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Intrastromal corneal ring segment implantation to correct astigmatism after penetrating keratoplasty
Sandro Coscarelli1, Guilherme Ferrara, Jose F Alfonso
1Ennio Coscarelli Eye Clinic, Belo Horizonte, Brazil.
Purpose:
To evaluate the clinical outcomes of implantation of Ferrara intrastromal corneal ring segments (ICRS) in patients with astigmatism after penetrating keratoplasty (PKP).
Setting:
Private clinic, Belo Horizonte, Brazil.
Design:
Retrospective consecutive case series.
Methods:
Chart records of post-PKP patients who had ICRS implantation from May 2005 to September 2009 were retrospectively reviewed. The following parameters were studied: corrected distance visual acuity (CDVA), keratometry (K) values, spherical equivalent (SE), spherical refractive error, corneal topographic astigmatism, minimum K, and maximum K.
Results:
The study evaluated 59 eyes (54 patients). The mean CDVA (logMAR) improved from 0.45 ± 0.17 (SD) (range 0.18 to 1.00) to 0.30 ± 0.17 (range 0.00 to 1.00). The mean SE was -6.34 ± 3.40 diopters (D) (range 0.37 to -16.50 D) preoperatively and -2.66 ± 2.52 D (range 0.87 to -10.50 D) postoperatively. The mean spherical refractive error decreased from -7.10 ± 3.07 D (range 2.15 to 16.68 D) preoperatively to -3.46 ± 2.05 D (range 0.88 to 10.79 D) postoperatively. No patient lost visual acuity. The mean corneal topographic astigmatism decreased from 3.37 ± 1.51 D preoperatively to 1.69 ± 1.04 D postoperatively. The mean maximum K value decreased from 48.09 ± 2.56 D to 44.17 ± 2.67 D and the mean minimum K value, from 44.90 ± 2.54 D to 42.46 ± 2.63 D. All changes were statistically significant (P<.0001).
Conclusion:
Intrastromal corneal ring segments effectively reduced corneal cylinder in patients with astigmatism after PKP.
