AIM:To evaluate the short-term clinical outcomes of Ferrara rings in keratoconus using an optimized nomogram developed after several years of research and retrospective analysis of clinical data.METHODS:This prospecti...AIM:To evaluate the short-term clinical outcomes of Ferrara rings in keratoconus using an optimized nomogram developed after several years of research and retrospective analysis of clinical data.METHODS:This prospective longitudinal non-comparative clinical trial evaluated 88 eyes of 88 patients(age 18-62 y)with keratoconus diagnosis from two Spanish centers.Ferrara ring segment(AJL Ophthalmic)implantation was performed in all cases,using the mechanical procedure in 25 eyes(28.4%)and a femtosecond laser-assisted procedure in 63 eyes(71.6%).The ring segments implanted in each case were selected using a new optimized nomogram that considered variables such as anterior corneal asphericity and astigmatism or the discrepancy among astigmatism and coma orientations.Visual,refractive,corneal topographic,aberrometric,and pachymetric changes after surgery were evaluated during a 3-month follow-up.RESULTS:The implants induced a significant refractive change as well as an improvement in uncorrected(UDVA)and corrected distance visual acuity(CDVA;P<0.001).Postoperative CDVA of 0.10 log MAR or better was achieved in 28.4%and 46.5%of eyes,respectively.Two eyes(2.3%)lost two or more lines of CDVA whereas a total of 53.5%of eyes gained lines of CDVA.A significant central anterior and posterior corneal flattening was induced(P≤0.003),with a significant reduction of anterior(P<0.001)and posterior corneal astigmatisms(P=0.048),and a change in anterior asphericity(P<0.001).Total primary coma(6 mm pupil)change was also statistically significant(preoperative 3.66±3.04μm vs postoperative 2.33±2.26μm,P<0.001).No significant differences were found in the effect of ring segments between cases implanted using the mechanical and femtosecond techniques(P≥0.101).CONCLUSION:The implantation of Ferrara rings based on the nomogram evaluated is safe and effective for promoting a visual rehabilitation in keratoconus,with a relevant control of primary coma aberration.展开更多
I am Dr. David P Pifiero from the Department of Optics, Pharmacology and Anatomy of the University of Alicante and from the Department of Ophthalmology of Vithas Medimar （Oftalmar） and Vithas Virgen del Carmen （Qv...I am Dr. David P Pifiero from the Department of Optics, Pharmacology and Anatomy of the University of Alicante and from the Department of Ophthalmology of Vithas Medimar （Oftalmar） and Vithas Virgen del Carmen （Qvision） hospitals in Spain.展开更多
Introduction Over the last years it the amount of biomedical information published has reached an unstoppable progression.One ophthalmologist fully dedicated would only reach a very little proportion of the informatio...Introduction Over the last years it the amount of biomedical information published has reached an unstoppable progression.One ophthalmologist fully dedicated would only reach a very little proportion of the information published,during his working day.Testing if the studies’conclusions are generalizable and applicable to his environment would also require knowledge and basic skills,to systematize and interpret the scientific literature.展开更多
基金Supported by the Ministry of Economy, Industry and Competitiveness of Spain within the program Ramón y Cajal (RYC-2016-20471)
文摘AIM:To evaluate the short-term clinical outcomes of Ferrara rings in keratoconus using an optimized nomogram developed after several years of research and retrospective analysis of clinical data.METHODS:This prospective longitudinal non-comparative clinical trial evaluated 88 eyes of 88 patients(age 18-62 y)with keratoconus diagnosis from two Spanish centers.Ferrara ring segment(AJL Ophthalmic)implantation was performed in all cases,using the mechanical procedure in 25 eyes(28.4%)and a femtosecond laser-assisted procedure in 63 eyes(71.6%).The ring segments implanted in each case were selected using a new optimized nomogram that considered variables such as anterior corneal asphericity and astigmatism or the discrepancy among astigmatism and coma orientations.Visual,refractive,corneal topographic,aberrometric,and pachymetric changes after surgery were evaluated during a 3-month follow-up.RESULTS:The implants induced a significant refractive change as well as an improvement in uncorrected(UDVA)and corrected distance visual acuity(CDVA;P<0.001).Postoperative CDVA of 0.10 log MAR or better was achieved in 28.4%and 46.5%of eyes,respectively.Two eyes(2.3%)lost two or more lines of CDVA whereas a total of 53.5%of eyes gained lines of CDVA.A significant central anterior and posterior corneal flattening was induced(P≤0.003),with a significant reduction of anterior(P<0.001)and posterior corneal astigmatisms(P=0.048),and a change in anterior asphericity(P<0.001).Total primary coma(6 mm pupil)change was also statistically significant(preoperative 3.66±3.04μm vs postoperative 2.33±2.26μm,P<0.001).No significant differences were found in the effect of ring segments between cases implanted using the mechanical and femtosecond techniques(P≥0.101).CONCLUSION:The implantation of Ferrara rings based on the nomogram evaluated is safe and effective for promoting a visual rehabilitation in keratoconus,with a relevant control of primary coma aberration.
文摘I am Dr. David P Pifiero from the Department of Optics, Pharmacology and Anatomy of the University of Alicante and from the Department of Ophthalmology of Vithas Medimar （Oftalmar） and Vithas Virgen del Carmen （Qvision） hospitals in Spain.
文摘Introduction Over the last years it the amount of biomedical information published has reached an unstoppable progression.One ophthalmologist fully dedicated would only reach a very little proportion of the information published,during his working day.Testing if the studies’conclusions are generalizable and applicable to his environment would also require knowledge and basic skills,to systematize and interpret the scientific literature.
