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Biomechanical evaluation of cornea with a new double surgical technique: intracorneal rings and cross-linking

Poster Details

First Author: S.García-Delpech SPAIN

Co Author(s):    A. Hervás Ontiveros   M. Benlloch Fornés   P. Udaondo   D. Salom   Á. Cisneros-Lanuza  

Abstract Details


To assess the clinical outcomes after Intracorneal Ring (ICR) implantation and the collagen crosslinking (CXL) for the management of keratocononus using femtosecond laser technology.


The study was done at Ophtalmology Service in Hospital La Fe in Valencia


A total of 13 patients (mean age 27.46+ 7,95 years) were treated with the double technique. The follow-up period was 12 months. Slit-lamp examination, subjective exam, pachymetry and ocular response analyzer measurements were performed. The Pentacam Topography was used to detect the level and position of ectatic corneal disorder and to obtain some parameters. The technique used to tunnel the corneal stroma and to also implement intrastromal rings was a femtosecond laser. After that, irradiating the cornea with ultraviolet A (λ = 370nm) to 3mW/cm irradiance ² for 30 minutes, which corresponds to a dose of 5.4 J / cm ² 0.3.


The mean corneal power preoperative in the 3 mm central zone was 48,16 + 45.22 mm (range 40.7 to 56,9)mm. In addition, the value after the surgery at the end of survey was 48.17+3.88 mm(range 41.7 to 56.3) mm. The hysteresis corneal preoperative (CH) was 7.18+ 1.41 and 7.77 + 1.08 respectively at 12 months. The resistance factor corneal preoperative (CRF) was 6.22 +1.65 and 12 months later 6.76+1.71. Not significant variability was observed.


Our results suggest that corneal collagen CXL & ICR can be a successful treatment at certain stages of keratoconus offering a possible way to stop progression in topography indices. The combination of ICRS and CXL to aid to reach a satisfactory visual acuity in cases which are contact lens intolerants such as soft-perm hybrid lenses, piggybacking lens systems or rigid gas-permeable can not to aid it . However, the Ocular Response Analyzer is not the best predictor of biomechanical corneal changes in the keratoconus. According to the analysis of all the information we can try from our point of view that patients after the intervention have won in quality of life however with a weak difference between values of CH and CRF. The main reason is ORA take a measure at central corneal area and the keratoconus is situated under corneal apex when the level of disorder is hight. But is possible that other variables to participate in the results. FINANCIAL INTEREST: NONE

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