Combined Corneal Cross-Linking and Myoring Implantation in Advanced Keratoconus: Femtosecond Laser versus Manual Dissection
Background. Intrastromal corneal ring segments are widely adopted for keratoconus management. However, the complete ring (Myoring) was proposed to be superior in advanced cases. Myoring can be implanted either via femtoassisted or manual dissection techniques. A comparison between both techniques ca...
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Journal of Ophthalmology |
| Online Access: | http://dx.doi.org/10.1155/2021/6673842 |
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| author | Ahmed Ibrahim Basiony Moataz Fayez ElSawy Mahmoud Mohamed Ismail Mohamed Samy Abd ElAziz Mahmoud Tawfik KhalafAllah Adel Galal Zaky |
| author_facet | Ahmed Ibrahim Basiony Moataz Fayez ElSawy Mahmoud Mohamed Ismail Mohamed Samy Abd ElAziz Mahmoud Tawfik KhalafAllah Adel Galal Zaky |
| author_sort | Ahmed Ibrahim Basiony |
| collection | DOAJ |
| description | Background. Intrastromal corneal ring segments are widely adopted for keratoconus management. However, the complete ring (Myoring) was proposed to be superior in advanced cases. Myoring can be implanted either via femtoassisted or manual dissection techniques. A comparison between both techniques can delineate any differences in the outcomes. Methods. This was a prospective interventional case series study. Sixty-four eyes with progressive advanced keratoconus were enrolled: 36 and 28 had femtoassisted or manual Myoring, respectively. Uncorrected visual acuity (UCVA), corrected distance visual acuity (CDVA), maximal keratometry (Kmax), spherical equivalent (SE) and corneal thinnest location were measured in all eyes preoperatively and at one, six, and 12 months postoperatively. Epi-off corneal cross-linking (CXL) was performed eight weeks after Myoring implantation for all cases. Results. Femtoassisted Myoring dissection significantly improved UCVA and CDVA from 0.1 ± 0.06 and 0.18 ± 0.1 preoperatively to 0.29 ± 0.08 and 0.43 ± 0.1 at 12 months. Also, manual technique similarly enhanced UCVA and CDVA from 0.11 ± 0.05 and 0.2 ± 0.1 preoperatively to 0.27 ± 0.2 and 0.4 ± 0.2 at 12 months. In terms of safety, while no cases of ring extrusion were encountered with the femtoassisted technique, six (21.4%) cases of extrusion were encountered in the manual group. Conclusion. Femtoassisted or manual Myoring technique followed by CXL is an effective choice for advanced progressive keratoconus. Although it did not reach a statistical significance, the high extrusion rate with manual dissection is a red flag to be considered. |
| format | Article |
| id | doaj-art-63f9fda8bde2444193ebfc59f572f14f |
| institution | Kabale University |
| issn | 2090-004X 2090-0058 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Ophthalmology |
| spelling | doaj-art-63f9fda8bde2444193ebfc59f572f14f2025-02-03T05:47:40ZengWileyJournal of Ophthalmology2090-004X2090-00582021-01-01202110.1155/2021/66738426673842Combined Corneal Cross-Linking and Myoring Implantation in Advanced Keratoconus: Femtosecond Laser versus Manual DissectionAhmed Ibrahim Basiony0Moataz Fayez ElSawy1Mahmoud Mohamed Ismail2Mohamed Samy Abd ElAziz3Mahmoud Tawfik KhalafAllah4Adel Galal Zaky5Department of Ophthalmology, Faculty of Medicine, Menoufia University, Menoufia, EgyptDepartment of Ophthalmology, Faculty of Medicine, Menoufia University, Menoufia, EgyptDepartment of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, EgyptDepartment of Ophthalmology, Faculty of Medicine, Menoufia University, Menoufia, EgyptDepartment of Ophthalmology, Faculty of Medicine, Menoufia University, Menoufia, EgyptDepartment of Ophthalmology, Faculty of Medicine, Menoufia University, Menoufia, EgyptBackground. Intrastromal corneal ring segments are widely adopted for keratoconus management. However, the complete ring (Myoring) was proposed to be superior in advanced cases. Myoring can be implanted either via femtoassisted or manual dissection techniques. A comparison between both techniques can delineate any differences in the outcomes. Methods. This was a prospective interventional case series study. Sixty-four eyes with progressive advanced keratoconus were enrolled: 36 and 28 had femtoassisted or manual Myoring, respectively. Uncorrected visual acuity (UCVA), corrected distance visual acuity (CDVA), maximal keratometry (Kmax), spherical equivalent (SE) and corneal thinnest location were measured in all eyes preoperatively and at one, six, and 12 months postoperatively. Epi-off corneal cross-linking (CXL) was performed eight weeks after Myoring implantation for all cases. Results. Femtoassisted Myoring dissection significantly improved UCVA and CDVA from 0.1 ± 0.06 and 0.18 ± 0.1 preoperatively to 0.29 ± 0.08 and 0.43 ± 0.1 at 12 months. Also, manual technique similarly enhanced UCVA and CDVA from 0.11 ± 0.05 and 0.2 ± 0.1 preoperatively to 0.27 ± 0.2 and 0.4 ± 0.2 at 12 months. In terms of safety, while no cases of ring extrusion were encountered with the femtoassisted technique, six (21.4%) cases of extrusion were encountered in the manual group. Conclusion. Femtoassisted or manual Myoring technique followed by CXL is an effective choice for advanced progressive keratoconus. Although it did not reach a statistical significance, the high extrusion rate with manual dissection is a red flag to be considered.http://dx.doi.org/10.1155/2021/6673842 |
| spellingShingle | Ahmed Ibrahim Basiony Moataz Fayez ElSawy Mahmoud Mohamed Ismail Mohamed Samy Abd ElAziz Mahmoud Tawfik KhalafAllah Adel Galal Zaky Combined Corneal Cross-Linking and Myoring Implantation in Advanced Keratoconus: Femtosecond Laser versus Manual Dissection Journal of Ophthalmology |
| title | Combined Corneal Cross-Linking and Myoring Implantation in Advanced Keratoconus: Femtosecond Laser versus Manual Dissection |
| title_full | Combined Corneal Cross-Linking and Myoring Implantation in Advanced Keratoconus: Femtosecond Laser versus Manual Dissection |
| title_fullStr | Combined Corneal Cross-Linking and Myoring Implantation in Advanced Keratoconus: Femtosecond Laser versus Manual Dissection |
| title_full_unstemmed | Combined Corneal Cross-Linking and Myoring Implantation in Advanced Keratoconus: Femtosecond Laser versus Manual Dissection |
| title_short | Combined Corneal Cross-Linking and Myoring Implantation in Advanced Keratoconus: Femtosecond Laser versus Manual Dissection |
| title_sort | combined corneal cross linking and myoring implantation in advanced keratoconus femtosecond laser versus manual dissection |
| url | http://dx.doi.org/10.1155/2021/6673842 |
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