Evidence map›Paper›PMID 32930519›Full record

Trial reportActa ophthalmologica2021

A novel Q-value-based nomogram for single intracorneal ring segment implantation versus standard manufacturer's nomogram combined with accelerated cross-linking for treatment of keratoconus: a randomized controlled trial.

Mohammed Iqbal, Ahmed Elmassry, Amr Mounir, Ola Ibrahim, Ashraf Soliman

Abstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Acta ophthalmologica, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
  4. Article
  5. Observational
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Mohammed IqbalDepartment of Ophthalmology, Faculty of Medicine, Sohag University, Sohag, Egypt.ORCID https://orcid.org/0000-0002-7954-1277
Ahmed ElmassryDepartment of Ophthalmology, Faculty of Medicine, Alexandria University, Alexandria, Egypt.ORCID https://orcid.org/0000-0003-4221-8932
Amr MounirDepartment of Ophthalmology, Faculty of Medicine, Sohag University, Sohag, Egypt.ORCID https://orcid.org/0000-0001-9682-671X
Ola IbrahimDepartment of Ophthalmology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.ORCID https://orcid.org/0000-0003-2993-6040
Ashraf SolimanDepartment of Ophthalmology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.ORCID https://orcid.org/0000-0003-0681-8113

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo compare the efficacy of implanting a single Keraring segment according to a novel Q-value-based nomogram (QN) to that of segment implantation according to the manufacturer's standard nomogram (SN), for keratoconus treatment.

methodsThis was a prospective, randomized controlled trial of 104 patients (104 eyes) with Amsler-Krumeich grade 1 or 2 keratoconus, and type 1 or 2 cone asymmetry determined according to manufacturer's classification. They were randomly distributed into two groups: group A patients (n = 52) underwent Keraring implantation according to the SN, and group B patients (n = 52) underwent implantation of a single (210° arc-length) Keraring segment according to the QN. Both treatments were combined with accelerated transepithelial cross-linking, and follow-up was 6 months. Main outcome measures were preoperative and postoperative visual acuity, subjective refraction and corneal topography.

resultsAt postoperative month 6, group B exhibited statistically significantly higher values of mean uncorrected distance visual acuity (UDVA), sphere, K2, K-average, K-max and Q-anterior (p = 0.02, 0.01, 0.002, 0.001, 0.0001 and 0.03, respectively) compared to that of group A. However, group A exhibited better refractive cylindrical improvements (p = 0.04). In group A, we documented spontaneous extrusion of one Keraring segment.

conclusionSingle 210° arc-length segment implantation using our objective QN was more efficacious for keratoconus treatment than using the subjective SN. The nomograms were comparable when the Q-anterior value was >-1.00; however, the QN was superior to the SN when the Q-anterior value was ≤-1.00. The QN yielded greater postoperative UDVA and smoother corneal remodelling than did the SN for treatment of grade 1 and 2 keratoconic eyes.

Indexed as

NomogramsAdolescentAdultCorneaCorneal TopographyCross-Linking ReagentsFemaleFollow-Up StudiesHumansKeratoconusLenses, IntraocularLens Implantation, IntraocularMaleMiddle AgedPhotochemotherapyPhotosensitizing AgentsCross-Linking ReagentsPhotosensitizing Agentscorneal asphericitycorneal cross-linkingintracorneal ringsKeraringskeratoconusQ-value nomogram

Identifiers

PMID32930519
PMCPMC8359282

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.