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Comparison of clinical and histological outcomes after intrastromal ring segments with cross-linking before and after implantation

Poster Details

First Author: L.Ibares-Frías SPAIN

Co Author(s):    P. Gallego   R. Cantalapiedra-Rodriguez   J. Merayo-Lloves   M. Martinez     

Abstract Details


To compare the clinical and histological response after intracorneal ring segment (ICRS) implantation with previous and posterior corneal crosslinking (CCL) in an experimental animal model (hen).


Group of Optical Diagnostic Techniques, University of Valladolid, Valladolid, Spain And Ophthalmology Department, Hospital Clínico Universitario de Valladolid, Valladolid, Spain


We performed surgery for this study on 16 hens (32 eyes) which were randomly divided into two groups. In the first group , epi-off CCL was performed before ICRS implantation by manual Technique (Ferrara Technique).In the second group implantation of ICRS was performed before epi-off collagen CCL. After ICRS implantation, hens were followed clinically for 4 months, when they were sent off for histological analysis of the eyes. Direct transmittance of the central cornea was also measured in each group. Values of the measured variables were analysed by calculating the mean and standard deviation. SPSS 19 Statistical software was used. An independent T Student Test was used for comparisons between the two groups. A p value less than 0.05 was considered to be statistically significant.


In the first group 64.2% of the eyes had good clinical follow up. Complications described were, superficial neovascularization, intense haze around the segment and intrasurgically segment break . In the second group 66.7% had good follow up and complications were ;neovascularization, spontaneous extrusion and the segmental weakening after cross linking procedure. Clinically, in both groups fewer deposits were found with lower intensity than in ICRS implantation without CXL. Histologically, statistically significant differences were found in corneal thickness, segment rotation and the number of cells around the segment. All these values were lower in the first group.


Cross linking in combination with ICRS implantation in an experimental animal model is related to some complications that must be considered in daily practice. Corneal cross linking before implantation of ICRS leads to less clinical and histopathological wound healing response than cross linking after implantation.Purpose:

To compare the clinical and histological response after intracorneal ring segment (ICRS) implantation with previous and posterior corneal cross linking (CCL) in an experimental animal model (hen). FINANCIAL INTEREST: NONE

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