Cargando…

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-maki...

Descripción completa

Detalles Bibliográficos
Autores principales: Shetty, Rohit, D’Souza, Sharon, Ramachandran, Sarika, Kurian, Mathew, Nuijts, Rudy M M A
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3955066/
https://www.ncbi.nlm.nih.gov/pubmed/24492498
http://dx.doi.org/10.4103/0301-4738.126170
_version_ 1782307532283314176
author Shetty, Rohit
D’Souza, Sharon
Ramachandran, Sarika
Kurian, Mathew
Nuijts, Rudy M M A
author_facet Shetty, Rohit
D’Souza, Sharon
Ramachandran, Sarika
Kurian, Mathew
Nuijts, Rudy M M A
author_sort Shetty, Rohit
collection PubMed
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.
format Online
Article
Text
id pubmed-3955066
institution National Center for Biotechnology Information
language English
publishDate 2014
publisher Medknow Publications & Media Pvt Ltd
record_format MEDLINE/PubMed
spelling pubmed-39550662014-03-31 Decision making nomogram for intrastromal corneal ring segments in keratoconus Shetty, Rohit D’Souza, Sharon Ramachandran, Sarika Kurian, Mathew Nuijts, Rudy M M A Indian J Ophthalmol Original Article 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. Medknow Publications & Media Pvt Ltd 2014-01 /pmc/articles/PMC3955066/ /pubmed/24492498 http://dx.doi.org/10.4103/0301-4738.126170 Text en Copyright: © Indian Journal of Ophthalmology http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Shetty, Rohit
D’Souza, Sharon
Ramachandran, Sarika
Kurian, Mathew
Nuijts, Rudy M M A
Decision making nomogram for intrastromal corneal ring segments in keratoconus
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 Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3955066/
https://www.ncbi.nlm.nih.gov/pubmed/24492498
http://dx.doi.org/10.4103/0301-4738.126170
work_keys_str_mv AT shettyrohit decisionmakingnomogramforintrastromalcornealringsegmentsinkeratoconus
AT dsouzasharon decisionmakingnomogramforintrastromalcornealringsegmentsinkeratoconus
AT ramachandransarika decisionmakingnomogramforintrastromalcornealringsegmentsinkeratoconus
AT kurianmathew decisionmakingnomogramforintrastromalcornealringsegmentsinkeratoconus
AT nuijtsrudymma decisionmakingnomogramforintrastromalcornealringsegmentsinkeratoconus