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Long-term outcomes of intracorneal ring segment implantation in 932 keratoconus eyes

Poster Details

First Author: F.Sammouh LEBANON

Co Author(s):    T. Baban   E. Warrak   -              

Abstract Details


To evaluate the progression of keratoconus disease in 932 eyes of 659 patients through visual, refractive and topographic data after intracorneal ring segments (ICRS) implantation, and to assess the possible correlation between the ratio of thinnest pachymetry to incision depth (T/I), and improvement of BCVA postoperatively.


Saint George Hospital – University Medical Center, Lebanon. Advanced Eye Care Hospital, Lebanon.


Retrospective review of 659 patients who underwent ICRS (Intacs®) implantation for keratoconus between September 1997 and November 2017. Demographics, preoperative and postoperative uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA) in LogMAR, corneal topography parameters (thinnest pachymetry, Kmax), T/I ratio and total follow-up time were evaluated. Statistical analysis was done using IBM SPSS Statistics 24.0 for windows.


932 eyes of 659 patients, with a mean age of 30.41years (Range 11-76years), were evaluated. Mean total follow-up time was 3.02years. 41 eyes had a total follow-up of more than 10years. Both UCVA and BCVA significantly improved after ICRS implantation (p<0.01). Only 18 eyes (2.66% of eyes of patients younger than 35years of age) were found to have progression of keratoconus based on postoperative topographic data (Mean age was 23.00years, 55.6% were females and total follow-up ranged from 2 to 10 years). T/I ratio of closer to 1.00 was found to be likely associated with a better BCVA improvement.


ICRS implantation showed long-term improved and stable visual and topographic results in a large case-series of patients with keratoconus. Only minimal rate of progression was detected in young patient population. T/I ratio could be used as a new parameter to predict a better BCVA outcome after ICRS implantation. However, further studies need to be conducted to better define predictability of visual outcomes postoperatively.

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