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Visual and tomographic outcomes of a 300° Arc-length ICRS implantation in moderate to advanced central keratoconus

Alfonso, JF; Torquetti, L; Fernández-Vega-Cueto, L; Allan, B; Poo-López, A; Alfonso-Bartolozzi, B; de la Cruz, J; ... Madrid-Costa, D; + view all (2021) Visual and tomographic outcomes of a 300° Arc-length ICRS implantation in moderate to advanced central keratoconus. Journal of Refractive Surgery , 37 (4) pp. 249-255. 10.3928/1081597X-20210115-01. Green open access

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Abstract

PURPOSE: To assess the outcomes of implanting a new 300° arc-length intrastromal corneal ring segment (ICRS) in moderate to advanced central hyperprolate keratoconus. METHODS: Forty-two eyes with moderate to advanced central hyperprolate keratoconus were evaluated before and after implanting an inferior 300° ICRS (AJL Ophthalmic). The clinical measurements taken included manifest refraction, uncorrected (UDVA) and corrected (CDVA) distance visual acuity (logMAR scale), and corneal tomographic analysis (Sirius; Costruzioni Strumenti Oftalmici). Changes in the anterior and posterior corneal surfaces and the root mean square (RMS) for coma-like aberrations for a pupil size of 4.5 mm were evaluated. All examinations were performed before surgery and 6 months after surgery. RESULTS: The mean UDVA improved from 1.12 ± 0.48 logMAR preoperatively to 0.73 ± 0.37 logMAR postoperatively (P < .0001). The mean CDVA changed from 0.33 ± 0.20 to 0.20 ± 0.11 logMAR (P < .0001). Postoperatively, the CDVA improved by two or more lines in 45.2% of the eyes and increased by one line in 19.04%, and none of the patients lost lines of CDVA. All of the anterior and posterior corneal tomographic parameters analyzed were significantly improved after surgery, except posterior flat keratometry, which remained unchanged. In 80.95% of the eyes, the postoperative mean keratometry was 50.00 diopters or less. The 6-month RMS for coma-like aberrations also declined significantly from 1.57 ± 0.68 to 1.06 ± 0.42 µm after surgery (P < .0001). CONCLUSIONS: These results suggest that implanting a 300° arc-length ICRS is a safe and effective procedure for treating patients with moderate to advanced central hyperprolate keratoconus and clear cornea.

Type: Article
Title: Visual and tomographic outcomes of a 300° Arc-length ICRS implantation in moderate to advanced central keratoconus
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.3928/1081597X-20210115-01
Publisher version: https://doi.org/10.3928/1081597X-20210115-01
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions.
Keywords: Corneal Stroma, Corneal Topography, Humans, Keratoconus, Prostheses and Implants, Prosthesis Implantation, Refraction, Ocular
UCL classification: UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Institute of Ophthalmology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL
URI: https://discovery.ucl.ac.uk/id/eprint/10157047
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