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Comparison of mechanical and femtosecond laser tunnel creation for intrastromal corneal ring segment implantation in keratoconus: prospective randomized clinical trial.

Abstract：

PURPOSE:To compare the outcomes of mechanical and femtosecond laser-assisted tunnel creation for intrastromal corneal ring segment (ICRS) implantation in eyes with keratoconus. SETTING:Kartal Training and Research Hospital, Istanbul, Turkey. METHODS:In this prospective study, consecutive eyes with keratoconus were randomly assigned to have ICRS tunnel creation with a mechanical device or a femtosecond laser. Keraring ICRS with a 5.0 mm diameter and 160-degree arc length were implanted in all cases. The uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, and keratometry (K) readings were measured preoperatively and 1 year postoperatively, and the data in the mechanical group and the femtosecond group were compared statistically. RESULTS:One year postoperatively, there was significant improvement in UDVA, CDVA, K readings, spherical equivalent (SE), and manifest sphere and cylinder in both groups (P<.05). The UDVA improved by 2.4 lines in the mechanical group and 2.0 lines in the femtosecond group and the CDVA by 3.3 lines and 2.7 lines, respectively; the mean reduction in maximum keratometry was 4.50 diopters (D) and 4.70 D, respectively, and the mean reduction in SE, 3.18 D and 3.09 D, respectively. There were no statistically significant differences between the 2 groups in visual or refractive results (P>.05). Anterior corneal perforation, superficial segment placement, and segment extrusion occurred in 1 eye each in the mechanical group. Segment migration occurred in 1 eye in the femtosecond group. CONCLUSION:Despite intraoperative complications in the mechanical group, the visual and refractive outcomes were similar to those in the femtosecond group.

journal_name

J Cataract Refract Surg

journal_title

Journal of cataract and refractive surgery

authors

Kubaloglu A,Sari ES,Cinar Y,Cingu K,Koytak A,Coşkun E,Ozertürk Y

doi

10.1016/j.jcrs.2010.04.028

subject

Has Abstract

pub_date

2010-09-01 00:00:00

pages

1556-61

issue

eissn

0886-3350

issn

1873-4502

pii

S0886-3350(10)00849-7

journal_volume

pub_type

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Comparison of mechanical and femtosecond laser tunnel creation for intrastromal corneal ring segment implantation in keratoconus: prospective randomized clinical trial.