A novel Q-value-based nomogram for single intracorneal ring segment implantation versus standard manufacturer's nomogram combined with accelerated cross-linking for treatment of keratoconus: a randomized controlled trial.
Acta Ophthalmol
; 99(4): e501-e511, 2021 Jun.
Article
em En
| MEDLINE
| ID: mdl-32930519
ABSTRACT
PURPOSE:
To compare the efficacy of implanting a single Keraring segment according to a novel Q-value-based nomogram (QN) to that of segment implantation according to the manufacturer's standard nomogram (SN), for keratoconus treatment.METHODS:
This was a prospective, randomized controlled trial of 104 patients (104 eyes) with Amsler-Krumeich grade 1 or 2 keratoconus, and type 1 or 2 cone asymmetry determined according to manufacturer's classification. They were randomly distributed into two groups group A patients (n = 52) underwent Keraring implantation according to the SN, and group B patients (n = 52) underwent implantation of a single (210° arc-length) Keraring segment according to the QN. Both treatments were combined with accelerated transepithelial cross-linking, and follow-up was 6 months. Main outcome measures were preoperative and postoperative visual acuity, subjective refraction and corneal topography.RESULTS:
At postoperative month 6, group B exhibited statistically significantly higher values of mean uncorrected distance visual acuity (UDVA), sphere, K2, K-average, K-max and Q-anterior (p = 0.02, 0.01, 0.002, 0.001, 0.0001 and 0.03, respectively) compared to that of group A. However, group A exhibited better refractive cylindrical improvements (p = 0.04). In group A, we documented spontaneous extrusion of one Keraring segment.CONCLUSION:
Single 210° arc-length segment implantation using our objective QN was more efficacious for keratoconus treatment than using the subjective SN. The nomograms were comparable when the Q-anterior value was >-1.00; however, the QN was superior to the SN when the Q-anterior value was ≤-1.00. The QN yielded greater postoperative UDVA and smoother corneal remodelling than did the SN for treatment of grade 1 and 2 keratoconic eyes.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Fármacos Fotossensibilizantes
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Córnea
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Implante de Lente Intraocular
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Reagentes de Ligações Cruzadas
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Nomogramas
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Ceratocone
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Lentes Intraoculares
Tipo de estudo:
Clinical_trials
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Diagnostic_studies
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Observational_studies
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Prognostic_studies
Limite:
Adolescent
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Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article