Resultados visuais e tomográficos do implante de anel corneano intraestromal de 140° de arco em ceratocone e DMP

• Autor(a) principal: Soares, Jordana Sandes Barbosa
• Data de Publicação: 2016
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UFG
• Texto Completo: http://repositorio.bc.ufg.br/tede/handle/tede/9801
• topic: Ceratocone; Anel intraestromal; Ectasia corneana; Keratoconus; Intrastromal corneal ring; Corneal ectasia; CLINICA MEDICA::OFTALMOLOGIA

The purpose of this study is evaluate the clinical outcomes of implantation of Ferrara intrastromal corneal ring segments (ICRS) with 140 degree of arch length in patients with keratoconus and pellucid marginal degeneration (PMD). This is a longitudinal and retrospective study carried out by analyzing medical records of surgeries performed. First we analyzed all the patients in the same group. After the patients were divided in three groups according to the number of implanted segments and thickness: Group 1 (2 segments 140/20), Group 2 (1 segment 140/15), Group 3 (1 segment 140/20). It was performed corneal tomography by Pentacam (Oculus, Wetzlar, Germany) in all patients preoperatively and 6 months after surgery and from this examination the following data were extracted: keratometry (k) asphericity (Q) and tomographic astigmatism. Refractive examinations was performed using logMAR visual acuity scale. Data were stored for later analysis SPSS software, version 22.0 (SPSS Inc.Chicago, FL, USA). The results of astigmatism were analyzed arithmetically (not vector analysis), and considering the cylinder axis through vector analysis. We evaluated 67 eyes. The analysis of all patients in the same group showed CDVA improved from +0.5 log MAR ± 0.20 to + 0.3 ± 0.21, (p=0.00). The average keratometry reduced from 49.8 D ± 7.01 to 47.34 D ± 4.90 (p=0.00). The average asphericity changed from -0.60 ± 0.86 to -0.23 ± 0.67 (p=0.00). The mean preoperative tomographic astigmatism decreased from -8.0 D ± 3.45 to -4.53 D ± 2,52 (p=0.00). In group 1, visual acuity improved from 0.4 ± 0.3 log MAR to 0.20 ± 0.1 log MAR (p =0.02), average keratometry reduced from 54.0 ± 6.6 to 49.3 ± 4.3 D (p =0.00), an average asphericity modified -1.1 ± 0.6 to -0.5 ± 0.6 (p=0.00) and reduced astigmatism tomographic -10.3 ± 2.9 to 5.7 ± 1.8 D (p=0.00). In group 2, there was a reduction of tomographic astigmatism from -6.3 ± 2.9 to -3.8 ± 2.2 D (p=0.00), an improvement of visual acuity with correction of 0.4 ± 0.2 Log MAR to 0.2 ± 0.1Log (p=0.00). Group 3 reduced the tomographic astigmatism to -7.5 ± 3.9 to -3.7 ± 2.2 D (p=0.02). We conclude that the 140° arc ring reduces tomographic astigmatism and effectively improves visual acuity, with an option for selected cases of ectasia corneal.