Results of intrastromal corneal ring segment implanted alone or combined with same-day corneal crosslinking and their correlation with preoperative corneal biomechanical strain from finite element analysis
Copyright © 2020 Published by Wolters Kluwer on behalf of ASCRS and ESCRS..
PURPOSE: To compare the results of intrastromal corneal ring segment (ICRS) alone or combined with same-day corneal crosslinking (CXL) and investigate the relationship of preoperative corneal biomechanics data on the outcomes.
SETTING: Department of Ophthalmology of Federal University of Parana.
DESIGN: Prospective nonrandomized interventional comparative study.
METHODS: Forty-nine eyes of 44 keratoconus patients underwent ICRS only (n = 27, Group 1) or same day ICRS+CXL (n = 22, Group 2) and were followed up for at least 24 months. Visual acuity and preoperative and postoperative tomographic variables were compared between groups. Tomographic data were obtained with a dual Scheimpflug analyzer, and eye-specific finite-element models were used to derive 3 variables related to preoperative biomechanical strain (maximum principal strain [MPS]): mean MPS (mMPS), highest local MPS (hMPS), and position of the hMPS (hMPSx and hMPSy). The relationship between preoperative strain data and the change (∆, difference between postoperative and preoperative data) in tomographic parameters was also investigated.
RESULTS: Steepest (K2) and maximum keratometry (Kmax), inferior-superior (I-S) index, coma, and cone location magnitude index (CLMI) significantly improved in both groups. Corrected distance visual acuity was significantly better after ICRS alone (P = .03), whereas corneal asymmetry measured through the I-S index was better after CXL+ICRS (P = .04). In Group 1, hMPSy significantly correlated with K2, tomographical cylinder, mean keratometry, and ∆spherical aberration, whereas mMPS significantly correlated with ∆eccentricity. In Group 2, hMPS significantly correlated with K2, Kmax, I-S index, and ∆coma, and hMPSy significantly correlated with I-S index and ∆coma. The mMPS significantly correlated with ∆CLMI.
CONCLUSIONS: ICRS alone seems to be the most suitable option to improve visual acuity, whereas combined ICRS+CXL provided better corneal regularizing results. Preoperative peak strain (hMPS) was predictive of the extent of regularization and flattening after ICRS+CXL.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:47 |
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| Enthalten in: |
Journal of cataract and refractive surgery - 47(2021), 7 vom: 01. Juli, Seite 916-926 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Serpe, Crislaine C [VerfasserIn] |
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| Links: |
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| Themen: |
9007-34-5 |
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| Anmerkungen: |
Date Completed 27.07.2021 Date Revised 24.03.2023 published: Print Citation Status MEDLINE |
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| doi: |
10.1097/j.jcrs.0000000000000533 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM31864231X |
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| 100 | 1 | |a Serpe, Crislaine C |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Results of intrastromal corneal ring segment implanted alone or combined with same-day corneal crosslinking and their correlation with preoperative corneal biomechanical strain from finite element analysis |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 27.07.2021 | ||
| 500 | |a Date Revised 24.03.2023 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2020 Published by Wolters Kluwer on behalf of ASCRS and ESCRS. | ||
| 520 | |a PURPOSE: To compare the results of intrastromal corneal ring segment (ICRS) alone or combined with same-day corneal crosslinking (CXL) and investigate the relationship of preoperative corneal biomechanics data on the outcomes | ||
| 520 | |a SETTING: Department of Ophthalmology of Federal University of Parana | ||
| 520 | |a DESIGN: Prospective nonrandomized interventional comparative study | ||
| 520 | |a METHODS: Forty-nine eyes of 44 keratoconus patients underwent ICRS only (n = 27, Group 1) or same day ICRS+CXL (n = 22, Group 2) and were followed up for at least 24 months. Visual acuity and preoperative and postoperative tomographic variables were compared between groups. Tomographic data were obtained with a dual Scheimpflug analyzer, and eye-specific finite-element models were used to derive 3 variables related to preoperative biomechanical strain (maximum principal strain [MPS]): mean MPS (mMPS), highest local MPS (hMPS), and position of the hMPS (hMPSx and hMPSy). The relationship between preoperative strain data and the change (∆, difference between postoperative and preoperative data) in tomographic parameters was also investigated | ||
| 520 | |a RESULTS: Steepest (K2) and maximum keratometry (Kmax), inferior-superior (I-S) index, coma, and cone location magnitude index (CLMI) significantly improved in both groups. Corrected distance visual acuity was significantly better after ICRS alone (P = .03), whereas corneal asymmetry measured through the I-S index was better after CXL+ICRS (P = .04). In Group 1, hMPSy significantly correlated with K2, tomographical cylinder, mean keratometry, and ∆spherical aberration, whereas mMPS significantly correlated with ∆eccentricity. In Group 2, hMPS significantly correlated with K2, Kmax, I-S index, and ∆coma, and hMPSy significantly correlated with I-S index and ∆coma. The mMPS significantly correlated with ∆CLMI | ||
| 520 | |a CONCLUSIONS: ICRS alone seems to be the most suitable option to improve visual acuity, whereas combined ICRS+CXL provided better corneal regularizing results. Preoperative peak strain (hMPS) was predictive of the extent of regularization and flattening after ICRS+CXL | ||
| 650 | 4 | |a Clinical Trial | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 7 | |a Cross-Linking Reagents |2 NLM | |
| 650 | 7 | |a Photosensitizing Agents |2 NLM | |
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| 700 | 1 | |a Seven, Ibrahim |e verfasserin |4 aut | |
| 700 | 1 | |a Dupps, William J |c Jr |e verfasserin |4 aut | |
| 700 | 1 | |a Santhiago, M R |e verfasserin |4 aut | |
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