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Efficacy of Complete Rings (Myoring) in Treatment of Keratoconus: A Systematic Review and Meta-Analysis Publisher Pubmed



Janani L1, 2 ; Tanha K1 ; Najafi F3, 4 ; Jadidi K5 ; Nejat F5 ; Hashemian SJ6 ; Dehghani M7 ; Sadeghi M8
Authors
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Authors Affiliations
  1. 1. Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
  2. 2. Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
  3. 3. Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
  4. 4. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Department of Ophthalmology, Bina Eye Hospital Research Center, Tehran, Iran
  6. 6. Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
  7. 7. Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
  8. 8. Department of Epidemiology, School of Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Source: International Ophthalmology Published:2019


Abstract

Purpose: We aimed to systematically review the existing evidence and determine the efficacy of MyoRing as a novel method for treatment of keratoconus using meta-analysis. Methods: Online electronic search of Medline, ISI Web of Science, Embase, Scopus, and Cochrane Library databases was performed with reference lists of relevant articles for pre–post trials published through August 2017. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), sphere, cylinder, spherical equivalent (SE), maximum, minimum, and mean keratometry were considered as the visual acuity outcomes. Weighted mean difference (WMD) with 95% confidence interval was used as pooled estimation of intervention efficacy using random-effects meta-analysis. Heterogeneity was measured with the Cochran Q statistic and quantified with the I2 statistic using Stata software. Results: Of the 47 potentially related studies, 21 eligible studies were included in the meta-analysis. The mean of uncorrected distance visual acuity (UDVA) based on LogMAR in patients with keratoconus had a significant change 3 months after implantation/embedding of the complete ring (WMD = − 0.73 (CI = − 0.88 to − 0.58), I2 = 79.9%, p < 0.001). Results support a statistically significance improvement in CDVA, SE, sphere, cylinder, and maximum keratometry after surgical intervention. Range of reported safety index, stability, and efficacy index by included studies was 1.7–2.7, 74–100%, and 0.9–1.96, respectively. Conclusions: MyoRing is an appropriate treatment option for keratoconus. Findings of this meta-analysis demonstrated that main visual outcomes have been improved 3, 6, and 12 months after the implantation of the complete ring (MyoRing). © 2019, Springer Nature B.V.
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