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First Author: D.Pietrini FRANCE
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To present early results with the new Keraring 355Ḟ intrastromal corneal ring (ICR; Mediphacos, Minas Gerais, Brazil) in keratoconus treatment.
Centre de la cornée et du kératocône, Paris
A case study of bilateral implantation of the Keraring 355Ḟ ICR, which is recommended for use in cases of advanced central-nipple type keratoconus.
A 32-year-old female patient presented with keratoconus in both eyes. Visual exam revealed central keratoconus with central pachymetry of 423 ?m, keratometry of K1:51.8 D, K2: 53.2 D, K2 axis:134Ḟ, UCVA of 0.1, BCVA of 0.6, astigmatism of 1.4 D, and primarily myopic refraction of -7.50 Sph -1.50 Cyl Ṫ 110Ḟ OD. The pre-operative exam was similar in OS with central-nipple type keratoconus with a central pachymetry of 412 ?m, keratometry of K1: 52.8 D, K2: 55.7 D, K2 axis: 44Ḟ, astigmatism of 2.9 D, UCVA of counting finger, CDVA of 0.4, and myopic refraction of -8.75 Sph -2.50 Cyl Ṫ 60Ḟ. The ring was implanted in a pocket created with a femtosecond laser at a depth of 300 ?m with an 8-mm incision. Five months post-operatively, UCVA improved to 0.6, the patient gained one line of CDVA, and achieved a refraction of +0.50 Sph -1.00Cyl Ṫ 70Ḟ OD. The patient had an 80-?m reduction in anterior elevation and considerable flattening of the cornea without inducing high amounts of astigmatism. In the left eye, UCVA improved to 0.5, the patient gained two lines of CDVA, and achieved a refraction of +0.50 Sph -1.00 Cyl Ṫ 80Ḟ.
The Keraring 355Ḟ is a new option that is specifically designed for nipple-type keratoconus. It has a high flattening effect and considerably reduces corneal asphericity. It is an additional tool for customizing keratoconus treatment based on the patients distinct corneal profile.