Long-Term Follow-Up Of Keratoconus Patients Treated With Innovative Intracorneal Ring-Supported Graft Surgery.

To evaluate the long-term outcomes of patients with keratoconus treated using a novel intracorneal ring-supported graft surgery technique.

Retrospective, case-series study

This study encompassed 10 patients diagnosed with moderate to severe keratoconus who underwent an innovative surgical technique. The procedure involved the creation of a corneal lenticule from the donor eye using a femtosecond laser, ensuring precise diameter and thickness. An innovative full-circle ring made of polymethylmethacrylate, featuring two spherical side surfaces and an inner and outer rim, was utilized.

Clinical outcomes were evaluated through measurements of visual acuity, corneal topography, corneal biomechanics, and patient-reported symptoms. Follow-up examinations were conducted to assess corneal stability and potential complications. Corneal confocal microscopy was also employed as an additional measurement.

The mean follow-up period was four years (ranging from 3 to 5 years). When compared to preoperative measurements, improvement in uncorrected visual acuity and reduction in spherical equivalent refractive error were observed, although not statistically significant. However, in all patients, mean keratometry values (measured by Pentacam) showed a significant decrease, and the stiffness parameter (measured by Corvis ST) improved significantly over the follow-up period (p=0.006 and p<0.001, respectively). There were no severe complications, and the graft remained stable. Mild halos at night were reported by two patients, while others experienced no bothersome symptoms.

The intracorneal ring-supported graft surgery demonstrated excellent stability and increased corneal stiffness during long-term follow-up. This technique appears to be a safe and effective therapeutic option for keratoconic eyes, providing significant improvements in corneal biomechanics and corneal regularity.