Assessment of Epithelial Thickness in Keratoconic Patients Before and After Intracorneal Ring Segment Implantation Using Anterior Segment Optical Coherence Tomography

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
R F Mohamed ◽  
R M F Elghazawy ◽  
S M Fawzy ◽  
T A Badran
Keyword(s):  
Visual Acuity ◽  
Anterior Segment ◽  
Case Series ◽  
Treatment Modalities ◽  
Ophthalmological Examination ◽  
Epithelial Thickness ◽  
Case Series Study ◽  
Before And After ◽  
Ring Segment ◽  
Intracorneal Ring Segment

Abstract Background Keratoconus, the most common primary corneal ectasia, is a bilateral asymmetric corneal degeneration accompanied with local corneal thinning and occurs mostly in the inferior and central part of the cornea, it usually causes high myopia and irregular astigmatism which results in poor quality of vision. Based on disease severity, many treatment modalities exist including glasses and contact lenses for mild to moderate disease, while corneal graft preserved for more advanced disease. In advent of alternative treatments, intrastromal ring implantation have been introduced which improves visual acuity and optical aberrations and also corrects refractive errors and mean keratometric data, anterior segment Optical cohehernce Tomography epithelial mapping is anew modality to assess epithelial thickness. Objective: To investigate epithelial thickness changes in keratoconic patients before and after intracorneal ring segment implantation using AS OCT. Methods: Thirty eyes with early to moderate keratoconus were included in this prospective interventional case series study which has been conducted at patients from Ain shams university hospitals, after the approval of the research ethical committee in the Faculty of Medicine, Ain Shams University between March to October. All cases underwent a Complete ophthalmological examination before surgery. the examination included Visual acuity assessment and Best corrected visual acuity. Slit Lamp Biomicroscopy examination with fundus examination through dilated pupil using D lens & Corneal Topography, Anterior segment Optical cohehernce Tomography Epithelial mapping(zeiss). Results: we found that epithelial thickness showing statistically significant change comparing pre and post operative epithelial mapping especially in certain areas in the map,area ( _ ),( _ )  mm. Conclusion: There is increase in epithelium thickness in keratoconic corneas after intracorneal ring segment implantation to compensate for stromal irregularities in patients with keratoconus.

scholarly journals Anatomical and Visual Effects of Implantable Phakic Contact Lens on Correction of Myopia

2022 ◽  
Author(s):  
Mahmoud Ekram ◽  
Ahmed Mohamed Kamal Elshafei ◽  
Asmaa Anwar Mohamed ◽  
Mohamed Farouk Sayed Othman Abdelkader
Keyword(s):  
Visual Acuity ◽  
Anterior Chamber ◽  
Contact Lens ◽  
Anterior Segment ◽  
Anterior Chamber Depth ◽  
Case Series ◽  
Care Group ◽  
Case Series Study ◽  
Significant Difference ◽  
The Mean

Abstract Purpose: To evaluate the anatomical effects of implantable phakic contact lens (IPCL) (Care Group, India) on anterior segment and its visual outcomes .Patients and methods: In a prospective interventional case series study, 60 highly myopic eyes of 32 patients were subjected to IPCL implantation in the Ophthalmology Department of Minia University Hospital, Egypt from January 2019 to June 2021. All patients had complete ophthalmic examination and were followed up for 1 year. Pentacam was used for preoperative and postoperative estimation of anterior chamber depth (ACD), anterior chamber angle (ACA), anterior chamber volume (ACV) and IPCL vault in the 1st, 3rd, and 12th months. Assessment of corneal endothelium was done using specular microscope preoperatively and after 12 months. Preoperative and postoperative refraction and visual acuity were measured. Results: There was a statistically significant decrease in ACD, ACA, and ACV. There was no significant difference between preoperative and postoperative mean intraocular pressure (IOP) by the 12th month (P=0.163). The mean preoperative endothelial cell count (ECD) was significantly reduced from 2929.3±248 cells/mm2 to 2737.9±303 cells/mm2 at the 12th month (P<0.001). with a statistically highly significant improvement of mean Log Mar uncorrected visual acuity (UCVA) from 1.48±0.19 preoperatively to 0.46±0.11 by the end of follow up (P<0.001) with insignificant difference between preoperative best corrected visual acuity (BCVA) and postoperative UCVA (P=0.209). In the 12th month, the mean vault was 240±540 μm. No sight threatening complications occurred.Conclusion: Although IPCL induced anatomical changes, it was safe and effective for correction of high myopia.

Unilateral Ectasia characterized by Advanced Diagnostic Tests

2016 ◽  
Vol 5 (1) ◽  
pp. 40-51 ◽  
Author(s):  
Bernardo Lopes ◽  
Marcella Q Salomão ◽  
Isaac C Ramos ◽  
Fernando Faria-Correia
Keyword(s):  
Visual Acuity ◽  
Femtosecond Laser ◽  
Diagnostic Tests ◽  
Diagnostic Methods ◽  
Distance Visual Acuity ◽  
Epithelial Thickness ◽  
Ring Segment ◽  
Intracorneal Ring Segment ◽  
The Right

ABSTRACT To describe a case of very asymmetric ectasia successfully treated by femtosecond laser-assisted intracorneal ring segment implantation, in which the diagnosis of unilateral ectasia in the right eye was based on the clinical findings including history, follow-up, and advanced diagnostic data. The patient's history was positive for ocular allergy with moderate- to-intense eye rubbing only in the right eye. The uncorrected distance visual acuity was 20/63 in the right eye and 20/32 in the left eye. The corrected distance visual acuity (CDVA) was 20/40 in the right eye (-1.75-4.00 × 35°) and 20/16 in the left eye (-0.50-0.25 × 115°). After femtosecond laser-assisted intracorneal ring segment implantation, the right eye improved CDVA to 20/20-1. Concerning ectasia/keratoconus diagnosis, the left eye remained stable over 1 year of follow-up with unremarkable topometric, tomographic, and biomechanical findings. Epithelial thickness mapping by spectral domain optical coherence tomography and very-high-frequency digital ultrasound demonstrated epithelial thickness within normal limits in the left eye. Advanced diagnostic methods along with clinical data enable the distinction from unilateral ectasia cases and subclinical (fruste) keratoconus. Literature review is also performed along with case presentation and discussion. How to cite this article Ramos IC, Reinstein DZ, Archer TJ, Gobbe M, Salomão MQ, Lopes B, Luz A, Faria-Correia F, Gatinel D, Belin MW, Ambrósio R Jr. Unilateral Ectasia characterized by Advanced Diagnostic Tests. Int J Kerat Ect Cor Dis 2016;5(1):40-51.

scholarly journals Pre-Descemetic Placement of Intracorneal Ring Segments for Keratoconus after Mechanical Implantation

2021 ◽  
pp. 940-943
Author(s):  
Faady Yahya ◽  
Christian F. Prünte ◽  
Hendrik P.N. Scholl ◽  
Zisis Gatzioufas
Keyword(s):  
Visual Acuity ◽  
High Resolution ◽  
Femtosecond Laser ◽  
Anterior Segment ◽  
Slit Lamp ◽  
Anterior Segment Oct ◽  
Ring Segment ◽  
Intracorneal Ring Segment

We report the case of a 23-year-old male who was referred to our clinic for a routine follow-up examination. The patient was treated for keratoconus 3 years ago in Colombia, where intracorneal ring segments were implanted mechanically in both eyes to improve his visual acuity. Surprisingly, we discovered a pre-descemetic placement of intracorneal ring segments, which could lead to potential complications, under circumstances. We illustrate this impressive finding with slit-lamp photography and high-resolution anterior segment OCT and advocate for the use of femtosecond laser as the method of choice for intracorneal ring segment insertion in order to provide maximal precision and safety.

scholarly journals Safety and effectiveness of intrastromal corneal ring segment implantation at Al-Dharan Eye Specialist Hospital, Al-Dharan, Saudi Arabia

2019 ◽  
Vol 6 (4) ◽  
pp. 1295
Author(s):  
Abdulaziz Alaqsam ◽  
Mohanna AL-Jindan ◽  
Ammar Almahmod ◽  
Ibrahim Gosadi
Keyword(s):  
Visual Acuity ◽  
Saudi Arabia ◽  
Case Series ◽  
Applanation Tonometry ◽  
Retrospective Case ◽  
Intrastromal Corneal Ring ◽  
Case Series Study ◽  
Ring Segment ◽  
The Mean ◽  
One Year

Background: Intrastromal corneal ring segment (ICRS) implantation is one of the treatment options of keratoconus. This study is aiming to evaluate safety and effectivness of ICRS implantation at Al-Dharan Eye Specialist Hospital.Methods: This study is a descriptive retrospective case series study. The target population of this study is patients diagnosed with corneal ectasia who underwent ICRS implantation in Al-Dharan Eye Specialist Hospital, Al-Dharan, Saudi Arabia. Preoperative and postoperative data about uncorrected visual acuity (UCVA), best spectacle–corrected visual acuity (BSCVA), manifest refraction, keratometry, applanation tonometry, corneal topography, and slit-lamp biomicroscopy and indirect ophthalmoscopy were retrieved from medical records of department of Medical Archive. Paired students t-test was used to compare preoperative and postoperative means of study variables.Results: The total number of recruited patients in this study was 57 patients where 62% of them were males. Sixty-six treated eyes were included in this study where no intra-operative complications were recorded. Upon comparing the mean preoperative data to the mean postoperative data at three months, six months and one year intervals, an overall improvement in the measured outcomes was witnessed. UCVA, BSCVA, and keratometric readings exhibited a statistically significant improvement when comparing preoperative with one-year postoperative findings (p<0.001).Conclusions: The findings of this study indicate that ICRS implantation is a safe and effective treatment for keratoconus.

Visual outcomes in advanced keratoconus using different strategies: Scleral lens, intracorneal ring segment and lamellar keratoplasty

2021 ◽  
pp. 112067212199473
Author(s):  
Guilherme Rocha ◽  
Bruna Viana Vieira ◽  
Bárbara Mírian Silva Mendes ◽  
Camila Ishii Iguma ◽  
Thairis Cássia Santana Silva ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Case Series ◽  
Lamellar Keratoplasty ◽  
Retrospective Case ◽  
Visual Outcomes ◽  
Significant Difference ◽  
Ring Segment ◽  
Intracorneal Ring Segment ◽  
Better Than

Purpose: To compare VA outcomes in patients with advanced keratoconus wearing SCL or after ICRS or DALK. In addition, determine the percentage of complimentary treatments after ICRS and DALK, and which of these was fitting a SCL, and final visual acuity (f-VA) results. Methods: Retrospective case series analyzed 55 eyes with advanced keratoconus fitted with SCL, or after ICRS or a DALK between 2010 and 2018. The variables analyzed were sex, age, UDVA, CDVA, SEQ, K-readings, and f-VA after complimentary treatments. Results: Twenty-eight eyes underwent a DALK, 14 were fitted with a SCL, and other 13 underwent ICRS insertion. Patients after DALK and after ICRS showed statistically significant improvement in UDVA and CDVA after surgery, with no difference between these groups. Patients fitted with SCL showed statistically higher CDVA improvement when compared to ICRS. After DALK and ICRS, respectively, nine eyes (32.14%) and seven eyes (53.85%) were fitted with SCL. Comparison between f-VA with SCL in three groups showed that the best result was achieved in DALK + SCL, with statistically significant difference to only SCL. Conclusion: We showed that the CDVA of eyes fitted with SCL without any surgical treatment was statistically better than CDVA of eyes after ICRS insertion. After DALK and ICRS insertion, many patients needed a complimentary treatment to improve CDVA. The most chosen treatment was fitting a SCL. After this, all eyes showed statistically significant improvement in f-VA, with statistically better results for DALK + SCL when compared to SCL fitted in advanced keratoconus without any surgical treatment.

scholarly journals Changes in keratometry readings and Pterygium induced astigmatism after Pterygium excision

2020 ◽  
Vol 11 (2) ◽  
pp. 2673-2678
Author(s):  
Mohammed Qasim Al Nuwaini ◽  
Hyder M. AL.Talaqani ◽  
Giyathaldeen T. Neameh ◽  
Mustafa A. Al Zubaidi Md
Keyword(s):  
Visual Acuity ◽  
Anterior Segment ◽  
Case Series ◽  
Preoperative Assessment ◽  
Surgical Excision ◽  
Visual Rehabilitation ◽  
Aged People ◽  
Case Series Study ◽  
Long Time ◽  
Pterygium Excision

Pterygium can cause deterioration of vision by distortion the corneal smooth surface, and so induce astigmatism usually with the rule type, which is reversible by Pterygium excision surgery. So the aim of this study to evaluate prospectively,  the change in keratometeric readings and corneal refractive status after pterygium excision surgery, a case series study was carried out on117eyes of 117 patients with primary Pterygium. It was carried out over a period of 9 months from 1st, January 2018 to 30th. September 2018, for patients, were admitted to the departments of ophthalmology at Najaf city. All patients underwent preoperative assessment for visual acuity (using Snellen’s chart), anterior segment examination, and posterior segment examination using Slitlamp biomicroscopy with condensing lens, refraction and Keratometry using auto-refractometers. All data collected preoperatively then one month postoperatively. Data analysis and comparison then performed. The findings of this study was that Pterygium is more prevalent in males than females, as it found in (81%) of males and only (19%) in females, and more prevalent in young to middle-aged people between (30-45 years 59%), grade II (45%) are presented. This study also found that keratometric (K1, K2) readings in all grade are significantly reduced postoperatively, where preoperative mean K1 was (43.43D±0.67), that decreased to a postoperative mean of (42.95D±0.6). Astigmatism associated pterygium at all grades also showed significant improvement, where the total mean preoperative astigmatism was (1.04D ± 0.80), that became (0.36 D± 0.20) one month later. This improvement also applied on visual acuity, as most of the patient were had visual acuity between (6/12) to ( 6/18) that represent (50%), (37%) of our sample, which improves to (64%) with visual acuity of (6/6) one-month postoperatively. We conclude that  Pterygium excision, associated with significant improvement in refraction and keratometeric readings. And we suggested for eye protection should be considered, when spend long time work outdoor, like proper polarized and UV filter sunglasses, also if possible, avoid work outdoor during sunny and hot days. Surgical excision of Pterygium in early stages will result in better visual rehabilitation.

scholarly journals Intracorneal Ring Segment Implantation for the Management of Keratoconus in Children

Vision ◽  
2020 ◽  
Vol 5 (1) ◽  
pp. 1
Author(s):  
Pablo Larco ◽  
Pablo Larco ◽  
Daniel Torres ◽  
David P. Piñero
Keyword(s):  
Spherical Aberration ◽  
Case Series ◽  
Corneal Astigmatism ◽  
Corneal Surface ◽  
Case Series Study ◽  
Corrected Distance Visual Acuity ◽  
Ring Segment ◽  
Intracorneal Ring Segment ◽  
Series Study

The short-term safety and efficacy of intracorneal ring segment (ICRS) implantation in keratoconus eyes of children are investigated in this study. A retrospective interventional case series study including a total of 33 keratoconus eyes (age 8 to 17 years) that had undergone ICRS (Keraring segments, Mediphacos) implantation was conducted. Information about visual, refractive, pachymetric, corneal topographic and aberrometric, and corneal endothelial changes during a 3-month follow-up were extracted and analysed. A significant improvement was observed in logMAR corrected distance visual acuity (p = 0.005), combined with a statistically significant reduction in keratometric readings (p < 0.001). A reduction in the magnitude of corneal astigmatism of ≥1 D was observed in 52.8% of eyes. No significant changes were observed in corneal endothelial density (p = 0.317). Significant changes were found in the anterior vertical coma component (p = 0.002) as well as in the spherical aberration of the posterior corneal surface (p = 0.004). Only two relevant complications were described: one corneal microperforation with penetration of the ring segment into the anterior chamber (1 eye, 2.8%), and a case of ring extrusion (1 eye, 2.8%). ICRS implantation in children keratoconus eyes allows a reduction of corneal astigmatism, irregularity, and aberrations, leading to a significant visual improvement.

scholarly journals The Effects of Ramadan Fasting on Anterior Segment Parameters, Visual Acuity and Intraocular Pressures of the Eye

2017 ◽  
Vol 11 (1) ◽  
pp. 152-155 ◽  
Author(s):  
Ozlem Barut Selver ◽  
Melis Palamar ◽  
Kevser Gerceker ◽  
Sait Egrilmez ◽  
Ayse Yagci
Keyword(s):  
Visual Acuity ◽  
Anterior Chamber ◽  
Corneal Thickness ◽  
Anterior Segment ◽  
Anterior Chamber Depth ◽  
Ophthalmological Examination ◽  
Significant Difference ◽  
Before And After ◽  
Group 2 ◽  
Group 1

Objective: It is aimed to determine whether fasting during Ramadan has any significant effect on anterior chamber parameters, visual acuity and intraocular pressures. Methods: 31 fasting (Group 1) and 30 non-fasting healthy volunteers (Group 2) were enrolled. All cases underwent an ophthalmological examination and anterior segment parameter evaluation (central corneal thickness (CCT), anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA), pupil size) with Pentacam before and after the breaking of the Ramadan fast in Group 1, before and after dinner in Group 2. Results: The mean age was 43.35 ± 13.20 in Group 1, 43.17 ± 12.90 in Group 2 (p= 0.955). No significant difference was detected in any of the parameters in both groups. Conclusion: There is a need for more detailed and associated studies to understand better about the influence of Ramadan fast on various ocular parameters.

Evaluating Vitality and Periodontal Sensitivity of Teeth Adjacent to the Site of Open Sinus Lift Surgery before and after Treatment: A Case Series Study

2020 ◽  
Vol 30 (2) ◽  
pp. 77-81
Author(s):  
Amir Moeintaghavi ◽  
Negar Azami ◽  
Mohammad Sadegh Zohrevand ◽  
Farid Shiezadeh ◽  
Hamid Jafarzadeh ◽  
...  
Keyword(s):  
Case Series ◽  
Sinus Lift ◽  
Case Series Study ◽  
Before And After ◽  
Series Study

Intracorneal circular ring implant with femtosecond laser: Pocket versus tunnel

2021 ◽  
pp. 112067212199472
Author(s):  
Luis Izquierdo ◽  
Ana M Rodríguez ◽  
Ramón A Sarquis ◽  
Diego Altamirano ◽  
Maria A Henriquez
Keyword(s):  
Visual Acuity ◽  
Femtosecond Laser ◽  
Randomized Study ◽  
Circular Ring ◽  
Continuous Ring ◽  
Refractive Outcomes ◽  
Scheimpflug Imaging ◽  
Ring Segment ◽  
Intracorneal Ring Segment ◽  
Student’S T

Purpose: To evaluate and compare visual and refractive outcomes after implantation of the intracorneal continuous ring 360° arc (ICCR) versus the intracorneal ring segment 340° arc (ICRS) using femtosecond laser for central keratoconus. Setting: Research Department, Oftalmosalud, Instituto de Ojos, Lima, Peru. Methods: Randomized study that included 40 eyes of 32 patients diagnosed with central keratoconus between November 2014 and March 2015. Twenty eyes had an implantation of ICCR (MyoRing, Dioptex GmbH, Austria) through an intrastromal pocket and 20 eyes had an implantation of ICRS (Keraring, Mediphacos, Brazil) through an intrastromal tunnel. Both procedures were performed with a femtosecond laser (LDV Z6 model, Ziemer Ophthalmic Systems AG). Visual acuity (VA), refraction, and Scheimpflug imaging analysis were performed pre- and postoperatively at 1 month and 1 year. Comparisons of means were performed using the Student’s t-test. Results: At 1 year, uncorrected VA improved 0.77 LogMAR ( p < 0.001) in the ICCR group and 0.79 LogMAR ( p = 0.01) in the ICRS group; mean sphere improvement was 5.13 Diopters (D) in the ICCR group and 6.27 D in the ICRS group ( p < 0.001 both); mean Steeper Keratometry improvement was 4.24 D in the ICCR group and 5.53 D in the ICRS group ( p < 0.001 both). In the ICCR group, mean decrease in the pachymetry at the thinnest point of the cornea was 32.16 µm ( p = 0.01), and in the ICRS group, mean increase was 4.2 µm at 1 year ( p = 0.61). Conclusion: Intracorneal continuous ring 360° arc (ICCR) and intracorneal ring segment 340° (ICRS) are effective treatments for central keratoconus. No significant differences between rings were found on visual acuity, refraction, and keratometry improvement.

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