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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


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.


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


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.


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.


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.

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