title: Refractive, topographic, and visual outcomes of same-day corneal cross-linking with Ferrara intracorneal ring segments in patients with progressive keratoconus.
abstract: OBJECTIVE
  To report refractive, topographic, and visual outcomes 12 months after same-day treatment with corneal cross-linking (CXL) and Ferrara intracorneal ring segments (ICRS) in eyes with progressive keratoconus (KC) and contact lens intolerance.
  
  
  METHODS
  This was a case series of 7 eyes (7 patients) with progressive mild to moderate keratoconus and contact lens intolerance undergoing implantation of Ferrara ICRS immediately followed by corneal cross-linking. Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), refractive error, pachymetry, and keratometry were evaluated at 3, 6, and 12 months of follow-up.
  
  
  RESULTS
  Mean follow-up was 11.7 ± 3.6 months (range, 5-17 months). Mean preoperative UCVA and BSCVA were 0.10 ± 0.07 (range, 0.05-0.2) and 0.56 ± 0.08 (range, 0.5-0.7), respectively. One year after the treatment, mean UCVA and BSCVA measured 0.60 ± 0.24 (range, 0.32-0.9) and 0.82 ± 0.25 (range, 0.5-1.2), respectively. The mean spherical equivalent decreased significantly (P < 0.05) with 3.5 diopters (D). Mean K values (average keratometry of the cornea) decreased from 46.81 ± 2.13 D (range, 44-51 D) to 43.97 ± 2.22 D (range, 42-47.5 D) 1 year after the treatment. The average preoperative thinnest pachymetry measured 462 ± 46 μm (range, 410 ± 546 μm) and did not change significantly after the treatment. In patient 1, the inferior ICRS was removed 5 months postoperatively because of implant migration.
  
  
  CONCLUSIONS
  The combined treatment of corneal cross-linking and Ferrara ICRS is a safe procedure that may be considered in patients with progressive mild to moderate KC and contact lens intolerance.
authors: Department of Ophthalmology, Erasmus MC, Rotterdam, the Netherlands. i.saelens@erasmusmc.nl
authors: Isabelle E Y
authors: IE
authors: Saelens
authors: Marjolijn C
authors: MC
authors: Bartels
authors: Isabel
authors: I
authors: Bleyen
authors: Gabriel
authors: G
authors: Van Rij
mesh_terms: D000328:Adult; D003261:Contact Lenses; D003315:Cornea / Q000601:surgery; D003319:Corneal Stroma / Q000601:surgery; D019781:Corneal Topography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007640:Keratoconus / Q000503:physiopathology / Q000532:radiotherapy* / Q000601:surgery*; D008297:Male; D019904:Polymethyl Methacrylate; D019736:Prostheses and Implants; D019919:Prosthesis Implantation; D012029:Refraction, Ocular / Q000502:physiology; D012030:Refractive Errors / Q000503:physiopathology; D012189:Retrospective Studies; D014467:Ultraviolet Therapy; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult
chemical_list: D019904:Polymethyl Methacrylate