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Keratoconus progression after intrastromal corneal ring segment implantation according to age: 5-year follow-up cohort study

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Abstract

Background/aims

Intrastromal corneal ring segments (ICRS) have been found to be useful in correcting keratoconus by decreasing irregular astigmatism, thereby potentially improving visual acuity. However, its long-term effects in keratoconus progression are not completely understood, mainly concerning the effects of age on ICRS implantation results. This study aimed to evaluate long-term effects of ICRS implantation according to age at implantation.

Methods

We conducted a longitudinal retrospective study, where we evaluated patients with keratoconus who underwent ICRS implantation between 2004 and 2012.

Results

We evaluated 34 eyes for 5 years post-operatively. The mean age of the 21 men and 7 women was 20.59 ± 4.65 years. Best spectacle-corrected visual acuity (BSCVA) improved from 0.32 ± 0.19 in the preoperative period to 0.46 ± 0.27 6 months post-operatively. After up to 5 years of follow-up, there was no significant difference in mean visual acuity of the group. As expected, there was a significant decrease in keratometric values after corneal ring implantation, which remained stable over the 5-year follow-up. Among the 34 cases analysed, nine (26%) showed signs of disease progression. In eight of the nine documented progression cases, patients were 21 years old or younger, revealing that these patients were sevenfold more likely to progress than those aged over 21 years.

Conclusion

In our series of cases, ICRS implantation was shown to be an excellent treatment to reduce corneal curvature and improve visual acuity at all ages, but it did not stabilize the disease, especially in young patients with more aggressive forms of the keratoconus.

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Funding

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Authors and Affiliations

  1. OftalmoCentro, Private Clinic, Porto Alegre, Av. Coronel Lucas de Oliveira, 505/709, 90440-011, Porto Alegre, RS, Brazil

    Bruno Schneider de Araujo, Diane Ruschel Marinho & Sergio Kwitko

  2. Department of Ophthalmology and Otolaryngology, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil

    Bruno Schneider de Araujo, Diane Ruschel Marinho & Sergio Kwitko

  3. School of Medicine, Universidade Luterana do Brasil (ULBRA), Canoas, RS, Brazil

    Leticia Kubo

Authors
  1. Bruno Schneider de Araujo
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  2. Leticia Kubo
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  3. Diane Ruschel Marinho
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  4. Sergio Kwitko
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Contributions

All authors made substantial contributions to the research. SK was the principal investigator. BSA collected the data and drafted the manuscript. All authors contributed to the design, analysis and interpretation of the data, and to the revision of the manuscript.

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Correspondence to Bruno Schneider de Araujo.

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The authors declare that they have no conflict of interest.

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Research Ethics Committee at Hospital de Clínicas de Porto Alegre (No. 1.387.808).

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de Araujo, B.S., Kubo, L., Marinho, D.R. et al. Keratoconus progression after intrastromal corneal ring segment implantation according to age: 5-year follow-up cohort study. Int Ophthalmol 40, 2847–2854 (2020). https://doi.org/10.1007/s10792-020-01468-4

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  • DOI: https://doi.org/10.1007/s10792-020-01468-4

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