ESCRS - PP05.13 - Outcomes And Complications Of A 320-Degree Intrastromal Corneal Ring Segment (320-Icrs) In Keratoconus Patients

Outcomes And Complications Of A 320-Degree Intrastromal Corneal Ring Segment (320-Icrs) In Keratoconus Patients

Published 2022 - 40th Congress of the ESCRS

Reference: PP05.13 | Type: Free paper | DOI: 10.82333/fnfv-zw73

Authors: Celso Miguel Furtado Cabral Gomes Costa* 1 , Edgar Lopes 2 , Luis Bernardes 1 , Vitor Maduro 3 , Nuno Alves 4 , Andreia Rosa 5 , João Feijão 6 , Maria J. Quadrado 5 , Joaquim Murta 5

1Department of Ophthalmology,Centro Hospitalar e Universitário de Coimbra (CHUC),Coimbra,Portugal, 2Department of Ophthalmology,Centro Hospitalar Universitario Lisboa Central,Lisboa,Portugal, 3Department of Ophthalmology,Centro Hospitalar Universitario Lisboa Central,Lisboa,Portugal;Department of Ophthalmology,Hospital Lusiadas,Lisboa,Portugal, 4Department of Ophthalmology,Hospital CUF Descobertas,Lisboa,Portugal, 5Department of Ophthalmology,Centro Hospitalar e Universitário de Coimbra (CHUC),Coimbra,Portugal;Faculty of Medicine,University of Coimbra,Coimbra,Portugal, 6Department of Ophthalmology,Hospital Lusiadas,Lisboa,Portugal

Purpose

To report the clinical and tomographic outcomes and complications of a 320-degree intrastromal corneal ring segment implantation with the femtosecond laser in keratoconus patients.

Setting

Ophthalmology Department, Centro Hospitalar e Universitário de Coimbra, Portugal

Faculty of Medicine, University of Coimbra, Coimbra, Portugal

Ophthalmology Department, Centro Hospitalar Universitario Lisboa Central, Lisboa, Portugal

Unidade de Oftalmologia Hospital Lusiadas, Lisboa, Portugal

Hospital CUF Descobertas, Lisboa, Portugal

Methods

We performed a retrospective case series analysis of keratoconus patients consecutively submitted to implantation of a 320-degree ICRS, by a femtosecond laser–assisted procedure. Clinical parameters, such as uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA), spherical equivalent (SE) obtained by subjective refraction, as well as tomographic parameters, such as keratometry, pachymetry, asphericity and corneal irregularity indices were assessed preoperatively and postoperatively (3-9 months after the procedure).

Results

Fifteen patients were enrolled, with a mean age of 30.43 years (±13.96), 66.66% male (10). Mean UDVA improved from 1,12 logMAR to 0,72 logMAR (P=0.082). Mean CDVA improved from 0.63 logMAR to 0.26 logMAR (P=0.170). Mean SE improved from -5.51D to -2.51D (P= 0.258). Mean keratometry reduced from 59,63D to 54,88D (P=0,141), and maximum keratometry from 69.99D to 62.10D (P=0.307). Q value increased from -1.78 to -1.09 (P=0.372). Pachymetry remained stable and all the indices of irregularity improved, although only the index of surface variation and the index of height asymmetry were statistically significant (P=0.037 and P=0.048, respectively). No complications were reported.

Conclusions

Our work supports that implantation of a 320-degree ICRS is effective in improving visual acuity and tomographic parameters in keratoconus patients, by modification of the corneal shape, especially in those patients with severe keratoconus with low pachymetry, in which other therapeutic modalities may remain controversial, arresting the need for a corneal transplant. Additionally, it is a safe procedure. Further randomized controlled studies are needed to corroborate our work.