AI Article Synopsis

  • Keratoconus (KC) causes progressive vision loss in patients, and the study aims to improve and stabilize vision for these individuals through a multi-step treatment approach.
  • The study involved 36 patients who received a combination of procedures: intracorneal ring segment (ICRS) implantation, wavefront-guided transepithelial photorefractive keratectomy (TPRK), and accelerated corneal collagen cross-linking (ACXL), with significant improvements in various visual and corneal measurements observed after the treatments.
  • The results suggest that this triple therapy is safe and effective for moderate KC, leading to better visual acuity and reduced corneal irregularities, with improvements sustained over time.

Article Abstract

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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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9375462PMC
http://dx.doi.org/10.4103/sjopt.sjopt_26_20DOI Listing

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