ESCRS - PO478 - Comparison Of Visual, Tomographic, And Biomechanical Outcomes Of 360 Degrees Intracorneal Ring Implantation With And Without Corneal Crosslinking For Progressive Keratoconus: A 5-Year Follow-Up

Comparison Of Visual, Tomographic, And Biomechanical Outcomes Of 360 Degrees Intracorneal Ring Implantation With And Without Corneal Crosslinking For Progressive Keratoconus: A 5-Year Follow-Up

Published 2022 - 40th Congress of the ESCRS

Reference: PO478 | Type: Free paper | DOI: 10.82333/k4hn-6m27

Authors: Mehrdad Mohammadpour 1 , Masoud Khorrami-Nejad* 1 , Narges Khoshtinat 1 , Mahsa Ranjbar Pazooki 1

1Tehran University of Medical Sciences,Tehran,Iran, Islamic Republic Of

Purpose

To evaluate the long-term (5 years) results of 360 degrees intracorneal ring (ICR) implantation with and without corneal crosslinking (CXL) in patients with progressive keratoconus (KCN).

Setting

This study was done at Farabi Eye Hospital in Tehran, Iran. 

Methods

This historical cohort study was performed on 35 eyes with progressive KCN, which was randomly divided into 2 groups. Fourteen patients were implanted only with ICR, and 21 patients with KCN were treated with ICR plus CXL simultaneously. Uncorrected distance visual acuity (UCDVA), corrected distance visual acuity (CDVA), and refractive components were collected from patients' medical records. The biomechanical properties of patients were measured using the Corvis ST (Oculus, Inc, Weltzar, Germany). Corneal topography and aberrometry parameters were also recorded from the Pentacam HR device (Oculus).

Results

Both UCVA and CDVA increased in both groups after ICR implantation; however, this improvement was more significant in the ICR plus CXL group (P = 0.002 and P = 0.001, respectively). The mean improvement of CDVA in patients with ICR implantation with and without CXL was 0.56 ± 0.67 and 0.33 ± 0.61, respectively. A comparison of the long-term postoperative Tomographic and Biomechanical Index between 2 groups showed a better result in the ICR plus CXL group (P = 0.012). Topographic findings of the anterior corneal surface (flat-K, steep-K, mean-K, and astigmatism) after surgery were significantly better than before surgery in both groups (P < 0.05).

Conclusions

Although ICR implantation alone might halt the KCN progression with acceptable visual, topographic, and biomechanical outcomes, the combination of ICR and CXL has an adjuvant and synergistic effect, especially in long-term follow-up.