Efficacy of different procedures of intra-corneal ring segment implantation in keratoconus : A systematic review and meta-analysis
d'Azy, Cédric Benoist, Pereira, Bruno, Chiambaretta, Frédéric and Dutheil, Frédéric. (2019) Efficacy of different procedures of intra-corneal ring segment implantation in keratoconus : A systematic review and meta-analysis. Translational Vision Science and Technology. 8(3), p. 38. https://doi.org/10.1167/tvst.8.3.38
|Authors||d'Azy, Cédric Benoist, Pereira, Bruno, Chiambaretta, Frédéric and Dutheil, Frédéric|
Purpose: To evaluate the efficacy of the functional, keratometric, and refractive postoperative parameters of intracorneal ring segment (ICRS) implantation in keratoconus and its association with collagen cross-linking (CXL), photorefractive keratectomy (PRK), and intraocular lenses (IOLs).
Methods: We conducted a systematic review and meta-analysis on case series published between 2007 and 2017.
Results: We included 95 case series with a total of 4560 patients. We included 64 studies of the ICRS procedure, 20 studies of ICRS+CXL, 9 studies of ICRS+CXL+PRK, and 5 studies of ICRS+IOL. We demonstrated an overall improvement of all parameters in all procedures. Cylinder was decreased with an overall effect size (ES) of −1.15 (−1.36 to −0.95; I2 = 93.7%). Corrected distance visual acuity was improved with an overall ES of 0.89 (0.78 to 1.00; I2 = 81.9%). Maximal keratometry was decreased with an overall ES of 0.98 (0.85 to 1.11; I2 = 78.9%). ICRS+IOL is the best procedure to improve spherical equivalent and uncorrected distance visual acuity (P < 0.05) compared with other procedures. ICRSs versus ICRS+CXL are similar in all parameters except for corrected distance visual acuity. ICRS+CXL+PRK is better than ICRS alone in all parameters except for the correction of spherical equivalent.
Conclusions: Although the quality and strength of the data are questionable, ICRS implantation is an effective strategy to preserve visual function in keratoconic patients. Particularly, ICRS+CXL+PRK could be a low invasive procedure to propose to young keratoconic patients.
Translational Relevance: To propose an overview of postoperative parameters on each ICRS procedure on keratoconus.
|Journal||Translational Vision Science and Technology|
|Journal citation||8 (3), p. 38|
|Publisher||Association for Research in Vision and Ophthalmology Inc.|
|Digital Object Identifier (DOI)||https://doi.org/10.1167/tvst.8.3.38|
|Open access||Published as ‘gold’ (paid) open access|
|Research or scholarly||Research|
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|Publication process dates|
|Deposited||31 May 2021|
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