ABSTRACT
PURPOSE: To report refractive, topographic, pachymetric, tonometric, and corneal biomechanical outcomes 24 months after corneal cross-linking (CXL), followed by insertion of intrastromal corneal ring segments (ICRS) in keratoconic eyes. DESIGN: Prospective randomized clinical trial. SETTINGS: Institutional. STUDY POPULATION: Thirty-nine eyes of 31 patients, allocated into 2 groups. INTERVENTION: Patients in the CXL group underwent corneal CXL with riboflavin and ultraviolet A (UVA) light. Patients in the riboflavin eyedrops group received riboflavin 0.1% (w/v) eyedrops - 20% dextran solution for 1 month. After 3 months, all patients underwent insertion of ICRS. MAIN OUTCOME MEASURES: Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), and topography were evaluated at baseline, at 1 month and 3 months after CXL or riboflavin eyedrops, and again at 1-, 3-, 6-, 12-, and 24-month intervals after ICRS insertion. RESULTS: Mean (standard deviation [SD]) baseline UCVA and BSCVA in the CXL group and the riboflavin eyedrops group were 1.12 (0.59) and 0.84 (0.49), and 0.68 (0.43) and 0.45 (0.23), respectively; 24-month mean (SD) UCVA and BSCVA in the CXL group and the riboflavin eyedrops group were 0.79 (0.50) and 0.62 (0.28), and 0.52 (0.45) and 0.32 (0.21), respectively, with no statistically significant difference between groups (P = .70 and P = .78).There were no statistical differences between groups postoperatively at 24 months for all 3 topographic parameters, flattest-K1 (P = .81), steepest-K2 (P = .68), and average keratometry (mean power; P = .52). CONCLUSIONS: ICRS insertion, with or without prior CXL, showed no difference between groups in terms of refractive, topographic, pachymetric, tonometric, and corneal biomechanical results at 24 months.
Subject(s)
Corneal Stroma/surgery , Keratoconus/drug therapy , Keratoconus/surgery , Photosensitizing Agents/therapeutic use , Prostheses and Implants , Riboflavin/therapeutic use , Ultraviolet Rays , Adolescent , Adult , Biomechanical Phenomena , Cell Count , Collagen/metabolism , Combined Modality Therapy , Corneal Stroma/metabolism , Corneal Topography , Elasticity/physiology , Endothelium, Corneal/pathology , Female , Humans , Intraocular Pressure , Keratoconus/metabolism , Keratoconus/physiopathology , Male , Middle Aged , Prospective Studies , Prosthesis Implantation , Refraction, Ocular/physiology , Tomography, Optical Coherence , Treatment Outcome , Visual Acuity/physiology , Young AdultABSTRACT
Foi realizada uma investigaçäo por amostragem, com o objetivo de conhecer a prevalência de tracoma inflamatório em pré-escolares e escolares nos municípios de Franco da Rocha e Francisco Morato, para subsidiar a implantaçäo das açöes de controle da doença. Foram examinadas 1057 crianças selecionadas de uma amostra de escolares e pré-escolares. Os dados foram coletados através de entrevista e exame ocular externo. A prevalência total de tracoma encontrada foi de 2,5 por cento, sendo 1,5 por cento de tracoma inflamatório. Outras afecçöes oculares também foram encontradas. Apesar da prevalência encontrada ser pequena, comparada às encontradas em outras áreas endêmicas no Estado, considerou-se importante a implantaçäo do sistema de vigilância epidemiológica na área.
