{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T20:14:02Z","timestamp":1785788042968,"version":"3.56.0"},"reference-count":36,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2021,2,14]],"date-time":"2021-02-14T00:00:00Z","timestamp":1613260800000},"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 compare VA outcomes in patients with advanced keratoconus wearing SCL or after ICRS or DALK. In addition, determine the percentage of complimentary treatments after ICRS and DALK, and which of these was fitting a SCL, and final visual acuity (f-VA) results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Retrospective case series analyzed 55 eyes with advanced keratoconus fitted with SCL, or after ICRS or a DALK between 2010 and 2018. The variables analyzed were sex, age, UDVA, CDVA, SEQ, K-readings, and f-VA after complimentary treatments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Twenty-eight eyes underwent a DALK, 14 were fitted with a SCL, and other 13 underwent ICRS insertion. Patients after DALK and after ICRS showed statistically significant improvement in UDVA and CDVA after surgery, with no difference between these groups. Patients fitted with SCL showed statistically higher CDVA improvement when compared to ICRS. After DALK and ICRS, respectively, nine eyes (32.14%) and seven eyes (53.85%) were fitted with SCL. Comparison between f-VA with SCL in three groups showed that the best result was achieved in DALK\u2009+\u2009SCL, with statistically significant difference to only SCL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>We showed that the CDVA of eyes fitted with SCL without any surgical treatment was statistically better than CDVA of eyes after ICRS insertion. After DALK and ICRS insertion, many patients needed a complimentary treatment to improve CDVA. The most chosen treatment was fitting a SCL. After this, all eyes showed statistically significant improvement in f-VA, with statistically better results for DALK\u2009+\u2009SCL when compared to SCL fitted in advanced keratoconus without any surgical treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1120672121994731","type":"journal-article","created":{"date-parts":[[2021,2,15]],"date-time":"2021-02-15T00:06:45Z","timestamp":1613347605000},"page":"1563-1570","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["Visual outcomes in advanced keratoconus using different strategies: Scleral lens, intracorneal ring segment and lamellar keratoplasty"],"prefix":"10.1177","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9304-7550","authenticated-orcid":false,"given":"Guilherme","family":"Rocha","sequence":"first","affiliation":[{"name":"Contact Lens Sector, Refractive Surgery and Cornea Sector, Hospital Oftalmol\u00f3gico de Bras\u00edlia, Brasilia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruna Viana","family":"Vieira","sequence":"additional","affiliation":[{"name":"Hospital Oftalmol\u00f3gico de Bras\u00edlia, Brasilia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e1rbara M\u00edrian Silva","family":"Mendes","sequence":"additional","affiliation":[{"name":"Hospital Oftalmol\u00f3gico de Bras\u00edlia, Brasilia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camila Ishii","family":"Iguma","sequence":"additional","affiliation":[{"name":"Hospital Oftalmol\u00f3gico de Bras\u00edlia, Brasilia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thairis C\u00e1ssia Santana","family":"Silva","sequence":"additional","affiliation":[{"name":"Refractive Surgery, Cornea and Contact Lens Sector, Hospital Oftalmol\u00f3gico de Bras\u00edlia, Brasilia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luciene Barbosa","family":"de Sousa","sequence":"additional","affiliation":[{"name":"Cornea Sector, Universidade Federal de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7182-8073","authenticated-orcid":false,"given":"Patrick Frensel","family":"Tzelikis","sequence":"additional","affiliation":[{"name":"Cornea Sector and Refractive Surgery Sector, Hospital Oftalmol\u00f3gico de Bras\u00edlia, Brasilia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,2,14]]},"reference":[{"key":"bibr1-1120672121994731","doi-asserted-by":"publisher","DOI":"10.1016\/j.clae.2010.04.006"},{"key":"bibr2-1120672121994731","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6257(97)00119-7"},{"key":"bibr3-1120672121994731","doi-asserted-by":"publisher","DOI":"10.1016\/j.survophthal.2017.06.009"},{"key":"bibr4-1120672121994731","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD009700.pub2."},{"key":"bibr5-1120672121994731","doi-asserted-by":"publisher","DOI":"10.1016\/j.survophthal.2015.02.004"},{"key":"bibr6-1120672121994731","doi-asserted-by":"publisher","DOI":"10.1097\/00003226-199711000-00003"},{"key":"bibr7-1120672121994731","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0b013e318211401f"},{"issue":"1","key":"bibr8-1120672121994731","first-page":"1","volume":"2","author":"Fine P","year":"2013","journal-title":"Int J Kerat Ect 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