{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T21:58:10Z","timestamp":1789077490504,"version":"build-2803163510"},"reference-count":45,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,9,15]],"date-time":"2020-09-15T00:00:00Z","timestamp":1600128000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Ophthalmologica"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To compare the efficacy of implanting a single Keraring segment according to a novel Q\u2010value\u2010based nomogram (QN) to that of segment implantation according to the manufacturer's standard nomogram (SN), for keratoconus treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective, randomized controlled trial of 104 patients (104 eyes) with Amsler\u2010Krumeich grade 1 or 2 keratoconus, and type 1 or 2 cone asymmetry determined according to manufacturer's classification. They were randomly distributed into two groups: group A patients (<jats:italic>n<\/jats:italic>\u00a0=\u00a052) underwent Keraring implantation according to the SN, and group B patients (<jats:italic>n<\/jats:italic>\u00a0=\u00a052) underwent implantation of a single (210\u00b0 arc\u2010length) Keraring segment according to the QN. Both treatments were combined with accelerated transepithelial cross\u2010linking, and follow\u2010up was 6\u00a0months. Main outcome measures were preoperative and postoperative visual acuity, subjective refraction and corneal topography.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At postoperative month 6, group B exhibited statistically significantly higher values of mean uncorrected distance visual acuity (UDVA), sphere, K2, K\u2010average, K\u2010max and Q\u2010anterior (p\u00a0=\u00a00.02, 0.01, 0.002, 0.001, 0.0001 and 0.03, respectively) compared to that of group A. However, group A exhibited better refractive cylindrical improvements (p\u00a0=\u00a00.04). In group A, we documented spontaneous extrusion of one Keraring segment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Single 210\u00b0 arc\u2010length segment implantation using our objective QN was more efficacious for keratoconus treatment than using the subjective SN. The nomograms were comparable when the Q\u2010anterior value was &gt;\u22121.00; however, the QN was superior to the SN when the Q\u2010anterior value was \u2264\u22121.00. The QN yielded greater postoperative UDVA and smoother corneal remodelling than did the SN for treatment of grade 1 and 2 keratoconic eyes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aos.14611","type":"journal-article","created":{"date-parts":[[2020,9,25]],"date-time":"2020-09-25T15:49:17Z","timestamp":1601048957000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["A novel Q\u2010value\u2010based nomogram for single intracorneal ring segment implantation versus standard manufacturer's nomogram combined with accelerated cross\u2010linking for treatment of keratoconus: a randomized controlled trial"],"prefix":"10.1111","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7954-1277","authenticated-orcid":false,"given":"Mohammed","family":"Iqbal","sequence":"first","affiliation":[{"name":"Department of Ophthalmology Faculty of Medicine Sohag University Sohag 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