{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T18:47:44Z","timestamp":1780512464316,"version":"3.54.1"},"reference-count":22,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2020,8,24]],"date-time":"2020-08-24T00:00:00Z","timestamp":1598227200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Ophthalmology"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To evaluate the outcomes of implanting intrastromal corneal ring segment (ICRS) using two different strategies in a specific paracentral keratoconus phenotype.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Eighty-nine eyes with paracentral keratoconus with perpendicular topographic astigmatism and comatic axes were evaluated before and after implanting a 150\u00b0 arc-length ICRS. Patients were divided into two groups according to the axis where the ICRS was implanted: Group I: comatic axis and Group II: flat topographic axis. Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refractive errors, and root mean square (RMS) for coma-like aberration were recorded. The postoperative follow-up was 1\u2009year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Mean UDVA (logMAR) changed from 0.49\u2009\u00b1\u20090.37 preoperatively to 0.30\u2009\u00b1\u20090.32 6\u2009months afterwards ( p\u2009&lt;\u20090.001) in the group I and from 0.53\u2009\u00b1\u20090.34 to 0.37\u2009\u00b1\u20090.35 ( p\u2009&lt;\u20090.001), in the group II. Mean CDVA in group I changed from 0.11\u2009\u00b1\u20090.18 preoperatively to 0.06\u2009\u00b1\u20090.14 6\u2009months after surgery ( p\u2009&lt;\u20090.001). In group II the improvement did not reach statistical significance (from 0.09\u2009\u00b1\u20090.10 to 0.07\u2009\u00b1\u20090.09; p\u2009=\u20090.06). No eyes lost lines of CDVA in group I. Eight eyes (15.7%) lost lines of CDVA in group II. The spherical equivalent decreased after surgery in both groups ( p\u2009&lt;\u20090.001). The RMS for corneal coma-like aberration only decreased in the group I ( p\u2009&lt;\u20090.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Both strategies provided safe and effective visual and refractive outcomes in the specific keratoconus phenotype analyzed. The orthopedic strategy provided better visual outcomes than the refractive one.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1120672120952346","type":"journal-article","created":{"date-parts":[[2020,8,24]],"date-time":"2020-08-24T05:30:40Z","timestamp":1598247040000},"page":"1540-1545","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":17,"title":["Intrastromal corneal ring segment implantation in paracentral keratoconus with perpendicular topographic astigmatism and comatic axis"],"prefix":"10.1177","volume":"31","author":[{"given":"Luis","family":"Fern\u00e1ndez-Vega-Cueto","sequence":"first","affiliation":[{"name":"Fern\u00e1ndez-Vega Ophthalmological Institute, Oviedo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Lisa","sequence":"additional","affiliation":[{"name":"Fern\u00e1ndez-Vega Ophthalmological Institute, Oviedo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bel\u00e9n","family":"Alfonso-Bartolozzi","sequence":"additional","affiliation":[{"name":"Fern\u00e1ndez-Vega Ophthalmological Institute, Oviedo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Madrid-Costa","sequence":"additional","affiliation":[{"name":"Optometry and Vision Department, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0373-8209","authenticated-orcid":false,"given":"Jos\u00e9 F","family":"Alfonso","sequence":"additional","affiliation":[{"name":"Fern\u00e1ndez-Vega Ophthalmological Institute, Oviedo, 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