Evidence map›Paper›PMID 41041042›Full record

ReviewJournal of current ophthalmology

Asymmetric Intracorneal Ring Segments for the Management of Keratoconus: A Systematic Review and Meta-Analysis.

Dillan Cunha Amaral, Milton Ruiz Alves, Jaime Guedes, Helvécio Neves Feitosa Filho, Eduardo Henrique Cassins Aguiar, Dhiogo Cezar Correa, Evandro Ribeiro Diniz, Raiza Jacometti, Ricardo Noguera Louzada

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Journal of current ophthalmology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. Review
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

9 authors.

Dillan Cunha AmaralDepartment of Ophthalmology and Otorhinolaryngology, Facuty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil.
Milton Ruiz AlvesDepartment of Ophthalmology and Otorhinolaryngology, Faculty of Medicine, University of São Paulo, São Paulo, São Paulo, Brazil.
Jaime GuedesGlaucoma Research Center, Wills Eye Hospital, Philadelphia, PA, USA.
Helvécio Neves Feitosa FilhoFaculty of Medicine, University of Fortaleza, Fortaleza, CE, Brazil.
Eduardo Henrique Cassins AguiarDepartment of Ophthalmology and Otorhinolaryngology, Facuty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil.
Dhiogo Cezar CorreaDepartment of Ophthalmology and Otorhinolaryngology, Faculty of Medicine, University of São Paulo, São Paulo, São Paulo, Brazil.
Evandro Ribeiro DinizDepartment of Ophthalmology and Otorhinolaryngology, Faculty of Medicine, University of São Paulo, São Paulo, São Paulo, Brazil.
Raiza JacomettiDepartment of Ophthalmology and Otorhinolaryngology, Faculty of Medicine, University of São Paulo, São Paulo, São Paulo, Brazil.
Ricardo Noguera LouzadaDepartment of Ophthalmology and Otorhinolaryngology, Facuty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose: To investigate the outcomes of asymmetric (AS) Keraring intracorneal ring segments (ICRS) implantation in patients with all types, types 2 (Duck) and 3 (Snowman) of keratoconus. Methods: The protocol for this systematic review was registered in the International Prospective Register of Systematic Reviews (CRD42023482841). From inception to December 2023, we systematically searched PubMed, Embase, Cochrane Library, and Web of Science. Due to heterogeneity, a random-effects model was used for all analyses. Publication bias was evaluated using the risk of bias in nonrandomized studies of interventions tool, and sensitivity analyses included leave-one-out and Baujat methods. Meta-regression explored the effects of age, sex, and follow-up time on heterogeneous outcomes. Software R version 4.3.2 was used for statistical analysis. Results: From 318 initial articles, 7 studies (3 prospective and 4 retrospective cohorts) met inclusion criteria, pooling 435 eyes from 365 patients across seven countries. Significant improvements were observed postoperatively for uncorrected distance visual acuity (mean differences [MD]: 0.49, confidence interval [CI]: 0.42-0.57), corrected distance visual acuity (CDVA) (MD: 0.18, CI: 0.07-0.29), topographic astigmatism (MD: 2.04 diopter [D], CI: 1.51-2.58 D), maximum keratometric (MD: 4.42 D, CI: 3.24-5.60 D), comatic aberration (MD: 0.56 µm, CI: 0.29-0.82 µm), refractive astigmatism (MD: -2.52 D, CI: -3.08 to -1.95 D), spherical equivalent (SE) (MD: -2.86 D, CI: -4.02 to -1.70 D), and mean keratometry (MD: 2.92 D, CI: 1.94-3.91 D). Subgroup analyses for keratoconus types 2 and 3 revealed consistent improvements across most parameters. Sensitivity analysis identified specific studies influencing heterogeneity without altering statistical significance. Meta-regression revealed associations for follow-up and male gender in SE, CDVA, and topographic astigmatism, while age showed no consistent effect. Conclusion: The implantation of AS Keraring ICRS was safe and effective, improving visual, topographic, and refractive parameters in patients with keratoconus of phenotype types 2, 3, and all types.

Indexed as

Corneal topographyIntracorneal ring segmentsKeratoconusMeta-analysis

Identifiers

PMID41041042
PMCPMC12487811

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-SA
Read underepoch 390

Registered trials

None linked

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.