de Sanctis Ugo, Caselgrandi Paolo, Gennaro Carlo, Tosi Cecilia, Borrelli Enrico, Marolo Paola, Reibaldi Michele
Section of Ophthalmology, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy.
Studio Oculistico de Sanctis, 10121 Turin, Italy.
J Clin Med. 2025 Jan 28;14(3):870. doi: 10.3390/jcm14030870.
To assess the outcome of Keraring (Mediphacos, Brazil) implantation according to a topographic pattern-based nomogram in eyes with mild to moderate keratoconus. : A topographic pattern-based nomogram was used to guide Keraring selection in 47 consecutive eyes with stage I-II keratoconus (Amsler-Krumeich staging), which underwent femtosecond laser-assisted implantation at a single center. Electronic data of LogMar uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) manifest refraction and tomographic analysis (Pentacam HR, Oculus, Germany) measured preoperatively and at the last postoperative examination were retrospectively analyzed. Mean follow-up was 18.8 months. (range 3-35). Mean UDVA improved ( < 0.001) from 0.87 ± 0.27 to 0.35 ± 0.21. UDVA increased on average by 5.13 lines. Mean CDVA improved from 0.21 ± 0.10 to 0.09. ± 0.07, and the proportion of eyes with CDVA ≥ 20/25 increased from 29.8% to 85.1% after surgery. No eyes lost lines of CDVA. The Alpins correction index of astigmatism was 0.77 and the mean refractive cylinder decreased from 4.99 ± 1.89 to -2.31 ± 1.47 D ( < 0.001). Mean and maximal keratometry was reduced on average by -2.10 ± 1.42 D and -3.02 ± 3.68 D, respectively ( < 0.001). The RMS of corneal high-order aberrations dropped from 3.296 ± 1.180 µm to 2.192 ± 0.919 µm, and that of vertical coma from -2.656 ± 1.189 µm to -1.427 ± 1.024 µm ( < 0.001). All topometric indices improved after surgery. Planning Keraring implantation using the topographic pattern-based nomogram is very effective and safe in eyes with mild to moderate keratoconus. Using that nomogram of UDVA and CDVA are clinically significant.
根据基于地形图模式的列线图评估在轻至中度圆锥角膜眼中植入Keraring（巴西Mediphacos公司）的效果：使用基于地形图模式的列线图指导47例连续的I-II期圆锥角膜（Amsler-Krumeich分期）患者在单中心接受飞秒激光辅助植入Keraring。回顾性分析术前及最后一次术后检查时测量的LogMar未矫正远视力（UDVA）、矫正远视力（CDVA）、显验光和断层扫描分析（德国Oculus公司的Pentacam HR）的电子数据。平均随访时间为18.8个月（范围3 - 35个月）。平均UDVA从0.87±0.27提高到0.35±0.21（P<0.001）。UDVA平均提高了5.13行。平均CDVA从0.21±0.10提高到0.09±0.07，术后CDVA≥20/25的眼比例从29.8%增加到85.1%。没有眼的CDVA下降。散光的Alpins矫正指数为0.77，平均屈光柱镜度从4.99±1.89 D降至 - 2.31±1.47 D（P<0.001）。平均角膜曲率和最大角膜曲率分别平均降低了 - 2.10±1.42 D和 - 3.02±3.68 D（P<0.001）。角膜高阶像差的均方根从3.296±1.180 µm降至2.192±0.919 µm，垂直彗差从 - 2.656±1.189 µm降至 - 1.427±1.024 µm（P<0.001）。术后所有地形图指标均得到改善。使用基于地形图模式的列线图规划Keraring植入在轻至中度圆锥角膜眼中非常有效且安全。使用该列线图对UDVA和CDVA具有临床意义。
