Abstract：
OBJECTIVE: To review the prevalence and describe the characteristics, of cases with late-onset intracorneal ring segments (ICRS) keratopathy in a multicenter study.
METHODS: A retrospective multicentric case-series study was performed in a specialized keratoconus service, from Buenos Aires, Argentina. An electronic clinical chart from patients with ICRS keratopathy between January 1999 and January 2019 was reviewed. We included cases with late-onset distal-apical ICRS keratopathy, which was defined as a persistent corneal lesion developed 12 months or later after implantation, located over, around, or closer to the ICRS. All the surgeries were performed by a manual corneal tunnel creation technique. Samples were taken to rule out infectious etiology.
RESULTS: From 5217 eyes that underwent ICRS implantation, 13 cases (0.24%) were detected. The keratopathy onset was 72 ± 42.98 months (29-133) after ICRS implantation. Cultures were negative in all cases. An ICRS exchange was made for five cases in stage I and four in stage II. Four cases presented with partial ICRS extrusion in stage III. ICRS exchange was possible in two of them and a penetration keratoplasty was necessary for the rest. All cases remained stable 1 year after surgical procedures.
CONCLUSIONS: A late-onset distal-apical ICRS keratopathy was detected with low prevalence (0.24%) in a large sample. It was classified into three stages according to its severity. Different treatments were selected for each stage, obtaining stable results 1 year after treatment.
METHODS: A retrospective multicentric case-series study was performed in a specialized keratoconus service, from Buenos Aires, Argentina. An electronic clinical chart from patients with ICRS keratopathy between January 1999 and January 2019 was reviewed. We included cases with late-onset distal-apical ICRS keratopathy, which was defined as a persistent corneal lesion developed 12 months or later after implantation, located over, around, or closer to the ICRS. All the surgeries were performed by a manual corneal tunnel creation technique. Samples were taken to rule out infectious etiology.
RESULTS: From 5217 eyes that underwent ICRS implantation, 13 cases (0.24%) were detected. The keratopathy onset was 72 ± 42.98 months (29-133) after ICRS implantation. Cultures were negative in all cases. An ICRS exchange was made for five cases in stage I and four in stage II. Four cases presented with partial ICRS extrusion in stage III. ICRS exchange was possible in two of them and a penetration keratoplasty was necessary for the rest. All cases remained stable 1 year after surgical procedures.
CONCLUSIONS: A late-onset distal-apical ICRS keratopathy was detected with low prevalence (0.24%) in a large sample. It was classified into three stages according to its severity. Different treatments were selected for each stage, obtaining stable results 1 year after treatment.
摘要：
目的：回顾患病率并描述特征，在多中心研究中，晚发性角膜内环形节段（ICRS）角膜病变的病例。
方法：在专业的圆锥角膜服务机构中进行了一项回顾性多中心病例系列研究，来自布宜诺斯艾利斯,阿根廷。回顾了1999年1月至2019年1月ICRS角膜病变患者的电子临床图。我们纳入了晚发性远端根尖ICRS角膜病变的病例，其定义为植入后12个月或更晚出现持续性角膜病变，位于上方，周围，或更接近ICRS。所有手术均通过手动角膜隧道创建技术进行。取样以排除感染性病因。
结果：从接受ICRS植入的5217只眼，检出13例(0.24%)。植入ICRS后，角膜病变的发病时间为72±42.98个月（29-133）。培养物在所有情况下都是阴性的。对第一阶段的五个案例和第二阶段的四个案例进行了ICRS交换。在第三阶段出现部分ICRS挤压的4例病例。其中两个可以进行ICRS交换，其余的则需要进行穿透性角膜移植术。所有病例在外科手术后1年保持稳定。
结论：在大样本中检测到晚发性根尖远端ICRS角膜病变，患病率较低（0.24%）。根据其严重程度将其分为三个阶段。每个阶段选择不同的处理方法，治疗后1年获得稳定结果。
方法：在专业的圆锥角膜服务机构中进行了一项回顾性多中心病例系列研究，来自布宜诺斯艾利斯,阿根廷。回顾了1999年1月至2019年1月ICRS角膜病变患者的电子临床图。我们纳入了晚发性远端根尖ICRS角膜病变的病例，其定义为植入后12个月或更晚出现持续性角膜病变，位于上方，周围，或更接近ICRS。所有手术均通过手动角膜隧道创建技术进行。取样以排除感染性病因。
结果：从接受ICRS植入的5217只眼，检出13例(0.24%)。植入ICRS后，角膜病变的发病时间为72±42.98个月（29-133）。培养物在所有情况下都是阴性的。对第一阶段的五个案例和第二阶段的四个案例进行了ICRS交换。在第三阶段出现部分ICRS挤压的4例病例。其中两个可以进行ICRS交换，其余的则需要进行穿透性角膜移植术。所有病例在外科手术后1年保持稳定。
结论：在大样本中检测到晚发性根尖远端ICRS角膜病变，患病率较低（0.24%）。根据其严重程度将其分为三个阶段。每个阶段选择不同的处理方法，治疗后1年获得稳定结果。
