RESUMO
PURPOSE: to compare five-year outcomes of two complete intracorneal implants (MyoRing versus annular-shaped intracorneal implant [AICI]) combined with accelerated corneal cross-linking (A-CXL) in progressive KCN. METHODS: In this historical cohort study, preoperative and postoperative visual, refractive, tomographic, biomechanical, and aberrometric parameters of 27 eyes of 27 patients who underwent implantation of two complete rings (13 AICI and 14 MyoRing) combined with A-CXL were recorded. RESULTS: The mean age of patients in "AICI plus A-CXL" and "MyoRing plus A-CXL" groups were 28.1 ± 4.6 and 26.3 ± 3.8 years, respectively. All pre- and postoperative visual and refractive parameters between the two groups were not significantly different (p > 0.05). Comparing pre- and postoperative tomographic measurements showed that anterior corneal surface (ACS) flat-K and corneal thickness at pachymetric apex significantly improved for MyoRing plus A-CXL group after five years (p < 0.05). On the other hand, ACS K-max and mean-K values were significantly improved for AICI plus A-CXL group after five years (p < 0.05). Both groups revealed significant improvements in ACS steep-K and corneal astigmatism (p < 0.05). Five years after surgery, the high order aberration in the AICI group (2.60 ± 0.83) was significantly better than the MyoRing group (1.70 ± 0.43) (p = 0.007). CONCLUSIONS: Both complete intrastromal rings (MyoRing or AICI) combined with A-CXL significantly Improved visual, refractive, and corneal aberrometric, biomechanical, and tomographic parameters and halt the progression of KCN with comparable long-term outcomes.
Assuntos
Ceratocone , Fotoquimioterapia , Humanos , Adulto Jovem , Adulto , Acuidade Visual , Crosslinking Corneano , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/uso terapêutico , Substância Própria/cirurgia , Estudos de Coortes , Ceratocone/diagnóstico , Ceratocone/tratamento farmacológico , Ceratocone/cirurgia , Topografia da Córnea/métodos , Seguimentos , Reagentes de Ligações Cruzadas/uso terapêutico , Riboflavina/uso terapêuticoRESUMO
AIM: To compare the anterior and posterior corneal astigmatism and total refractive astigmatism before and after MyoRing implantation in keratoconus(KCN)patients.METHODS: In this historical cohort study, the preoperative and postoperative total refractive, anterior and posterior corneal astigmatism of KCN patients implanted with a 360-degree full-ring implant(MyoRing)were compared before and after four consecutive follow-up sessions at 3, 6, 9, and 12 mo after surgery.RESULTS: The study encompassed 79 KCN patients(85 eyes), comprising 43 males and 36 females. The mean age of the patients was 29±7.41 years, ranging from 17 to 48 years. Throughout the follow-up sessions, a gradual decrease was observed in the trend of changes for total refractive astigmatism, anterior corneal astigmatism, and posterior corneal astigmatism. Postoperatively, total refractive astigmatism measurements exhibited a significant decrease of 2.09 D at 12 mo after MyoRing implantation(4.27±3.15 vs 2.18±1.63 D, P<0.001). Additionally, post-operative measurements revealed an enhancement of approximately 3.20 D and 0.59 D for anterior and posterior corneal astigmatism, respectively [6.40±1.90 vs 3.20±1.75 D for anterior corneal astigmatism(P<0.001)and 1.30±0.55 vs 0.71±0.35 D for posterior corneal astigmatism(P<0.001)].CONCLUSION: MyoRing implantation demonstrates significant improvements in astigmatism parameters, encompassing total refractive astigmatism as well as anterior and posterior corneal astigmatism.