A retrospective study was conducted at Rifay Ophthalmology Center, Rabat, Morocco, on patients with progressive keratoconus who underwent ICR implantation. Preoperative and postoperative evaluations included corneal tomography and CDVA assessment. Surgery was performed using either manual stromal dissection or femtosecond laser-assisted tunnel creation
Intracorneal Rings In The Treatment Of Keratoconus
Published 2025 - 43rd Congress of the ESCRS
Reference: PPE.13 | Type: ESONT Abstract | DOI: 10.82333/mmqb-ag56
Authors: Yasser Rifay*
Purpose
Keratoconus is a progressive corneal disorder causing stromal thinning and visual impairment. This study evaluates the efficacy of intracorneal ring segments (ICRs) in managing keratoconus, focusing on corneal curvature, visual acuity, and refractive stability. Outcomes with adjunctive corneal cross-linking (CXL) are also examined, alongside factors like patient selection, surgical techniques, and complications to optimize treatment strategies
Setting
Methods
A retrospective analysis was conducted on keratoconus patients with progressive disease, CDVA < 0.6, contact lens intolerance, and corneal pachymetry > 400 µm. Central corneal scarring was excluded. Femtosecond laser-assisted intrastromal tunnel creation was followed by ICR implantation, with segment selection based on topography and refraction. Postoperative assessments included keratometric indices, higher-order aberrations, refractive stability, and CDVA. Complications like migration and extrusion were documented. CXL outcomes were analyzed separatel
Results
Topographic improvement: Mean keratometry values showed significant flattening.
Visual acuity: Both uncorrected and best-corrected visual acuity improved in most cases.
Stability and complications: Most cases were stable, but a small percentage experienced ring migration and extrusion, requiring repositioning or removal.
Adjunctive procedures: Patients who underwent combined ICR + CXL showed better long-term stability
Visual acuity: Both uncorrected and best-corrected visual acuity improved in most cases.
Stability and complications: Most cases were stable, but a small percentage experienced ring migration and extrusion, requiring repositioning or removal.
Adjunctive procedures: Patients who underwent combined ICR + CXL showed better long-term stability
Conclusions
ICRs represent an effective option for improving corneal regularity and vision in keratoconus patients, particularly when used in combination with CXL. Careful patient selection, proper surgical technique, and close postoperative monitoring are essential to optimize outcomes and minimize complications.