ABSTRACT
To assess the efficacy of intrastromal rings for management of keratoconus [KCN]. This prospective non comparative case series includes 14 eyes of 11 contact lens intolerant patients with KCN. Corneal thickness of at least 450 micro at the site of segment insertion was required for enrollment. Uncorrected visual acuity [UCVA], best corrected visual acuity [BCVA], refraction, pachymetry, endothelial cell count and anterior chamber depth were measured pre and post operatively. Fourteen eyes of 11 patients [7 male and 4 female] with mean age of 32 years [21-40] were operated and followed 3 to 8 months [mean 6.1 months]. UCVA increased from 0.76 +/- 0.40 LogMAR preoperatively to 0.45 +/- 0.30 post operatively and BCVA from 0.29 +/- 0.10 to 0.23 +/- 0.20 [P=0.001]. Mean preoperative spherical equivalent was -4.19 +/- 1.70 D which decreased to -2.10 +/- 2.30 D post-operatively. Mean pre and post operative keratometry was 48.64 +/- 3.1 and severe vascularization in 2. Lipoid deposition occurred in the tunnel in 4 eyes [29%] and one broken segment was noticed 3 days after the operation. INTACS are effective for the treatment of mild moderate KCN, however it cannot be an alternative to deep lamellar keratoplasty or penetrating keratoplasty
ABSTRACT
Purpose: to evaluate the predictability, efficacy, and safety of iris-claw Artisan[TM]phakic intraocular lenses for myopia
Methods: through a prospective clinical study, 35 eyes of 21 patients with myopia from -5 to 26.5 diopters underwent implantation of the Artisan lens. Patients were examined 1, 3, and 7 days [all eyes]; 1 month [28 eyes], 3 months [29 eyes], and 6 months [32 eyes] after the procedure. A thorough ophthalmic examination including endothelial cell count, pachymetry, and topography was performed before and after the operation
Results: mean age of the patients was 31.6 years [range, 18-43]. Mean spherical equivalent [SE] changed from -15.71 +/- 4.90 diopters [D] before surgery to -0.65 +/- 0.94 D at 1 month, -0.58 +/- 1.10 D at 3 months, and -0.56 +/- 0.89 D 6 months after surgery. At 6 months, 15 eyes [46.9%] had uncorrected visual acuity of 20/40 or better and 23 eyes [71.9%] had SE within +/- 1.00 D of emmetropia. Two eyes lost 1 line and two eyes lost 2 lines of best-corrected visual acuity [BCVA], no eye lost more than 3 lines. Twenty-one eyes [65.6%] gained one to three lines of BCVA. Mean endothelial cell count changed from 2889 at baseline to 2823 at three months [P= 0.002]. There was no significant change in corneal pachymetry. Sterile endophthalmitis was seen in 4 eyes 1.5 months postoperatively which was treated successfully by corticosteroid therapy. No angle closure glaucoma or ocular hypertension was seen at postoperative visits
Conclusion: implantation of Artisan phakic lens was found to be predictable and efficient for correction of myopia. Its effect on corneal endothelium should be considered and more investigations are recommended