Comparison of the MyoRing implantation depth by mechanical dissection using PocketMaker microkeratome versus Melles\xa0hook via AS-OCT

Shiva Pirhadi,Hossein Aghamollaei,Hashem Daryabari,Neda Mohammadi,Seyed Aliasghar Mosavi,Khosrow Jadidi

doi:10.1186/s12886-018-0806-2

Abstract

BackgroundThis paper seeks to evaluate the depth and outcomes of MyoRing implantation using two mechanical dissection procedures including: PocketMaker microkeratome in opposition to the Melles hook method.MethodsThis retrospective study was carried out on 39 eyes of 38 keratoconus patients (28 male and 10 female) with the mean age of 28.97frac{+}{.}10.37 years and had undergone MyoRing implantation by the two mentioned methods. The MyoRing was inserted into the corneal pocket which was made manually in 18 eyes (Melles hook group) or with PocketMaker microkeratome in 21 eyes (PocketMaker group). The mean follow up time was 9.81frac{+}{.}3.7 months with pre-operative and post-operative ophthalmic examination including uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), keratometry readings and central corneal thickness measurement. AS-OCT (Casia, SS-1000, Tomey, Nagoya, Japan) imaging was used to measure MyoRing insertion depth, exactly.ResultsPre-operative and post-operative UCVA (LogMAR) mean change for the PocketMaker and Melles hook groups were recorded at 0.75 ± 0.32 and 0.78 ± 0.33, respectively. Similarly, BCVA (LogMAR) mean change were 0.27 ± 0.22 and 0.23 ± 0.22. Mean keratometry (Kmean) change were 6.06 ± 4.18 and 6.56 ± 3.55 respectively. UCVA change (P = 0.767), BCVA change (P = 0.77) and Kmean change (P = 0.693) showed that there was no statistically significant difference between both groups for any parameter. Depth measurements achieved from AS-OCT images showed that there was no statistically significant difference in pocket depth between two methods of MyoRing implantation (P = 0.413).ConclusionsThe results of Myoring implantation outcomes using mechanical dissection via PocketMaker microkeratome as against Melles hook are comparable.

Highlights

This paper seeks to evaluate the depth and outcomes of MyoRing implantation using two mechanical dissection procedures including: PocketMaker microkeratome in opposition to the Melles hook method
Pre-operative and post-operative uncorrected visual acuity (UCVA) (LogMAR) mean change for the PocketMaker and Melles hook groups were recorded at 0.75 ± 0.32 and 0.78 ± 0.33, respectively
Depth measurements achieved from anterior segment optical coherence tomography (AS-OCT) images showed that there was no statistically significant difference in pocket depth between two methods of MyoRing implantation (P = 0.413)

Summary

Introduction

This paper seeks to evaluate the depth and outcomes of MyoRing implantation using two mechanical dissection procedures including: PocketMaker microkeratome in opposition to the Melles hook method. There are several ways to manage different stages of this disease These stages include the use of contact lens, corneal collagen cross-linking (CXL), intracorneal ring implantation, lamellar and penetrating keratoplasty [2,3,4,5,6]. The ring is inserted into an intrastromal pocket, which is created by femtosecond laser [11, 13] or a microkeratome PocketMaker (Dioptex GmbH, Austria) [8]. It can be inserted mechanically using the Melles hook approach. The depth of the corneal pocket was suggested to be 300 μm [11, 12]

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Conclusion