Intrastromal corneal ring segment implantation to correct astigmatism after penetrating keratoplasty

J Cataract Refract Surg. 2012 Jun;38(6):1006-13. doi: 10.1016/j.jcrs.2011.12.037.

Abstract

Purpose: To evaluate the clinical outcomes of implantation of Ferrara intrastromal corneal ring segments (ICRS) in patients with astigmatism after penetrating keratoplasty (PKP).

Setting: Private clinic, Belo Horizonte, Brazil.

Design: Retrospective consecutive case series.

Methods: Chart records of post-PKP patients who had ICRS implantation from May 2005 to September 2009 were retrospectively reviewed. The following parameters were studied: corrected distance visual acuity (CDVA), keratometry (K) values, spherical equivalent (SE), spherical refractive error, corneal topographic astigmatism, minimum K, and maximum K.

Results: The study evaluated 59 eyes (54 patients). The mean CDVA (logMAR) improved from 0.45 ± 0.17 (SD) (range 0.18 to 1.00) to 0.30 ± 0.17 (range 0.00 to 1.00). The mean SE was -6.34 ± 3.40 diopters (D) (range 0.37 to -16.50 D) preoperatively and -2.66 ± 2.52 D (range 0.87 to -10.50 D) postoperatively. The mean spherical refractive error decreased from -7.10 ± 3.07 D (range 2.15 to 16.68 D) preoperatively to -3.46 ± 2.05 D (range 0.88 to 10.79 D) postoperatively. No patient lost visual acuity. The mean corneal topographic astigmatism decreased from 3.37 ± 1.51 D preoperatively to 1.69 ± 1.04 D postoperatively. The mean maximum K value decreased from 48.09 ± 2.56 D to 44.17 ± 2.67 D and the mean minimum K value, from 44.90 ± 2.54 D to 42.46 ± 2.63 D. All changes were statistically significant (P<.0001).

Conclusion: Intrastromal corneal ring segments effectively reduced corneal cylinder in patients with astigmatism after PKP.

MeSH terms

  • Adult
  • Astigmatism / physiopathology
  • Astigmatism / surgery*
  • Biocompatible Materials
  • Corneal Stroma / surgery*
  • Corneal Topography
  • Female
  • Follow-Up Studies
  • Humans
  • Keratoplasty, Penetrating*
  • Male
  • Polymethyl Methacrylate
  • Postoperative Complications*
  • Prostheses and Implants*
  • Prosthesis Implantation*
  • Refraction, Ocular / physiology
  • Retrospective Studies
  • Treatment Outcome
  • Visual Acuity / physiology

Substances

  • Biocompatible Materials
  • Polymethyl Methacrylate