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Type presentatieOral presentation
TitelMorphological characterization and clinical effects of stromal alterations after intracorneal ring segments (ICRS) implantation in keratoconus
DoelTo analyze the stromal tissue changes after ICRS implantation and their refractive and topographic effects in patients with keratoconus.
MethodesThis retrospective case series included 15 patients with clinical peri-segmental lamellar channel deposits after ICRS implantation for keratoconus. The stromal changes were investigated using in-vivo confocal microscopy. Two patients underwent a penetrating keratoplasty after ICRS implantation, the explanted corneas were processed for histopathology and transmission electron microscopy (TEM). Refractive and topographic effects were investigated comparing the uncorrected (UDVA) and corrected (CDVA) distance visual acuity, spherical equivalent (SE), flat (K1), steep (K2) and steepest (Kmax) keratometry before and after detection of lamellar channel deposits.
ResultatenIn-vivo confocal microscopy revealed diffuse linear and focal granular hyperreflective structures. Histologically, there was mild proliferation of fibroblasts and fibrosis. TEM demonstrated focal accumulations of degenerated keratocytes with cytoplasmic lipid inclusions. There were no significant changes for UDVA (Δ = 0.0 ± 0.2 logMAR; p = 0.67), CDVA (Δ = 0.0 ± 0.1 logMAR; p = 0.32), SE (Δ 0.1 ± 0.9 D; p = 0.22), K1 (Δ = 0.3 ± 1.0 D; p = 0.28), K2 (Δ = 0.1 ± 0.9 D; p = 0.51) and Kmax (Δ = 0.3 ± 1.5 D; p = 0.17).
ConclusieTwo types of structural stromal changes were identified: (1) diffuse peri-segmental fibrosis and (2) lamellar channel deposits. These structural changes showed no evidence of refractive or topographic effect.
BelangenverstrengelingNee
Auteur 1
NaamHAMON
InitialenL
InstituutUniversitätsklinikum des Saarlandes
StadHomburg
Auteur 2
NaamSchlötzer-Schrehardt
InitialenU
InstituutUniversitätsklinikum Erlangen
StadErlangen
Auteur 3
NaamFlockerzi
InitialenFA
InstituutUniversitätsklinikum des Saarlandes
StadHomburg
Auteur 4
NaamSeitz
InitialenB
InstituutUniversitätsklinikum des Saarlandes
StadHomburg
Auteur 5
NaamDaas
InitialenL
InstituutUniversitätsklinikum des Saarlandes
StadHomburg
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