Intrastromal Corneal Ring Segments in Previously Cross-Linked versus Virgin Keratoconic Corneas: A Multi-Parameter Propensity Score Matched Analysis.

IF 3.2 3区医学 Q2 OPHTHALMOLOGY

Journal of cataract and refractive surgery Pub Date : 2025-08-25 DOI:10.1097/j.jcrs.0000000000001768

Karim Kozhaya, Jad F Assaf, Nasrine Anais El Salloukh, Nour Nasser, Shady T Awwad

{"title":"Intrastromal Corneal Ring Segments in Previously Cross-Linked versus Virgin Keratoconic Corneas: A Multi-Parameter Propensity Score Matched Analysis.","authors":"Karim Kozhaya, Jad F Assaf, Nasrine Anais El Salloukh, Nour Nasser, Shady T Awwad","doi":"10.1097/j.jcrs.0000000000001768","DOIUrl":null,"url":null,"abstract":"Purpose: To compare outcomes of intrastromal corneal ring segments (ICRS) insertion in crosslinked (CXL) versus non-CXL keratoconic eyes, using a multi-parameter propensity score matching (PSM).Setting: American University of Beirut Medical Center, Beirut, Lebanon.Design: Retrospective case series.Methods: A total of 198 eyes with mild to moderate keratoconus who underwent ICRS insertion were included. Our data were divided into two groups, based on whether CXL was performed before ICRS insertion. A PSM was used to balance the following covariates: age, gender, ICRS segment thickness, arc size, optical zone, topographic data and total corneal coma. Visual, refractive, topographic and total corneal aberrometric data were measured preoperatively and at 6 months post-ICRS implantation.Results: After 1:1 PSM, 32 eyes from 27 patients with prior CXL were matched to 32 untreated eyes from 30 patients. Preoperative parameters were not statistically different between the groups (ps>.05). Both groups displayed a statistically significant improvement in visual, refractive, and topographic (simulated keratometry, maximum axial keratometry, and keratometric astigmatism) and total corneal aberrometric (total higher order aberrations and coma) outcomes 6 months after ICRS insertion (all ps<.05). The changes in all reported visual, refractive, topographic and total corneal aberrometric outcomes were not statistically different between CXL and non-CXL eyes (all ps>.05).Conclusions: When properly matched for preoperative disease type and severity, ICRS insertion had a similar improvement in eyes with and without CXL.","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":3.2000,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of cataract and refractive surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/j.jcrs.0000000000001768","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: To compare outcomes of intrastromal corneal ring segments (ICRS) insertion in crosslinked (CXL) versus non-CXL keratoconic eyes, using a multi-parameter propensity score matching (PSM).

Setting: American University of Beirut Medical Center, Beirut, Lebanon.

Design: Retrospective case series.

Methods: A total of 198 eyes with mild to moderate keratoconus who underwent ICRS insertion were included. Our data were divided into two groups, based on whether CXL was performed before ICRS insertion. A PSM was used to balance the following covariates: age, gender, ICRS segment thickness, arc size, optical zone, topographic data and total corneal coma. Visual, refractive, topographic and total corneal aberrometric data were measured preoperatively and at 6 months post-ICRS implantation.

Results: After 1:1 PSM, 32 eyes from 27 patients with prior CXL were matched to 32 untreated eyes from 30 patients. Preoperative parameters were not statistically different between the groups (ps>.05). Both groups displayed a statistically significant improvement in visual, refractive, and topographic (simulated keratometry, maximum axial keratometry, and keratometric astigmatism) and total corneal aberrometric (total higher order aberrations and coma) outcomes 6 months after ICRS insertion (all ps<.05). The changes in all reported visual, refractive, topographic and total corneal aberrometric outcomes were not statistically different between CXL and non-CXL eyes (all ps>.05).

Conclusions: When properly matched for preoperative disease type and severity, ICRS insertion had a similar improvement in eyes with and without CXL.

查看原文本刊更多论文

交联前角膜与新生角膜的角膜间环段：多参数倾向评分匹配分析。

目的：使用多参数倾向评分匹配（PSM）比较交联（CXL）和非CXL角膜锥形眼的角膜间环段（ICRS）插入的结果。地点：贝鲁特美国大学医学中心，黎巴嫩贝鲁特。设计：回顾性病例系列。方法：对行ICRS植入术的轻中度圆锥角膜198眼进行分析。我们的数据根据是否在ICRS插入前进行CXL分为两组。使用PSM来平衡以下协变量：年龄，性别，ICRS段厚度，弧大小，光学区，地形数据和角膜总昏迷。术前和植入icrs后6个月测量视力、屈光、地形和角膜总像差数据。结果：经1:1 PSM后，27例既往CXL患者的32只眼与30例未治疗的32只眼匹配。两组术前参数比较差异无统计学意义（p < 0.05）。在ICRS植入6个月后，两组在视力、屈光、地形（模拟角膜屈光、最大轴向角膜屈光和角膜散光）和角膜总像差（总高阶像差和昏迷）方面均有统计学意义上的改善（均p < 0.05）。结论：当术前疾病类型和严重程度适当匹配时，ICRS植入在有和没有CXL的眼睛中有相似的改善。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

$Journal of cataract and refractive surgery$

Journal of cataract and refractive surgery 医学-外科

CiteScore

5.60

自引率

14.30%

发文量

259

审稿时长

8.5 weeks

期刊介绍： The Journal of Cataract & Refractive Surgery (JCRS), a preeminent peer-reviewed monthly ophthalmology publication, is the official journal of the American Society of Cataract and Refractive Surgery (ASCRS) and the European Society of Cataract and Refractive Surgeons (ESCRS). JCRS publishes high quality articles on all aspects of anterior segment surgery. In addition to original clinical studies, the journal features a consultation section, practical techniques, important cases, and reviews as well as basic science articles.