Purpose: Keratoconus (KC) leads to gradual progressive loss of vision in young and adult patients. For the purpose of visual rehabilitation and for hindering KC progression in patients, we designed this study. The main aim of this study is to help the KC patients to improve and stabilize their vision.
Methods: This prospective consecutive uncontrolled study includes 36 eyes of 36 patients with moderate degree of KC. All patients underwent combined wavefront-guided transepithelial photorefractive keratectomy (TPRK) and accelerated corneal collagen cross-linking (ACXL) after intracorneal ring segment (ICRS) implantation. Different measures will be evaluated at baseline, after ICRS implantation, and at one, 3, 6, and 12 months after combined (TPRK and ACXL). These measurements are uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction spherical equivalent (MRSE), corneal indices based on Scheimpflug tomography, and higher-order aberrations (HOAs) based on (Sirius, Schwind) tomography.
Results: There were significant improvements in logMAR (UDVA and CDVA) and reduction in sphere, manifest cylinder, MRSE, maximal keratometry, and mean keratometry after ICRS implantation in the first stage. After TPRK and ACXL as the second stage, there were significant improvements in visual acuity of both logMAR UDVA and CDVA. Reduction in refractive outcomes, including MRSE, sphere, and manifest cylinder. All corneal indices including steep, flat, mean, and maximal keratometries had been decreased. Furthermore, there were significant improvements in the final root mean square, HOAs, and coma aberrations from baseline.
Conclusion: In moderate KC, triple therapy of ICRS implantation followed by combined TPRK and ACXL appears to be a safe and effective approach. This approach provides an improvement in visual acuity, refraction, corneal indices, and HOAs. These improvements were maintained for 1 year postoperatively. It also halts KC progression.
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http://dx.doi.org/10.4103/sjopt.sjopt_26_20 | DOI Listing |
BMC Ophthalmol
December 2024
Ophthalmology Department, Faculty of Medicine, Sohag University, Almohafza St. Mailbox: 82511, Sohag, 82511, Egypt.
Purpose: To evaluate the clinical outcomes of implanting two symmetrical Kerarings via a femtosecond laser in grade three keratoconus.
Patients And Methods: This was a retrospective nonrandomized controlled clinical study. The study included one eye from each of twenty-three patients, all with Grade 3 keratoconus as classified by the Amsler-Krumeich classification.
J Cataract Refract Surg
December 2024
Department of Ophthalmology, Sorocaba Eye Hospital, Sorocaba Eye Bank, Sorocaba, São Paulo, Brazil.
Purpose: To investigate the effectiveness and safety of customized femtosecond laser-assisted corneal allogenic intrastromal ring segments (CAIRS) implantation in keratoconus patients with a history of intrastromal corneal ring segment (ICRS) explantation.
Setting: Sorocaba Eye Hospital (Hospital Oftalmológico de Sorocaba - HOS), Sorocaba, Brazil.
Design: Prospective case series.
PLoS One
December 2024
ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.
Background: The cornea plays a role in the refractive power of the eye, and when its natural curvature and thickness are compromised by diseases such as keratoconus or high myopia, this results in loss of visual acuity. Intracorneal rings (ICRs) were developed as a treatment option to restore the natural corneal curvature by implanting rings into tunnels cut within the corneal stroma. However, selecting and placing the appropriate ring can be difficult, and predicting refractive outcomes is challenging.
View Article and Find Full Text PDFBiomater Adv
March 2025
Center for Biomaterials and Tissue Engineering (CBIT), Universitat Politècnica de València, Valencia, Spain; CIBER de Bioinginiería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III, Spain.
Articular cartilage has limited regenerative capacity, so focal lesions generate mechanical stress in the joint that induces an aggravation of the damage, which ultimately leads to osteoarthritis. We recently suggested the use of microgels at the site of the cartilage defect, as a support material, to generate a biomechanical environment where pluripotent cells differentiate towards the hyaline cartilage phenotype. Here we propose a chondral regeneration strategy based on subchondral bone injury, and filling the defect site with an agglomerate of two types of microspheres, some rigid made of a biodegradable polyester (40 μm mean diameter), and others with a gel consistency made of platelet-rich plasma obtained from circulating blood (70-110 μm diameter).
View Article and Find Full Text PDFJ Orthop Traumatol
November 2024
Department of Orthopaedic Surgery, National Taiwan University Hospital, 7 Chungsan South Road, Taipei City, 10002, Taiwan.
Background: Autologous minced cartilage is a method for cartilage defect repair, and our study focuses on a newly developed biphasic cylindrical osteochondral construct designed for use in human knees. We aimed to compare its clinical effectiveness and safety with microfracture, the commonly utilized reparative treatment for knee chondral or osteochondral defects.
Materials And Methods: Conducted as a prospective multicenter, randomized controlled, non-inferiority trial across nine hospitals, the study involved 92 patients with International Cartilage Repair Society (ICRS) grade 3 to 4 chondral or osteochondral lesions on femoral condyles.
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