Visual rehabilitation in moderate keratoconus: combined corneal wavefront-guided transepithelial photorefractive keratectomy and high-fluence accelerated corneal collagen cross-linking after intracorneal ring segment implantation

Autor: Eung Kweon Kim, David Sung Yong Kang, Byoung Jin Ha, Tae Im Kim, Hun Lee, Jin-Young Choi, Kyoung Yul Seo
Rok vydání: 2017
Předmět:
Male
Visual acuity
genetic structures
Combined corneal wavefront-guided transepithelial photorefractive keratectomy and accelerated corneal collagen cross-linking
medicine.medical_treatment
Scheimpflug principle
Corneal collagen cross-linking
Visual Acuity
law.invention
0302 clinical medicine
lcsh:Ophthalmology
law
Lenses
Intraocular
medicine.diagnostic_test
General Medicine
Corneal topography
Photorefractive keratectomy
Cross-Linking Reagents
Female
Intracorneal ring segment implantation
Collagen
medicine.symptom
Research Article
Adult
Keratoconus
medicine.medical_specialty
Corneal Stroma
Refraction
Ocular
Photorefractive Keratectomy
Prosthesis Implantation
03 medical and health sciences
Young Adult
Ophthalmology
medicine
Humans
Retrospective Studies
Coma
Keratometer
business.industry
Corneal Topography
medicine.disease
eye diseases
Photochemotherapy
lcsh:RE1-994
030221 ophthalmology & optometry
sense organs
business
030217 neurology & neurosurgery
Follow-Up Studies
Zdroj: BMC Ophthalmology
BMC Ophthalmology, Vol 17, Iss 1, Pp 1-14 (2017)
ISSN: 1471-2415
Popis: Background To investigate the effects of combined corneal wavefront-guided transepithelial photorefractive keratectomy (tPRK) and accelerated corneal collagen cross-linking (CXL) after intracorneal ring segment (ICRS) implantation in patients with moderate keratoconus. Methods Medical records of 23 eyes of 23 patients undergoing combined tPRK and CXL after ICRS implantation were retrospectively analyzed. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction spherical equivalent (MRSE), corneal indices based on Scheimpflug tomography, higher-order aberrations (HOAs), and corneal biomechanical properties were evaluated before and after ICRS implantation, and at 1, 3, and 6 months after combined tPRK and CXL. Results There were significant improvements in final logMAR UDVA and logMAR CDVA, and reductions in sphere, MRSE, and all corneal indices from baseline. Significant improvements in logMAR UDVA and reductions in sphere, MRSE, maximal keratometry, keratometry at the apex, mean keratometry, and keratoconus index were noted after ICRS implantation. After tPRK and CXL, significant improvements in logMAR UDVA and logMAR CDVA, and reductions in cylinder and all corneal indices were observed. There were significant improvements in final root mean square HOAs and coma aberrations from baseline, but no changes from baseline after ICRS implantation. Significant reductions in final radius and deformation amplitude from baseline were noted. Conclusions Combined tPRK and accelerated CXL after ICRS implantation in moderate keratoconus appears to be a safe and effective treatment, providing an improvement in visual acuity, corneal indices, and HOAs. Trial registration retrospectively registered (identification no. NCT03355430 ). Date registered: 28/11/2017.
Databáze: OpenAIRE
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