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Raul Alonso Flores Martin, Regina Velasco, Oscar Baca Lozada, Alejandro Babayan Sosa, Elisa Alegria Gomez, Cristina Pacheco Del Valle, Oscar Fernandez Vizcaya; Corneal collagen cross-linking and intrastromal corneal rings implantation in patients with keratoconus. Case series.. Invest. Ophthalmol. Vis. Sci. 2019;60(9):5061. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To describe corneal behavior and clinical results of corneal collagen crosslinking with simultaneous implantation of intrastromal corneal rings in patients with progressive keratoconus.
Ambispective study of 10 patients (10 eyes) with progressive keratoconus who underwent femtosecond-assisted (Visumax) implantation of intrastromal corneal rings and corneal collagen crosslinking in the same day. Different intrastromal corneal rings were used: INTACS and SI5 Kerarings. Corneal topography was done pre and postoperatively using Scheimpflug imaging with Pentacam HR. Analysis of corneal collagen cross-linking demarcation line and location of corneal rings was evaluated with OCT Visante, (Carl Zeiss Meditec), as well as slit lamp biomicroscopy. Keratoconus grade was II or III and an accelerated epithelium-off technique was used in all cases. Postoperatively, uncorrected visual acuity (UCVA), best spectacle corrected visual acuity (BSCVA), astigmatism, spherical equivalent, Q-value and complications were recorded. Follow-up time was between 3 and 6 months.
UCVA and BSCVA improved in all cases. Keratometric readings improved from 50.31 (±3.3) to 49.87 (±3.17) with a mean reduction of 0.53 diopters. Spherical equivalents improved from -7.3 (±3.55) to -5.3 (±2.55) with a mean reduction of 2.03 diopters. Q-values decreased in all cases. Crosslinking demarcation lines were noted in all cases at 239 (±28) microns depth. No complications were noted. Most of the improvement was observed in the keratoconus grade II patients with initial K-readings less than 53 diopters.
Performing both accelerated corneal collagen crosslinking and femtosecond-assisted intrastromal corneal rings implantation in the same surgical event may be an efficient and effective way of addressing both the progressive and sight-degrading problems of progressive keratoconus. These procedures are recommended in patients intolerant or unwilling to use rigid gas-permeable contact lenses to achieve the best possible vision and to help stop keratoconus progression. Further follow up is needed.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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