ophthalmologyОфтальмологияOphthalmology in Russia1816-50952500-0845Ophthalmology10.18008/1816-5095-2019-1S-85-90ophthalmology-904Research ArticleКЛИНИЧЕСКИЕ И ЭКСПЕРИМЕНТАЛЬНЫЕ ИССЛЕДОВАНИЯCLINICAL & EXPERIMENTAL RESEARCHСравнительные результаты имплантации роговичного кольца MyoRing и сочетанного применения имплантации MyoRing с кросслинкингом роговицы у пациентов с кератоконусомMyoRing Implantation in Comparison with MyoRing Implantation Combined with Corneal Collagen Crosslinking for Keratoconushttps://orcid.org/0000-0002-0569-1264КазакбаеваГ. М.KazakbaevaG. M.

младший научный сотрудникул. Пушкина, 90, Уфа 450008, Российская Федерация

Research AssistantPushkin str., 90, Ufa 450008, Russia

gyullibikbova@gmail.comГБУ «Уфимский научно-исследовательский институт глазных болезней Академии наук Республики Башкортостан»РоссияUfa Eye Research InstituteRussian Federation201922042019161S8590Copyright © Казакбаева Г.М., 20192019Казакбаева Г.М.Kazakbaeva G.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.ophthalmojournal.com/opht/article/view/904

Цель: провести сравнительную оценку эффективности лечения кератоконуса путем имплантации роговичного кольца MyoRing и сочетания имплантации кольца с кросслинкингом роговицы в отдаленные сроки. Пациенты и методы. В исследование вошел 101 пациент (124 глаза) с прогрессирующим кератоконусом в возрасте от 18 до 59 лет. Всем пациентам были имплантированы интрароговичные кольца (ИРК). Пациенты были разделены на 2 группы: контрольную составили 59 пациентов (76 глаз), которым имплантировали ИРК, основную — 42 пациента (48 глаз), у которых имплантация MyoRing сочеталась с кросслинкингом роговицы (CXL). Результаты. Через 36 месяцев после проведенного лечения в обеих группах наблюдалось снижение средних значений преломляющей силы роговицы: в контрольной — на 8,45 D и в основной — на 7,44 D, роговичный астигматизм снизился на 3,33 и на 3,11 D, сферический эквивалент — на 7,72 и 6,29 D соответственно. Наименьшая толщина роговицы в период наблюдения оставалась стабильной. В обеих группах отмечено улучшение некорригированной и корригированной остроты зрения, а разницу в КОЗ в сроки до 12 месяцев после операции можно объяснить образованием псевдохейза в группе с комбинированной процедурой. Вывод. Имплантация ИРК MyoRing и сочетание MyoRing с CXL показали эффективность и безопасность в отношении стабилизации прогрессирующего кератоконуса, а также коррекции сопутствующих аметропий через 3 года после операции. Существенной разницы при проведении имплантации MyoRing и в сочетании с кросслинкингом роговицы в визуальных и рефракционных результатах не наблюдалось, за исключением показателя преломляющей силы роговицы. Необходимы более длительные последующие и рандомизированные проспективные исследования с большим числом пациентов.

Purpose: tо estimate the effectiveness of complete corneal ring (MyoRing) implantation compared with MyoRing implantation combined with corneal collagen crosslinking (CXL) for keratoconus treatment for 36 months follow-up. Patients and Methods. There were 101 patients (124 eyes) with progressing keratoconus aged 18–59 years in the study. Intracorneal rings were implanted in all patients. The patients were divided into 2 groups. MyoRing implantation was performed in a series of 59 patients (76 eyes) with keratoconus II–III Amsler classification, 42 patients (48 eyes) had MyoRing implantation combined with CXL. Implantation of a MyoRing in the corneal pocket was performed using a PocketMaker microkeratome and corneal intrastromal implantation system. Results. Keratometry was reduced in both groups; after MyoRing implantation for 8,45 D and MyoRing combined with CXL for 7,44 D, the spherical equivalent decreased for 7,72 and 6,29 D respectively, after 36 months. The cylinder decreased to 3,33 D with MyoRing alone and to 3,11 D with MyoRing combined with CXL. The smallest corneal thickness remained stable during 36 months after the procedure. There was an improvement in uncorrected and corrected visual acuity, and the difference in the CRF within the period of up to 12 months after the operation. It can be explained by the pseudochase formation in the group with a combined procedure. Conclusion. The implantation of the MyoRing IRC and the combination of MyoRing with CXL showed efficacy and safety in stabilizing keratoconus stabilization, as well as correction of comorbided ametropia 3 years after surgery. Both MyoRing implantation and MyoRing combined with CXL were effective in the stabilization of progressive keratoconus, as well as the correction of ametropia 3 years after surgery. There was no significant difference in MyoRing implantation and its combination with corneal crosslinking in visual and refractive results. The refractive power of the cornea was only one exeption. Long follow-up and randomized prospective studies with a large number of patients are needed.

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The authors declare that there are no conflicts of interest present.