CISIS/MyoRing case studies
The following case studies, which were selected on the basis of didactic criteria, shall help the interested patient to assess their case in relation to MyoRing treatment and assist eye doctors who treat patients with keratoconus to identify the right treatment approach and assess the results to be expected. In these case studies, the following abbreviations are used:
UDVA = uncorrected visual acuity
CDVA = corrected visual acuity
Keratoconus
Stage II keratoconus in both eyes
A 37-year-old female patient from Switzerland presented for CISIS treatment with a mild form of keratoconus. Prior to the MyoRing treatment, the patient’s refractive power and visual acuity were:
Right eye CDVA 0.8 with +0.25 s -1.75 c x 75° I UDVA 0.5
Left eye CDVA 1.0 with -0.25 s -2.0 c x 105° I UDVA 0.6
Five months after MyoRing treatment, the patient had the following refractive power und visual acuity:
Right eye UDVA 1.0
Left eye UDVA 1.0
The patient is highly satisfied and perfectly capable of managing her daily tasks without any vision aids at all.
Stage II keratoconus in the right eye
A 26-year-old Arab patient with mild keratoconus underwent CISIS treatment in his right eye. Prior to the intervention, the patient had the following refractive power and visual acuity:
Right eye UDVA 0.6 no improvement with glasses
One year after CISIS treatment, the patient had the following finding:
Right eye UDVA 1.0
Stage IV keratoconus in both eyes
A 35-year-old Italian patient suffering from highly advanced keratoconus in the left eye underwent CISIS treatment. Before the intervention he had:
Right eye CDVA 0.4 and I UDVA 0.3
Left eye CDVA 0.15 with -15.75s -7.25c x 115° I UDVA 0.05
The patient did not present for a follow-up exam in my practice. He was satisfied with the result and transmitted the data obtained from his ophthalmologist in Italy by e-mail:
Left eye UDVA 0.5.
Stage III keratoconus in the right eye
An Austrian patient came to my practice to have his glasses adjusted when he was 19 years old. At that time he had no identifiable abnormalities:
Right eye CDVA 1.0 with -1.25s - 1.25c x 160°
Left eye CDVA 1.0 with -1.75s -0.5c x 25°
Since his corneal topography was not examined, he was not diagnosed with keratoconus.
Three years later, the patient again presented at my practice because he felt that his vision had deteriorated - this time with clinically manifest keratoconus. He had the following refractive power and visual acuity:
Right eye UDVA 0.5 Glasses do not improve vision
Left eye UDVA 1.0 with -2.0s -1.25c x 20°
Today, six years after CISIS treatment of the right eye, the patient constantly has the following right eye findings:
Right eye CDVA 0.9 with +0.5s -1.25c x 10° I UDVA 0.8
The patient is satisfied. He has not yet experienced progression in his left eye.
Stage III keratoconus in the right eye
A German patient presented with the following findings prior to undergoing treatment:
Right eye CDVA 0.05 with -8.0s -1.5c x 20° I UDVA counting fingers
Left eye CDVA 0.8 with -2.5s -1.5c 135° I UDVA 0.4
CISIS was performed in the right eye.
The patient’s ophthalmologist in Germany reported the following post-operative data from his satisfied patient six months after the intervention:
Right eye UDVA 0.7
Stage III keratoconus in both eyes
A 23-year-old Austrian female patient with keratoconus underwent CISIS treatment in both eyes. Her findings before the intervention were as follows:
Right eye UDVA 0.2 no improvement with glasses
Left eye UDVA 0.3 no improvement with glasses
Three years after CISIS, she has the following constant refractive power and visual acuity in both eyes:
Right eye CDVA 0.7 with -4.0s I UDVA 0.4
Left eye CDVA 0.8 with -1.25s I UDVA 0.7
Stage III keratoconus in the left eye
A 40-year-old Austrian male patient with keratoconus in both eyes underwent CISIS treatment in the left eye. Before the intervention, his left eye findings were:
Left eye CDVA 0.1 with -16.5s -5.75c x 155°
One year after CISIS, the patient had the following findings:
Left eye CDVA 0.5 with -6.75s -3.25c x 140° I UDVA 0.3
After cornea transplantation with unsatisfactory outcome
Condition after corneal transplant surgery for keratoconus in both eyes
An Austrian patient who had undergone corneal transplant surgery in both eyes for keratoconus treatment presented at my practice with the following clinical findings:
Right eye 0.7 with -11.0s -3.25c x 165° I UDVA counting fingers
Left eye 0.3 with -2.0s - 8,0c x 55° I UDVA counting fingers
The patient wore a hard contact lens in the right eye, which he tolerated well, but had problems with it in the left eye. A MyoRing was therefore added to his left-eye transplant.
One year after CISIS, the patient had the following findings:
Left eye 0.8 with -0.25s -1.75c x 15° I UDVA 0.7
Condition after corneal transplant surgery for keratoconus treatment in both eyes
A German patient, who had undergone corneal transplant surgery in both eyes for keratoconus treatment, presented at my practice with the following clinical findings:
Right eye 0.6 with -11.0s -2.25c x 85° I UDVA counting fingers
Left eye 0.8 with -8.75s -2.25c x 145° I UDVA counting fingers
The patient was wearing hard contact lenses, which he tolerated well in the left eye. In the right eye, which was intolerant to contact lenses, a MyoRing was added to the transplant.
One year after CISIS, the patient had the following right eye findings:
Right eye 0.7 with plano -1.75c x 145° I UDVA 0.6
Post-LASIK keratectasia
Post-LASIK keratectasis in both eyes
A patient from Russia had undergone LASIK treatment four years prior to presenting at my practice. Because he had developed post-LASIK keratectasia in both eyes, CISIS treatment was performed on both eyes.
Prior to CISIS, the patient had the following findings:
Right eye 0.6 with -0.25s -0.75c x 150° I UDVA 0.5
Left eye 0.5 with -8.5s - 3.0c x 15° I UDVA 0.2
Six months after CISIS in both eyes, the patient’s visual acuity was as follows:
Right eye UDVA 0.9
Left eye UDVA 0.5
