Wavefront-Guided Photorefractive Keratectomy for Correction of Residual Refractive Error after Intacs Implantation in Patients with Keratoconus
Journal of Ophthalmic and Optometric Sciences,
Vol. 1 No. 4 (2017),
24 Tir 2017
,
Page 22-28
https://doi.org/10.22037/joos.v1i4.24307
Abstract
Purpose: To evaluate the efficacy of Wavefront-guided photorefractive keratectomy (PRK) for correction of residual refractive
error after intrastromal corneal ring segments (ICRS) insertion for treatment of keratoconus.
Patients and Methods: In this prospective case series five eyes of 5 keratoconus patients who had previous ICRS implantation (four Intacs TM and one Keraring), underwent Wavefront-guided PRK to correct residual refractive error.
Results: Three months postoperatively, the mean spherical equivalent (SE) improved from 2.07 ± 1.38 Diopter to - 0.87 ± 0.54 Diopter. Four out of 5 eyes were within ± 1.00 D of Plano refraction. Three eyes had UCVA of 20/30 or better (all eyes; 20/40 or better). After 6 months, the mean SE was - 0.75 ± 0.50 Diopter and all eyes were within ± 1.00 D of Plano refraction. UCVA was 20/20 in 2 eyes, 20/30 or better in 2 eyes and 20/40 in one eye. One patient lost one line of BCVA.
Conclusion: This case series showed that wavefront-guided PRK might be an effective procedure for correction of residual refractive error after ICRS insertion in keratoconus patients. Significant improvement in UCVA was seen in all cases after PRK without any complications and haze.
How to Cite
References
. Krachmer JH, Mannis MJ, Holland EJ. Cornea.Mosby/Elsevier; 2011.
Barbara A, Rabinowitz YS. Textbook on Keratoconus: New Insights. Jaypee Brothers, Medical Publishers; 2011.
Espana EM, Tseng SC. Analysis of contact lens intolerance by exploring neuroanatomic integration of ocular surface defense. Contact Lens and Anterior Eye. 2003;26(3):131-137.
Glasson MJ, Stapleton F, Keay L, Sweeney D, Willcox MD. Differences in clinical parameters and tear film of tolerant and intolerant contact lens wearers. Investigative ophthalmology & visual science. 2003;44(12):5116-5124.
Colin J. European clinical evaluation: use of Intacs for the treatment of keratoconus. J Cataract Refract Surg. 2006;32(5):747-755.
Güell JL, Morral M, Salinas C, Elies D, Gris O, Manero F. Four-year follow-up of intrastromal corneal ring segments in patients with keratoconus. J Emmetropia. 2010;1:9-15.
Uçakhan ÖÖ, Kanpolat A, Özdemir Ö. Contact lens fitting for keratoconus after Intacs placement. Eye & contact lens. 2006;32(2):75-77.
Chen CY, Keeffe JE, Garoufalis P, et al. Vision-related quality of life comparison for emmetropes, myopes after refractive surgery, and myopes wearing spectacles or contact lenses. J Refract Surg. 2007;23(8):752-759.
Pesudovs K, Garamendi E, Elliott DB. A quality of life comparison of people wearing spectacles or contact lenses or having undergone refractive surgery. J Refract Surg. 2006;22(1):19-27.
Beljan J, Beljan K, Beljan Z. Complications caused by contact lens wearing. Coll Antropol. 2013;37 Suppl 1:179-187.
Gomez L, Chayet A. Laser in situ keratomileusis results after intrastromal corneal ring segments (Intacs). Ophthalmology. 2001;108(10):1738-1743.
Tan BU, Purcell TL, Nalgirkar A, Ehrenhaus MP, Torres LF, Schanzlin DJ. Photorefractive keratectomy for the correction of residual refractive error with Intacs intrastromal corneal ring segments in place. Journal of Cataract & Refractive Surgery. 2008;34(6):909-915.
Asbell PA, Ucakhan OO, Odrich M. Photorefractive keratectomy after intrastromal corneal ring segment explantation. Am J Ophthalmol. 1999;128(6):755-756.
Ito M, Arai H, Fukumoto T, Toda I, Tsubota K. INTACS before or after laser in situ keratomileusis: correction of thin corneas with moderately high myopia. J Refract Surg. 2004;20(6):818-822.
Mian SI, Jarade EF, Scally A, Azar DT. Combined ICRS insertion and LASIK to maximize postoperative residual bed thickness in high myopia. J Cataract Refract Surg. 2004;30(11):2383-2390.
Kymionis GD, Kontadakis GA, Kounis GA, et al. Simultaneous topography-guided PRK followed by corneal collagen cross-linking for keratoconus. Journal of Refractive Surgery. 2009;25(9):S807.
Spadea L, Paroli M. Simultaneous topography-guided PRK followed by corneal collagen cross-linking after lamellar keratoplasty for keratoconus. Clin Ophthalmol. 2012;6:1793- 1800.
Al-Tuwairqi W, Sinjab MM. Intracorneal ring segments implantation followed by sameday topography-guided PRK and corneal collagen CXL in low to moderate keratoconus. J Refract Surg. 2013;29(1):59-63.
Coskunseven E, Jankov MR, 2nd, Grentzelos MA, Plaka AD, Limnopoulou AN, Kymionis GD. Topography-guided transepithelial PRK after intracorneal ring segments implantation and corneal collagen CXL in a three-step procedure for keratoconus. J Refract Surg. 2013;29(1):54-58.
Dirani A, Fadlallah A, Syed ZA, et al. Non-topography-guided photorefractive keratectomy for the correction of residual mild refractive errors after ICRS implantation and CXL in keratoconus. J Refract Surg. 2014;30(4):266-271.
Iovieno A, Legare ME, Rootman DB, Yeung SN, Kim P, Rootman DS. Intracorneal ring segments implantation followed by same-day photorefractive keratectomy and corneal collagen cross-linking in keratoconus. J Refract Surg. 2011;27(12):915-918.
Kanellopoulos AJ. Comparison of sequential vs same-day simultaneous collagen crosslinking and topography-guided PRK for treatment of keratoconus. J Refract Surg. 2009;25(9):S812-818.
Kanellopoulos AJ, Binder PS. Management of corneal ectasia after LASIK with combined, same-day, topography-guided partial transepithelial PRK and collagen cross-linking: the athens protocol. J Refract Surg. 2011;27(5):323-331.
Kremer I, Aizenman I, Lichter H, Shayer S, Levinger S. Simultaneous wavefront-guided photorefractive keratectomy and corneal collagen crosslinking after intrastromal corneal ring segment implantation for keratoconus. J Cataract Refract Surg. 2012;38(10):1802-1807.
Yeung SN, Low SA, Ku JY, et al. Transepithelial phototherapeutic keratectomy combined with implantation of a single inferior intrastromal corneal ring segment and collagen crosslinking in keratoconus. J Cataract Refract Surg. 2013;39(8):1152-1156.
Hirsh A, Barequet IS, Levinger S. [Wavefront-guided lasek after intacs in eyes with stable keratoconus]. Harefuah. 2006;145(3):181-182, 247-188.
- Abstract Viewed: 123 times
- PDF Downloaded: 53 times
