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Indications for intrastromal corneal ring segments in ectasia after laser in situ keratomileusis

2012; Lippincott Williams & Wilkins; Volume: 38; Issue: 12 Linguagem: Inglês

10.1016/j.jcrs.2012.07.036

1873-4502

Luis F. Brenner, Jorge L. Alió, Alfredo Vega-Estrada, Julio Baviera, Jaime Beltrán, Rosario Cobo-Soriano,

Ophthalmology and Visual Impairment Studies

To evaluate clinical results of intrastromal corneal ring segments (ICRS) in a large series of post-laser in situ keratomileusis (LASIK) ectasia and determine which clinical parameters were related to the success of this technique.Vissum Corporation and Clínica Baviera Group, Alicante, Spain.Case series.Intrastromal corneal ring segments were implanted to correct the spherocylindrical error and improve visual acuity. Based on a previously described grading system, the best indications for ICRS implantation to treat post-LASIK ectasia were evaluated. The variables related to favorable outcomes over a 12-month follow-up were determined.Patients who lost 2 or more lines due to post-LASIK ectasia had a mean gain of +2.89 lines of corrected distance visual acuity (CDVA) after ICRS implantation (P<.001) and a mean CDVA of 0.81 (95% confidence interval, 0.74-0.88). In contrast, patients who did not lose vision after ectasia had a mean loss of -2.00 lines of CDVA after the ICRS implantation (P<.001). The odds ratio of a gain of at least 1 line of CDVA was 18 times greater for those who had lost 2 or more lines of CDVA after ectasia.The best indications for ICRS were a loss of 2 or more lines of CDVA after ectasia and post-LASIK ectasia grade 4. Patients who do not have vision loss after ectasia and those classified as grade 1 should not be considered candidates for ICRS implantation.No author has a financial or proprietary interest in any material or method mentioned.