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.
Journal
Journal of cataract and refractive surgery
ISSN: 1873-4502
Titre abrégé: J Cataract Refract Surg
Pays: United States
ID NLM: 8604171
Informations de publication
Date de publication:
01 07 2021
01 07 2021
Historique:
received:
14
09
2020
accepted:
17
11
2020
pubmed:
11
12
2020
medline:
28
7
2021
entrez:
10
12
2020
Statut:
ppublish
Résumé
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. Department of Ophthalmology of Federal University of Parana. Prospective nonrandomized interventional comparative study. 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. 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. 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.
Identifiants
pubmed: 33298778
pii: 02158034-202107000-00015
doi: 10.1097/j.jcrs.0000000000000533
doi:
Substances chimiques
Cross-Linking Reagents
0
Photosensitizing Agents
0
Collagen
9007-34-5
Riboflavin
TLM2976OFR
Types de publication
Clinical Trial
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
916-926Subventions
Organisme : NEI NIH HHS
ID : R01 EY028667
Pays : United States
Organisme : NEI NIH HHS
ID : R01 EY023381
Pays : United States
Organisme : NEI NIH HHS
ID : P30 EY025585
Pays : United States
Informations de copyright
Copyright © 2020 Published by Wolters Kluwer on behalf of ASCRS and ESCRS.
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