{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T20:43:48Z","timestamp":1786653828630,"version":"build-2736575974"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"Suppl 3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>\n                      This retrospective longitudinal study evaluated the biomechanical E-staging in KC corneas before and after intracorneal ring segment (ICRS) implantation (Intacs\n                      <jats:sup>\u00ae<\/jats:sup>\n                      SK, Addition Technology, Illinois, United States).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Biomechanical E-staging for ectatic corneal diseases was applied retrospectively on 49 KC corneas of 41 patients who underwent ICRS implantation. The main outcome parameters included the Corvis Biomechanical Factor (CBiF, the linearized Corvis Biomechanical Index and the biomechanical parameters included), the resulting biomechanical E-staging, the stress-strain index, thinnest corneal thickness (TCT), maximal anterior keratometry (Kmax), and the anterior radius of curvature (ARC). They were evaluated at 1.9 \u00b1 1.1 months preoperatively and postoperatively after 2.8 \u00b1 0.7, 5.8 \u00b1 1.0, and 10.6 \u00b1 2.3 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The CBiF decreased (4.9 \u00b1 0.5 | 4.7 \u00b1 0.5,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.0013), and the E-staging increased significantly (2.8 \u00b1 0.8 | 3.1 \u00b1 0.9,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.0012, paired\n                      <jats:italic toggle=\"yes\">t<\/jats:italic>\n                      -test) from preoperatively to the first postoperative follow-up. The difference remained significant after 6 months; however, there was no more difference after 11 months. TCT was stable, whereas Kmax and ARC significantly decreased after ICRS implantation (TCT: 464 \u00b1 49, 470 \u00b1 51, 467 \u00b1 38, 461 \u00b1 48; Kmax: 56.3 \u00b1 4.5, 54.7 \u00b1 4.5, 54.2 \u00b1 4.8, 54.1 \u00b1 4.3; ARC: 51.5 \u00b1 3.4, 48.3 \u00b1 3.8, 48.6 \u00b1 3.0, 48.6 \u00b1 3.2 preoperatively and 3, 6, and 11 months postoperatively, respectively). Besides Kmax and ARC, Ambr\u00f3sio\u2019s relational thickness to the horizontal profile (ARTh) was the only parameter that was significantly lower than preoperatively at any follow-up (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2264 0.0024, Wilcoxon matched-pairs test).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>\n                      Intacs\n                      <jats:sup>\u00ae<\/jats:sup>\n                      SK implantation results in an increasing biomechanical E-staging in the first postoperative months with stabilization near preoperative values after 1 year. Significantly lower ARTh values at any follow-up document the ICRS effect and contribute to a slightly higher postoperative biomechanical E-staging value.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijo.ijo_2944_23","type":"journal-article","created":{"date-parts":[[2024,4,20]],"date-time":"2024-04-20T04:01:01Z","timestamp":1713585661000},"page":"S495-S500","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Evaluation of dynamic corneal response parameters and the biomechanical E-staging after Intacs\u00ae SK implantation in keratoconus"],"prefix":"10.4103","volume":"72","author":[{"given":"Elias","family":"Flockerzi","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Saarland University Medical Center, Homburg, 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