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Mechanical intrastromal corneal ring segment (ICRS)implantation: 5 year results

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Session Details

Session Title: Cornea
Session Date/Time: Sunday 28/02/2016 | 08:30-11:00
Paper Time: 08:48
Venue: MC2 Room
First Author: : B.Carvalho PORTUGAL
Co Author(s): :    S. Crisostomo   N. Silva   M. Noronha   N. Alves   V. Maduro   P. Candelaria

Abstract Details


To present the anatomical and functional data obtained from patients with keratoconus (KC) submitted to mechanical intrastromal corneal ring segment (ICRS) implantation.


Centro Hospitalar Lisboa Central, Ophthalmology Department.


Retrospective study with a selected sample of patients with KC stages II and III. Inclusion criteria demanded the existence of thorough clinical records, minimum follow-up time of 12 months and pre and postoperative corneal computerized topographical data. Patients with a history of acute corneal hydrops, more than 60 D keratometry, corneal endothelial cell count of less than 1000 cells per mm2, previous ocular surgery or other known ocular pathologies were excluded. Data concerning keratometry, corneal astigmatism, pachymetry, asphericity, spherical equivalent and best corrected visual acuity (BCVA) were evaluated at three follow-up checkpoints: 12, 36 and 60 months.


158 patients (ie. 188 eyes) were included in the study. Mean age at time of surgery was 32.36 years (15-71 years). By Amsler-Krumeich criteria 28.7% of patients had stage II KC and 71.3% had stage III KC. BCVA (LogMAR) averaged 0.51 SD 0.34 at the preoperative period, and 0.17 SD 0.17, 0.14 SD 0.17 and 0.15 SD 0.17, at 12, 36 and 60 months after surgery, respectively. All topometric parameters improved after surgery. Mean follow-up time was 33.78 months (SD 17.93), during which five cases of disease progression, two cases of implant extrusion were observed and retunnelizations were necessary.


Intrastromal corneal ring segments combine technical simplicity with reversibility, efficacy and safety in stabilizing KC progression, providing good tectonic and functional outcomes as well as improved visual acuity and reduced astigmatism. The rate of complications found in this study matches those reported in similar series.

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