Decision making nomogram for intrastromal corneal ring segments in keratoconus
Purpose: To create a nomogram for the insertion of intrastromal corneal ring segments (ICRS) (Intacs® ) in eyes with keratoconus. Setting: Tertiary eye care center in South India. Materials and Methods: This prospective, non-randomized, interventional case series used a self-designed decision-making...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2014-01-01
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| Series: | Indian Journal of Ophthalmology |
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| Online Access: | http://www.ijo.in/article.asp?issn=0301-4738;year=2014;volume=62;issue=1;spage=23;epage=28;aulast=Shetty |
| _version_ | 1819264667474722816 |
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| author | Rohit Shetty Sharon D′Souza Sarika Ramachandran Mathew Kurian Rudy M M A Nuijts |
| author_facet | Rohit Shetty Sharon D′Souza Sarika Ramachandran Mathew Kurian Rudy M M A Nuijts |
| author_sort | Rohit Shetty |
| collection | DOAJ |
| description | Purpose: To create a nomogram for the insertion of intrastromal corneal ring segments (ICRS) (Intacs® ) in eyes with keratoconus. Setting: Tertiary eye care center in South India. Materials and Methods: This prospective, non-randomized, interventional case series used a self-designed decision-making nomogram for the selection of ICRS in keratoconus patients based on the centration of the cone, mean refractive spherical equivalent (MRSE), and mean keratometry (Km) values. The 3, 6, and 12 months clinical outcomes were compared to historical controls. Primary endpoints were improvement in uncorrected and best-corrected vision and change in the keratometric values. Results: Group A comprised of 52 eyes of 50 patients that followed the nomogram, while Group B comprised of 25 eyes of 23 non-nomogram historical controls matched for baseline parameters.In Group A, the uncorrected distance visual acuity (UDVA) improved from 0.16 ± 0.15 to 0.25 ± 0.16 (P < 0.001), corrected distance visual acuity (CDVA) from 0.58 ± 0.2 to 0.69 ± 0.21 (P = 0.022), MRSE from -5.41 ± 4.94 to -1.71 ± 2.88 (P < 0.001), Km from 51.77 ± 5.45 to 48.63 ± 4.37 (P < 0.001), and astigmatism reduced from 5.86 ± 2.61 to 4.91 ± 2.72 diopters (P < 0.001).In Group B, improvement in the average MRSE was from -6.44 ± 5.32 to -3.26 ± 2.82 (P < 0.013) and in the average Km from 53.64 ± 5.32 to 50.31 ± 5.02 (P < 0.001). Other parameters did not improve significantly.A statistically significant difference was present in the percentage of patients achieving a good clinical outcome between the two groups (P < 0.001; Chi-square). Conclusion: The nomogram provides a means to choose the appropriate ICRS, hence improving the outcome in patients with keratoconus. |
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| format | Article |
| id | doaj.art-567c57595fa14d0c90be60729ea1a8e0 |
| institution | Directory Open Access Journal |
| issn | 0301-4738 1998-3689 |
| language | English |
| last_indexed | 2024-12-23T20:33:08Z |
| publishDate | 2014-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Ophthalmology |
| spelling | doaj.art-567c57595fa14d0c90be60729ea1a8e02022-12-21T17:32:10ZengWolters Kluwer Medknow PublicationsIndian Journal of Ophthalmology0301-47381998-36892014-01-01621232810.4103/0301-4738.126170Decision making nomogram for intrastromal corneal ring segments in keratoconusRohit ShettySharon D′SouzaSarika RamachandranMathew KurianRudy M M A NuijtsPurpose: To create a nomogram for the insertion of intrastromal corneal ring segments (ICRS) (Intacs® ) in eyes with keratoconus. Setting: Tertiary eye care center in South India. Materials and Methods: This prospective, non-randomized, interventional case series used a self-designed decision-making nomogram for the selection of ICRS in keratoconus patients based on the centration of the cone, mean refractive spherical equivalent (MRSE), and mean keratometry (Km) values. The 3, 6, and 12 months clinical outcomes were compared to historical controls. Primary endpoints were improvement in uncorrected and best-corrected vision and change in the keratometric values. Results: Group A comprised of 52 eyes of 50 patients that followed the nomogram, while Group B comprised of 25 eyes of 23 non-nomogram historical controls matched for baseline parameters.In Group A, the uncorrected distance visual acuity (UDVA) improved from 0.16 ± 0.15 to 0.25 ± 0.16 (P < 0.001), corrected distance visual acuity (CDVA) from 0.58 ± 0.2 to 0.69 ± 0.21 (P = 0.022), MRSE from -5.41 ± 4.94 to -1.71 ± 2.88 (P < 0.001), Km from 51.77 ± 5.45 to 48.63 ± 4.37 (P < 0.001), and astigmatism reduced from 5.86 ± 2.61 to 4.91 ± 2.72 diopters (P < 0.001).In Group B, improvement in the average MRSE was from -6.44 ± 5.32 to -3.26 ± 2.82 (P < 0.013) and in the average Km from 53.64 ± 5.32 to 50.31 ± 5.02 (P < 0.001). Other parameters did not improve significantly.A statistically significant difference was present in the percentage of patients achieving a good clinical outcome between the two groups (P < 0.001; Chi-square). Conclusion: The nomogram provides a means to choose the appropriate ICRS, hence improving the outcome in patients with keratoconus.http://www.ijo.in/article.asp?issn=0301-4738;year=2014;volume=62;issue=1;spage=23;epage=28;aulast=ShettyLasikcorneal scarscorneoplastiquepremium cataract surgeryrefractive complicationsradial keratotomypterygiumpingueculaastigmatismcorneal scarsAntioxidantselectromagnetic rationglutathionelensoxidative stress2-ethylpyridineapoptosisARPE-19 cellscigarette smoke toxicantmitochondrial membrane potentialreactive oxygen/nitrogen speciesIntacskeratoconusnomogram |
| spellingShingle | Rohit Shetty Sharon D′Souza Sarika Ramachandran Mathew Kurian Rudy M M A Nuijts Decision making nomogram for intrastromal corneal ring segments in keratoconus Indian Journal of Ophthalmology Lasik corneal scars corneoplastique premium cataract surgery refractive complications radial keratotomy pterygium pinguecula astigmatism corneal scars Antioxidants electromagnetic ration glutathione lens oxidative stress 2-ethylpyridine apoptosis ARPE-19 cells cigarette smoke toxicant mitochondrial membrane potential reactive oxygen/nitrogen species Intacs keratoconus nomogram |
| title | Decision making nomogram for intrastromal corneal ring segments in keratoconus |
| title_full | Decision making nomogram for intrastromal corneal ring segments in keratoconus |
| title_fullStr | Decision making nomogram for intrastromal corneal ring segments in keratoconus |
| title_full_unstemmed | Decision making nomogram for intrastromal corneal ring segments in keratoconus |
| title_short | Decision making nomogram for intrastromal corneal ring segments in keratoconus |
| title_sort | decision making nomogram for intrastromal corneal ring segments in keratoconus |
| topic | Lasik corneal scars corneoplastique premium cataract surgery refractive complications radial keratotomy pterygium pinguecula astigmatism corneal scars Antioxidants electromagnetic ration glutathione lens oxidative stress 2-ethylpyridine apoptosis ARPE-19 cells cigarette smoke toxicant mitochondrial membrane potential reactive oxygen/nitrogen species Intacs keratoconus nomogram |
| url | http://www.ijo.in/article.asp?issn=0301-4738;year=2014;volume=62;issue=1;spage=23;epage=28;aulast=Shetty |
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