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Comparison of visual, refractive, and topographic outcomes between manual technique and femtosecond laser-assisted for intrastromal corneal ring segment implantation in keratoconus

Poster Details

First Author: R.Carneiro de Freitas PORTUGAL

Co Author(s):                        

Abstract Details


To compare the visual, refractive, topographic and aberrometric results of intrastromal corneal ring segments (ICRS) implantation with manual dissection and femtosecond laser-assisted surgery.


Hospital de Braga, Portugal Instituto Oftalmológico Fernandez-Vega, Spain


This multicentre study included patients with paracentral keratoconus, in which the difference between the axes of the topographic flattest and the coma aberration was < 60°, who had Ferrara-type ICRS implantation (Keraring SI6, Mediphacos) using manual dissection or femtosecond laser (FS) technique. LogMAR uncorrected (UDVA) and corrected (CDVA) distance visual acuity, residual refractive errors, and the root mean square (RMS) for corneal coma-like aberration were recorded before and 6 months after ICRS implantation.


The study included 194 eyes: 84 eyes in the manual group and 110 in the FS group. There was an improvement in UDVA and CDVA for both groups (P<0.01), and there were no statistically significant differences between groups (P>0.3). For both groups, there was a reduction in spherical equivalent after surgery (P<0.01). There were no statistically significant differences between groups in spherical equivalent reduction (P= 0.34) The RMS coma like reduction was 0.93 ± 0.76 μm and 0.83 ± 0.80 μm in the manual and femtosecond group, respectively (P=0.2). While in the FS group no complications were reported, in the manual group the complications rate was 13,09%.


Both surgical techniques demonstrated to be effective concerning visual, refractive, topographic and aberrometric parameters. The femtosecond laser is a safer surgical procedure, with no complications reported.

Financial Disclosure:


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