Comparison Of Clinical Outcomes Between 3 Different Femtosecond Laser Platforms For The Implantation Of Asymmetric Intracorneal Ring-Segment For Keratoconus In Simultaneous With Corneal Collagen Cross-Linking. Safety And Security.

To describe the clinical outcomes obtained after implantation of asymmetric intracorneal corneal ring segments (ICRS) (variable thickness and width) assisted with 3 different variety of femtosecond laser platforms for tunnel creation in simultaneous with corneal cross linking (CXL).

All patients were operated on in the operating rooms of the Zaldivar Institute, the surgeries were performed under the same safety standards.

This retrospective and descriptive study includes patients with keratoconus described as duck phenotype. All eyes underwent implantation of single Asymmetric intrastromal ring (ICRS 160/250 microns) using 3 differents Femtosecond laser platforms for tunnel creation, 10 eyes for each platform. All settings for tunnel creation where the same, 10 patients underwent half tunnel and 20 patients 360 degrees tunnels. Visual outcomes, refractive changes and corneal topography were evaluated after the surgery as well as safety and reproducibility. 

30 eyes of 23 patients where evaluated, 7 patients had bilateral surgery and 16 patients had one single eye surgery, all patients follow up was performed for at least  12 months. 60 % of the patients where female, the mean age was 31 years (range 12-43), significant improvement was shown in UDVA, CDVA, K readings, as well as reduction in cylinder in all eyes. There were no statistically significant differences between the 3 groups of patients considering segment placement, deepness and stability. One patient had segment migration.

Implantation of the Asymmetric ICRS in keratoconus describe us duck phenotype is a safe and reproducible option for the treatment of keratoconus. The results present an improvement in visual acuity and quality in all cases, topographic and aberrometric parameters presented improvement after showing regularization of the corneal topography. The use of femtosecond laser for tunnel creation are a safe and effective tool.