Efficacy of single or paired intrastromal corneal ring segment implantation combined with collagen crosslinking in keratoconus
Bibliographic record
Abstract
PURPOSE: To evaluate the efficacy of single or paired intrastromal corneal ring segments (ICRS) combined with ultraviolet-A and riboflavin collagen crosslinking (CXL) in patients with keratoconus. SETTING: Cornea Unit, Toronto Western Hospital, Toronto, Ontario, Canada. DESIGN: Retrospective comparative case series. METHODS: Consecutive patients with keratoconus had femtosecond laser-assisted ICRS implantation combined with same-day CXL between 2008 and 2011. The main outcome measures included improvement in visual acuity, subjective refractive error, keratometry values, and total higher-order aberration (HOA). RESULTS: Eighty-five eyes of 74 patients with keratoconus (paired ICRS: 47 eyes of 40 patients; single ICRS: 38 eyes of 34 patients) were included in the study. The uncorrected distance visual acuity was significantly improved after single ICRS (3.4 lines; P=.04) and paired ICRS (2.7 lines; P=.01) implantation combined with CXL, while corrected distance visual acuity (CDVA) remained stable. The single and paired ICRS groups had a significant reduction in mean cylinder at 1 year (single ICRS: -3.84 diopters [D] ± 1.72 [SD] versus -2.19 ± 1.54 D, P=.02; paired ICRS: -3.91 ± 1.45 D versus -2.96 ± 1.92 D) (P=.02). There was no significant difference in total HOAs. Single ICRS implantation and paired ICRS implantation with CXL were equivalent in all refractive parameters. No patient lost lines of CDVA. CONCLUSION: As determined by corneal topography, implantation of single or paired ICRS combined with same-day CXL was safe and effective in patients with keratoconus.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".