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Bilateral and sequential intrastromal corneal ring segment implantation combined with simultaneous flash corneal collagen cross-linking for the treatment of bilateral keratoconus

Poster Details

First Author: J.Grandin ARGENTINA

Co Author(s):    C. Gordillo   A. Lotfi                 

Abstract Details

Purpose:

To evaluate the safety, topographic and refractive outcomes of bilateral and sequential intrastromal corneal ring segments implantation (Intraseg�Â�®) assisted by femtosecond laser (Intralase�Â�®) combined with simultaneous Flash corneal collagen cross-linking (CXL) for the treatment of bilateral keratoconus.

Setting:

All the procedures were performed at Cornea Department of Zaldivar Institute in Mendoza, Argentina.

Methods:

This retrospective study included patients with previous diagnostic of progressive bilateral keratoconus. Inclusion criteria were baseline CDVA of 0.5 or better (logMAR), contact lens intolerance, a clear central cornea, and maximum keratometry (K) reading up to 59 D. All patients undergone ICRs implantation with Intraseg�Â�® ICRs (Gamma Vision) assited with femtosecond laser for tunnel creation in combination with Flash CXL (18 Mv) in 5 minutes. Complete evaluation including, Uncorrected Distance visual acuity UDVA,CDVA, refractive and corneal keratometrics value were measured preoperatively and at 1, 3, 6, and 12 months postoperatively.

Results:

400 eyes of 200 patients were analyzed, 61,9% were male and 38.1% were female. The mean age of patients was 31.41 DS 10,73. The mean UDVA (logMAR) changed from 1.00 �Â�± 0.63 preoperatively to 0,45 �Â�± 0,56 postoperatively, and CDVA from 0.37 �Â�± 0.24 to 0,13 �Â�±0,17. Mean depth of implantation was 401�Â�±17.89 and mean Kmax decreased from 48.04 D preoperatively to 46,92 D (p<.0003) postoperatively, while Kmin changed from 45.59 D to 44.42 D. Mean cylinder decreased from 3.58 (range 1.50 to 9.8.) to 2,11 (range 0,50 to 4,75). No complications were describe in this case series.

Conclusions:

Bilateral and simultaneaous ICRs implantation assited with femtosencond and combined with sequential flash cross linking in keratoconus is a safe and effective technique providing significant improvement in both UDVA and CDVA, keratometry values and reducing refractive cylinder and improving visual rehabilitation time for both eyes and reducing post-operative recovery.

Financial Disclosure:

NONE

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