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Efficacy of complete rings (MyoRing) in treatment of Keratoconus: a systematic review and meta-analysis

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Abstracts

Purpose

We aimed to systematically review the existing evidence and determine the efficacy of MyoRing as a novel method for treatment of keratoconus using meta-analysis.

Methods

Online electronic search of Medline, ISI Web of Science, Embase, Scopus, and Cochrane Library databases was performed with reference lists of relevant articles for pre–post trials published through August 2017. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), sphere, cylinder, spherical equivalent (SE), maximum, minimum, and mean keratometry were considered as the visual acuity outcomes. Weighted mean difference (WMD) with 95% confidence interval was used as pooled estimation of intervention efficacy using random-effects meta-analysis. Heterogeneity was measured with the Cochran Q statistic and quantified with the I2 statistic using Stata software.

Results

Of the 47 potentially related studies, 21 eligible studies were included in the meta-analysis. The mean of uncorrected distance visual acuity (UDVA) based on LogMAR in patients with keratoconus had a significant change 3 months after implantation/embedding of the complete ring (WMD =  − 0.73 (CI = − 0.88 to − 0.58), I2 = 79.9%, p < 0.001). Results support a statistically significance improvement in CDVA, SE, sphere, cylinder, and maximum keratometry after surgical intervention. Range of reported safety index, stability, and efficacy index by included studies was 1.7–2.7, 74–100%, and 0.9–1.96, respectively.

Conclusions

MyoRing is an appropriate treatment option for keratoconus. Findings of this meta-analysis demonstrated that main visual outcomes have been improved 3, 6, and 12 months after the implantation of the complete ring (MyoRing).

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Acknowledgements

We thank native English speaking editor from Birmingham Research Park (United Kingdom) for improving the use of English in the manuscript.

Funding

This study was partially supported by funds from Vice-Chancellor for Research of Iran University of Medical Sciences (IUMS), Tehran, Iran (Grant Number:94-05-27-27457). The funding sources had no role in study design, data collection, analysis, interpretation, and preparation of the manuscript.

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Authors and Affiliations

  1. Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran

    Leila Janani & Kiarash Tanha

  2. Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran

    Leila Janani

  3. Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Islamic Republic of Iran

    Fereshteh Najafi

  4. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran

    Fereshteh Najafi

  5. Department of Ophthalmology, Bina Eye Hospital Research Center, Tehran, Islamic Republic of Iran

    Khosrow Jadidi & Farhad Nejat

  6. Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran

    Seyed Javad Hashemian

  7. Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran

    Mohsen Dehghani

  8. Department of Epidemiology, School of Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran

    Masoumeh Sadeghi

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  1. Leila Janani
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Contributions

LJ, KJ, and FN conceived the idea and designed the study. KT, LJ, and FN collected data, reviewed literature, and extracted data. KT, LJ, and MS, and MD participated in the analysis of data and interpreted the results. LJ, MD, and MS conceived the study aims and design, provide the data and measures, and designed the analysis. KJ, FN, and SJH reanalyzed data, made substantial contribution to interpretation of data, drafting the manuscript and revising it critically for important intellectual content and final approval of the version to be submitted and any revised version. All authors reviewed, discussed, provided critical comments, and approved the final manuscript. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication.

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Correspondence to Masoumeh Sadeghi.

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Janani, L., Tanha, K., Najafi, F. et al. Efficacy of complete rings (MyoRing) in treatment of Keratoconus: a systematic review and meta-analysis. Int Ophthalmol 39, 2929–2946 (2019). https://doi.org/10.1007/s10792-019-01121-9

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