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Intracorneal ring segments in management of moderate keratoconus, the revival of the technique in our department

Poster Details

First Author: J.Pinheiro-Costa PORTUGAL

Co Author(s):    L. Torrão   L. Figueira   R. Moreira   F. Falcão-Reis     

Abstract Details



Purpose:

Intracorneal ring segments (ICRS) were originally designed for myopia correction, but now they are mainly used in mild to moderate keratoconus to improve contact lens tolerance and visual acuity. The purpose of the present study was to evaluate the efficacy of ICRS in the management of moderate ectatic corneal disease.

Setting:

Department of Ophthalmology, Centro Hospitalar São João, Porto, Portugal.

Methods:

Twenty one eyes from 21 patients with a clear cornea in visual axis suffering from contact lens intolerance underwent ICRS implantation by the same surgeon (LT). Nineteen eyes had a stage II or III Ahmsler-Krumeich keratoconus and 2 eyes had post-LASIK iatrogenic keratectasia. In 16 eyes were inserted 2 symmetric Intacs Sk® segments and in 5 eyes were inserted 1 or 2 Keraring® segments. The tunnel was manually created in all cases, at a depth of approximately 80% of the corneal thickness in the 6-7 mm central zone.

Results:

The mean follow-up after ICRS implantation was 15.6 ±10.4 months. Mean best-corrected visual acuity changed from 0.3 ±0.14 preoperatively to 0.5 ±0.18 postoperatively (p<.01). Fourteen patients (66.7%) improved contact lens tolerance. Mean Coma decreased from 3.14 ±0.97 to 2.63 ±1.13 rms (p=.023). Improvements in maximum K and in astigmatism were observed too. One patient had a corneal perforation during the surgery, and only one INTAC segment was placed. In five patients the ring segments were removed by extrusion or corneal neovascularization. None of the cases had major complications such corneal infection or loss of visual acuity.

Conclusions:

ICRS provides a valid alternative to early keratoplasty in patients with a clear central cornea and contact lens intolerance. It can improve contact lens tolerability and visual acuity. FINANCIAL INTEREST: NONE

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