Keratokonus Tedavisinin Farklı Evrelerinde Femtosaniye Lazerle KeraRing İmplantasyonu

Year 2024, Volume: 7 Issue: 3, 339 - 347, 27.10.2024

Ayşem Gül Ulukartal , Nilgün Solmaz , Önder Feyza

https://doi.org/10.53446/actamednicomedia.1515016

Abstract

Amaç: Femtosaniye lazer destekli KeraRing (Mediphacos, Belo Horizonte, Brezilya) implantasyonunun keratokonus tedavisinde güvenilirliğini ve etkinliğini araştırmak.
Yöntem: Kontakt lens kullanamayan 14 hastanın 15 gözüne intrastromal korneal halka segmentleri (KeraRing, Mediphacos, Brezilya) implante edildi. Korneal tünel oluşturulması için femtosaniye lazer (Intralase, 60 Hz) kullanıldı. Korneadaki ektatik alanın dağılımına göre, 9 göze çift segment, 6 göze tek segment implante edildi. Olguların preoperatif ve postoperatif düzeltilmemiş görme keskinliği (UCVA), en iyi düzeltilmiş görme keskinliği (BCVA), objektif ve subjektif refraksiyon ile topografik korneal eğrilik (K) değerleri Wilcoxon testi kullanılarak karşılaştırıldı.
Bulgular: Hastaların ortalama yaşı 25±7.46 (aralık: 15-39) yıl olup, ortalama postoperatif takip süresi 10.8±7.37 (aralık: 1-24 ay) aydır. BCVA, takip süresi boyunca tüm gözlerde artmış, ortalama 0.12±0.1'den 0.38±0.24'e yükselmiştir (p<0.001). BCVA, 12 gözde ortalama 0.40±0.15'ten 0.55±0.23'e yükselmiş (p=0.003), 2 gözde değişmemiş ve 1 gözde 1 satır azalmıştır. Subjektif sferik refraksiyon -3.02±3.8'den -1.43±2.7'ye, subjektif silindirik refraksiyon ise -4.2±1.8'den -1.03±1.1'e düşmüştür (p<0.005). Ortalama topografik astigmatizma -5.03±2.0 D'den -3.27±2.35 D'ye (p=0.012) ve ortalama K değeri 52.6±4.7 D'den 50.35±4.4 D'ye düşmüştür (p<0.005). Postoperatif dönemde, bir vakada tünel içinde halka segmentlerinin hafif migrasyonu dışında komplikasyon gözlenmemiştir.
Sonuç: Femtosaniye lazer destekli intrakorneal halka implantasyonu, keratokonusta görsel sonuçlar açısından etkili ve güvenilir bir yöntemdir.

Keywords

keraring, femtosaniye lazer, keratokonus

KeraRing Implantation with Femtosecond Laser in Keratoconus Treatment at Different Stages

Abstract

Objective: To investigate the reliability and effectiveness of femtosecond laser-assisted KeraRing (Mediphacos, Belo Horizonte, Brazil) implantation in treating keratoconus.
Methods: Intrastromal corneal ring segments (KeraRing, Mediphacos, Brazil) were implanted in 15 eyes of 14 patients unable to tolerate contact lenses. Femtosecond laser (Intralase, 60 Hz) was used for corneal tunnel creation. Based on the distribution of ectatic area on the cornea, dual segments were implanted in 9 eyes, while single segments were implanted in 6 eyes. Preoperative and postoperative uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), objective and subjective refraction, and topographic corneal curvature (K) values of the cases were compared using the Wilcoxon test.
Results: The mean age of patients was 25±7.46 (range: 15-39) years, with a mean postoperative follow-up period of 10.8±7.37 (range: 1-24 months). BCVA improved in all eyes during the follow-up period, increasing from a mean of 0.12±0.1 to 0.38±0.24 (p<0.001). BCVA increased in 12 eyes, with a mean of 0.40±0.15 to 0.55±0.23 (p=0.003), remained unchanged in 2 eyes, and decreased by 1 line in 1 eye. Subjective spherical refraction decreased from -3.02±3.8 to -1.43±2.7, and subjective cylindrical refraction decreased from -4.2±1.8 to -1.03±1.1 (p<0.005). Mean topographic astigmatism decreased from -5.03±2.0 D to -3.27±2.35 D (p=0.012), and mean K value decreased from 52.6±4.7 D to 50.35±4.4 D (p<0.005). During the postoperative period, no complications were observed except for a slight migration of ring segments within the tunnel in one case.
Conclusion: Femtosecond laser-assisted intracorneal ring implantation is an effective and reliable method for visual outcomes in keratoconus.

Keywords

keraring, femtosecond laser, keratoconus

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