MyoRing implantation in cases of myopia not eligible for laser vision correction

Session Details

Session Title: Refractive Corneal Surgery

Session Date/Time: Wednesday 17/09/2014 | 08:00-09:30

Paper Time: 09:07

Venue: Boulevard A

First Author: : A.Daxer AUSTRIA

Co Author(s): :                  

Abstract Details

Purpose:

Laser Vision Correction (LVC) of myopia may result in a vision threatening long-term complication known as post-LASIK Keratectasia. Risk factors are, but not limited to, high myopia, thin cornea and irregular corneal surface. MyoRing implantation have been demonstrated to be able to flatten the corneal surface considerably and to stabilize the cornea biomechanically. Here I shall demonstrate techniques how to effectively use MyoRing implantation for the treatment of Myopia in order to avoid LVC long term complications and present the related clinical data.

Setting:

gutSEHEN Eye Center and Department of Ophthalmology, University of Innsbruck, Austria

Methods:

Ten eyes of 6 patients suffering from Myopia and showing risk factors for post-operative keratectasia and, therefore, being not eligible for LVC were treated by means of Corneal IntraStromal Implantation Surgery (CISIS) with MyoRing implantation with or without additional LVC. Mean age of the patiens was 30 years +/- 6 years standarddeviation (std). Mean follow-up time postoperatively ranged from 6 months to 3 years (mean 15 months). MyoRing implantation was performed using MyoRing intra-corneal implants (DIOPTEX GmbH, Austria) and PocketMaker Ultrakeratome (DIOPTEX GmbH, Austria). In cases of additional LVC, the additional treatment was performed using Wavelight Allegretto 400 Herz (Wavelight GmbH, Germany) and IntraLase (IntraLase Inc., USA).

Results:

All treatments were uneventful without any complication. All eyes had Corrected Distance Visual Acuity (CDVA) of 1.0 (20/20) preoperatively. The preoperative refraction ranged from - 5.25 diopters to -10.5 diopters (sphere) and -0.25 diopters to - 4 diopters (cylinder). Mean Sphere preoperatively was - 8.06 diopters +/- 1.75 diopters (std). Mean cylinder preoperatively was -1.94 diopters +/- 1.39 diopers (std). Pachymetry at the thinnest point was 520 microns +/- 40 microns preoperatively and 514 microns +/- 53 microns postoperatively. The changes in pachymetry were satistically not significant. Postoperatively, sphere was +0.53 diopters +/- 0.81 diopters (mean +/- std) and cylinder was -1.22 diopters +/- 0.94 diopters (mean +/- std). Except one high miopic case with preoperative cylinder of -4 diopters which resulted in UDVA of 0.6 postoperatively, all eyes had UDVA of 0.8 or better and all eyes (10 of 10) had CDVA of 1.0 or better. Best refractive data and best visual performance resulted from a combined treatment of CISIS and LVC.

Conclusions:

The treatment of myopia in cases with risk factors for keratectasia after LVC by means of CISIS with MyoRing implantation with or without combined LVC gives similar refractive results compared to published data from LVC only. In cases of manifest Keratoconus, MyoRing implantation without combined LVC is recommended. In cases, however, which do not show manifest Keratoconus but who are not eligible for LVC the combined treatment of LVC and MyoRing implantation is an excellent option to achieve both, good uncorrected visual performance and corneal stability. Further studies over a longer period of time are required and conducted.

Financial Interest:

One or more of the authors... has significant investment interest in a company producing, developing or supplying product or procedure presented