Офтальмохирургия (Jan 2016)
Intrastromal keratoplasty with intracorneal ring segments implantation for the astigmatism correction in post-PKP patients with keratoconus
Abstract
Purpose. To evaluate the clinical outcomes of intracorneal ring segments (ICRS) implantation and femtosecond laserassisted ICRS implantation to correct the residual astigmatism in post-PKP patients with keratoconus.Material and methods. The study evaluated 28 eyes with residual astigmatism in post-PKP patients with keratoconus. Preop and post-op examination included: refractometry, uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA), corneal topography, pachymetry, con-focal microscopy. The ICRS was performed in 15 cases (group 1), femtosecond laser-assisted ICRS was performed in 13 cases (group 2).Results. Patients were examined 1, 3 and 6 month after the surgery. The results 3 month after the surgery in the group 1: the mean UCVA improved from 0.13±0.14 to 0.39±0.14, the mean BCVA – from 0.49±0.28 to 0.68±0.1, the mean astigmatism decreased from 8.21±2.21D to 3.20±0.74D, the mean maximum K value decreased from 49.00±2.30D to 44.38±1.90D, the mean minimum K value was 40.82±2.42D preoperatively and 41.18±2.06D postoperatively. The results 3 month after the surgery in the group 2: the mean UCVA improved from 0.09±0.05 to 0.44±0.17, the mean BCVA – from 0.42±0.30 to 0.64±0.17, the mean astigmatism decreased from 7.50±2.47D to 3.16±1.53D, the mean maximum K value decreased from 47.71±2.39D to 43.83±2.73D, the mean minimum K value was 40.29±2.68D preoperatively and 40.67±2.10D postoperatively. At 6 months postoperatively there was no significant difference in relation to the 3-month outcomes.Conclusion. The implantation of ICRS may be an effective procedure for the residual astigmatism correction in post- PKP patients with keratoconus with good visual, refractive and topographic outcomes. The use of the femtosecond laserassistance may provide the ICRS implantation more safe and accurate.
