Changes in visual function under mesopic and photopic conditions after intrastromal corneal ring segment implantation for different stages of keratoconus

• Published in: Journal of cataract and refractive surgery Vol. 39; no. 3; pp. 393 - 402
• Main Authors: Carballo, Jesús, BS, Puell, María Cinta, PhD, Cuiña, Ricardo, MD, Vázquez, José María, MsC, Benitez-del-Castillo, José M., MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2013
• Subjects: Adolescent; Adult; Color Vision - physiology; Contrast Sensitivity - physiology; Corneal Pachymetry; Corneal Stroma - surgery; Female; Humans; Keratoconus - classification; Keratoconus - physiopathology; Keratoconus - surgery; Male; Mesopic Vision - physiology; Middle Aged; Ophthalmology; Prospective Studies; Prostheses and Implants; Prosthesis Implantation; Refractive Surgical Procedures - methods; Visual Acuity - physiology; Young Adult
• ISSN: 0886-3350; 1873-4502
• DOI: 10.1016/j.jcrs.2012.09.025

Purpose To analyze and compare the changes in visual function under mesopic and photopic conditions in different stages of keratoconus before and after Keraring intrastromal corneal ring segment (ICRS) implantation. Setting Clinico San Carlos Hospital and Faculty of Optics and Optometry, Complutense University, Madrid, Spain. Design Case series. Methods Keratoconic eyes were evaluated under mesopic (0.1 to 0.2 candelas [cd]/m2 ) and photopic (85 cd/m2 ) conditions. LogMAR high-contrast corrected distance visual acuity (CDVA) and low-contrast CDVA were assessed using the Bailey-Lovie test and logarithmic contrast sensitivity, using the Pelli-Robson test. Results The study evaluated 12 eyes with stage I keratoconus, 21 eyes with stage 2, and 14 eyes with stage 3. The mean change in photopic high-contrast CDVA was 0.16 logMAR ± 0.20 (SD) ( P <.00001). Photopic low-contrast CDVA increased by a mean of 0.14 ± 0.26 logMAR ( P =.0005), photopic contrast sensitivity by a mean of 0.09 ± 0.22 logMAR ( P =.005), and mesopic high-contrast CDVA by a mean of 0.10 ± 0.26 logMAR ( P =.03). There were no significant differences between stages. Surgery did not affect the mean changes in mesopic low-contrast CDVA or mesopic contrast sensitivity for any stage. Conclusions Implantation of ICRS in keratoconic eyes increased photopic high-contrast CDVA, low-contrast CDVA, and contrast sensitivity. Under low luminance, the mean changes in high-contrast CDVA, low-contrast CDVA, and contrast sensitivity did not worsen after ICRS implantation performed 5.0 mm from the visual axis, despite the rings being partially superimposed on the mydriatic pupil. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned.