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Sequential ICRS implantation and corneal transepithelial CXL in keratoconus

Poster Details

First Author: A.Saif USA

Co Author(s):    M. Ahmed   H. el Saftawy   M. Saif              

Abstract Details

Purpose:

To assess the safety and efficacy of sequential transepithelial corneal collagen cross linking (CXL), after surgical implantation of Kera intracorneal ring segments (ICRS) in keratoconus eyes.

Setting:

Multicentre study, Research Institute Of Ophthalmology , Beni Suef university and Memorial Institute Of Ophthalmology, Cairo Egypt.

Methods:

This retrospective comparative study included 40 consequitive eyes of 29 patient with progressive, mild to moderate Keratoconus that were randomly divided into two groups. Group 1 included 20 eyes that underwent kerarings (Mediphacos Inc., Belo Horizonte, Brazil) implantation, and group 2 included 20 eyes that underwent kerarings insertion followed by transepithelial CXL one month later. In both groups channel creation was performed manually.

Results:

There was statistically significant improvement in both groups, uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA), with significant reduction in refractive error and keratometric values (p<0.05). There was no statistically significant difference between both groups regarding changes in UDVA, CDVA and refractive error (p>0.05). However, group 2 revealed more statistically significant reduction in spherical refraction after 3m and highly significant improvement after 6m.

Conclusions:

ICRS implantation is an effective procedure for visual and refractive improvement in keratoconic eyes. However, the addition of TE- CXL to the procedure compensates for residual superficial irregularities , disrupts the progression of the disease and provides greater improvements in spherical values . The process is simply a deep stretch with a superficial lamellar stiffness .

Financial Disclosure:

NONE

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