Purpose
To develop and validate a novel automated software, Keratoconus Easy Fix®, to assess intrastromal rings (ICRS) surgical plans for keratoconus.
Methods
We developed a novel software that uses the data inserted by the surgeon and correlates this information with normograms, provided by manufacturer and modified by Dr. Albertazzi, giving as result a surgical plan indicating which ICRS should be used, ring position, and incision location. A Single-center, retrospective, noncomparative series of 62 eyes (45 patients) was conducted using the surgical plans provided by the software. Patients name, clinical ID, keratoconus topography type, subjective refraction with sphere, astigmatism with axis or theoric refraction with Kf and Ks with respective axis must be inserted for software analysis and surgical plan result. All patients had at least 6-month follow-up. Main outcome measures were evaluated as a reduction of the keratometric (K) values: K minimal (Kmin) and K maximal (Kmax)).Visual outcome were measured as improve in uncorrected distance visual acuity (UDVA), best corrected visual acuity (CDVA), and refractive error (myopia and astigmatism) reduction (decimal scale). Data were processed with R-programing language for descriptive and inference statistical analysis. All patients were informed and consented use of the software.
Results
There were a significant reduction of keratometric values Kmax ( Kmax-pre 49,72 ± 4,36 to Kmax-post 46,84 ± 3,59). Regarding VA there were a significative (p<0.01) reduction: Mean UDVA change from 0,31 ± 0,22 to 0,56 ± 0,31;. Mean DCVA from 0,73 ± 0,23 to 0,81 ± 0,21. Myopic and astigmatism components were highly reduced after ICRS implantation (P < 0.01). Myopia was reduced from -2,64± 3,34 to -1,81 ± 2,78. Astigmatism was reduced from -2,99 ± 1,63 to -1,01 ± 1,36. No intraoperative and postoperative complications occurred in these eyes.
Conclusions
Keratoconus Easy Fix®, is an effective, user-friendly software that provides ICRS surgical plans with good postsurgical result. This program should be used to asses keratoconus surgeons but mustn’t be replaced by a good and detail clinical evaluation, the final decision is always a surgeons responsibility.