Astigmatism Clinical Trial
Official title:
Intrastromal Corneal Ring Segment Implantation for High Astigmatism on Postkeratoplasty Eyes
To evaluate the clinical outcomes of Intrastromal Corneal Ring Segment (ICRS) implantation to correct high-degree astigmatism on eyes with prior penetrating keratoplasty (PK).
Eighteen eyes of 18 patients, 8 men and 10 women, with high levels (> 5 diopters [D]) of
postkeratoplasty astigmatism were studied in a nonrandomized, retrospective, observational
case series. Mean age at the time of ICRS implantation was 38 years, range 22 to 49 years.
PK was performed to treat keratoconus in 15 patients, corneal scar after trauma in 2
patients, and Fuchs endothelial dystrophy in 1 patient. All patients were spectacle and
contact lens intolerant. There was no active corneal disease or problem apart from high
astigmatism.
Minimum time of ICRS implantation was 2 years after PK and at least 6 months after sutures
removal.
Preoperative examinations included personal medical ocular history, uncorrected visual
acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), refraction, keratometry,
intraocular pressure (IOP) measurement by applanation tonometry, corneal astigmatism,
surface regularity index, surface asymmetry index, tonometry, slit-lamp biomicroscopy,
specular microscopy, and fundus examination.
Main outcome measures included UCVA, BSCVA, refraction, keratometry and computerized
analysis of corneal topography.
All surgeries were performed by the same surgeon (BAN) at the Goiania Eye Institute, between
July 2007 and January 2009. Corneal tunnels were created by means of mechanical dissection
in all eyes. Intrastromal corneal ring segments implantation was indicated because of the
existence of reduced best spectacle-corrected visual acuity (BSCVA) or contact lens
intolerance. Intracorneal ring segments implantations were performed by the same surgeon
following the same protocol. All eyes were implanted with the Cornealring (Visiontech
Medical Optics, Belo Horizonte, MG, Brazil). Mean follow-up after ICRS implantation was 12
months (range, 09 to 22 months).
The procedure, its goals, and possible complications were explained and all patients signed
an informed consent. The amount and axis of astigmatism to be corrected by ICRS was based on
manifest refraction.
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Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Single Blind (Investigator), Primary Purpose: Treatment
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