Indications and visual outcomes of intrastromal corneal ring segment implantation in a large patient series

To describe the indications for and visual outcomes of intrastromal corneal ring segment implantation. A large retrospective case-series chart-review study was conducted using Sorocaba Ophthalmological Hospital medical records. This study included 1222 eyes (1196 patients) that were surgically treat...

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Bibliographic Details
Published in:	Clinics (São Paulo, Brazil) Vol. 72; no. 6; pp. 370 - 377
Main Authors:	Tognon, Taíse, Campos, Mauro, Wengrzynovski, João Paulo, Barella, Kleyton Arlindo, Pasqualotti, Adriano, de Brito Martins, Luiz Antônio, dos Santos Forseto, Adriana, de Sousa, Luciene Barbosa
Format:	Journal Article
Language:	English
Published:	Brazil Elsevier España, S.L.U 01-06-2017 Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo Faculdade de Medicina / USP Elsevier España
Subjects:	Adolescent Adult Aged Aged, 80 and over Astigmatism - surgery Brazil Clinical Science Cornea Corneal Edema - surgery Corneal Stroma - pathology Corneal Stroma - surgery Ectasia Epidemiology Female Humans Keratoconus - surgery Male MEDICINE, GENERAL & INTERNAL Middle Aged Ophthalmologic Surgical Procedure Prostheses and Implants Prosthesis Implantation Retrospective Studies Severity of Illness Index Treatment Outcome Visual Acuity Young Adult Brazil Cornea Ophthalmologic Surgical Procedure Epidemiology Ectasia
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Summary:	To describe the indications for and visual outcomes of intrastromal corneal ring segment implantation. A large retrospective case-series chart-review study was conducted using Sorocaba Ophthalmological Hospital medical records. This study included 1222 eyes (1196 patients) that were surgically treated between November 2009 and December 2012. The following preoperative data were collected: age, gender, type of medical care and funding source, surgical technique, best-corrected visual acuity, manifest sphere and cylinder refractive error, maximum and minimum central keratometry, and pachymetry measurements of the cornea at the thinnest point and at the ring channel. The postoperative best-corrected visual acuity and patient satisfaction were also determined. The cases were classified into six groups: four keratoconus groups (severe, advanced, moderate and mild), a pellucid marginal degeneration group and a post-graft irregular astigmatism group. This study was approved by the Brazilian Registry of Clinical Trials (UTN number 1111-1182-6181, TRIAL RBR-6S72RF). The age (mean±standard deviation) of the patients was 31.0±10.0 years. The most prevalent pathology was keratoconus (1147 eyes, 93.8%). A correlation was found between ectasia severity and medical assistance (p<0.001), and the most serious cases was treated by the Brazilian public health system. No complications were found in a total of 1155 surgeries, and after surgery, 959 patients were satisfied. Among the 164 dissatisfied patients, the majority failed to show improved best-corrected visual acuity. Patients in the public health system underwent surgical intervention for keratoconus later than those with private sources of funding. In the vast majority of operated cases, the patients reported improvements in vision.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1807-5932 1980-5322 1980-5322
DOI:	10.6061/clinics/2017(06)07