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Causes of intrastromal corneal ring segment explantation: clinicopathologic correlation analysis.

Tipo: Artículo
Autores: Ferrer C, Alió JL, Montañés AU, Pérez-Santonja JJ, del Rio MA, de Toledo JA, Teus MA, Javaloy J.
Títuto Revista: Journal of cataract and refractive surgery
Referencia:
Colaboradores: Instituto Oftalmológico de Alicante (IOA)(RD07/0062/0018); Instituto Barraquer (RD07/0062/0007).
Centro: 14 - IOA - UMH
J Cataract Refract Surg. 2010 Jun;36(6):970-7.

Causes of intrastromal corneal ring segment explantation: clinicopathologic correlation analysis.

Source

Vissum Corporation-Instituto Oftalmológico de Alicante, Division of Ophthalmology, Universidad Miguel Hernandez, Alicante, Spain. cferrer@vissum.com

Abstract

PURPOSE:

To determine the main causes of intrastromal corneal ring segment (ICRS) explantation and the relationship with the microscopic findings on the ICRS surface.

SETTING:

Vissum Corporation-Instituto Oftalmológico de Alicante, Alicante, Spain.

METHODS:

This study evaluated ICRS that were explanted in centers in Spain from 2000 to 2008. Clinical data (reasons for explantation, date of implantation/explantation, tunnel creation technique, ICRS type) and scanning electron microscopy findings on the ICRS surface (adherent tissue-like material, cell deposits, protein) were documented.

RESULTS:

Intrastromal corneal ring segments were explanted from 58 eyes (47 patients). The main cause was extrusion (48.2% of explanted segments), followed by refractive failure (ie, poor refractive outcome) (37.9%), keratitis (6.8%; 3.7% culture positive), and corneal melting and perforation (6.8%). Scanning electron microscopy showed cells and cell debris on the ICRS explanted by extrusion, a clean surface on the ICRS explanted for refractive failure, and bacteria (cocci) in the case of proven infectious keratitis.

CONCLUSIONS:

The main cause of explantation was extrusion of the ICRS followed by refractive failure. There was a clear correlation between the cause of explantation and the microscopic findings on the ICRS. Extrusion was accompanied by inflammatory cells and cell debris on the ICRS surface. No inflammatory reaction was observed on the ICRS explanted for refractive failure.

(c) 2010 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

PMID: 20494769 [PubMed - indexed for MEDLINE]