PURPOSE To assess epithelial corneal remodeling by anterior segment optical coherence tomography (AS-OCT) after intracorneal ring segments (ICRS) implantation in keratoconic eyes. METHODS This prospective observational study included patients with keratoconus receiving ICRS of different arc lengths according to their tomographic pattern. AS-OCT and corneal topography (Scheimpflug camera) were performed before and 1, 3, and 6 months after surgery. Corneal pachymetry mapping was performed and total corneal and epithelial thicknesses (3-mm central and 16 points on 6-mm zone) were measured over the pupil center using AS-OCT. Topographic parameters were also assessed. RESULTS A total of 68 keratoconic eyes were analyzed (Amsler-Krumeich stages 1 to 4) in four groups of 17 eyes: 210° ICRS, 320° ICRS, double 160° ICRS, and single 160° ICRS. Corneal pachymetry mapping revealed that epithelial thickness increased significantly in the internal zones juxtaposed to the ICRS without smoothing during the postoperative period (P < .05). Mean maximum epithelial thickness increased from 67 ± 6 to 79 ± 7 µm for 210° ICRS, 66 ± 9 to 82 ± 4 µm for 320° ICRS, 63 ± 6 to 78 ± 7 µm for double 160° ICRS, and 62 ± 5 to 77 ± 5 µm for single 160° ICRS (P < .0001). Significant epithelial thickening at the apex of the cone was observed in all groups (P < .05). CONCLUSIONS Significant epithelial thickening occurs after ICRS implantation adjacent to the ICRS to compensate for the ridge created with a thickening of epithelium over the cone due to regularization of the stromal surface. [J Refract Surg. 2021;37(6):404-413.].

中文翻译：

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圆锥角膜角膜内环段手术后的术后角膜上皮重塑：光学相干断层扫描研究。

目的 通过前段光学相干断层扫描 (AS-OCT) 评估圆锥角膜内角膜内环段 (ICRS) 植入后上皮角膜重塑。方法 这项前瞻性观察研究包括根据断层扫描模式接受不同弧长 ICRS 的圆锥角膜患者。在手术前和手术后 1、3 和 6 个月进行 AS-OCT 和角膜地形图（Scheimpflug 相机）。进行角膜厚度测量，并使用 AS-OCT 在瞳孔中心测量角膜和上皮总厚度（中央 3 毫米和 6 毫米区域上的 16 个点）。还评估了地形参数。结果 共分析了 68 只圆锥角膜（Amsler-Krumeich 阶段 1 至 4），每组 17 只眼：210° ICRS、320° ICRS、双 160° ICRS 和单 160° ICRS。角膜厚度测量显示，在术后期间，与 ICRS 并列的内部区域的上皮厚度显着增加，但没有平滑（P < .05）。平均最大上皮厚度从 210° ICRS 的 67 ± 6 增加到 79 ± 7 µm，320° ICRS 的 66 ± 9 到 82 ± 4 µm，双 160° ICRS 的 63 ± 6 到 78 ± 7 µm，以及 62 ± 5单个 160° ICRS 为 77 ± 5 µm (P < .0001)。在所有组中都观察到锥体顶端的显着上皮增厚 (P < .05)。结论 在 ICRS 植入后，ICRS 附近会发生显着的上皮增厚，以补偿由于基质表面规则化而在锥体上的上皮增厚形成的脊。[J 屈光手术。2021;37(6):404-413.]。