Asymmetric Thickness Intracorneal Ring Segments for Keratoconus
Pedro Manuel Baptista,1,2 João Heitor Marques,1 Miguel Mesquita Neves,1 Miguel Gomes,1,2 Luís Oliveira1 1Ophthalmology Department, Centro Hospitalar Universitário Do Porto, Porto, Portugal; 2Instituto De Ciências Biomédicas Abel Salazar, Porto, P...
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2020
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oai:doaj.org-article:aa5a0000ef4f4ac097d10f9f5554c08f2021-12-02T13:32:05ZAsymmetric Thickness Intracorneal Ring Segments for Keratoconus1177-5483https://doaj.org/article/aa5a0000ef4f4ac097d10f9f5554c08f2020-12-01T00:00:00Zhttps://www.dovepress.com/asymmetric-thickness-intracorneal-ring-segments-for-keratoconus-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Pedro Manuel Baptista,1,2 João Heitor Marques,1 Miguel Mesquita Neves,1 Miguel Gomes,1,2 Luís Oliveira1 1Ophthalmology Department, Centro Hospitalar Universitário Do Porto, Porto, Portugal; 2Instituto De Ciências Biomédicas Abel Salazar, Porto, PortugalCorrespondence: Pedro Manuel BaptistaCentro Hospitalar Universitário Do Porto, Largo Prof. Abel Salazar, Porto 4099-001, PortugalTel +0035-1917868372Email pedroyybaptista@gmail.comPurpose: To describe the anatomical and functional results of the implantation of asymmetric thickness intracorneal ring segments (AS-ICRS) in eyes with keratoconus and asymmetric/irregular astigmatism (type 2 – Duck – and type 3 – Snowman – phenotypes, Fernandez-Vega/Alfonso morphologic Keratoconus classification).Materials and Methods: Retrospective observational study including 19 consecutive patients (21 eyes) with keratoconus who underwent manual implantation of the Keraring® Asymmetric ICRS (AS). Analysis included demographic and clinical data and Pentacam (Oculus®) measurements: topographic astigmatism; topographic flat meridian (K1), steepest meridian (K2) and the maximum keratometric point (Kmax); total root mean square (RMS) and high order RMS (HOA) aberrations and comatic Zernike coefficients (Z31;Z3− 1) at 0º and 90º meridians.Results: Overall mean age was 35.3± 11.7 years and median follow-up was 7.1 months (range 6– 12). At the end of follow-up, a significant improvement from baseline was achieved in both UDVA (0.24± 0.22; p=0.017) and CDVA (0.21± 0.17; p< 0.001). Regarding topographic measurements, the greatest decrease was observed in K2 (2.76± 1.9D; p< 0.001) and astigmatism (1.97± 1.5; p< 0.001). Aberrometry analysis showed a reduction of 1.27± 3.2μm in the total RMS (p=0.085), 0.24± 0.9μm in HOA (p=0.227) and 0.78± 0.5 (p< 0.001) in the 90º component of comatic aberration. The procedure effects in the CDVA, topographic and aberrometric parameters were higher in type 2 cones without statistical significance (p> 0.05 in all).Conclusion: Implantation of the Keraring® Asymmetric ICRS in keratoconus with asymmetric/irregular astigmatism allowed an improvement of several clinical, topographic and aberrometric parameters, with clinical efficacy and safety, with a tendency to a greater effect in the type 2 cones.Keywords: aberrometry, asymmetric, astigmatism, ICRS, keratoconusBaptista PMMarques JHNeves MMGomes MOliveira LDove Medical PressarticleaberrometryasymmetricastigmatismicrskeratoconusOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 14, Pp 4415-4421 (2020) |
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aberrometry asymmetric astigmatism icrs keratoconus Ophthalmology RE1-994 Baptista PM Marques JH Neves MM Gomes M Oliveira L Asymmetric Thickness Intracorneal Ring Segments for Keratoconus |
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Pedro Manuel Baptista,1,2 João Heitor Marques,1 Miguel Mesquita Neves,1 Miguel Gomes,1,2 Luís Oliveira1 1Ophthalmology Department, Centro Hospitalar Universitário Do Porto, Porto, Portugal; 2Instituto De Ciências Biomédicas Abel Salazar, Porto, PortugalCorrespondence: Pedro Manuel BaptistaCentro Hospitalar Universitário Do Porto, Largo Prof. Abel Salazar, Porto 4099-001, PortugalTel +0035-1917868372Email pedroyybaptista@gmail.comPurpose: To describe the anatomical and functional results of the implantation of asymmetric thickness intracorneal ring segments (AS-ICRS) in eyes with keratoconus and asymmetric/irregular astigmatism (type 2 – Duck – and type 3 – Snowman – phenotypes, Fernandez-Vega/Alfonso morphologic Keratoconus classification).Materials and Methods: Retrospective observational study including 19 consecutive patients (21 eyes) with keratoconus who underwent manual implantation of the Keraring® Asymmetric ICRS (AS). Analysis included demographic and clinical data and Pentacam (Oculus®) measurements: topographic astigmatism; topographic flat meridian (K1), steepest meridian (K2) and the maximum keratometric point (Kmax); total root mean square (RMS) and high order RMS (HOA) aberrations and comatic Zernike coefficients (Z31;Z3− 1) at 0º and 90º meridians.Results: Overall mean age was 35.3± 11.7 years and median follow-up was 7.1 months (range 6– 12). At the end of follow-up, a significant improvement from baseline was achieved in both UDVA (0.24± 0.22; p=0.017) and CDVA (0.21± 0.17; p< 0.001). Regarding topographic measurements, the greatest decrease was observed in K2 (2.76± 1.9D; p< 0.001) and astigmatism (1.97± 1.5; p< 0.001). Aberrometry analysis showed a reduction of 1.27± 3.2μm in the total RMS (p=0.085), 0.24± 0.9μm in HOA (p=0.227) and 0.78± 0.5 (p< 0.001) in the 90º component of comatic aberration. The procedure effects in the CDVA, topographic and aberrometric parameters were higher in type 2 cones without statistical significance (p> 0.05 in all).Conclusion: Implantation of the Keraring® Asymmetric ICRS in keratoconus with asymmetric/irregular astigmatism allowed an improvement of several clinical, topographic and aberrometric parameters, with clinical efficacy and safety, with a tendency to a greater effect in the type 2 cones.Keywords: aberrometry, asymmetric, astigmatism, ICRS, keratoconus |
format |
article |
author |
Baptista PM Marques JH Neves MM Gomes M Oliveira L |
author_facet |
Baptista PM Marques JH Neves MM Gomes M Oliveira L |
author_sort |
Baptista PM |
title |
Asymmetric Thickness Intracorneal Ring Segments for Keratoconus |
title_short |
Asymmetric Thickness Intracorneal Ring Segments for Keratoconus |
title_full |
Asymmetric Thickness Intracorneal Ring Segments for Keratoconus |
title_fullStr |
Asymmetric Thickness Intracorneal Ring Segments for Keratoconus |
title_full_unstemmed |
Asymmetric Thickness Intracorneal Ring Segments for Keratoconus |
title_sort |
asymmetric thickness intracorneal ring segments for keratoconus |
publisher |
Dove Medical Press |
publishDate |
2020 |
url |
https://doaj.org/article/aa5a0000ef4f4ac097d10f9f5554c08f |
work_keys_str_mv |
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_version_ |
1718392874432724992 |