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Can intracorneal segments stabilize progression of keratoconus?

Poster Details

First Author: M.Assouline FRANCE

Co Author(s):    T. Guedj   L. Bessede           

Abstract Details



Purpose:

To assess the effect of intracorneal segments (ICS) effect on the corneal shape in keratoconus. To determine whether this effect progresses with time and how long it takes to stabilize. To investigate whether ICS can halt the progression of keratoconus and offer a temporary alternative to corneal crosslinking.

Setting:

Centre IĆ©naVision and Clinique de la Vision, Paris France

Methods:

Retrospective review of 193 consecutive cases meeting the following inclusion criteria (n=56) - progressing keratoconus (1 diopter per year) or verified contact lens intolerance - loss of best corrected visual acuity - intrastromal implantation of either Keraring or Intacs after femtosecond dissection available Orbscan maps at a minimum 2 years interval postoperatively Exclusion criteria were post-Lasik ectasia, preoperative keratometry greater than 60 diopters or pahcymetry lower than 400 micrometers. Full numerical data recorder extraction was obtained for the central 6 mm of each Orbscan exam and analyzed for keratometry, anterior and posterior elevation, and reference spheres.

Results:

Over a 4 years follow up period, maximum and mean keratometry kept on decreasing from 60.1+/-6.1 to 55.7+/-1.8 D and 51.7 to 41.6 respectively. Max anterior elevation decreased for 1 year from 58+/-22 um to 36+/-12 um then increased slowly to 44+/-10 um at 4 years. Anterior best fit sphere changed from 7.82+/-0.33 to 8.12+/-0.21 mm at 4 years.

Conclusions:

These results suggest that: - primary treatment for progressing keratoconus should be ICS implantation which may both improve and stabilize corneal shape - indication for corneal crosslinking should be delayed 1 to 4 years or more while monitoring the progression of ICS beneficial effect on corneal shape and avoiding the potential complication (infection, scaring, phototoxicity) of crosslinking. FINANCIAL INTEREST: NONE

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