{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,12,4]],"date-time":"2022-12-04T05:20:33Z","timestamp":1670131233308},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,3,16]],"date-time":"2021-03-16T00:00:00Z","timestamp":1615852800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,3,16]],"date-time":"2021-03-16T00:00:00Z","timestamp":1615852800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Microwave thermokeratoplasty (MTK) is a surgical procedure for the correction of pathologic corneal steepening. The purpose of this study was to examine the postoperative outcomes of eyes with advanced keratoconus that underwent femtosecond-laser zig-zag penetrating keratoplasty (z-PK) following MTK for reshaping of the central cornea. This study involved 32 eyes of 32 consecutive advanced keratoconus patients; i.e., 25 eyes of 25 patients who underwent MTK prior to z-PK (MTK\u2009+\u2009z-PK group), and 7 eyes of 7 patients who underwent z-PK alone (z-PK group). In all treated eyes, visual acuity (VA) and corneal topography were measured before surgery and at 6-months postoperative. At 6-months postoperative, the mean uncorrected distance VA (logarithm of the minimum angle of resolution) and surface regularity index (SRI) of the MTK\u2009+\u2009z-PK group was 0.62\u2009\u00b1\u20090.39 (mean\u2009\u00b1\u2009standard deviation) and 1.26\u2009\u00b1\u20090.45, respectively, while that in the z-PK group was 1.02\u2009\u00b1\u20090.18 and 7.64\u2009\u00b1\u20093.22, respectively. Both variables were significantly better in the MTK\u2009+\u2009z-PK group than in the z-PK group (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). The findings in this study reveal that MTK prior to z-PKP is effective for improving UDVA and reducing the irregularity of corneal topography in patients with advanced keratoconus.<\/jats:p>","DOI":"10.1038\/s41598-021-85470-5","type":"journal-article","created":{"date-parts":[[2021,3,16]],"date-time":"2021-03-16T11:14:42Z","timestamp":1615893282000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of penetrating keratoplasty outcomes with or without microwave thermokeratoplasty"],"prefix":"10.1038","volume":"11","author":[{"given":"Osamu","family":"Hieda","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koichi","family":"Wakimasu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shigeru","family":"Kinoshita","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chie","family":"Sotozono","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,3,16]]},"reference":[{"key":"85470_CR1","doi-asserted-by":"publisher","first-page":"336","DOI":"10.1097\/01.ico.0000179739.31196.e8","volume":"25","author":"TS Ignacio","year":"2006","unstructured":"Ignacio, T. S., Nguyen, T. B., Chuck, R. S., Kurtz, R. M. & Sarayba, M. A. Top hat wound configuration for penetrating keratoplasty using the femtosecond laser: a laboratory model. Cornea 25, 336\u2013340 (2006).","journal-title":"Cornea"},{"key":"85470_CR2","doi-asserted-by":"publisher","first-page":"737","DOI":"10.1016\/j.ajo.2007.01.056","volume":"143","author":"L Buratto","year":"2007","unstructured":"Buratto, L. & Bohm, E. The use of the femtosecond laser in penetrating keratoplasty. Am. J. Ophthalmol. 143, 737\u2013742 (2007).","journal-title":"Am. J. Ophthalmol."},{"key":"85470_CR3","first-page":"347","volume":"14","author":"I Ratkay-Traub","year":"2001","unstructured":"Ratkay-Traub, I. et al. Ultra-short pulse (femtosecond) laser surgery: initial use in LASIK flap creation. Ophthalmol. Clin. North Am. 14, 347\u2013355 (2001).","journal-title":"Ophthalmol. Clin. North Am."},{"key":"85470_CR4","doi-asserted-by":"publisher","first-page":"2208","DOI":"10.1016\/j.ophtha.2007.08.048","volume":"114","author":"M Farid","year":"2007","unstructured":"Farid, M., Kim, M. & Steinert, R. F. Results of penetrating keratoplasty performed with a femtosecond laser zigzag incision initial report. Ophthalmology 114, 2208\u20132212 (2007).","journal-title":"Ophthalmology"},{"key":"85470_CR5","doi-asserted-by":"publisher","first-page":"1638","DOI":"10.1016\/j.ophtha.2009.05.003","volume":"116","author":"M Farid","year":"2009","unstructured":"Farid, M., Steinert, R. F., Gaster, R. N., Chamberlain, W. & Lin, A. Comparison of penetrating keratoplasty performed with a femtosecond laser zig-zag incision versus conventional blade trephination. Ophthalmology 116, 1638\u20131643 (2009).","journal-title":"Ophthalmology"},{"key":"85470_CR6","doi-asserted-by":"publisher","first-page":"486","DOI":"10.1016\/j.ophtha.2010.08.002","volume":"118","author":"WD Chamberlain","year":"2011","unstructured":"Chamberlain, W. D., Rush, S. W., Mathers, W. D., Cabezas, M. & Fraunfelder, F. W. Comparison of femtosecond laser-assisted keratoplasty versus conventional penetrating keratoplasty. Ophthalmology 118, 486\u2013491 (2011).","journal-title":"Ophthalmology"},{"key":"85470_CR7","doi-asserted-by":"publisher","DOI":"10.1007\/s00417-012-2054-0","author":"F Birnbaum","year":"2012","unstructured":"Birnbaum, F., Wiggermann, A., Maier, P. C., Bohringer, D. & Reinhard, T. Clinical results of 123 femtosecond laser-assisted penetrating keratoplasties. Graefe Arch. Clin. Exp. Ophthalmol. https:\/\/doi.org\/10.1007\/s00417-012-2054-0 (2012).","journal-title":"Graefe Arch. Clin. Exp. Ophthalmol."},{"key":"85470_CR8","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1097\/ICO.0000000000000408","volume":"34","author":"JA Gomes","year":"2015","unstructured":"Gomes, J. A. et al. Global consensus on keratoconus and ectatic diseases. Cornea 34, 359\u2013369 (2015).","journal-title":"Cornea"},{"key":"85470_CR9","doi-asserted-by":"publisher","first-page":"636","DOI":"10.1016\/S0002-9394(14)71076-1","volume":"123","author":"RH Gross","year":"1997","unstructured":"Gross, R. H., Poulsen, E. J., Davitt, S., Schwab, I. R. & Mannis, M. J. Comparison of astigmatism after penetrating keratoplasty by experienced cornea surgeons and cornea fellows. Am. J. Ophthalmol. 123, 636\u2013643 (1997).","journal-title":"Am. J. Ophthalmol."},{"key":"85470_CR10","doi-asserted-by":"publisher","first-page":"225","DOI":"10.2174\/1874364101711010225","volume":"11","author":"B Seitz","year":"2017","unstructured":"Seitz, B. et al. Penetrating keratoplasty for keratoconus: excimer versus femtosecond laser trephination. Open Ophthalmol. J. 11, 225\u2013240 (2017).","journal-title":"Open Ophthalmol. J."},{"key":"85470_CR11","doi-asserted-by":"crossref","unstructured":"Busin, M., Zambianchi, L., Franceschelli, F., Lamberti, G. & al-Naweiseh, I. Intraoperative cauterization of the cornea can reduce postkeratoplasty refractive error in patients with keratoconus. Ophthalmology 105, 1524\u20131529; discussion 1529\u20131530 (1998).","DOI":"10.1016\/S0161-6420(98)98040-X"},{"key":"85470_CR12","first-page":"1135","volume":"78","author":"M Itoi","year":"1974","unstructured":"Itoi, M., Kuribayashi, H. & Yamaguchi, T. Thermokeratoplasty\u2013experience with 180 cases. Nippon Ganka Gakkai Zasshi 78, 1135\u20131140 (1974).","journal-title":"Nippon Ganka Gakkai Zasshi"},{"key":"85470_CR13","doi-asserted-by":"publisher","first-page":"481","DOI":"10.1016\/j.ajo.2010.05.014","volume":"150","author":"N Kato","year":"2010","unstructured":"Kato, N., Toda, I., Kawakita, T., Sakai, C. & Tsubota, K. Topography-guided conductive keratoplasty: treatment for advanced keratoconus. Am. J. Ophthalmol. 150, 481\u2013489 (2010).","journal-title":"Am. J. Ophthalmol."},{"key":"85470_CR14","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1016\/j.jcrs.2009.10.032","volume":"36","author":"A Barsam","year":"2010","unstructured":"Barsam, A., Patmore, A., Muller, D. & Marshall, J. Keratorefractive effect of microwave keratoplasty on human corneas. J. Cataract Refract. Surg. 36, 472\u2013476 (2010).","journal-title":"J. Cataract Refract. Surg."},{"key":"85470_CR15","doi-asserted-by":"crossref","first-page":"682","DOI":"10.3928\/1081-597X-20011101-08","volume":"17","author":"BS Trembly","year":"2001","unstructured":"Trembly, B. S. et al. Microwave thermal keratoplasty for myopia: keratoscopic evaluation in porcine eyes. J. Refract. Surg. 17, 682\u2013688 (2001).","journal-title":"J. Refract. Surg."},{"key":"85470_CR16","doi-asserted-by":"publisher","first-page":"787","DOI":"10.3928\/1081597X-20121011-07","volume":"28","author":"A Vega-Estrada","year":"2012","unstructured":"Vega-Estrada, A., Alio, J. L., Plaza Puche, A. B. & Marshall, J. Outcomes of a new microwave procedure followed by accelerated cross-linking for the treatment of keratoconus: a pilot study. J. Refract. Surg. 28, 787\u2013793 (2012).","journal-title":"J. Refract. Surg."},{"key":"85470_CR17","doi-asserted-by":"publisher","first-page":"372","DOI":"10.3928\/1081-597X-19891101-06","volume":"5","author":"SA Dingeldein","year":"1989","unstructured":"Dingeldein, S. A., Klyce, S. D. & Wilson, S. E. Quantitative descriptors of corneal shape derived from computer-assisted analysis of photokeratographs. Refract. Corneal Surg. 5, 372\u2013378 (1989).","journal-title":"Refract. Corneal Surg."},{"key":"85470_CR18","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1001\/archopht.1991.01080030051037","volume":"109","author":"SE Wilson","year":"1991","unstructured":"Wilson, S. E. & Klyce, S. D. Quantitative descriptors of corneal topography: a clinical study. Arch. Ophthalmol. 109, 349\u2013353 (1991).","journal-title":"Arch. Ophthalmol."},{"key":"85470_CR19","doi-asserted-by":"publisher","first-page":"1497","DOI":"10.1016\/S0161-6420(95)30840-8","volume":"102","author":"ON Serdarevic","year":"1995","unstructured":"Serdarevic, O. N., Renard, G. J. & Pouliquen, Y. Randomized clinical trial of penetrating keratoplasty: before and after suture removal comparison of intraoperative and postoperative suture adjustment. Ophthalmology 102, 1497\u20131503 (1995).","journal-title":"Ophthalmology"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-85470-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-85470-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-85470-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,3]],"date-time":"2022-12-03T05:09:59Z","timestamp":1670044199000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-85470-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,16]]},"references-count":19,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["85470"],"URL":"https:\/\/doi.org\/10.1038\/s41598-021-85470-5","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,16]]},"assertion":[{"value":"26 July 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 February 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 March 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"5995"}}