Intrastromal corneal ring segment implantation for ectasia after refractive surgery

• Autor(a) principal: Stival,Larissa Rossana Souza
• Data de Publicação: 2015
• Outros Autores: Nassaralla,Belquiz R. do Amaral, Figueiredo,Marisa Novaes Falleiro Chaves de, Bicalho,Frederico, Nassaralla Junior,João Jorge
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Arquivos brasileiros de oftalmologia (Online)
• Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27492015000400212
• topic: Cornea/surgery; Corneal disease; Keratomileusis, laser in situ; Photorefractive keratectomy; Dilatation, pathologic; Refractive surgical procedures; Prostheses and implants

ABSTRACTPurpose:To evaluate the clinical outcomes of intrastromal corneal ring segment (ICRS) implantation to correct ectasia in eyes with prior refractive surgery.Methods:Forty-one eyes of 25 patients (13 men, 12 women; mean age, 28.66 years) with ectasia after refractive surgery [photorefractive keratectomy (PRK) or laser in situ keratomileusis (LASIK)] were included in a nonrandomized, retrospective, observational case series. Corneal tunnels were created by mechanical dissection in all eyes. Main outcome measures included uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BCVA), refraction, keratometry, and computerized analysis of corneal topography. Patients were divided into two groups by the type of refractive surgery (Group A: PRK, Group B: LASIK).Results:The mean preoperative manifest astigmatism decreased from -1.88 to -0.84 D in Group A (p=0.096) and -3.18 to -1.77 D in Group B (p=0.000). The mean keratometric astigmatism decreased from -2.58 to -1.66 D in Group A (p=0.010) and -4.80 to -2.78 D in Group B (p=0.000). The mean spherical equivalent decreased from -2.97 to -2.05 D in Group A (p=0.065) and -3.31 to -2.42 D in Group B (p=0.014). No significant between-group differences were noted on the comparison of preoperative and postoperative results. No intraoperative or postoperative complications were observed.Conclusion:ICRS implantation is a useful treatment option for ectasia following refractive surgery, and it has significantly reduced the refractive cylinder and increased best spectacle-corrected visual acuity.