Literature DB >> 17471342

New surgical approaches to the management of keratoconus and post-LASIK ectasia.

Bryan U Tan1, Tracy L Purcell, Luis F Torres, David J Schanzlin.   

Abstract

PURPOSE: The objective of this study is to describe the authors' results with intrastromal corneal ring segments (Intacs) and a new variation of lamellar keratoplasty, termed intralamellar keratoplasty (ILK), for the treatment of keratoconus (KCN) and post-laser-assisted in situ keratomileusis (LASIK) ectasia.
METHODS: A retrospective review of contact lens-intolerant KCN and post-LASIK ectasia cases that had surgery with either Intacs or ILK was performed. The end points were mean uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), spherical equivalent (SE), manifest and topographic cylinder, and restoration of contact lens tolerance.
RESULTS: Intacs were implanted in 13 keratoconic or post-LASIK ectasia eyes of 11 subjects. Mean UCVA improved by 1 line (range, -5 to +8); mean BCVA improved by 1 line (range, -1 to +4). Mean manifest SE was essentially unchanged. Mean manifest cylinder was reduced by 2.77 diopters (D), mean topographic cylinder was decreased by 2.29 D, and 12 of 13 eyes were successfully able to wear contact lenses. Four eyes with advanced KCN underwent ILK. Mean UCVA improved by 1 line (range, 0 to 12); mean BCVA improved by 4 lines (range, 1 to 10). Mean SE was lessened by 1.13 D. Mean manifest cylinder was reduced by 1.82 D and mean topographic cylinder by 1.14 D. Half the subjects were successfully fit with contact lenses.
CONCLUSION: Both Intacs and ILK improved mean UCVA, BCVA, and manifest and topographic astigmatism. In most cases, good contact lens fit was achieved with visual rehabilitation to levels that obviated penetrating keratoplasty.

Entities:  

Mesh:

Year:  2006        PMID: 17471342      PMCID: PMC1809910     

Source DB:  PubMed          Journal:  Trans Am Ophthalmol Soc        ISSN: 0065-9533


  23 in total

1.  Visual acuity measurements.

Authors:  Jack T Holladay
Journal:  J Cataract Refract Surg       Date:  2004-02       Impact factor: 3.351

2.  Feasibility of contact lens fitting on keratoconus patients with INTACS inserts.

Authors:  Richard L Nepomuceno; Brian S Boxer Wachler; Barry A Weissman
Journal:  Cont Lens Anterior Eye       Date:  2003-12       Impact factor: 3.077

3.  Comparison of single-segment and double-segment Intacs for keratoconus and post-LASIK ectasia.

Authors:  Munish Sharma; Brian S Boxer Wachler
Journal:  Am J Ophthalmol       Date:  2006-03-20       Impact factor: 5.258

4.  Keratoconus managed with intacs: one-year results.

Authors:  Samuel Levinger; Russell Pokroy
Journal:  Arch Ophthalmol       Date:  2005-10

5.  Central lamellar keratoplasty for optical indications.

Authors:  H K Soong; D G Katz; A A Farjo; A Sugar; R F Meyer
Journal:  Cornea       Date:  1999-05       Impact factor: 2.651

6.  Long-term graft survival after penetrating keratoplasty.

Authors:  Robert W Thompson; Marianne O Price; Patrick J Bowers; Francis W Price
Journal:  Ophthalmology       Date:  2003-07       Impact factor: 12.079

7.  Management of keratoconus with Intacs.

Authors:  Charalambos S Siganos; George D Kymionis; Nikos Kartakis; Michalis A Theodorakis; Nikos Astyrakakis; Ioannis G Pallikaris
Journal:  Am J Ophthalmol       Date:  2003-01       Impact factor: 5.258

8.  Microkeratome-assisted lamellar keratoplasty for keratoconus: stromal sandwich.

Authors:  Kamil Bilgihan; Sengül C Ozdek; Ayça Sari; Berati Hasanreisoglu
Journal:  J Cataract Refract Surg       Date:  2003-07       Impact factor: 3.351

9.  Management of corneal ectasia after laser in situ keratomileusis with INTACS.

Authors:  Charalambos S Siganos; George D Kymionis; Nikos Astyrakakis; Ioannis G Pallikaris
Journal:  J Refract Surg       Date:  2002 Jan-Feb       Impact factor: 3.573

10.  Intracorneal ring segments for iatrogenic keratectasia after laser in situ keratomileusis or photorefractive keratectomy.

Authors:  Carlo F Lovisolo; Joseph F Fleming
Journal:  J Refract Surg       Date:  2002 Sep-Oct       Impact factor: 3.573

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  4 in total

1.  Intrastromal corneal ring implants for corneal thinning disorders: an evidence-based analysis.

Authors: 
Journal:  Ont Health Technol Assess Ser       Date:  2009-04-01

2.  Collagen cross-linking with riboflavin and ultraviolet-A light in keratoconus: One-year results.

Authors:  Maria Clara Arbelaez; Maria Bernardita Sekito; Camila Vidal; Sanak Roy Choudhury
Journal:  Oman J Ophthalmol       Date:  2009-01

3.  Thirty-month results after the treatment of post-LASIK ectasia with allogenic lenticule addition and corneal cross-linking: a case report.

Authors:  Meiyan Li; Dong Yang; Feng Zhao; Tian Han; Meng Li; Xingtao Zhou; Katherine Ni
Journal:  BMC Ophthalmol       Date:  2018-11-12       Impact factor: 2.209

4.  Mini-scleral Contact Lens for Management of Poor Visual Outcomes after Intrastromal Corneal Ring Segments Implantation in Keratoconus.

Authors:  Fatemeh Alipour; Firoozeh Rahimi; Mohammad Naser Hashemian; Zahra Ajdarkosh; Ramak Roohipoor; Masoumeh Mohebi
Journal:  J Ophthalmic Vis Res       Date:  2016 Jul-Sep
  4 in total

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