Al-Habboubi Hussain F, Martinez-Osorio Hernan, Y Maktabi Azza M, Badawi Abdulrahman H, Aldosari Faisal N, Khandekar Rajiv, Al-Swailem Samar A
Division of Comprehensive, Medical Education, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
Division of Anterior Segment, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
Saudi J Ophthalmol. 2022 Jul 11;36(1):64-69. doi: 10.4103/sjopt.sjopt_70_22. eCollection 2022 Jan-Mar.
To evaluate the causes and long-term outcomes after intrastromal corneal ring segment (ICRS) explantation in the King Khaled Eye Specialist Hospital.
This was retrospective cohort study. Two groups were analyzed: Group one, ICRS surgery done in our hospital ( = 41) and group two, surgery done outside but removed in our hospital ( = 29). Causes and postoperative management after ICRS removal were analyzed. For statistical analysis, groups were analyzed into two subgroups of causes of ICRS removal: Visual disturbance versus extrusion/infection/neovascularization (NV) subgroups; and two subgroups of postoperative treatment: Corneal transplant (CT) versus Contact lens (CL)/eyeglasses subgroups.
The most common cause of ICRS removal in group one was visual disturbance (45.2%) while in group two was extrusion (41.2%). CL is the preferable management after explantation. 76% of ICRS removal occurred during the first 4 years. In group 1, there was significant worse preimplantation visual acuity ( = 0.02) in CT subgroup versus CL/eyeglasses. CT subgroup had lower pachymetry of 437.4 μm ( = 0.04) and higher myopia of 8.05 ( = 0.03) than CL/eyeglasses subgroup. For group two, there was a significant improvement in uncorrected visual acuity in visual disturbances subgroup after explantation ( = 0.004). After explantation, visual disturbances subgroup had higher myopia -4.4 than extrusion subgroup -1.15 ( = 0.004).
Seventy-six percent of ICRS removal occurred during the first 4 years. High myopia and pachymetry lower than 437 um were associated with visual disturbances and further management with corneal transplantation. High myopia was also associated with visual disturbances in surgeries done outside our hospital.
评估在沙特国王哈立德眼科专科医院进行基质内角膜环片（ICRS）取出术的原因及长期预后。
这是一项回顾性队列研究。分析了两组：第一组，在我院进行的ICRS手术（n = 41）；第二组，在院外进行手术但在我院取出（n = 29）。分析了ICRS取出后的原因及术后处理。为进行统计分析，将两组按ICRS取出原因分为两个亚组：视力障碍与挤出/感染/新生血管形成（NV）亚组；术后治疗分为两个亚组：角膜移植（CT）与隐形眼镜（CL）/眼镜亚组。
第一组ICRS取出的最常见原因是视力障碍（45.2%），而第二组是挤出（41.2%）。取出术后CL是更可取的处理方式。76%的ICRS取出发生在最初4年内。在第一组中，CT亚组与CL/眼镜亚组相比，植入前视力明显更差（P = 0.02）。CT亚组的角膜厚度为437.4μm，低于CL/眼镜亚组（P = 0.04），近视度数更高，为8.05（P = 0.03）。对于第二组，取出术后视力障碍亚组的未矫正视力有显著改善（P = 0.004）。取出术后，视力障碍亚组的近视度数为-4.4，高于挤出亚组的-1.15（P = 0.004）。
76%的ICRS取出发生在最初4年内。高度近视和角膜厚度低于437μm与视力障碍及角膜移植的进一步处理相关。高度近视在我院院外进行的手术中也与视力障碍相关。
