cisis

Results - case studies

UDVA…uncorrected viusal acuity

CDVA…corrected visual acuity

Patient ID 2396

A 26-year-old female patient with severe myopia of approximately 10 dioptres in both eyes underwent a MyoRing treatment in the left eye. She had been wearing contact lenses, but had not tolerated them well, and had been repeatedly suffering from severe inflammatory conditions in the eyes. Prior to MyoRing treatment, the patient had the following refractory power and vision accuracy:

CDVA           1.0         with         -10.5 s -0.25 c x 145°      I              UDVA           counting fingers

One year following her MyoRing treatment, the patient’s refractory power and visual acuity was:

CDVA           1.0         with         -0.5s -1.25 c x 150°          I             UDVA           0.7

The patient is highly satisfied and plans to undergo the same treatment in her right eye soon, where she is still wearing a contact lens. She manages most of her daily activities without any vision aids. When she takes out the contact lens from her right eye, the vision of her left eye is very good without a vision aid.

Patient ID 3884

A 25-year-old female patient with severe myopia and high-grade regular astigmatism in both eyes underwent MyoRing treatment in both eyes. She had been using contact lenses, which she hadn’t tolerated well; she had occasionally switched to relatively strong eyeglasses, but these had caused her great cosmetic problems. Prior to MyoRing treatment, the patient had the following refractive power and visual acuity:

Right eye CDVA           1.0         with         -7.25 s – 4.0 c x 5°           I             UDVA           counting fingers

Left eye CDVA           1.0         with         -9.25 s -2.75 c x 175°      I             UDVA           counting fingers

One year after MyoRing treatment, the patient had the following refractive power and visual acuity:

Right eye CDVA           1.0         with         +1.25 s – 2.75 c x 25°      I           UDVA           0.6

Left eye  CDVA           1.0         with         +0.25 s -1.25 c x 0°          I            UDVA           0.8

In the first months following initial MyoRing treatment, the MyoRing in the right eye was modified twice to optimise the result. Changing the MyoRing is almost as easy as changing a contact lens; it is 100% pain-free and usually takes less than a minute. The patient is satisfied and spends nearly the whole day without vision aids. In special situations, such as driving the car at night, she wears light and comfortable glasses.

Patient ID 5477

A 48-year-old female patient was extremely myopic and underwent a CISIS procedure. Prior to CISIS, the patient had the following findings:

Right eye CDVA           0.6         with         -16.50 s -0.5 c x 55°         I             UDVA           counting fingers

Left eye CDVA           0.6         with         -16.00 s – 0.5 c x 55°       I             UDVA           counting fingers

One year after CISIS, the patient had the following refractive power and visual acuity:

Right eye CDVA           0.6         with         -1.0 s                                  I             UDVA           0.5

Left eye CDVA           0.6         with         -1.5 s                                  I             UDVA           0.4

The patient basically needs no vision aids during her daily activities.

Patient ID 2949

A 22-year-old female patient was suffering from myopia and did not tolerate her contact lenses well. This is why she presented for a preliminary exam to undergo laser treatment. Since the exam revealed a suspicious corneal topography, the patient was recommended not to undergo laser treatment due to the risk of post-operative keratectasia following laser treatment. Initially, CISIS was performed in the left eye. Prior to CISIS, the patient had the following refractive power and visual acuity:

Right eye CDVA           1.0         with         -6.0 s -0.75 c x 175°         I             UDVA           0.05

Left eye CDVA           1.0         with         -7.25 s – 0.75c x 165°      I             UDVA           0.05

One month after CISIS, the MyoRing was replaced by another one with a different size because the patient was not fully satisfied with the result. After a further month, the patient’s treated left eye showed the following finding:

Left eye     CDVA           1.0         with         -0.5 s – 1.0 c x 5°              I             UDVA           0.8

The patient was still dissatisfied and complained in particular about halos around sources of light and glare phenomena. Upon the patient’s request, the MyoRing was removed. MyoRing removal is a harmless and pain-free procedure which only takes roughly one minute. One week after MyoRing removal, the patient had the following refractive power and visual acuity:

Right eye CDVA           1.0         with         -6.0 s -1.0 c x 5°               I             UDVA           0.05

Left eye CDVA           1.0         with         -7.25 s – 1.25 c x 170°     I             UDVA           0.05

Today, the patient wears her old eyeglasses again. She has no complaints whatsoever, except for the fact of having to wear eyeglasses.

Patient ID 3844

A 23-year-old female patient with contact lens intolerability presented at my practice to undergo a preliminary exam for laser treatment of her myopia. It turned out that laser treatment was contraindicated because the patient was suffering from rheumatic fever, a condition which may lead to irreversible turbidity of the central cornea. The patient’s wellbeing was severely compromised by the fact that she had to wear eyeglasses. Initially, I was apprehensive about performing CISIS as there is no scientific evidence to confirm the potential of rheumatic fever causing the corneal tissue to negatively respond to the MyoRing and leading to corneal turbidity. After an in-depth interview we agreed to take the inherent risk of a MyoRing treatment on condition that the patient is closely monitored for a minimum period of six months and the MyoRing is removed immediately upon the very first signs of corneal turbidity.

The refractive power and visual acuity before the CISIS procedure was:

Right eye CDVA           1.0         with         -2.25 s -0.75 c x 70°                       I             UDVA           0.4

Left eye CDVA           1.0         with         -2.75 s – 0.5 c x 100°                      I             UDVA           0.3

Six months after CISIS, the patient had:

Right eye UDVA           1.0

Left eye CDVA           1.0         with         +0.25 s – 0.75c c x 150°                 I             UDVA           0.8

Until the most recent examination, there were no signs of corneal turbidity. The patient is highly satisfied and needs no additional vision aids.

Patient ID 2853

A 24-year-old patient with myopia had the following clinical findings:

Right eye CDVA           1.0         with         -9.0 s -1.0 c x 0°               I             UDVA           counting fingers

Left eye CDVA          1.0         with         -10.0 s – 0.75 c x 170°     I             UDVA           counting fingers

She underwent a CISIS procedure.

One year after CISIS, the patient had:

Right eye CDVA           1.0         with        -0.5 s -0.5 c x 10°                           I             UDVA           0.7

Left eye CDVA           1.0         with        -0.25 s – 0.5 c x 170°                    I             UDVA           0.8

The patient is satisfied and is almost entirely independent of vision aids. Only when driving at night, she occasionally wears eyeglasses.

Patient ID 4225

A 26-year-old myopic patient with severely reduced corneal thickness in both eyes (right eye: 470 µm, left eye: 480 µm), but no topographical irregularities suspicious of keratoconus, presented with the following refractive power and visual acuity:

Right eye CDVA           1.0         with         -7.0 s -2.5 c x 15° I             UDVA           counting fingers

Left eye CDVA           1.0         with         -8.0 s – 2.25 c x 160° I             UDVA           counting fingers

On account of the reduced thickness of the patient’s cornea, laser treatment was not a viable option.  Moreover, the patient had relatively wide pupils, which after CISIS treatment would have resulted in glare phenomena and halos around sources of light at night. The rule which applies in both laser treatment and CISIS is: the higher the dioptres to be corrected, the smaller the optical zone. However, if vision correction is split up into two separate treatment sessions (e.g. LASEK and CISIS), each treatment session has its own optical zone. This allows to achieve a larger optical zone and reduce the risk of night-time glare. Since the MyoRing is a fully closed ring, it has the ability to strengthen the cornea by a factor of more than 2. Even in the event that the patient suffers from undiagnosed keratoconus, he is not at risk of keratectasia despite laser ablation. After thorough consultation, the patient agreed to have a combination of LASEK and CISIS done.

One year after CISIS, the patient had the following findings:

Right eye UDVA           1.0

Left eye UDVA             1.0

Corneal thickness is only reduced by approximately 15 µm despite the significant correction of his vision, which is of no relevance considering that the biomechanically relevant corneal thickness is now more than 900 µm thanks to the MyoRing. The patient does not experience any disturbing glare at night and is extremely satisfied with the result. He is able to perform his daily routine without any vision aids.

 

 

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