Intrastromal corneal ring segments for management of keratoconus.
Keratoconus is a progressive corneal ectasia, which can be managed both by conservative measures like glasses or contact lenses in non-progressive cases or surgical procedures like collagen crosslinking (CXL) with or without adjuvant measures like intrastromal corneal rings segments (ICRS) or topography guided ablation. Various kinds of ICRS are available to the surgeon, but it is most essential to be able to plan the implantation of the ring to optimize outcomes.


OBJECTIVE
The aim of this study is to evaluate the visual outcome and progression in patients of keratoconus implanted with ICRS.


METHODS
Two different types of ICRS-Intacs (Addition Technology) and Kerarings (Mediphacos Inc.) were implanted in 2 different cohorts of patients and were followed-up to evaluate the outcome of the procedure. All patients underwent a complete ocular examination including best spectacle corrected visual acuity, slit lamp examination fundus examination, corneal topography and pachymetry. The ICRS implantation is done with CXL to stop the progression of the disease. Improvement in uncorrected visual acuity (UCVA), best spectacle corrected visual acuity and topographic changes were analyzed.


RESULTS
A significant improvement in keratometry and vision was seen in both groups.


CONCLUSIONS
ICRS have been found to reduce corneal irregularity and flatten keratometry with improvement in UCVA and best corrected visual acuity.
Department of Refractive Surgery, Narayana Nethralaya, Superspeciality Eye Institute, Bangalore, Karnataka, India.
Sri
S
Ganesh
Rohit
R
Shetty
Sharon
S
D'Souza
Sarika
S
Ramachandran
Mathew
M
Kurian
D000328:Adult; D003319:Corneal Stroma / Q000601:surgery*; D019781:Corneal Topography; D006801:Humans; D007640:Keratoconus / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D019904:Polymethyl Methacrylate; D019736:Prostheses and Implants; D019919:Prosthesis Implantation; D012029:Refraction, Ocular / Q000502:physiology; D016896:Treatment Outcome; D014786:Vision Disorders / Q000534:rehabilitation; D014792:Visual Acuity
D019904:Polymethyl Methacrylate