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L.B. Sousa, L. Grupenmacher, L.T. Dalfre, T.B. C. Andrade; Comparison Among Intra–Estromal Ring Implant and Automated Anterior Lamellar Keratoplasty Techniques in the Treatment of Keratoconus Patients . Invest. Ophthalmol. Vis. Sci. 2006;47(13):1323.
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To compare the effectiveness of intra–estromal ring implant(AIC) and automated anterior lamellar keratoplasty (ALTK) techniques in the treatment of keratoconus patients
Thirty patients with keratoconus and keratoplasty indication were selected from the Cornea and External Diseases section of the Sorocaba Ophthalmologic Hospital. The inclusion criteria’s were keratometry value smaller than 65 D in the largest axis by topographical exam, absence of cornea opacity and agreement in participating in the study. They were submitted to complete ophthalmologic exam, including cornea topography (TC), ultrasonic paquimetry and specular microscopy (EM). The patients were submitted to the procedures ( Keraring® implant or ALTK) by two experience surgeons in each technique, in a randomized way. The follow–up visits were at 1, 7 and 15 days of post operative, monthly until the third month, in the sixth and twelfth post operative month ,by an eye specialist different from the surgeon.
All the patients were submitted to the determined surgical procedure.. On the 30 day follow up, the patients of the group I present visual acuity without correction (VAsc) of 0,093 ± 0,047 (pre–op of 0,04 ±0,034); EM without alterations in relation to the preoperative values, the same happening with the paquimetry. The topography showed a medium flattening of 4 D in each axis. One patient presented extrusion of a ring fragment and 3 presented difficulty of cicatrization of the incision. In the group 2, the patients present VAsc of 0,14 ± 0,07 (pre–op of 0,036 ± 0,024), with no alteration in the values of EM. The paquimetry values were increased in 184µ in the central area and the topography presented a medium flattening of 10 D. Until this time, no complications was observed in this group.
With 30 days of follow–up, the accomplishment of AIC and ALTK in patients with keratoconus determined an improvement of VAsc and a cornea flattening. ALTK promoted thicker corneas. Six months of follow–up will be presented.
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