Coscarelli Sandro, Rodrigues Pablo, Rocha Guilherme, Torquetti Leonardo
Ennio Coscarelli Eye Clinic, Belo Horizonte 30140-001, Brazil.
Escola Paulista de Medicina, São Paulo 04023-062, Brazil.
Int J Ophthalmol. 2020 Dec 18;13(12):1955-1960. doi: 10.18240/ijo.2020.12.17. eCollection 2020.
To evaluate the clinical results after implantation of a new intrastromal corneal ring segment (ICRS) associated with photorefractive keratectomy (PRK) to correct high myopia (HM) patients with thin corneas.
We evaluated 42 eyes of 23 HM patients that had ICRS implantation followed by PRK. The mean age of patients was 29.1±7.12y (range 18 to 40 years old). Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), keratometry, spherical equivalent, pachymetry, and aberrometry were compared using ANOVA with repeated measurements evaluated preoperatively and at last follow-up visit after the procedures. The refractive predictability and simulated/real corneal ablation were also assessed.
The mean follow-up time after PRK was 6.8±1.6mo. The mean preoperative UCVA improved from 20/800 preoperative to 20/100 after ICRS and 20/35 after PRK. The mean preoperative BCVA was 20/25 (range from 20/30 to 20/20) and remained unchanged after ICRS implantation. Following the PRK the mean BCVA was 20/25 (range from 20/30 to 20/20). The mean spherical equivalent decreased from -7.25±1.12 (range -5.00 to -9.00) preoperatively to -3.32±1.0 (range -2.00 to -5.00) postoperatively (<0.001) after ICRS implantation and decreased from -2.44±1.51 preoperatively to 0.32±0.45 (range -0.625 to 0.875) postoperatively (<0.001) after PRK. The change in BCVA and topographic astigmatism was statistically significant (<0.0001).
ICRS in HM associated with PRK can be a tissue saving procedure and an alternative surgical option for correction of moderate to high myopia.
评估一种新型基质内角膜环片（ICRS）联合准分子激光角膜切削术（PRK）植入后矫正薄角膜高度近视（HM）患者的临床效果。
我们评估了23例接受ICRS植入后行PRK的HM患者的42只眼。患者平均年龄为29.1±7.12岁（范围18至40岁）。使用重复测量方差分析比较术前和术后最后一次随访时的裸眼视力（UCVA）、最佳矫正视力（BCVA）、角膜曲率测量、等效球镜度、角膜厚度测量和像差测量。还评估了屈光预测性和模拟/实际角膜消融情况。
PRK术后平均随访时间为6.8±1.6个月。术前平均UCVA从术前的20/800提高到ICRS术后的20/100和PRK术后的20/35。术前平均BCVA为20/25（范围从20/30至20/20），ICRS植入后保持不变。PRK术后平均BCVA为20/25（范围从20/30至20/20）。等效球镜度平均值术前从-7.25±1.12（范围-5.00至-9.00）降至ICRS植入术后的-3.32±1.0（范围-2.00至-5.00）（<0.001），PRK术后从术前的-2.44±1.51降至术后的0.32±0.45（范围-0.625至0.875）（<0.001）。BCVA和地形图散光的变化具有统计学意义（<0.0001）。
ICRS联合PRK治疗HM可作为一种节省组织的手术方法，是矫正中高度近视的一种替代手术选择。
