International Medical Case Reports Journal (Feb 2018)

Implantation of intracorneal ring segments in pediatric patients: long-term follow-up

  • Abreu AC,
  • Malheiro L,
  • Coelho J,
  • Neves MM,
  • Gomes M,
  • Oliveira L,
  • Menéres P

Journal volume & issue
Vol. Volume 11
pp. 23 – 27

Abstract

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Ana Carolina Abreu,1 Luisa Malheiro,1 João Coelho,1 Miguel Mesquita Neves,1 Miguel Gomes,1,2 Luis Oliveira,1,2 Pedro Menéres1,2 1Ophthalmology Department of Hospital de Santo António – Centro Hospitalar do Porto, Porto, Portugal; 2Ophthalmology Department, Instituto de Ciências Biomédicas Abel Salazar (ICBAS) – Universidade do Porto, Porto, Portugal Purpose: To analyze the long-term outcomes of intracorneal ring segments (ICRS) implantation for keratoconus management in pediatric patients. Methods: Retrospective case series review of the long-term (>5 years) outcomes of Intacs® ICRS implantation for keratoconus in pediatric patients (age <18 years old at the time of surgery) between January 2008 and December 2011 at Ophthalmology Department of Hospital de Santo António. Demographic data, follow-up time, preoperative and postoperative uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA) in decimal scale, and corneal topography were evaluated. Statistical analysis was done using SPSS for windows (version 24). Significance was set at p<0.0125. Results: Fourteen eyes of 14 patients, with a mean age of 15.36 years (range 10–18 years), were included in this study. All patients had been diagnosed with keratoconus with reported progression in the 6 months prior to surgery. Follow-up time was 6.36±0.97 years. UCVA and BCVA improved after ICRS implantation (p<0.0125). Keratometry (K) minimum (Kmin) and K maximum (Kmax) decreased after surgery (p<0.0125). During follow-up, UCVA, BCVA, Kmin, and Kmax values ranged, showing a tendency to worsen at the end of follow-up. However, statistically significant differences were not observed. Conclusion: ICRS implantation showed good visual and topographic results in pediatric patients. Long-term follow-up suggests that, despite ICRS implantation, there is still progression of keratoconus. To the best of our knowledge, there are no reports regarding the long-term efficacy of ICRS implantation in pediatric patients. Keywords: intracorneal ring segments, keratoconus, pediatric patients

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