Technique of simultaneous femtosecond laser assisted Myoring implantation and accelerated intrastromal collagen cross-linking for management of progressive keratoconus: A novel technique.
OBJECTIVE
To describe a novel surgical technique for the management of progressive keratoconus by simultaneous femtosecond laser-assisted Myoring implantation and accelerated corneal intrastromal collagen cross-linking with Dextran Free Riboflavin.


METHODS
After creating a corneal pocket with femtosecond laser, Dextran Free Riboflavin was injected into the intrastromal pocket. Then the Myoring was implanted in the corneal pocket and accelerated corneal intrastromal collagen cross-linking was performed with no epithelial debridement.


RESULTS
The cornea remained clear and the central keratometry was decreased significantly with marked improvement in uncorrected visual acuity up to two years following treatment. Anterior segment OCT revealed good centration and intended implant depth with desirable increase in the corneal stromal reflectivity confirming effective collagen cross-linking.


CONCLUSIONS
Simultaneous femtosecond laser-assisted Myoring implantation and accelerated corneal intrastromal collagen cross-linking with Dextran Free Riboflavin is a safe and effective technique for management of keratoconus and improving vision.
Eye Research Center, Farabi Eye Center of Excellency, Tehran University of Medical Sciences, Faculty of Medicine, Tehran, Iran.
Mehrdad
M
Mohammadpour
Eye Research Center, Farabi Eye Center of Excellency, Tehran University of Medical Sciences, Faculty of Medicine, Tehran, Iran.
Hassan
H
Hahemi
Eye Research Center, Farabi Eye Center of Excellency, Tehran University of Medical Sciences, Faculty of Medicine, Tehran, Iran.
Mahmoud
M
Jabbarvand
D003094:Collagen / Q000008:administration & dosage*; D003319:Corneal Stroma / Q000601:surgery*; D019781:Corneal Topography; D003432:Cross-Linking Reagents / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000473:pathology / Q000628:therapy*; D053685:Laser Therapy / Q000379:methods*; D011474:Prosthesis Design; D019919:Prosthesis Implantation / Q000379:methods*; D012029:Refraction, Ocular; D016896:Treatment Outcome; D014792:Visual Acuity; D055815:Young Adult
D003432:Cross-Linking Reagents; D003094:Collagen
Corneal cross-linking; Intracorneal implant; Keratoconus; MyoRing