title: Intrastromal corneal ring segments delay corneal grafting in patients with keratoconus.
abstract: OBJECTIVE
  To assess the impact of intrastromal corneal ring segments (ICRS) as a surgical alternative to corneal grafting in patients with keratoconus who were scheduled for a corneal transplant.
  
  
  METHODS
  This single-surgeon, single-center, retrospective, observational case series study included 19 eyes of 18 patients (mean age, 23.36 ± 6.22 years) with a confirmed diagnosis of keratoconus. These patients were enrolled from the State of Goiás, Brazil corneal graft waiting list. Following extensive pre-operative testing, including the measurement of best-corrected visual acuity (BCVA), applanation tonometry, biomicroscopy, funduscopy, pachymetry, and corneal topography, patients were implanted with Keraring® ICRS. Patients underwent clinical examination at postoperative days 1, 7, 30, 90, and 180 and were examined again 2 years following surgery.
  
  
  RESULTS
  At the 2-year cut-off following ICRS implantation (mean follow-up, 28.72 ± 4.71 months), there was a statistically significant improvement in BCVA (logMAR) from 0.59 ± 0.35 preoperatively to 0.35 ± 0.45 postoperatively ( p <0.01). Three of 19 eyes (15.8%) still required keratoplasty. In the remaining patients (84.2%), BCVA was managed with spectacles (52.6%) or contact lenses (31.6%). One patient developed infectious keratitis, requiring removal of ICR at the first postoperative visit.
  
  
  CONCLUSIONS
  ICRS implantation may be a surgical alternative to keratoplasty in patients with keratoconus. This procedure may delay or even eliminate the need for keratoplasty in such patients.
authors: Centro de Referência em Oftalmologia, Universidade Federal de Goiás, Goiânia, GO, Brazil.
authors: Luiz Arthur F
authors: LA
authors: Beniz
authors: Centro de Referência em Oftalmologia, Universidade Federal de Goiás, Goiânia, GO, Brazil.
authors: Gustavo H
authors: GH
authors: Queiroz
authors: Centro de Referência em Oftalmologia, Universidade Federal de Goiás, Goiânia, GO, Brazil.
authors: Carlos F
authors: CF
authors: Queiroz
authors: Centro de Referência em Oftalmologia, Universidade Federal de Goiás, Goiânia, GO, Brazil.
authors: Wanessa L
authors: WL
authors: Lopes
authors: Centro de Referência em Oftalmologia, Universidade Federal de Goiás, Goiânia, GO, Brazil.
authors: Leiser F
authors: LF
authors: Moraes
authors: Centro de Referência em Oftalmologia, Universidade Federal de Goiás, Goiânia, GO, Brazil.
authors: José
authors: J
authors: Beniz
mesh_terms: D000293:Adolescent; D000328:Adult; D003319:Corneal Stroma / Q000601:surgery*; D019781:Corneal Topography; D016039:Corneal Transplantation; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000601:surgery*; D008297:Male; D011184:Postoperative Period; D019736:Prostheses and Implants; D019919:Prosthesis Implantation; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014792:Visual Acuity; D014850:Waiting Lists; D055815:Young Adult