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Patient outcomes following intrastromal corneal ring segment (KeraRing; Mediphacos, Belo Horizonte, Brazil) implantation, with femtosecond laser channel creation, in cases of keratoconus and pellucid marginal degeneration (PMD)

Poster Details

First Author: V.Ramjiani UK

Co Author(s):    S. Rojanasakul   M. Edwards   M. Raynor              

Abstract Details


To report: (1) early changes in visual acuity and refraction, (2) patient satisfaction, and (3) complications following KeraRing implantation in patients with keratoconus and PMD.


Sheffield Teaching Hospitals, United Kingdom


29 patients with keratoconus and 3 patients with PMD (35 eyes) who underwent KeraRing implantation with channels created by femtosecond laser with post-operative follow up between 1 to 2 months were included in the study. Changes in uncorrected visual acuity (UCVA), best spectacle corrected visual acuity (BSCVA), and refraction was measured. Subjective patient satisfaction and adverse events were assessed.


A statistically significant improvement was seen in UCVA and cylinder. Mean UCVA improved by 0.24 logMAR units [confidence interval (CI) ±0.18]. Mean cylinder was reduced from +6.74 (CI ±0.98) to +4.18(CI±1.10). Mean BSCVA, sphere and spherical equivalent all improved but weren’t statistically significant. Excluding three people with no follow up data, 78% of cases (n=25) reported a subjective improvement, with all eyes maintaining or improving BSCVA and no complications. 22% (n=7) with poor subjective outcomes had either; worse/unchanging objective acuity and/or refraction (n=5), or a complication (n=2). Complications included implant extrusion and microbial keratitis.


KeraRing implants effectively achieve corneal regularisation with statistically significant improvements in astigmatism. The majority of patients report improvement in quality of life. Statistical significant improvements were reported in UCVA. The majority of patients maintained or improved BSCVA following implantation. All patients who maintained BSCVA already had achieved good baseline BSCVA of 0.17 logMAR or better (≥6/9). This data represents the first cohort of patients to receive KeraRing implants in our department. We expect more positive results with future operations as surgical experience progresses.

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