Dockery Philip W, Parker John S, Massenzio Erik M, Parker Jack S
Wills Eye Hospital, Philadelphia, USA.
Parker Cornea, Birmingham, USA.
Eur J Ophthalmol. 2023 May;33(3):1324-1330. doi: 10.1177/11206721231155213. Epub 2023 Feb 5.
To compare the clinical outcomes of intracorneal ring segment (ICRS) implantation in eyes with advanced vs. mild/moderate keratoconus (KCN).
A retrospective analysis of 141 eyes of 111 patients with KCN who underwent ICRS implantation. Preoperative maximum keratometry (Kmax) was <57 diopters (D) in 70 eyes and >57 D in 71 eyes. Postoperatively, corrected distance visual acuity (CDVA), Kmax, and intraoperative and postoperative complications were assessed at 1 day, 1 month, and 1 year.
Corneas with a preoperative Kmax >57 D experienced greater reduction in axial curvature after ICRS implantation than corneas with a preoperative Kmax <57 D (7.0 D vs. 5.5 D, =0.005) and gained more Snellen lines of CDVA (3 vs. 1, <0.001) by 1 year postoperatively. The incidences of the most prevalent complications (explantation, extrusion, and infectious keratitis) did not differ significantly between the two groups (p=0.29, p=0.99, p=0.98).
The visual and topographic effects of ICRS implantation are greater in eyes with more advanced KCN, with no increase in the incidence of the most common complications.
比较角膜内环植入术(ICRS)治疗重度与轻/中度圆锥角膜(KCN)患者的临床效果。
对111例接受ICRS植入术的KCN患者的141只眼进行回顾性分析。术前最大角膜曲率(Kmax)<57屈光度(D)的有70只眼,>57 D的有71只眼。术后分别于1天、1个月和1年评估矫正远视力(CDVA)、Kmax以及术中及术后并发症。
术前Kmax>57 D的角膜在ICRS植入术后轴向曲率的降低幅度大于术前Kmax<57 D的角膜(7.0 D对5.5 D,P = 0.005),术后1年CDVA提高的Snellen行数更多(3行对1行,P<0.001)。两组中最常见并发症(取出、挤出和感染性角膜炎)的发生率无显著差异(P = 0.29,P = 0.99,P = 0.98)。
ICRS植入术对重度KCN患者的视力和地形学效果更佳,且最常见并发症的发生率未增加。