ESCRS - FP92 - THE EFFECTIVENESS OF INTRASTROMAL SEGMENT IMPLANTATION IN THE TREATMENT OF PROGRESSIVE KERATOCONUS OF THE INITIAL STAGES IN THE LONG-TERM FOLLOW-UP PERIOD (10 YEARS)

THE EFFECTIVENESS OF INTRASTROMAL SEGMENT IMPLANTATION IN THE TREATMENT OF PROGRESSIVE KERATOCONUS OF THE INITIAL STAGES IN THE LONG-TERM FOLLOW-UP PERIOD (10 YEARS)

Published 2022 - 26th ESCRS Winter Meeting

Reference: FP92 | Type: Abstracts | DOI: 10.82333/v8sj-aw28

Authors: Artem Zakharovich Ciganov 1 , Svetlana Borisovna Izmailova 1 , Lana Arutyunyan* 1

1Department of Transplantology and Optical-Reconstructive Surgery of the Anterior Segment of the Eyeball,S.N. Fyodorov Eye Microsurgery Federal State Institution of the Russian Ministry of Health,Moscow,Russian Federation

Purpose

One of the promising methods of treatment of the initial stages of progressive keratoconus, as a manifestation of the keratectatic process, is Intrastromal corneal ring segment implantation (ICRS). The first reports of the successful implementation of this type of surgical intervention in the treatment of patients with keratoconus appeared at the end of the 20th century. Therefore, the assessment of the safety and effectiveness of the operation in the long-term observation period is certainly relevant.

Setting

To analyze the effectiveness of ICRS implantation in patients with progressive keratectasias in the long term, taking into account the use of various techniques for the formation of corneal tunnels.

Methods

Clinical studies are based on the analysis of 1185 patients (1343 eyes) with keratectasias of various origins, who underwent ICRS. Mechanical technology was performed in 1007 cases (121 cases without the use of a graduated vacuum ring (GVK), 886 – with the use of GVK), with the use of a femtosecond laser – 336 cases. Keratoconus was diagnosed in 1193 eyes, of which stage II of the disease - in 856 eyes (64%), stage III – in 487 eyes (36%). One corneal ring segment was implanted in the area of the greatest ectasia in 872 cases of asymmetric keratectasia, and two corneal ring segment were implanted in 471 cases of symmetrical keratectasia.

Results

In all groups there was a stabilization of the keratectatic process. For 10 years, there was no progressive decrease in the thickness of the cornea and keratotopographic parameters did not change, and the ectasia zone was within the field of surgery, which indicates that ICRS has a refractive effect, and is also a method of stopping and preventing the progression of the keratectatic process.

Conclusion

Our 10-year experience of ICRS in the treatment of progressive keratectasias of various origins has proven high efficiency, the possibility of improving visual functions, stabilizing the ectatic process, and the safety of this type of surgical intervention.