management
title_full	Simultaneous intratunnel cross-linking with intrastromal corneal ring segment implantation versus simultaneous epithelium-off cross-linking with intrastromal corneal ring segment implantation for keratoconus management
title_fullStr	Simultaneous intratunnel cross-linking with intrastromal corneal ring segment implantation versus simultaneous epithelium-off cross-linking with intrastromal corneal ring segment implantation for keratoconus management
title_full_unstemmed	Simultaneous intratunnel cross-linking with intrastromal corneal ring segment implantation versus simultaneous epithelium-off cross-linking with intrastromal corneal ring segment implantation for keratoconus management
title_sort	simultaneous intratunnel cross-linking with intrastromal corneal ring segment implantation versus simultaneous epithelium-off cross-linking with intrastromal corneal ring segment implantation for keratoconus management
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/612d7b1f4455458fb35d0aeb85c81e3b
work_keys_str_mv	AT hosnym simultaneousintratunnelcrosslinkingwithintrastromalcornealringsegmentimplantationversussimultaneousepitheliumoffcrosslinkingwithintrastromalcornealringsegmentimplantationforkeratoconusmanagement AT nourm simultaneousintratunnelcrosslinkingwithintrastromalcornealringsegmentimplantationversussimultaneousepitheliumoffcrosslinkingwithintrastromalcornealringsegmentimplantationforkeratoconusmanagement AT azzams simultaneousintratunnelcrosslinkingwithintrastromalcornealringsegmentimplantationversussimultaneousepitheliumoffcrosslinkingwithintrastromalcornealringsegmentimplantationforkeratoconusmanagement AT salemm simultaneousintratunnelcrosslinkingwithintrastromalcornealringsegmentimplantationversussimultaneousepitheliumoffcrosslinkingwithintrastromalcornealringsegmentimplantationforkeratoconusmanagement AT elmayahe simultaneousintratunnelcrosslinkingwithintrastromalcornealringsegmentimplantationversussimultaneousepitheliumoffcrosslinkingwithintrastromalcornealringsegmentimplantationforkeratoconusmanagement
_version_	1718402472128544768

Simultaneous intratunnel cross-linking with intrastromal corneal ring segment implantation versus simultaneous epithelium-off cross-linking with intrastromal corneal ring segment implantation for keratoconus management

Ejemplares similares