Nosé W, Neves R A, Schanzlin D J, Belfort Júnior R
Department of Ophthalmology, Escola Paulista de Medicina, São Paulo Hospital, Brazil.
Refract Corneal Surg. 1993 Nov-Dec;9(6):452-8.
The Intrastromal Corneal Ring (ICR) is a new investigational medical device designed to alter corneal curvature without surgical intervention in the central cornea. The ring is inserted between the layers of the stroma in the cornea's periphery at two-thirds depth through an approximately 2-millimeter incision.
To investigate the safety and refractive effect of implanting an ICR of a given thickness (0.30 mm) and outer diameter (7.70 mm) into human corneas, an ICR was implanted into one nonfunctional eye of each of three patients during the period of March to May, 1991. One predesignated ICR was successfully explanted 5 months after implantation to evaluate the feasibility of ICR removal and to observe the effect of ring removal on corneal curvature. Patients were followed for 1 year after the initial implant procedure.
The three implant procedures and postoperative courses proceeded without any significant complications. Approximately 2.00 D of central corneal flattening was achieved in all eyes. No adverse reactions or other medically-significant complications were observed over a 1-year follow-up period. The patient who underwent ICR removal experienced no perioperative complications, and the patient's cornea has remained stable with a return to its preoperative curvature.
Although this study is preliminary and limited in scope, we have demonstrated that the ICR can be tolerated safely in the human cornea and results in a flattening of the corneal curvature that is stable for up to a year after insertion. The successful removal of the ICR begins to establish reversibility of the procedure and induced refractive effect.
角膜基质内环形植片(ICR)是一种新型的研究性医疗器械,旨在无需对中央角膜进行手术干预即可改变角膜曲率。通过一个约2毫米的切口,将该环植入角膜周边基质层之间,深度为三分之二。
为了研究将给定厚度(0.30毫米)和外径(7.70毫米)的ICR植入人角膜的安全性和屈光效果,在1991年3月至5月期间,将ICR植入三名患者的一只非功能性眼睛中。在植入5个月后,成功取出一个预先指定的ICR,以评估取出ICR的可行性,并观察取出环对角膜曲率的影响。在初次植入手术后,对患者进行了1年的随访。
三次植入手术及术后过程均未出现任何重大并发症。所有眼睛的中央角膜均变平了约2.00 D。在1年的随访期内,未观察到不良反应或其他具有医学意义的并发症。接受ICR取出手术的患者未出现围手术期并发症,患者的角膜保持稳定,恢复到术前曲率。
尽管本研究是初步的且范围有限,但我们已经证明ICR可以在人角膜中安全耐受,并导致角膜曲率变平,且在植入后长达一年的时间内保持稳定。ICR的成功取出开始确立了该手术及诱导屈光效果的可逆性。