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Combined corneal intrastromal implantation surgery with pocket cross-linking technique for keratoconus

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Session Details

Session Title: Presented Poster Session: Intraocular Refractive Results

Venue: Poster Village: Pod 2

First Author: : A.Elshahed EGYPT

Co Author(s): :    T. Aboul Nasr   A. Shaarawy   W. Orouk        

Abstract Details


To evaluate the clinical outcomes after Combined Corneal Intrastromal Implantation Surgery (CISIS) with pocket cross-linking technique for Keratoconus


Benha university, Egypt.


Intrastromal corneal pocket at depth of 300-µ is created by means of Pocket-Maker. Riboflavin injected within the pocket for 3 minutes only. UVA treatment applied for 10 minutes. MyoRing inserts of 240, 280, or 320-µm in thickness and 5, or 6-mm in diameter were implanted, according to its nomogram, in the corneal pocket at the end of the procedure. Visual, refractive, corneal topography, pachymetric, and IOP changes were evaluated during a 3-month follow-up. In addition, corneal biomechanical changes were evaluated by means of the Ocular Response Analyzer (Reichert, Buffalo, NY).


A significant improvement in UCVA was observed 1 week after surgery (P=0.003),which was consistent with significant reduction in SE (P=0.001) and cylinder (P=0.001).Furthermore, a significant corneal flattening of a mean value of 7.00 diopters (D) was found (P=0.001).This keratometric change was correlated with the magnitude of the CRF (r= - 0.782, P<0.008).No statistically significant changes were detected in corneal pachymetry postoperatively (P > 0.167).In regard to corneal biomechanics, no statistically significant changes were found at any time point of the follow-up (CH, P=0.717 & CRF, P=0.357) although, there is a small trend to an increase after 1 and 3 months.


Combined Corneal Intrastromal Implantation Surgery (CISIS) with pocket cross-linking technique for Keratoconus allows a significant reduction in myopic spherical error because of the successful corneal modeling. MyoRing always results in stabilization of the cornea in a new biomechanical equilibrium.

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