Posters

5 year stability evaluation in topographic indices in patients with keratoconus operated with intrastromal corneal ring segments

Poster Details

First Author: N.Fernández Meijide ARGENTINA

Co Author(s):    F. Terragni   A. Suarez Trujillo   T. Ortiz Basso   J. Bekerman   C. Vitelli        

Abstract Details

Purpose:

Several studies have demonstrated keratoconus stability after Intrastromal Corneal Ring Segments(ICRS) implantation. However, there are no reports of keratoconus stability after 5-year follow-up in our country. The purpose of this study is evaluate the keratoconus stability of patients operated at the Hospital Italiano de Buenos Aires with a 5-year follow up from the implantation. Primary objective is to compare mean keratometric indices (FlatK/SteepK(Kmean/DeltaK) measured at the first month and 5 years after surgery. Secondary objective is to compare the uncorrected distance visual acuity(UDCA) and corrected distance visual acuity(CDVA) at the first month and 5 years since implantation.

Setting:

Cornea and Refractive Surgery Service, Department of Ophthalmology, Hospital Italiano de Buenos Aires, Argentina.

Methods:

An ambispective cohort study of 42 eyes who underwent uneventful manual implantation of one or two ICRS for correction of clear corneal keratoconus at Hospital Italiano de Buenos Aires between january 2010 and december 2016. Inclusion criteria were patients over 18 years old, with clear corneas keratoconic eyes, low quality of vision and central corneal thickness of ≥ 400 microns who received ICRS. This study included 26 patients (23 were male patients) and 42 eyes (21 right eyes, 21 left eyes). Mean age was 38 years old (SD 13,07) and median follow up was 5.79 years (IQR 4,64- 6,82).

Results:

Topographic indices changed from the first month after ICRS implantation(data from clinical records) to the clinical evaluation after the follow up as following: Flat K from 44.92 D to 45.52 D (p 0.164), Steep K from 47.88 D to 47.85 D (p 0.644), Kmean from 46.55 D to 46.79 D(p 0.441), Delta K from 2.9 D to 2.28 D (p 1.0). UDCA changed from LogMAR 0.70 to LogMAR 1.00 (p 0.454); CDVA changed from LogMAR 0.30 to LogMAR 0.18(p 0.596); spherical refraction changed from -2.25 to -2.5(p 0.86); residual cylinder changed from -2.5 to -2.0(p 0.486).

Conclusions:

Implantation of short arc length intrastromal rings in patients with mild to moderate keratoconus showed to be an effective means of achieving stability. Moreover, many patients improved BCVA over time. Patient age should be considered in order to disclose whether this plays a role in non progression, since many patients were 35 years old or older.

Financial Disclosure:

None