Keratoconus progression after intrastromal corneal ring segment implantation according to age: 5-year follow-up cohort study
- 19 June 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in International Ophthalmology
- Vol. 40 (11), 2847-2854
- https://doi.org/10.1007/s10792-020-01468-4
Abstract
Background/aims Intrastromal corneal ring segments (ICRS) have been found to be useful in correcting keratoconus by decreasing irregular astigmatism, thereby potentially improving visual acuity. However, its long-term effects in keratoconus progression are not completely understood, mainly concerning the effects of age on ICRS implantation results. This study aimed to evaluate long-term effects of ICRS implantation according to age at implantation. Methods We conducted a longitudinal retrospective study, where we evaluated patients with keratoconus who underwent ICRS implantation between 2004 and 2012. Results We evaluated 34 eyes for 5 years post-operatively. The mean age of the 21 men and 7 women was 20.59 ± 4.65 years. Best spectacle-corrected visual acuity (BSCVA) improved from 0.32 ± 0.19 in the preoperative period to 0.46 ± 0.27 6 months post-operatively. After up to 5 years of follow-up, there was no significant difference in mean visual acuity of the group. As expected, there was a significant decrease in keratometric values after corneal ring implantation, which remained stable over the 5-year follow-up. Among the 34 cases analysed, nine (26%) showed signs of disease progression. In eight of the nine documented progression cases, patients were 21 years old or younger, revealing that these patients were sevenfold more likely to progress than those aged over 21 years. Conclusion In our series of cases, ICRS implantation was shown to be an excellent treatment to reduce corneal curvature and improve visual acuity at all ages, but it did not stabilize the disease, especially in young patients with more aggressive forms of the keratoconus.Keywords
This publication has 21 references indexed in Scilit:
- Sequential versus concurrent KERARINGS insertion and corneal collagen cross-linking for keratoconusBritish Journal of Ophthalmology, 2010
- The Influence of Gender and Hormone Status on the Severity and Progression of KeratoconusCornea, 2010
- Effect of treatment sequence in combined intrastromal corneal rings and corneal collagen crosslinking for keratoconusJournal of Cataract & Refractive Surgery, 2009
- Long-term follow-up of intrastromal corneal ring segments in keratoconusJournal of Cataract & Refractive Surgery, 2009
- Biomechanical and morphological corneal response to placement of intrastromal corneal ring segments for keratoconusJournal of Cataract & Refractive Surgery, 2009
- Intracorneal ring segment implantation for the management of keratoconus: Safety and efficacyJournal of Cataract & Refractive Surgery, 2007
- Inverse relationship between age and severity and sequelae of acute corneal hydrops associated with keratoconusBritish Journal of Ophthalmology, 2007
- Ferrara intracorneal ring segments for keratoconusJournal of Cataract & Refractive Surgery, 2004
- Keratoconus: Age of Onset and Natural HistoryOptometry and Vision Science, 1997
- Association between keratoconus and atopy.British Journal of Ophthalmology, 1989