New Asymmetrical Base & Thickness Intracorneal Ring Segment Implantation For The Treatment Of Keratoconus

To describe the visual results, topographic and refractive improvement of patients treated with double asymmetry ICR implantation.

All patients were treated at Cornea Department in Zaldivar Institute, Argentina

Inclusion criteria were consecutives eyes of keratoconic patients identify as "Duck" phenotype describe as paracentral ectasia, disabling visual acuity, in absence of corneal scars or striae. All patients were evaluated with complete ophthalmological examination including age, gender, selected eye, visual acuity (UDVA), corrected distance visual acuity (CDVA), slit lamp examination, endothelial cells evaluation and funduscopy. Corneal topography for pattern identification was performed previous and postoperative.

40 eyes of patients with keratoconus were analyzed, 63 % were male and 37% were female. The mean age of patients was 30.41 DS 9,73. The mean UDVA (logMAR) changed from 1.00 ± 0.63 preoperatively to 0.6 ± 0,56 postoperatively, and CDVA from 0.47 ± 0.24 to 0,23 ±0,17. Mean depth of implantation was 401±17.89 and mean Kmax decreased from 49.04 D preoperatively to 46,92 D (p<.0003) postoperatively. Mean manifiest cylinder decreased from -4.83 (range -1.50 to 8.50) to -1.75 (range 0,50 to 4,75). No complications were describe in this case series.

The identification of the corneal keratoconic type is mandatory to identify the pattern for achieving the correct selection of ICRS as well as the number and position of ICR for each ectatic cornea. Implantation of the asymmetrical base ICRS is a new option that allows to customized the treatment of Keratoconus which is safe and reproducible.