Clinical and functional results of keratoconus treatment with implantation of a single ICRS into the area of maximal corneal ectasia

Session Details

Session Title: Cornea - Surgical

First Author: S. Izmailova RUSSIA

Co. Authors :    V. Tchouprine   Z. Moroz   S. Avramenko              

Abstract Details:



Purpose:

To evaluate efficacy of keratoconus treatment with implantation of a single intrastromal corneal ring segment (ICRS) into the area of maximal corneal ectasia on the eyes with different stages of keratoconus.

Setting:

Fyodorov Eye Microsurgery Complex, Moscow, Russia.

Methods:

56 patients with keratoconus were treated with implantation of a single ICRS into the area of maximal corneal ectasia. ICRS were made of polymethyl methacrylate (PMMA) of 150 mcm thickness and were implanted into most ecstatic area at the depth of 80% of corneal thickness. Standard pre- and postoperative examination included: visometry, refractometry, corneal confocal microscopy (CM), keratotopography, pachymerty and anterior chamber depth with atterior optical coherent tomography (OCT). Average indices showed: uncorrected visual acuity (UCVA) 0,06±0,02, best corrected visual acuity (BCVA) 0,2±0,1, spherical equivalent -5,6±0,39 D, cylindrical equivalent -4,2±1,1 D, refractive power in the area of maximal ectasia 58,2±0,2 D, central corneal thickness 411±16 mcm. CM revealed supraendothelial folds of different intensity correlating with keratoconus stage.

Results:

Post-op results are described as stable during all observation period (3-36 months) and average indices showed: UCVA 0,4±0,14, BCVA 0,6±0,15, spherical equivalent -3,5±0,15 D, cylindrical equivalent -1,5±0,2 D, refractive power in the area of maximal ectasia 46,5±0,5 D, central corneal thickness 440±11mcm. CM revealed reduction of number and intensity of supraendothelial folds and pronounced fibroplastic reaction in the area of implanted ICRS.

Conclusions:

Above-listed findings allow us to presume that ICSR serves like a frame for ectatic cornea and prevents its further thinning, i.e. has an orthopedic function. We revealed increased central corneal thickness, reduction of anterior chamber depth presumably because of corneal flattening and tissue redistribution. With this in view the method could be considered as pathogenically approved.

No Financial Interest