Long Term Trends Of Icrs Explantation

To describe the long term trends of ICRS explantation in two major publications from Europe and the Middle East.

Metaanalysis of 2 major papers on long term follow up of ICRS explantation

A Metanalysis of two major papers was performed and ICRS explantation trends were described, as well as the correlation with the grade of keratoconus. Original data from Middle Eastern publication, including data available in the European publication, were retrieved and reanalyzed.

D'Oria F, Abdelghany AA, Ledo N, Barraquer RI, Alio JL. Incidence and Reasons for Intrastromal Corneal Ring Segment Explantation. Am J Ophthalmol. 2021 Feb;222:351-358.

Al-Habboubi HF, Martinez-Osorio H, Y Maktabi AM, Badawi AH, Aldosari FN, Khandekar R, Al-Swailem SA. Long-term outcomes and causes of intrastromal corneal ring segment explantation in a tertiary eye hospital. Saudi J Ophthalmol. 2022 Jul 11;36(1):64-69.

Intacs-SK was explanted in 93.1% from the Middle East, while in Spain 60.33% of them were Ferrara/Keraring, followed by Intacs-SK in 28.9%. Functional failure was more common in the Spanish group (61.15%) while 54.7% of the Middle East group had anatomical failure. In the Spanish group, functional failure was correlated with Ferrara/Keraring, while anatomical failure was correlated with Intacs-SK.

Overall anatomical failure has 2 peaks between the 1st and 2nd and between the 9th and 10th years, while the functional failure has 2 peaks between the 2nd and 3rd and between the 6th and 9th year. Refractive failure was more common in grade 1 to 3 keratoconus, while extrusion and penetrating keratoplasty were more common in grade 3, 4, and 4 plus.

The anatomical failure was correlated with Intacs-SK, a more advanced keratoconus, and was more common in the Middle East. Functional failure was correlated with Ferrara/Keraring, less advanced keratoconus and more common in Spain. The anatomical failure has 2 peaks between the 1st and 2nd and between the 9th and 10th years, while the functional failure has 2 peaks between the 2nd and 3rd and between the 6th and 9th year. Keratoplasty was more common in advanced keratoconus, while contact lenses were the preferable treatment after ICRS explantation in the Middle East.