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1.  REVIEW ARTICLES
The Epidemiology and Etiology of Keratoconus
Ariela Gordon-Shaag, Michel Millodot, Einat Shneor
[Year:2012] [Month:January-April] [Volume:1 ] [Number:1] [Pages:74] [Pages No:7-15]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10025-1002 | FREE

ABSTRACT

Keratoconus is a noninflammatory disorder characterized by ectasia of the central or inferior portion of the cornea. This review presents the scant epidemiological information known to date and the factors believed to cause the development of the disease. They are the genetic factors for which evidence come from family studies, twin studies and genetic loci. There appears to be multiple genes causing a keratoconus phenotype with variable penetration. However, the genetic predisposition might not be enough; environmental factors, such as eye rubbing, atopy and UV exposure, may have a role in generating the disease.

Keywords:Keratoconus, Epidemiology, Cornea, Prevalence.

How to Cite Gordon-Shaag A, Millodot M, Shneor E. The Epidemiology and Etiology of Keratoconus. Int J Keratoco Ectatic Corneal Dis 2012;1(1):7-15.

 
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2.  ORIGINAL ARTICLES
The Challenges of the Detection of Subclinical Keratoconus at Its Earliest Stage
Damien Gatinel, Alain Saad
[Year:2012] [Month:January-April] [Volume:1 ] [Number:1] [Pages:74] [Pages No:36-43]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10025-1007 | FREE

ABSTRACT

Undetected subclinical keratoconus (KC) is the main risk factor for iatrogenic ectasia. Many parameters have been proposed to help differentiate normal from subclinical KC corneas. Linear discriminant analysis is a technique that models the difference between different classes of data by looking for linear combinations of variables which best explain the data. The association of surfaces elevation, corneal thickness profile and anterior curvature indices leads to the best sensitivity and specificity for the discrimination between normal and early subclinical KC corneas.

Keywords:Keratoconus, Ectasia, Topography, Tomography.

How to Cite Gatinel D, Saad A. The Challenges of the Detection of Subclinical Keratoconus at Its Earliest Stage. Int J Keratoco Ectatic Corneal Dis 2012;1(1):36-43.

 
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3.  REVIEW ARTICLES
Corneal Physiology and Responses to Cross-Linking and Intracorneal Rings in Keratoconus
Aylin Kilic
[Year:2012] [Month:January-April] [Volume:1 ] [Number:1] [Pages:74] [Pages No:1-6]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10025-1001 | FREE

ABSTRACT

Keratoconus is a noninflammatory, usually, bilateral progressive disease. It is a pathology characterized by a progressive thinning and ectasia of the stroma that results in cone-shaped cornea. In advanced keratoconus with corneal opacities, keratoplasty, can be the only surgical alternative for a long time. Recently, new treatment alternatives were developed in keratoconus treatment, such as intracorneal ring segments and corneal crosslinking. Intracorneal ring segment acts as spacer elements between the bundles of corneal lamellae producing a shortening of the central arc length. Corneal cross-linking treatment increases the stiffness of the cornea. Several studies reported that collagen cross-linking can delay or stop keratoconus progression and produce better quality of vision.

Keywords:Keratoconus, Cross-linking, Cornea, Ectasia, Intracorneal ring.

How to Cite Kilic A. Corneal Physiology and Responses to Cross-Linking and Intracorneal Rings in Keratoconus. Int J Keratoco Ectatic Corneal Dis 2012;1(1):1-6.

 
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4.  CASE REPORTS
Corneal Ectasia after PRK
Jes Norgaard Mortensen
[Year:2012] [Month:January-April] [Volume:1 ] [Number:1] [Pages:74] [Pages No:73-74]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10025-1014 | FREE

ABSTRACT

It is well known that jatrogenic ectasia is lower in PRK compared to LASIK. The true incidence of post-LASIK and post-PRK ectasia remains unknown according to Dr Marguerite B McDonald. Corneal ectasia after PRK was reported to start after 3 to 5 years and after LASIK 6 to 18 months. The author reports of a case with corneal ectasia after PRK in both eyes that started after 16 years. Inspite of corneal cross-linking the progression of the ectasia progressed in both eyes.

Keywords:Ectasia, LASIK, PR.

How to Cite Mortensen JN. Corneal Ectasia after PRK. Int J Keratoco Ectatic Corneal Dis 2012;1(1):73-74.

 
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5.  ORIGINAL ARTICLES
Comparison of Placido, Scheimpflug and Combined Dual Scheimpflug-Placido Technologies in Evaluating Anterior and Posterior CLMI, SimK’s, as well as Kmax, in Keratoconic and Postrefractive Surgery Ectasia
Thomas F Mauger, Ashraf M Mahmoud, Cynthia J Roberts, Lena V Chheda, Rebecca A Kuennen, Andrew J Hendershot, Richard G Lembach
[Year:2012] [Month:January-April] [Volume:1 ] [Number:1] [Pages:74] [Pages No:44-52]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10025-1008 | FREE

ABSTRACT

Purpose: To calculate and compare cone location and magnitude index (CLMI ), Kmax and other corneal measures derived from three different technologies, Placido, Scheimpflug, and a combination dual Scheimpflug-Placido device, from the same group of eyes with keratoconus and postrefractive surgery corneal ectasia.

Methods:Keratoconus (n = 26) eyes of (n = 19) subjects and postrefractive surgery ectasia (n = 5) eyes of (n = 5) subjects were selected to have measurements performed using the Keratron Scout, Pentacam HR and Galilei Dual Scheimpflug Analyzer. Device-generated SimK’s and device-specific CLMI and Kmax indices as well as map data, were exported from each device. Index values for multiple exams were averaged. The map data were processed using The Ohio State University Corneal Topography Tool (OSUCTT) to calculate CLMI parameters, Kmax and SimK values using consistent algorithms on all three devices. Maps were averaged before calculation for multiple examinations. Repeated measures analysis of variance and posthoc analysis were used to identify differences between devices.

Results: The anterior axial CLMI calculated from the Keratron data was significantly higher than CLMI for the Galilei (p = 0.0443) or Pentacam (p < 0.0004) with keratoconus, 12.23 compared with 11.20 and 11.00 diopters, respectively. Kmax was also significantly higher in the Keratron than the Galilei (p = 0.0063) or the Pentacam (p < 0.0002). Galilei and Pentacam were not significantly different from each other in either CLMI (p = 0.6287) or Kmax (p = 0.2115). The anterior CLMI values for the postrefractive surgery ectasia eyes were not significantly different between devices. Posterior CLMI values were calculated from the Galilei and Pentacam data and were –2.60 and –2.46 diopters (p = 0.1173) for keratoconus and –2.66 and –3.04 diopters (p = 0.2242) for postrefractive surgery ectasia.

Conclusion:The small cone Placido measured dioptric values that were greater than the pure Scheimpflug system, but the difference was only about 1 diopter, which is not relevant clinically in evaluating and managing ectasia. The combined dual Scheimpflug-Placido system produced measured dioptric values between the other two technologies. The anterior CLMI calculations accurately predicted keratoconus with all three devices. The posterior CLMI in ectasia may be a potentially valuable calculation in demonstrating asymmetric steepening.

Keywords:Keratoconus, Collagen corneal cross-linking (CXL), Corneal topography, Placido disk topography, Ectasias.

How to cite this article: Mauger TF, Mahmoud AM, Roberts CJ, Chheda LV, Kuennen RA, Hendershot AJ, Lembach RG. Comparison of Placido, Scheimpflug and Combined Dual Scheimpflug-Placido Technologies in Evaluating Anterior and Posterior CLMI, SimK’s as well as Kmax, in Keratoconic and Postrefractive Surgery Ectasia. Int J Keratoco Ectatic Corneal Dis 2012;1(1):44-52.

 
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6.  ORIGINAL ARTICLES
Simplified Nomenclature for Describing Keratoconus
Michael W Belin, Joan T Kim, Peter Zloty, Renato Ambrosio Jr
[Year:2012] [Month:January-April] [Volume:1 ] [Number:1] [Pages:74] [Pages No:31-35]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10025-1006 | FREE

ABSTRACT

Keratoconus is a condition that has been described since the 1850s. It is typically defined as a bilateral, progressive, noninflammatory thinning and steepening disorder of the central or paracentral cornea. In its advanced form, diagnosis is rather straightforward. It is the subtler manifestations of keratoconus that impart a diagnostic challenge. With the advent of newer diagnostic equipment and the parameters that are now measurable, there is an opportunity to update our current classifications and definitions of keratoconus. The purpose of our paper is to propose and define terminology that reflects both our current knowledge and new data from diagnostic tests.

Keywords:Keratoconus, Classification, Tomography.

How to Cite Belin MW, Kim JT, Zloty P, Ambrosio R Jr. Simplified Nomenclature for describing Keratoconus. Int J Keratoco Ectatic Corneal Dis 2012;1(1):31-35.

 
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7.  CASE REPORTS
Collagen Corneal Cross-Linking followed by Intac Implantation in a Case of Post-PRK Ectasia
Ramez Barbara, David Zadok, Joseph Pikkel, Arie Marcovich, Hanna Garzozi, Orwa Nasser, Lamis Abdelaziz, Adel Barbara
[Year:2012] [Month:January-April] [Volume:1 ] [Number:1] [Pages:74] [Pages No:68-72]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10025-1013 | FREE

ABSTRACT

Collagen corneal cross-linking (CXL) has proved to be effective in halting the progression of keratoconus and post-LASIK ectasia.
Post-photorefractive keratectomy (PRK) ectasia, a rare PRK complication, has been reported in only a few cases, although PRK is the oldest form of laser refractive surgery. CXL for post- PRK ectasia has not been reported yet.
Here is a case of a 22-year-old male who developed post- PRK ectasia more than 1 year after the procedure and was treated using CXL. A few months after CXL, an Intac (Addition Technology) was implanted due to contact lens intolerance.

Keywords:PRK, Ectasia, Collagen corneal cross-linking (CXL), Keratoconus, Intac, Intacs, Intrastromal corneal rings.

How to Cite Barbara R, Zadok D, Pikkel J, Marcovich A, Garzozi H, Nasser O, Abdelaziz L, Barbara A. Collagen Corneal Cross-Linking followed by Intac Implantation in a Case of Post-PRK Ectasia. Int J Keratoco Ectatic Corneal Dis 2012;1(1):68-72.

 
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8.  ORIGINAL ARTICLES
Long-term Follow-up of Pachymetric and Topographic Alterations after Corneal Collagen Cross-Linking for Keratoconus
Paraskevi G Zotta, Diamantis D Almaliotis, George D Kymionis, Vasilios F Diakonis, Kostas A Moschou, Vasileios E Karampatakis
[Year:2012] [Month:January-April] [Volume:1 ] [Number:1] [Pages:74] [Pages No:22-25]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10025-1004 | FREE

ABSTRACT

Purpose: To determine the long-term alterations of corneal thickness, along with topographic outcomes, after corneal collagen cross-linking treatment (CXL) for keratoconus.

Materials and methods:In this retrospective case series, 46 patients (52 eyes), 32 males and 14 females, with progressive keratoconus were included. All eyes underwent CXL in accordance with the standard protocol (Dresden) for the treatment of their ectatic corneal disorder between January 2006 and June 2007. Pachymetric and topographic outcomes were evaluated preoperatively and at 1, 3, 6, 12, 24 and 36 months postoperatively.

Results: Mean follow-up was 28.08 ± 8.39 months (range, from 12 to 36 months). A statistically significant decline in corneal pachymetric values (at the thinnest location) when compared with preoperative values (467.65 ± 41.08 µm) was demonstrated at 1 (437.63 ± 50.57 µm), 3 (439.08 ± 52.27 µm), 6 (449.37 ± 52.73 µm), 12 (449.63 ± 83.53 µm) and 24 (459.97 ± 47.32 µm) months after CXL (p < 0.05, for all mentioned time intervals). Return to preoperative pachymetric values (469.52 ± 40.52 µm) was revealed 36 months post-CXL (p > 0.05). With respect to topographic (flat and steep keratometric values, keratoconus index), no statistically significant differences between preoperative and all postoperative intervals were found (p > 0.05, for all values for all time intervals).

Conclusion: Corneal pachymetric values reduce significantly up to 24 months after CXL treatment, while a return to preoperative values was revealed 36 months after the procedure. No significant changes' concerning topographic outcomes was demonstrated after CXL, indicating stability of these parameters.

Keywords: Keratoconus, Corneal cross-linking, Corneal pachymetry, Corneal topography, Keratoconus index.

How to cite this article: Zotta PG, Almaliotis DD, Kymionis GD, Diakonis VF, Moschou KA, Karampatakis VE. Long-term Follow-up of Pachymetric and Topographic Alterations after Corneal Collagen Cross-Linking for Keratoconus. Int J Keratoco Ectatic Corneal Dis 2012;1(1):22-25.

 
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9.  CASE REPORTS
Cataract Extraction and Toric Intraocular Lens Implantation for the Management of Pellucid Marginal Degeneration and Cataract
Irit Bahar, Omer Bialer
[Year:2012] [Month:January-April] [Volume:1 ] [Number:1] [Pages:74] [Pages No:66-67]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10025-1012 | FREE

ABSTRACT

We report cataract surgery with toric intraocular lens implantation for the management of senile cataract combined with pellucid marginal degeneration. A 72-year-old man with bilateral senile cataract and significant against-the-rule astigmatism sought counseling for blurry vision and glare, mostly in the right eye. Based on ophthalmic examination and corneal topography, a diagnosis of pellucid marginal degeneration and cataract was made. Since visual acuity and refraction had been stable in the past 3 years, the patient underwent cataract extraction and implantation of a custom-designed toric posterior chamber intraocular lens. Postoperative follow-up of 1.5-year demonstrated marked improvement in visual acuity, stable refraction and patient satisfaction. This treatment for pellucid marginal degeneration offers the simplicity of regular cataract surgery, and avoids the known complications of keratoplasty and other corneal surgical manipulation for the management of pellucid marginal degeneration.

Keywords:Pellucid marginal degeneration, Cataract, Astigmatism, Toric IOL.

How to Cite Bahar I, Bialer O. Cataract Extraction and Toric Intraocular Lens Implantation for the Management of Pellucid Marginal Degeneration and Cataract. Int J Keratoco Ectatic Corneal Dis 2012;1(1):66-67.

 
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10.  ORIGINAL ARTICLES
Collagen Cross-Linking and Keratoconus in Pediatric Patients
Ramez Barbara, Joseph Pikkel, Hanna Garzozi, Adel Barbara
[Year:2012] [Month:January-April] [Volume:1 ] [Number:1] [Pages:74] [Pages No:57-60]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10025-1010 | FREE

ABSTRACT

Purpose: To evaluate the efficacy of corneal cross-linking on keratoconic eyes in the pediatric age group.

Setting: Private laser center, Haifa, Israel, affiliated to Hadassah Hospital, Jerusalem.

Methods:This is a retrospective study of 29 eyes of 20 children treated with corneal cross-linking with aim to arrest the progression of keratoconus. We preformed collagen corneal cross-linking using riboflavin 0.1% and UVA irradiation. Followup ranged between 6 and 46 months (mean 25.5 months). Evaluation included uncorrected visual acuity, best spectacle corrected visual acuity, manifest refraction, slit lamp examination and corneal topography. Ocular response analyzer was used to assess the corneal resistance factor, corneal hysteresis and cornea compensated intraocular pressure.

Results: The results show improvement in uncorrected visual acuity and best spectacle-corrected visual acuity and reduction in astigmatism. There was no statistically significant change in sphere, keratometry, corneal resistance factor, corneal hysteresis or cornea compensated intraocular pressure.

Conclusion:Corneal cross-linking demonstrates efficacy in arresting the progression of keratoconus as well as improving uncorrected and best corrected visual acuity and reducing astigmatism.

Keywords:Keratoconus, Keratoconus in children, CXL, Collagen corneal cross-linking, Pediatric keratoconus.

How to cite this article: Barbara R, Pikkel J, Garzozi H, Barbara A. Collagen Cross-Linking and Keratoconus in Pediatric Patients. Int J Keratoco Ectatic Corneal Dis 2012;1(1):57-60.

 
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11.  CASE SERIES
UVA/Riboflavin Cross-Linking as an Alternative Treatment for Therapeutic Keratoplasty in Corneal Melting
N Al-Sabai, C Koppen, MJ Tassignon
[Year:2012] [Month:January-April] [Volume:1 ] [Number:1] [Pages:74] [Pages No:61-65]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10025-1011 | FREE

ABSTRACT

Purpose: To demonstrate the effectiveness of UVA/riboflavin cross-linking (CXL) in the treatment of therapy resistant corneal melting of different etiology.

Methods:This paper describes a series of four cases presenting severe ulcerative keratitis with infectious and noninfectious causes. In spite of intensive medical treatment, corneal melting did develop in all four eyes. CXL was performed to avoid imminent corneal perforation.

Results: After CXL, there was a rapid improvement in two eyes which healed completely within a month. In the other two eyes, an emergency keratoplasty had to be performed.

Conclusion:This case series highlights the effectiveness of CXL in the treatment of corneal melting as an addition to our current therapeutic armamentarium. Improvement can be expected in a few days after treatment. CXL can be considered as an adjunct therapy as soon as melting appears in severe corneal ulcers not responding to conventional, intensive treatment.

Keywords:Corneal melting, Corneal cross-linking, Corneal ulcer.

How to cite this article: Al-Sabai N, Koppen C, Tassignon MJ. UVA/Riboflavin Cross-Linking as an Alternative Treatment for Therapeutic Keratoplasty in Corneal Melting. Int J Keratoco Ectatic Corneal Dis 2012;1(1):61-65.

 
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12.  ORIGINAL ARTICLES
Corneal Cross-Linking for Progressive Keratoconus in Children: Our Experience
Erez Bakshi, Yaniv Barkana, Yakov Goldich, Isaac Avni, David Zadok
[Year:2012] [Month:January-April] [Volume:1 ] [Number:1] [Pages:74] [Pages No:53-56]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10025-1009 | FREE

ABSTRACT

Purpose: To assess the effect of corneal cross-linking on progressive keratoconus in children.

Methods:In this retrospective study we enrolled nine eyes of nine consecutive children aged 11 to 17 years old who underwent corneal riboflavin-UVA induced cross-linking for progressive keratoconus at the Department of Ophthalmology at Assaf Harofeh Medical Center. They were followed for 6 to 24 months (average 16 ± 8.1 months). Evaluated parameters were uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), manifest refraction, pachymetry, slit lamp examination and corneal topography.

Results: Cross-linking resulted in stability of visual acuity in seven of the nine (77.8%) treated eyes. We found a nonsignificant improvement in UCVA and BSCVA with a small reduction of manifest cylinder. Furthermore, there was an improvement in spherical equivalent that was close to statistical significance (p = 0.07). There was 0.86 D reduction of average Kmax value postoperatively (p = 0.36). Most patients (7 of 9, 77.8%) showed a long-term stability or reduction in Kmax.

Conclusion:In this study, we demonstrated the efficacy of corneal cross-linking in arresting the progression of keratoconus in children. We believe that larger scale studies in this age group should be performed to further establish the relevance of this technique in children.

Keywords:Keratoconus, UVA, Collagen corneal cross-linking.

How to cite this article: Bakshi E, Barkana Y, Goldich Y, Avni I, Zadok D. Corneal Cross-Linking for Progressive Keratoconus in Children: Our Experience. Int J Keratoco Ectatic Corneal Dis 2012;1(1):53-56.

 
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13.  ORIGINAL ARTICLES
Refractive, Tomographic and Biomechanical Outcomes after Implantation of Ferrara ICRS in Keratoconus Patients
Jose M Salgado-Borges, Claudia Costa-Ferreira, Manuel Monteiro, Jose Guilherme-Monteiro, Leonardo Torquetti Paulo Ferrara, Renato Ambrosio Jr
[Year:2012] [Month:January-April] [Volume:1 ] [Number:1] [Pages:74] [Pages No:16-21]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10025-1003 | FREE

ABSTRACT

Background:Nowadays, ICRS are a step in the treatment of keratoconus. The purpose of this study was to evaluate the refractive effect and the tomographic and biomechanical parameters in keratoconus patients implanted with Ferrara ICRS, and their stability after 18 months.

Materials and methods:Twenty eyes of 20 keratoconus patients implanted with ICRS were evaluated. The average follow-up was 18 months. UDVA, CDVA, biomicroscopy, tomography (Pentacam) and biomechanics (ORA) of the cornea were evaluated before and after surgery. For the comparison of groups, the Wilcoxon test was used.

Results: The mean UDVA improved from 1.00 to 0.30 and the mean CDVA improved from 0.51 to 0.12; both were statistically significant (p = 0.0001). The average keratometry decreased from 50.7D to 47.5D (p = 0.0003), and the average astigmatism decreased from 5.5D to 3.5D (p = 0.0058). The mean CCT did not change significantly after surgery, but the mean TPP increased from 441.2 to 455.2 µm (p = 0.004). There was a significant reduction in the anterior cornea elevation, both the central (from 16.2-8.8; p = 0.0066) and the minimum (from –43.2 to –57.1; p = 0.0228). No significant change was found for posterior corneal elevation and for biomechanical parameters (hysteresis or CRF).

Discussion: There was a significant improvement of UDVA and CDVA after ICRS implantation, in keratoconic eyes. There was a significant and stable corneal flattening, and a decrease of the astigmatism. Corneal biomechanic parameters did not change.

Keywords: Biomechanics, Intracorneal ring segments, Ferrara rings, Keratoconus, Tomography.

How to cite this article: Salgado-Borges JM, Costa-Ferreira C, Monteiro M, Guilherme-Monteiro J, Torquetti L, Ferrara P, Ambrosio R Jr. Refractive, Tomographic and Biomechanical Outcomes after Implantation of Ferrara ICRS in Keratoconus Patients. Int J Keratoco Ectatic Corneal Dis 2012;1(1):16-21.

 
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14.  Editorial
Why a Journal on Keratoconus?
Adel Barbara
[Year:2012] [Month:January-April] [Volume:1 ] [Number:1] [Pages:74] [Pages No:v-vi]
Full Text PDF | Abstract | FREE

New modalities for the diagnosis and management of keratoconus have been introduced over the last 15 to 20 years which have changed our way of thinking about keratoconus.

 
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15.  ORIGINAL ARTICLES
Predictors of Clinical Outcomes after Intrastromal Corneal Ring Segments Implantation
Leonardo Torquetti, Guilherme Ferrara, Paulo Ferrara
[Year:2012] [Month:January-April] [Volume:1 ] [Number:1] [Pages:74] [Pages No:26-30]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10025-1005 | FREE

ABSTRACT

Purpose: To evaluate the influence of age and severity of keratoconus in the clinical outcomes of implantation of Ferrara intrastromal corneal ring segments (ICRS).

Methods:A total of 1,073 eyes of 810 patients, consecutively operated from January 2006 to July 2008, were evaluated. Two independent analysis were made according to the age of patients and keratoconus staging. Four groups were created according to the age of patients: < 20 years old, 20 to 30, 30 to 40 and >40 years old. The patients were also evaluated according to the keratoconus stage (I to IV). The outcome analysis included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), keratometry (K), asphericity (Q), corneal volume (CV) and pachymetry. All patients were evaluated using the Pentacam.

Results: The postoperative increase in UDVA and CDVA was statistically significant in all groups (p < 0.05). The magnitude of improvement of CDVA was larger for patients between 21 and 30-year-old (CDVA = 20/40) and patients with keratoconus grade I (CDVA = 20/35) (p < 0.05). There was a statistically significant increase in CV and pachymetry postoperatively in all groups. The keratometry (3.95D) and asphericity (-0.77) reduction were larger in patients younger than 20-year-old and in patients with keratoconus grade IV (p < 0.05).

Conclusion: The best clinical outcomes are seen in patients between 20 and 30-year-old and initial cases of keratoconus (grade I). The more advanced the keratoconus, the larger magnitude of K and Q reduction after ICRS implantation.

Keywords: Keratoconus, Intrastromal corneal ring segments, Age, Severity of keratoconus.

How to cite this article: Torquetti L, Ferrara G, Ferrara P. Predictors of Clinical Outcomes after Intrastromal Corneal Ring Segments Implantation. Int J Keratoco Ectatic Corneal Dis 2012;1(1):26-30.

 
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16.  Guest Editorial
The Imperative of the Early Identification of Corneal Ectasia: The Importance of Routine Topographic/Tomographic Examination after Refractive Surgery
Thomas F Mauger, Cynthia J Roberts
[Year:2012] [Month:January-April] [Volume:1 ] [Number:1] [Pages:74] [Pages No:vii]
Full Text PDF | Abstract | FREE

The past 50 years of treatment of corneal ectatic disease involved delaying surgical intervention until the patient was nonfunctional with any optical aids. Contact lens fitting was the primary mechanism to treat mild to moderate cases. The various skill levels of the contact lens practitioner and the forbearance and perseverance of the patient determined the

 
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