ESCRS - P199 - VISUAL, REFRACTIVE AND TOPOGRAPHIC RESULTS AFTER IMPLANTATION OF INTRASTROMAL CORNEAL RING SEGMENTS IN PATIENTS WITH NIPPLE PHENOTYPE OF KERATOCONUS

VISUAL, REFRACTIVE AND TOPOGRAPHIC RESULTS AFTER IMPLANTATION OF INTRASTROMAL CORNEAL RING SEGMENTS IN PATIENTS WITH NIPPLE PHENOTYPE OF KERATOCONUS

Published 2022 - 26th ESCRS Winter Meeting

Reference: P199 | Type: Abstracts | DOI: 10.82333/maye-9a48

Authors: Álvaro Silva* 1 , Tiago Monteiro 1 , Fernando Faria Correia 1 , Nuno Franqueira 1 , Christophe Pinto 1 , Carlos Cruz 1 , Rui Silva 1 , Fernando Vaz 1

1Ophthalmology,Hospital de Braga,Braga,Portugal

Purpose

Keratoconus is a common, idiopathic corneal disorder with a substantial impact on the vision-related quality of life. This study aims to evaluate the visual, refractive and topographic outcomes of intrastromal corneal ring segments (ICRS) implantation in patients with nipple phenotype of keratoconus.

Setting

Ophthalmology Department, Hospital de Braga, Braga, Portugal

Methods

This retrospective cohort study included 29 eyes from 29 patients with nipple phenotype of keratoconus submitted to implantation of ICRS using a manual technique at the Hospital de Braga - between July 2011 and December 2016 - with a minimum postoperative follow-up time of 6 months. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), subjective refraction, corneal topography and corneal pachymetry were evaluated preoperatively and at 6 months postoperatively.

Results

At 6-months postoperatively, CDVA and UDVA were 0.26 ± 0.15 and 0.50 ± 0.20 logMAR, respectively, with a mean gain of 0.74 ± 0.21 (p<0.001) and 0.66 ± 0.20 logMAR (p<0.001). The safety index was 2.17 ± 2.21 and the efficacy index was 1.20 ± 1.44. 72.4% of the eyes revealed a gain of 1 or more Snellen lines of CDVA with 24.1% of the eyes showing a loss of 1 or more Snellen lines of CDVA. All refractive parameters - sphere (p<0.001), cylinder (p<0.001) and spherical equivalent (p<0.001) - revealed a significant postoperative improvement. Q-value (p<0.001), coma (p=0.003), anterior K1 (p<0.001), anterior K2 (p<0.001), anterior maximum K (p=0.002) and posterior K2 (p=0.006) improved significantly after ICRS implantation. No significant pachymetric changes were found from preoperative to postoperative evaluations (p=0.16). No vision threatening complications were noticed. No cases of endothelial perforation or epithelial extrusion of ICRS were observed.

Conclusion

ICRS implantation is an effective surgical procedure to improve visual, refractive and topographic parameters even in patients with nipple keratoconus. We found an excellent safety profile, with no intraoperative and postoperative complications in the first 6-months of follow-up.