Magnitude, management outcomes, and determinants of intrastromal corneal ring segment explantation in keratoconus patients at a tertiary eye hospital in Eastern Province Saudi Arabia
Purpose: To examine the prevalence of intrastromal corneal ring segment (ICRS) explants, their management outcomes, and determinants in patients with keratoconus at a tertiary eye care center in Eastern province - Saudi Arabia. Methods: This one-armed cohort study included cases of ICRSs explanted...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2020-01-01
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| Series: | Hail Journal of Health Sciences |
| Subjects: | |
| Online Access: | https://journals.lww.com/hjhs/Pages/default.aspx/article.asp?issn=1658-8312;year=2020;volume=2;issue=2;spage=68;epage=74;aulast=Al-Shammari |
| _version_ | 1797775239731478528 |
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| author | Yousef S Al-Shammari Fatimah Nadeer Alzaher |
| author_facet | Yousef S Al-Shammari Fatimah Nadeer Alzaher |
| author_sort | Yousef S Al-Shammari |
| collection | DOAJ |
| description | Purpose: To examine the prevalence of intrastromal corneal ring segment (ICRS) explants, their management outcomes, and determinants in patients with keratoconus at a tertiary eye care center in Eastern province - Saudi Arabia.
Methods: This one-armed cohort study included cases of ICRSs explanted at Dharan Eye Specialist Hospital from 2010 to 2020. The type of implant, laterality, corneal thickness, interval between implant and explant, reason for explant, refractive and topographic data, and further actions were recorded. Changes in uncorrected distance visual acuity (UCVA) and the manifest spherical equivalent refraction were the main outcomes.
Results: The ICRS explant rate was 5.6% (95% confidence interval 3.6; 7.4). Of the 35 explanted ICRSs, 29 were men (82.9%). The median interval between the ICRS implant and explant was one year (IQR 0.5: 2.4). Intacs (18) and Kerarings (16) were the main types of explanted ICRSs. Dissatisfaction among patients about their vision (11; 31.4%), complications in the cornea (8; 22.9%), problems with implantation (6; 17.1%), and progression of keratoconus (10; 28.6%) were the reasons for explantation. UCVA decline and myopic shift after explantation were noted but they were not statistically significant (P = 0.07). After explantation, 40% needed keratoplasty, while in 28.6% of eyes, the ICRS was reimplanted. The change in UCVA (Mann–Whitney P = 0.74) and manifest spherical equivalent refraction (Mann–Whitney P = 0.87) were not different in the Intact and Keraring ICRS groups.
Conclusions: The ICRS explant rate is low. This allows us to delay keratoplasty in 40% of cases by one year. It is still an acceptable option to manage keratoconus in one-quarter of explanted patients. |
| first_indexed | 2024-03-12T22:32:53Z |
| format | Article |
| id | doaj.art-c1eab8bfb4f645f3bed0e5312695a96d |
| institution | Directory Open Access Journal |
| issn | 1658-8312 1658-8592 |
| language | English |
| last_indexed | 2024-03-12T22:32:53Z |
| publishDate | 2020-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Hail Journal of Health Sciences |
| spelling | doaj.art-c1eab8bfb4f645f3bed0e5312695a96d2023-07-21T14:42:15ZengWolters Kluwer Medknow PublicationsHail Journal of Health Sciences1658-83121658-85922020-01-0122687410.4103/1658-8312.347587Magnitude, management outcomes, and determinants of intrastromal corneal ring segment explantation in keratoconus patients at a tertiary eye hospital in Eastern Province Saudi ArabiaYousef S Al-ShammariFatimah Nadeer AlzaherPurpose: To examine the prevalence of intrastromal corneal ring segment (ICRS) explants, their management outcomes, and determinants in patients with keratoconus at a tertiary eye care center in Eastern province - Saudi Arabia. Methods: This one-armed cohort study included cases of ICRSs explanted at Dharan Eye Specialist Hospital from 2010 to 2020. The type of implant, laterality, corneal thickness, interval between implant and explant, reason for explant, refractive and topographic data, and further actions were recorded. Changes in uncorrected distance visual acuity (UCVA) and the manifest spherical equivalent refraction were the main outcomes. Results: The ICRS explant rate was 5.6% (95% confidence interval 3.6; 7.4). Of the 35 explanted ICRSs, 29 were men (82.9%). The median interval between the ICRS implant and explant was one year (IQR 0.5: 2.4). Intacs (18) and Kerarings (16) were the main types of explanted ICRSs. Dissatisfaction among patients about their vision (11; 31.4%), complications in the cornea (8; 22.9%), problems with implantation (6; 17.1%), and progression of keratoconus (10; 28.6%) were the reasons for explantation. UCVA decline and myopic shift after explantation were noted but they were not statistically significant (P = 0.07). After explantation, 40% needed keratoplasty, while in 28.6% of eyes, the ICRS was reimplanted. The change in UCVA (Mann–Whitney P = 0.74) and manifest spherical equivalent refraction (Mann–Whitney P = 0.87) were not different in the Intact and Keraring ICRS groups. Conclusions: The ICRS explant rate is low. This allows us to delay keratoplasty in 40% of cases by one year. It is still an acceptable option to manage keratoconus in one-quarter of explanted patients.https://journals.lww.com/hjhs/Pages/default.aspx/article.asp?issn=1658-8312;year=2020;volume=2;issue=2;spage=68;epage=74;aulast=Al-Shammarikeratoconusintra corneal ringcorneacorneal topographykeratoplasty |
| spellingShingle | Yousef S Al-Shammari Fatimah Nadeer Alzaher Magnitude, management outcomes, and determinants of intrastromal corneal ring segment explantation in keratoconus patients at a tertiary eye hospital in Eastern Province Saudi Arabia Hail Journal of Health Sciences keratoconus intra corneal ring cornea corneal topography keratoplasty |
| title | Magnitude, management outcomes, and determinants of intrastromal corneal ring segment explantation in keratoconus patients at a tertiary eye hospital in Eastern Province Saudi Arabia |
| title_full | Magnitude, management outcomes, and determinants of intrastromal corneal ring segment explantation in keratoconus patients at a tertiary eye hospital in Eastern Province Saudi Arabia |
| title_fullStr | Magnitude, management outcomes, and determinants of intrastromal corneal ring segment explantation in keratoconus patients at a tertiary eye hospital in Eastern Province Saudi Arabia |
| title_full_unstemmed | Magnitude, management outcomes, and determinants of intrastromal corneal ring segment explantation in keratoconus patients at a tertiary eye hospital in Eastern Province Saudi Arabia |
| title_short | Magnitude, management outcomes, and determinants of intrastromal corneal ring segment explantation in keratoconus patients at a tertiary eye hospital in Eastern Province Saudi Arabia |
| title_sort | magnitude management outcomes and determinants of intrastromal corneal ring segment explantation in keratoconus patients at a tertiary eye hospital in eastern province saudi arabia |
| topic | keratoconus intra corneal ring cornea corneal topography keratoplasty |
| url | https://journals.lww.com/hjhs/Pages/default.aspx/article.asp?issn=1658-8312;year=2020;volume=2;issue=2;spage=68;epage=74;aulast=Al-Shammari |
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