ABSTRACT
PURPOSE: To evaluate the outcomes of femtosecond laser-assisted implantation of a 355-degree intracorneal ring (ICR) (Keraring) in patients with keratoconus in the three-year follow-up. SETTING: Future Femtolaser Center, Sohag, Egypt. DESIGN: Prospective interventional case series. PATIENTS AND METHODS: A prospective case series of 38 eyes of 26 patients with keratoconus had implantation of the 355-degree ICR keraring after tunnel creation with a femtosecond laser. The uncorrected visual acuities (UCVA) and best-corrected visual acuities (BCVA), sphere, cylinder, and manifest refraction spherical equivalent (SE), and mean keratometry (K), K max, and K min were evaluated preoperatively and 3, 6, 12, 24, and 36 months postoperatively, and all complications were reported. RESULTS: 38 eyes of 26 patients with mean age 25.92 ± 5.44 years were enrolled in the study, 11 were males (42.3%). The mean UCVA improved from 0.93 ± 0.21 to 0.63 ± 0.21 logMAR (P ≤ 0.001) and the mean BCVA from 0.67 ± 0.22 to 0.43 ± 0.26 logMAR (P < 0.001). The mean sphere, cylinder, and spherical equivalent have been changed dramatically from preoperative to 3 month postoperative, which is statistically significant (P ≤ 0.001), and the changes between 1 and 2 years and 2 and 3 years are also considerable and statistically significant; the K max and K min and K mean improved and the changes were statistically significant (P ≤ 0.001), and the changes between one, two, and three years were also statistically significant. The safety and efficacy indices were changed through the three-year follow-up. The complications were corneal neovascularization (36.84%), corneal melting (26.3%), and ring extrusion (31.5%) at the end of the study. CONCLUSIONS: Implantation of a 355-degree intracorneal keraring using femtosecond laser improved the visual, refractive, and topographic parameters in keratoconus patients, with a high rate of ICR extrusion and instability. The study has been registered for the Pan African Clinical Trial Registry (http://www.pactr.org) database within No: PACTR201810796878908 on 29 October 2018.
ABSTRACT
PURPOSE: To evaluate the corneal endothelial cell density and morphology in normal Egyptian eyes. METHODS: In total, 568 healthy eyes of 568 Egyptian volunteers aged 20 to 85 years were examined using noncontact specular microscopy for the central corneal thickness (CCT), mean endothelial cell density (MCD), coefficient of variation (CV) in cell area, mean cell area (MCA), and hexagonal cell (Hex) percentage. Variables were compared between sexes and between different age groups. RESULTS: The mean CCT, MCD, and MCA were 514.45 ± 43.04 µm, 2647.50 ± 382.62 cells/mm2, and 390.59 ± 149.94 µm2, respectively. MCD and MCA showed no significant differences between men and women (P=0.171 and 0.099, respectively), whereas CV (%) and Hex (%) showed significant differences (P=0.024 and 0.015, respectively). CCT (P=0.007, r = -0.113) and MCD (P < 0.001, r = -0.357) exhibited a significant negative correlation with age, whereas CV (%) (P < 0.001, r = 0.341) and MCA (P=0.008, r = 0.111) exhibited a significant positive correlation. The mean rate of endothelial cell loss from 20 to 85 years of age was 0.3% per year. CONCLUSIONS: Our results provide normative data for the corneal endothelium in healthy Egyptian eyes, thus increasing the knowledge base for corneal endothelial cell parameters in healthy Egyptian eyes. Furthermore, our findings can be used as baseline values for comparisons between Egyptian and other populations and for studies of the endothelial cell reserve and capacity for intraocular surgery and corneal transplantation.
