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已有 774 次阅读 2022-9-27 15:30 |系统分类:科研笔记

1 条,共 18

标题: Clinical evaluation of two types of intracorneal ring segments (ICRS) for keratoconus 

作者: Al-Tuwairqi, WS (Al-Tuwairqi, Waleed S.); Osuagwu, UL (Osuagwu, Uchechukwu L.); Razzouk, H (Razzouk, Haya); AlHarbi, A (AlHarbi, Ahmed); Ogbuehi, KC (Ogbuehi, Kelechi C.)

来源出版物: INTERNATIONAL OPHTHALMOLOGY  : 37  : 5  : 1185-1198  DOI: 10.1007/s10792-016-0385-2  出版年: OCT 2017  

Web of Science 核心合集中的 "被引频次": 0 

被引频次合计: 0 

摘要: To compare the outcome measures following implantation of two types of ICRS.

Forty-four eyes of keratoconic patients (aged 18-50 years) were randomly assigned to femtosecond laser-assisted Keraring ICRS (Group A) or MyoRing (Group B) implantation. Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, keratometry (K), and aberrations were compared preoperatively, at 3 and 6 months postoperatively. A survey was conducted to assess patient's satisfaction, 6 months postoperatively.

In Groups A (n = 26) and B (n = 18), UDVA was increased (P < 0.05), but CDVA increased only in Group A (P < 0.05) 6 months postoperatively. The mean K was reduced by 4.55 D (P < 0.0001) in Group A and 6.51 D (P < 0.001) in Group B. Six months postoperatively, the mean refraction spherical equivalent (MRSE) decreased by 2.90 and 3.60 D in Groups A and B, respectively (P < 0.0001). Between groups, coma was more reduced (P = 0.035) in Group B than A, 6 months postoperatively. On motivation for surgery, 88.9% of patients' ranked "desire to improve unaided vision" and "relief from glasses" (77%) topmost. Seventy-seven (77%) of Group A and 89% of Group B patients were satisfied with their unaided vision at the final visit, after 6 months.

KeraRing (A) and MyoRing (B) corneal implants both performed well in improving vision and stabilising the cornea. Implantation of the MyoRing caused greater reduction in coma and better patient satisfaction, but CDVA improved only in the Keraring group, at the final visit.

 

2 条,共 18

标题: Visual outcomes after femtosecond-assisted intracorneal MyoRing implantation: 18 months of follow-up 

作者: Mohebbi, M (Mohebbi, Masoomeh); Hashemi, H (Hashemi, Hassan); Asgari, S (Asgari, Soheila); Bigdeli, S (Bigdeli, Sara); Zamani, KA (Zamani, Kambiz Ameli)

来源出版物: GRAEFES ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY  : 254  : 5  : 917-922  DOI: 10.1007/s00417-015-3231-8  出版年: MAY 2016  

Web of Science 核心合集中的 "被引频次": 1 

被引频次合计: 1 

摘要: Purpose To determine the long-term results of femtosecond-assisted MyoRing implantation for the treatment of keratoconus.

Methods In this prospective, non-randomized, interventional clinical study, 47 eyes of 46 patients with keratoconus grade 1 to 3 entered the study. For all patients, a MyoRing (Dioptex, GmbH, Austria) was implanted using a femtosecond laser (Femto LDV, Ziemer, Germany).

Results At 18 months, mean uncorrected and best corrected visual acuity was 0.41 +/- 0.19 logMAR, (P = 0.004) and 0.62 +/- 0.22 logMAR (P < 0.001), and mean manifest refraction spherical equivalent was -0.38 +/- 2.62D (P < 0.001). The central 3-mm maximum and mean keratometry decreased by 5.20 +/- 3.06D and 4.77 +/- 2.47D, respectively (both P < 0.001), and the 8-mm maximum keratometry decreased by 1.16 +/- 5.50D (P = 0.185). Central and minimal corneal thickness showed an insignificant increase. Both corneal hysteresis and corneal resistance factor showed an insignificant decrease of about 0.13 mmHg. Endothelial cell count decreased by 215.43 +/- 300.55 cell/mm(2) (P < 0.001). Twenty-six subjects (55.3 %) had halo vision at night and 24 subjects (51.1 %) had glare at night.

Conclusions Femtosecond-assisted intracorneal MyoRing implantation can be an appropriate treatment option in keratoconus patients with central corneal protrusion, but the incidence of optical disturbances can be relatively high.

 

3 条,共 18

标题: Technique of simultaneous femtosecond laser assisted Myoring implantation and accelerated intrastromal collagen cross-linking for management of progressive keratoconus: A novel technique 

作者: Mohammadpour, M (Mohammadpour, Mehrdad); Hahemi, H (Hahemi, Hassan); Jabbarvand, M (Jabbarvand, Mahmoud)

来源出版物: CONTACT LENS & ANTERIOR EYE  : 39  : 1  : 9-14  DOI: 10.1016/j.clae.2015.06.004  出版年: FEB 2016  

Web of Science 核心合集中的 "被引频次": 0 

被引频次合计: 0 

摘要: Purpose: To describe a novel surgical technique for the management of progressive keratoconus by simultaneous femtosecond laser-assisted Myoring implantation and accelerated corneal intrastromal collagen cross-linking with Dextran Free Riboflavin.

Methods: After creating a corneal pocket with femtosecond laser, Dextran Free Riboflavin was injected into the intrastromal pocket. Then the Myoring was implanted in the corneal pocket and accelerated corneal intrastromal collagen cross-linking was performed with no epithelial debridement.

Results: The cornea remained clear and the central keratometry was decreased significantly with marked improvement in uncorrected visual acuity up to two years following treatment. Anterior segment OCT revealed good centration and intended implant depth with desirable increase in the corneal stromal reflectivity confirming effective collagen cross-linking.

Conclusion: Simultaneous femtosecond laser-assisted Myoring implantation and accelerated corneal intrastromal collagen cross-linking with Dextran Free Riboflavin is a safe and effective technique for management of keratoconus and improving vision. (C) 2015 Published by Elsevier Ltd on behalf of British Contact Lens Association.

 

4 条,共 18

标题: MYORING IMPLANTATION ALONE VERSUS CORNEAL COLLAGEN CROSS-LINKING FOLLOWING MYORING IMPLANTATION FOR MANAGEMENT OF KERATOCONUS: 1 YEAR FOLLOW UP 

作者: Nobari, SM (Nobari, Sahar Mojaled); Villena, C (Villena, Consuelo); Jadidi, K (Jadidi, Khosrow)

来源出版物: ACTA MEDICA MEDITERRANEA  : 32  特刊: 2  : 1077-1085  出版年: 2016  

Web of Science 核心合集中的 "被引频次": 1 

被引频次合计: 1 

摘要: Purpose: To compare combined MyoRing implantation with previously corneal collagen cross-linking (CXL-MyoRing) versus MyoRing implantation alone in patients with keratoconus.

Methods: This retrospective, comparative, cohort study included 33 eyes of 33 patients with keratoconus stage II and III according to Amsler-Krumeich classification. Two groups were performed for this study with 1 year follow up. The group 1 received MyoRing implantation and the group 2 received CXL approximately 12 months before MyoRing implantation. All patients had a complete pre and post-operative examination including visual, refractive and keratometry examinations.

Results: In Group 1 at the end of follow up the mean UDVA and CDVA improved by 9 and 4 lines of logMAR. In Group 2 the mean UDVA and CDVA improved by 8 and 2 lines of logMAR. There was not observed a statistically significant difference between mean UDVA of two groups postoperatively (p = 0.142) whereas the mean CDVA in Group 2 was significantly better than mean Group 1 at the end of follow up (p = 0.018). Spherical equivalent error and refractive astigmatism were significantly reduced in both groups which no statistically significant differences was noted in these refractive parameters between two groups. The mean keratometric values also were reduced in both groups at the end of follow up which no statistically significant difference was observed between two groups.

Conclusion: Both MyoRing implantation alone and combined MyoRing implantation with previously CXL were safe and effective methods for moderate and severe keratoconus and resulted in similar clinical outcomes after one year follow up. ExclusivelyMyoRing implantation alone demonstrated better outcome in mean CDVA.

 

5 条,共 18

标题: Full-Ring Intracorneal Implantation in Corneas With Pellucid Marginal Degeneration 

作者: Nobari, SM (Nobari, Sahar Mojaled); Villena, C (Villena, Consuelo); Jadidi, K (Jadidi, Khosrow)

来源出版物: IRANIAN RED CRESCENT MEDICAL JOURNAL  : 17  : 12  文献号: e28974  DOI: 10.5812/ircmj.28974  出版年: DEC 2015  

Web of Science 核心合集中的 "被引频次": 0 

被引频次合计: 0 

摘要: Background: Keratoconus (KCN) is a progressive, non-inflammatory ectacic disorder characterized by bilateral and asymmetrical conical protrusion of the cornea. MyoRing implantation and Collagen Crosslink (CXL) are two separate effective treatments for all stages of keratoconous. This study wants to show the effect of these treatments combination in patients with moderate and severe keratoconus.

Objectives: The aim of this study was to report on the visual and refractive outcomes of corneas with pellucid marginal degeneration following MyoRing implantation (DIOPTEX GmbH).

Patients and Methods: This study included 15 eyes of 15 patients, with an age range from 22 to 49 years old, and pellucid marginal degeneration. An intrastromal corneal ring (MyoRing) was inserted by the means of mechanical dissection using a PocketMaker microkeratome. The main outcome measures were uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction, and keratometry readings. The mean postoperative follow-up was ten months (range 6-12 months).

Results: The mean UDVA(LogMAR) improved significantly from 1.13 +/- 0.21 preoperatively to 0.24 +/- 0.13 postoperatively (P < 0.001), and the mean CDVA(LogMAR) improved significantly from 039 +/- 0.12 to 0.19 +/- 0.09 (P < 0.001). The mean cylinder of manifest refraction decreased significantly by 4.00 diopter(D) (P < 0.001). The mean spherical equivalent error(SE)decreased significantly from -6.00 +/- 3.60 D to -0.70 +/- 1.90 D, at the end of the follow-up period. Furthermore, with regards to corneal topography, a significant reduction was observed in keratometric values. The Kmax, Kmin and Kaverage decreased significantly by 5.00, 1.10 and 4.00 D, respectively (P < 0.001).

Conclusions: MyoRing implantation using the PocketMaker microkeratome appears to provide an effective method for treating pellucid marginal degeneration. Both UDVA and CDVA improved significantly. The corneal steepening and astigmatism were reduced in all subjects after MyoRing implantation.

 

6 条,共 18

标题: Biomechanics of Corneal Ring Implants 

作者: Daxer, A (Daxer, Albert)

来源出版物: CORNEA  : 34  : 11  : 1493-1498  DOI: 10.1097/ICO.0000000000000591  出版年: NOV 2015  

Web of Science 核心合集中的 "被引频次": 2 

被引频次合计: 2 

摘要: Purpose:To evaluate the biomechanics of corneal ring implants by providing a related mathematical theory and biomechanical model for the treatment of myopia and keratoconus.Methods:The spherical dome model considers the inhomogeneity of the tunica of the eye, dimensions of the cornea, lamellar structure of the corneal stroma, and asphericity of the cornea. It is used in this study for calculating a strengthening factor sf for the characterization of different ring-shaped corneal implant designs. The strengthening factor is a measure of the amount of strengthening of the cornea induced by the implant.Results:For ring segments and incomplete rings, sf = 1.0, which indicates that these implants are not able to strengthen the cornea. The intracorneal continuous complete ring (MyoRing) has a strengthening factor of up to sf = 3.2. The MyoRing is, therefore, able to strengthen the cornea significantly.Conclusions:The result of the presented biomechanical analysis of different ring-shaped corneal implant designs can explain the different postoperative clinical results of different implant types in myopia and keratoconus.

 

7 条,共 18

标题: Outcome of complete intrastromal ring implantation using femtosecond laser in pellucid marginal degeneration 

作者: Jabbarvand, M (Jabbarvand, M.); Hashemian, H (Hashemian, H.); Khodaparast, M (Khodaparast, M.); Bazvand, F (Bazvand, F.); Beheshtnejad, A (Beheshtnejad, A.)

来源出版物: EYE  : 29  : 6  : 783-790  DOI: 10.1038/eye.2015.33  出版年: JUN 2015  

Web of Science 核心合集中的 "被引频次": 1 

被引频次合计: 1 

摘要: Purpose To evaluate the effect of complete intrastromal corneal ring implantations on patients with pellucid marginal degeneration (PMD).

Design Prospective interventional case series

Patients and Methods Thirty-three eyes with PMD were included into the study. After pocket creation with femtosecond laser (Femtec; 20/10 PerfectVision), MyoRing implantation was performed. Uncorrected and corrected distance visual acuity (UDVA, CDVA), subjective refraction, keratometry, central corneal thickness, corneal biomechanical profile (Ocular Response Analysis), and whole-eye wavefront aberrometry (iTrace) were evaluated preoperatively and also postoperatively, 1 month, 3 months, 6 months, and 1 year after the operation.

Results One month after surgery, significant improvements were observed in UDVA (ANOVA; P = 0.02), mean keratometry, sphere (ANOVA; P < 0.001), and cylinder (ANOVA; P = 0.04) with no significant changes afterwards. No significant change occurred in the corneal biomechanical profile. Primary coma and trefoil reduced after 1 year (ANOVA; P values were 0.02 and 0.06, respectively). Primary spherical aberration significantly increased according to the 1-year follow-up (ANOVA; P < 0.001). No significant complication was observed.

Conclusion MyoRing is considered as a treatment modality for spherocylindrical correction in patients with PMD, with an acceptable safety and efficacy profile.

 

8 条,共 18

标题: Femtosecond laser-assisted implantation of complete versus incomplete rings for keratoconus treatment 

作者: Hosny, M (Hosny, Mohamed); El-Mayah, E (El-Mayah, Esraa); Sidky, MK (Sidky, Mohamed Karim); Anis, M (Anis, Mohamed)

来源出版物: CLINICAL OPHTHALMOLOGY  : 9  : 121-127  DOI: 10.2147/OPTH.S73855  出版年: 2015  

Web of Science 核心合集中的 "被引频次": 4 

被引频次合计: 4 

摘要: Purpose: To compare complete versus incomplete ring implantation for keratoconus correction.

Methods: We investigated 25 eye, of keratoconic patients, of which 15 had femtosecond-assisted MyoRing corneal implantation ((houp 1) and 10 had feintosecond-assisted Keraring segments ((houp 2). Uncorrected distance visual acuity (UCVA), best corrected distance visual acuity (BCVA), mean K (K-m), sphere, topographic cylinder, and corneal asphericity value (Q-value) were measured in all eyes preoperatively and at 4 weeks postoperatively (1 month).

Results: In Group 1, the Km change was -6.15 +/- 2.16 D, with a mean change in sphere of -4.45 +/- 2.18 D and a mean change in refractive cylinder of 2.32 +/- 3 D. UCVA change was 0.57 +/- 0.273 logarithm of the minimum angle of resolution (LogMAR), BCVA change was 0.2 +/- 0.27 (LogIVIAR), and the Q-value change was 0.43 +/- 2.6. In Group 2, the K was 3.15 +/- 1.68 D, UCVA change was 0.48 +/- 0.37 (LogIVIAR), BCVA change was 0.09 +/- 0.15 (LogMAR), and the 0-value change was 0.5 +/- 0.21. Changes in the means did not significantly differ between groups, except for the K change, which was significantly greater in Group I than in Group 2 (P=0.05).

Conclusion: Both complete ring and ring segment implantation are effective for improving corneal and visual parameters in.keratoconus. Complete ring implantation may have a greater flattening effect on the anterior corneal surface.

 

9 条,共 18

标题: Femtosecond Laser-Assisted MyoRing Implantation in Postoperative LASIK Ectasia 

作者: Jabbarvand, M (Jabbarvand, Mahmoud); Hashemian, M (Hashemian, Mohammadnaser); Hashemian, H (Hashemian, Hesam); Bazvand, F (Bazvand, Fatemeh); Khodaparast, M (Khodaparast, Mehdi)

来源出版物: JOURNAL OF REFRACTIVE SURGERY  : 30  : 7  : 462-466  DOI: 10.3928/1081597X-20140521-02  出版年: JUL 2014  

Web of Science 核心合集中的 "被引频次": 0 

被引频次合计: 0 

摘要: PURPOSE: To evaluate the effect of MyoRing implantations (DIOPTEX GmbH, Linz, Austria) in patients with ectasia after LASIK.

METHODS: MyoRing implantation was performed in 15 eyes of 14 patients with ectasia after LASIK using a femtosecond laser. Uncorrected and corrected distance visual acuity, refraction, keratometry, central corneal thickness, corneal biomechanical profile, and corneal aberrometry were evaluated preoperatively and at 1, 3, and 6 months, and 1 year postoperatively.

RESULTS: Uncorrected distance visual acuity (1.02 +/- 0.48 to 0.30 +/- 0.18 logMAR), maximum keratometry (50.14 +/- 1.82 to 43.80 +/- 1.21 diopters), and sphere (-4.4 +/- 4.8 to +1.50 +/- 0.61 diopters) were significantly improved from preoperative values at 1 month after surgery with no significant change afterward. Corrected distance visual acuity did not improve significantly 1 month after implantation, but between the 1- and 3-month follow-up visits, a significant improvement (0.30 +/- 0.1 to 0.17 +/- 0.13 logMAR) was observed without any additional improvement thereafter. A nearly significant (P = .05) increase in central corneal thickness (439.4 +/- 19 to 452.2 +/- 20 mu m) was observed during the 1-month postoperative period. Primary coma, higher-order aberrations, and trefoil showed an insignificant decrease 1 month after surgery and afterward. Spherical aberration significantly increased between the preoperative visit and the first postoperative visit. Corneal hysteresis and corneal resistance factor showed no significant change between visits.

CONCLUSIONS: MyoRing is a safe and effective method in patients with ectasia after LASIK. It can improve corrected distance visual acuity and reduce refractive error in these patients.

 

10 条,共 18

标题: Implantation of a Complete Intrastromal Corneal Ring at 2 Different Stromal Depths in Keratoconus 

作者: Jabbarvand, M (Jabbarvand, Mahmoud); Hashemi, H (Hashemi, Hassan); Mohammadpour, M (Mohammadpour, Mehrdad); Khojasteh, H (Khojasteh, Hassan); Khodaparast, M (Khodaparast, Mehdi); Hashemian, H (Hashemian, Hesam)

来源出版物: CORNEA  : 33  : 2  : 141-144  DOI: 10.1097/ICO.0000000000000026  出版年: FEB 2014  

Web of Science 核心合集中的 "被引频次": 6 

被引频次合计: 6 

摘要: Purpose:The aim of this study was to evaluate the clinical outcomes of intrastromal MyoRing (Dioptex, GmbH, Linz, Austria) implantation at 2 different depths of 250 and 300 m.Methods:This was a prospective interventional randomized controlled trial, a pilot study. Keratoconic patients with keratometry values between 48 and 52 diopters were randomly divided into 2 groups. A continuous intrastromal corneal ring of the same size was implanted at 2 different stromal depths of 250 m (group 1) and 300 m (group 2) using femtosecond laser technology for both groups. Visual and refractive outcomes, keratometry, corneal biomechanical characteristics, and higher order aberrations were compared at the 1-year postoperative follow-up.Results:In both groups, uncorrected distance visual acuity significantly improved after MyoRing implantation, whereas neither of these showed any improvement in the corrected distance visual acuity. In addition, the mean central keratometry and spherical and cylindrical refraction reduced significantly in both groups, and spherical aberration increased significantly in both groups. On one hand, coma was reduced almost significantly in both groups, and on the other hand, corneal hysteresis and corneal resistance factor did not change significantly after the operation. None of the patients in both groups had intraoperative or postoperative complications. There were no differences observed in any of the measured variables of the 2 study groups.Conclusions:An implantation depth of 250 m has comparable outcomes with the previously applied 300-m implantation depth. It may be appropriate for selected cases of keratoconus with lower pachymetry.

 

11 条,共 18

标题: Clinical Outcomes after Complete Intracorneal Ring Implantation and Corneal Collagen Cross-Linking in an Intrastromal Pocket in One Session for Keratoconus 

作者: Studeny, P (Studeny, Pavel); Krizova, D (Krizova, Deli); Stranak, Z (Stranak, Zbynek)

来源出版物: JOURNAL OF OPHTHALMOLOGY  文献号: 568128  DOI: 10.1155/2014/568128  出版年: 2014  

Web of Science 核心合集中的 "被引频次": 0 

被引频次合计: 0 

摘要: Purpose. The aim of this work was to evaluate the results after combined surgery implantation of full rings and CXL in one session in a group of patients with keratoconus during a 12-month follow-up. Material and Methods. The study included 22 eyes of 20 keratoconic patients, mean age of 28.41 (from 18 to 50) years. A full ring was inserted and afterwards 0.1% riboflavin solution was injected into the corneal pocket through the incision tunnel. The cornea was irradiated with UV-A light for 30 minutes. Postoperative visits were scheduled for the first week and months 1, 3, 6, 12, and 24 after surgery. Minimal follow-up time was 12 months. Results. The mean UDVA improved by 6 lines from before the operation to 1 year after the operation, the mean CDVA improved by approximately 2.5 lines, and the mean K improved by 3.94 D. Statistically significant reductions of sphere (P < 0.001), cylinder (P = 0.004), and spherical (P < 0.001) equivalents were found 1 month after surgery. Conclusion. The combined surgery MyoRing implantation and CXL seems to be a safe method in the treatment of keratoconus. We noticed an improvement of the refractive error in all of our patients.

 

12 条,共 18

标题: Continuous intracorneal ring implantation for keratoconus using a femtosecond laser 

作者: Jabbarvand, M (Jabbarvand, Mahmoud); SalamatRad, A (SalamatRad, Ahmad); Hashemian, H (Hashemian, Hesam); Mazloumi, M (Mazloumi, Mehdi); Khodaparast, M (Khodaparast, Mehdi)

来源出版物: JOURNAL OF CATARACT AND REFRACTIVE SURGERY  : 39  : 7  : 1081-1087  DOI: 10.1016/j.jcrs.2013.02.054  出版年: JUL 2013  

Web of Science 核心合集中的 "被引频次": 12 

被引频次合计: 15 

摘要: PURPOSE: To assess the clinical outcomes after continuous intracorneal ring (ICR) implantation for the management of keratoconus using femtosecond laser technology.

SETTING: Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.

DESIGN: Prospective nonrandomized consecutive case series.

METHODS: All patients presented with reduced visual acuity, contact lens intolerance, and a central corneal thickness of more than 360 mu m. A Myoring ICR was inserted in an intrastromal pocket created by a femtosecond laser. The visual, refractive, aberrometric, and corneal biomechanical outcomes were measured preoperatively as well as 1, 3, and 6 months and 1 year postoperatively.

RESULTS: The study comprised 98 keratoconic eyes of 98 patients with a mean age of 30.7 years +/- 9.01 (SD). Fifteen eyes (15.3%) had grade I keratoconus, 37 eyes (37.7%) had grade II keratoconus, 24 eyes (24.5%) had grade III keratoconus, and 22 eyes (22.4%) had grade IV keratoconus. The uncorrected and corrected distance visual acuities and spherical and cylindrical errors improved 1 month after surgery (P<.001); however, no changes were detected thereafter (P>.05). The mean keratometry and corneal astigmatism decreased 1 month after surgery (P<.001); however, no significant change was observed at the 3-month or 1-year visits compared with the 1-month values (P>.05). Primary coma decreased significantly (P=.03), and spherical aberrations increased significantly (P<.001) postoperatively.

CONCLUSION: Continuous ICR implantation in keratoconus appears to be an acceptable substitute for keratoplasty in advanced keratoconus. (C) 2013 ASCRS and ESCRS

 

13 条,共 18

标题: Intacs Followed by MyoRing Implantation in Severe Keratoconus 

作者: Behrouz, MJ (Behrouz, Mahmoud Jabbarvand); Hashemian, H (Hashemian, Hesam); Khodaparast, M (Khodaparast, Mehdi); Rad, AS (Rad, Ahmad Salamat); Shadravan, M (Shadravan, Mahla)

来源出版物: JOURNAL OF REFRACTIVE SURGERY  : 29  : 5  : 364-366  DOI: 10.3928/1081597X-20130313-01  出版年: MAY 2013  

Web of Science 核心合集中的 "被引频次": 1 

被引频次合计: 1 

摘要: PURPOSE: To describe the outcome of complete intrastromal ring (MyoRing, DIOPTEX GmBH, Linz, Austria) implantation following intrastromal corneal ring segment (Intacs, Addition Technology, Inc., Sunnyvale, CA) implantation for severe keratoconus.

METHODS: Case report.

RESULTS: A MyoRing was implanted in a keratoconic patient who had undergone a previous Intacs implantation surgery 4 years previously without Intacs explantation and had residual refractive error. There were no intraoperative or postoperative complications. After 1 year; mean keratometric power decreased from 50.3 to 43.6 diopters, uncorrected distance visual acuity improved from 20/400 to 20/50, and corrected distance visual acuity improved from 20/200 to 20/30.

CONCLUSIONS: In selected severe keratoconus cases with high myopia and steep keratometry previously treated with Intacs implantation, if significant residual refractive error is observed, secondary implantation of MyoRing over Intacs may improve vision and refraction.

 

14 条,共 18

标题: Continuous Corneal Intrastromal Ring Implantation for Treatment of Keratoconus in an Iranian Population 

作者: Jabbarvand, M (Jabbarvand, Mahmoud); Salamatrad, A (Salamatrad, Ahmad); Hashemian, H (Hashemian, Hesam); Khodaparast, M (Khodaparast, Mehdi)

来源出版物: AMERICAN JOURNAL OF OPHTHALMOLOGY  : 155  : 5  : 837-842  DOI: 10.1016/j.ajo.2012.11.015  出版年: MAY 2013  

Web of Science 核心合集中的 "被引频次": 15 

被引频次合计: 16 

摘要: PURPOSE: To evaluate the effect of mechanical implantation of a continuous intrastromal ring in keratoconus.

DESIGN: Prospective, interventional, nonrandomized, case series.

METHODS: The MyoRing (Dioptex GmbH) was implanted after creation of an intrastromal pocket for 95 eyes of 95 patients with moderate and advanced keratoconus. All patients had at least 12 months of follow-up. Preoperative and postoperative visual acuity, keratometry, aberrometry, and refraction were the main outcome measures of the study.

RESULTS: A significant improvement in uncorrected and corrected distance visual acuity was observed 1 month after surgery, which was consistent with the significant reduction in sphere (5.74 diopters [D]) and cylinder (3.02 D). No significant changes were detected in these parameters afterward. Furthermore, a significant corneal flattening of a mean value of 9.78 D was found. Both spherical myopia and astigmatism underwent reduction, but the reduction in myopia was more remarkable than astigmatism. Higher-order aberrations and coma-like aberrations decreased significantly, but spherical aberrations increased after surgery. No significant change in central corneal thickness was observed at any point after operation. There were no significant differences between 2 keratometry groups (higher or lower than 53 D) in visual gain after the procedure. There were no major complications during or after surgery. MyoRing explantation was performed in 4 eyes (4%). The refraction, visual acuity, and corneal topography returned to the preoperative status 1 month later for all 4 eyes.

CONCLUSIONS: MyoRing implantation has an acceptable efficacy profile in moderate and advanced keratoconus. (Am J Ophthalmol 2013;155:837-842. (C) 2013 by Elsevier Inc. All rights reserved.)

 

15 条,共 18

标题: Clinical Outcomes After Complete Ring Implantation in Corneal Ectasia Using the Femtosecond Technology A Pilot Study 

作者: Alio, JL (Alio, Jorge L.); Pinero, DP (Pinero, David P.); Daxer, A (Daxer, Albert)

来源出版物: OPHTHALMOLOGY  : 118  : 7  : 1282-1290  DOI: 10.1016/j.ophtha.2010.12.012  出版年: JUL 2011  

Web of Science 核心合集中的 "被引频次": 22 

被引频次合计: 22 

摘要: Purpose: To evaluate the clinical outcomes after implantation of the MyoRing (DIOPTEX GmBH, Linz, Austria) by means of femtosecond laser technology in eyes with corneal ectasia.

Design: Retrospective, consecutive, nonrandomized, case series.

Participants: A total of 12 eyes of 11 patients with ages ranging from 17 to 50 years were included. All cases were diagnosed with corneal ectasia according to the standard criteria: 1 case of post-LASIK ectasia and 11 cases of keratoconus. All cases presented with reduced best spectacle-corrected visual acuity, contact lens intolerance or discomfort, and central corneal thickness of more than 350 mu m.

Methods: MyoRing inserts of 280 mu m in thickness and 5 mm in diameter were implanted in all cases into an intrastromal corneal pocket created by means of femtosecond technology. Visual, refractive, corneal topography, and pachymetric changes were evaluated during a 6-month follow-up. In addition, corneal biomechanical changes were evaluated by means of the Ocular Response Analyzer (Reichert, Buffalo, NY).

Main Outcome Measures: Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction, keratometry, corneal asphericity, corneal higher-order aberrations, pachymetry, corneal hysteresis (CH), and corneal resistance factor (CRF).

Results: A significant improvement in UDVA was observed 1 week after surgery (P = 0.001), which was consistent with the significant reduction in sphere (P = 0.002) and cylinder (P = 0.004). No significant changes were detected in these parameters afterward (P >= 0.263). Furthermore, a significant corneal flattening of a mean value of 8.03 diopters (D) was found (P = 0.005). This keratometric change was correlated with the magnitude of corneal coma-like aberrations (r = 0.830, P = 0.003) and the CRF (r = -0.782, P = 0.008). In regard to aberrometry, a statistically significant increase in primary spherical aberration was found 1 month after surgery (P = 0.001). In addition, a significant reduction in higher-order corneal aberrations was found 3 to 6 months after surgery (P = 0.027). Significant corneal thickening was also observed postoperatively in the central, nasal, and temporal areas (P <= 0.013). No statistically significant changes were detected (P >= 0.176) in corneal biomechanics. Explantation was performed in a very advanced keratoconus because of the extremely poor visual outcome.

Conclusions: MyoRing implantation using femtosecond technology in keratoconus allows successful corneal modeling, although the use of large diameters is advisable.

 

16 条,共 18

标题: Corneal Crosslinking and Visual Rehabilitation in Keratoconus in One Session Without Epithelial Debridement: New Technique 

作者: Daxer, A (Daxer, Albert); Mahmoud, HA (Mahmoud, Haifa A.); Venkateswaran, RS (Venkateswaran, R. S.)

来源出版物: CORNEA  : 29  : 10  : 1176-1179  DOI: 10.1097/ICO.0b013e3181d2c644  出版年: OCT 2010  

Web of Science 核心合集中的 "被引频次": 15 

被引频次合计: 15 

摘要: A new surgical technique for the treatment of keratoconus is presented. This technique combines a new corneal crosslinking method with implantation of a flexible full-ring implant into a "closed'' corneal pocket via a narrow incision tunnel in 1 surgical session. Riboflavin is not applied in the form of eyedrops onto a corneal surface after epithelial removal but is instilled into the corneal pocket without the need for epithelial debridement. A case of advanced keratoconus treated in this manner is presented. Uncorrected visual acuity increased by 7 lines from 0.05 to 0.25, and the average central K reading decreased by 11 diopters. The haze seen during the early postoperative period diminished in the first month after surgery.

 

17 条,共 18

标题: Intracorneal continuous ring implantation for keratoconus: One-year follow-up 

作者: Daxer, A (Daxer, Albert); Mahmoud, H (Mahmoud, Haifa); Venkateswaran, RS (Venkateswaran, Rengaswamy Srinivasan)

来源出版物: JOURNAL OF CATARACT AND REFRACTIVE SURGERY  : 36  : 8  : 1296-1302  DOI: 10.1016/j.jcrs.2010.03.039  出版年: AUG 2010  

Web of Science 核心合集中的 "被引频次": 18 

被引频次合计: 22 

摘要: PURPOSE: To evaluate intracorneal continuous ring (ICCR) implantation for the treatment of keratoconus.

SETTING: Eye specialist centers, Europe and Middle East.

METHOD: This study assessed the results of implantation of a MyoRing ICCR in 15 eyes with keratoconus. Outcome measures included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA) (spectacle correction), refraction, complications, and side effects. Postoperative follow-up was up to 1 year.

RESULTS: The study evaluated 15 eyes of 11 patients (8 men, 3 women) with a mean age of 35 years +/- 12 (SD) (range 22 to 60 years). Preoperatively, the mean central corneal thickness was 435 +/- 41 mu m (range from 350 to 485 mu m) and the mean keratometry (K) readings, 48.96 +/- 3.4 diopters (D) (range 43.75 to 56.62 D). Postoperatively, there was a statistically significant improvement in the UDVA, CDVA, K readings, manifest spherical and cylindrical refractive errors, and spherical equivalent (P<.05). The mean UDVA improved by almost 10 lines, from 0.07 (1.24 +/- 0.35 logMAR) to 0.56 (0.27 +/- 0.17 logMAR), and the mean CDVA improved by almost 3 lines, from 0.42 (0.40 +/- 0.17 logMAR) to 0.77 (0.12 +/- 0.10 logMAR). The mean K reading decreased by 5.76 D, from 48.96 D to 43.20 D. No serious intraoperative complications occurred. Side effects included glare and night-vision problems.

CONCLUSIONS: Treatment of keratoconus with ICCR implantation significantly improved visual function. The nomogram requires grading the disease using the K readings only. The UDVA and CDVA also improved during the first postoperative year.

 

18 条,共 18

标题: CISIS: reversible treatment of high myopia and keratoconus 

作者: Daxer, A (Daxer, A.)

来源出版物: SPEKTRUM DER AUGENHEILKUNDE  : 23  : 1  : 39-41  DOI: 10.1007/s00717-009-0305-1  出版年: MAR 2009  

Web of Science 核心合集中的 "被引频次": 3 

被引频次合计: 3 

摘要: A new Corneal intrastromal implantation system (CISIS) for the treatment of high myopia and keratoconus is presented. Myopia beyond 10 diopters and even advanced cases of keratoconus can be treated. The system consists of a particular microkeratome (PocketMaker) for the creation of an almost closed intracorneal pocket, and the flexible full-ring implant (MyoRing) to be inserted into the corneal pocket via a small incission tunnel. The mechanism of action is increasing the central corneal curvature and regularisation of the central corneal surface by addition of volume to the corneal periphery. The procedure is quick and easy to perform.




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