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• W4387079217 abstract "Keratoconus (KC) is an ectatic corneal disorder that causes, as the irregular astigmatism progress, severe vision loss. Surgical options allow us to correct, partially or totally, the induced refractive error. Intracorneal ring segments (ICRS) implantation represents a minimally invasive surgical option that improves visual acuity by modifying the corneal geometry. The success rate after ICRS implantation is high, and most importantly, the overall complication rate is low. Corneal allogenic intrastromal ring segments consists of ring segments derived from allogenic eye bank-processed donor corneas that can be combined simultaneously or sequentially with corneal cross linking (CXL) procedure in keratoconic patients intolerant to rigid gas permeable contact lenses. Selective topography guided sequential and simultaneous excimer laser transepithelial photorefractive or phototherapeutic keratectomy combined with conventional and accelerated CXL is another way in selected cases to improve spectacles corrected distance visual acuity (CDVA) of keratoconic eyes. The microphotoablative remodeling of the central corneal profile is generally planned by using topo-guided excimer laser software, optimizing the optical zones, minimizing tissue consumption to a maximum 55 µm of corneal stroma and taking into account the contribution of the epithelium and posterior corneal surface thank to ray-tracing software thus avoiding overcorrections. Phakic intraocular lens (PIOL) implant is considered in patients with stable disease, acceptable CDVA and with acceptable anatomical requirements. The two types of pIOLs, depending on their implantation inside the eye, are anterior chamber (AC)-pIOLs, with Artilens (Ophtec BV) representing the only commercially available model, which fixate to the anterior surface of the iris by using a polymethomethacrolate claw at the 2haptics, and posterior chamber (PC)-pIOLs, with ICL (Staar) concentrating almost all available scientific evidence about the use of PC-pIOL in KC. Patients with both cataracts and KC present unique challenges for the surgeon, given the peculiar optical characteristics of the ectatic corneas. In the preoperative evaluation, the correct IOL power is difficult to obtain due to the irregular corneal shape and K values. IOL selection is a crucial moment in the surgery. Toric IOL is recommended, but carefully judging the topography and the possible need of subsequent keratoplasties." @default.
• W4387079217 created "2023-09-28" @default.
• W4387079217 creator A5010900700 @default.
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• W4387079217 creator A5076990057 @default.
• W4387079217 creator A5091654539 @default.
• W4387079217 date "2023-09-01" @default.
• W4387079217 modified "2023-10-08" @default.
• W4387079217 title "Refractive Surgical Correction and Treatment of Keratoconus" @default.
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