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oai:docta.ucm.es:20.500.14352/120622023-08-25T22:27:06Zcom_20.500.14352_14col_20.500.14352_15

00925njm 22002777a 4500 dc Monteiro, Tiago author Mendes, José Ferreira author Faria Correira, Fernando author Franqueira, Nuno author Madrid Costa, David author Alfonso, José F. author 2018-02 Purpose: To evaluate visual, refractive, and corneal topography outcomes in eyes with keratoconus that have undergone exchange/adjustment surgery with a new intrastromal corneal ring segment (ICRS) combination after unsuccessful visual and/or refractive outcomes after primary ICRS surgery. Methods: A retrospective nonrandomized case series was conducted including consecutive eyes of patients with keratoconus that underwent ICRS adjustment after an unsuccessful visual outcome. Patients were divided into 2 groups: group 1 was made up of patients with Intacs ICRSs that were exchanged for the Ferrara ICRS type, and group 2 consisted of patients who maintained the same ICRS type after undergoing ICRS adjustment surgery (change of the arc length or thickness). Uncorrected distance visual acuity, best-corrected distance visual acuity (CDVA), keratometry, asphericity, higher-order aberrations, and corneal regularity indexes (ISV and IHD) (Pentacam HR; OCULUS) were assessed preoperatively and 12 months after each procedure. Results: Twenty-six eyes from 26 patients were included, 8 eyes in group 1 and 18 eyes in group 2. The eyes in both groups improved their CDVA values after ICRS exchange, in group 1 from 0.27 ± 0.11 preoperatively to 0.54 ± 0.17 postoperatively (P = 0.001), and in group 2 from 0.34 ± 0.22 to 0.61 ± 0.15 (P < 0.0001). In both groups, there was also a significant improvement in the refractive cylinder, topographic cylinder, and coma after ICRS adjustment (P < 0.05). Conclusions: ICRS implantation has been shown to be a reversible and adjustable surgical procedure for keratoconus treatment. Good outcomes can be obtained after ICRSs are exchanged. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved 0277-3740 10.1097/ICO.0000000000001449 https://hdl.handle.net/20.500.14352/12062 https://doi.org/10.1097/ICO.0000000000001449 https://shop.lww.com/ Adjustment of intrastromal corneal ring segments after unsuccessful implantation in keratoconic eyes