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Aberrometric and visual outcomes in intracorneal ring segments (ICRS) with sequential cross-linking (CXL) in keratoconus corneas: a long-term follow-up

Poster Details

First Author: H.Elsaftawy EGYPT

Co Author(s):    M. Salaheldin   O. Hashim   A. Saif              

Abstract Details


To analyse the effectivity, predictability, safety and aberrometric changes of implanted intracorneal ring segments (ICRS) (Kera rings Mediphacos, Brazil) with sequential cross-linking (CXL) in Keratoconus patients during 24-month follow-up


A Retrospective, consecutive case series of twenty one Keratoconus patients were included, all were patients of the Research Institute of Ophthalmology (RIO)Cairo Egypt.


Twenty-one eyes of 17 Keratoconus patients were included, mean age 23.76 years (range 18-30) (18 Females and 5 males) . ICRS were implanted from 2010-2013. Mechanical dissection of the lamellar pockets was the technique used. CXL followed 6 weeks later. Postoperative refraction, topography, and aberrometry follow up was done at 6-12-24 months. Aberrometry used coefficient settings in NIDEK OPD-Scan for more sensitivity.


There was a statistically significant improvement in UCVA and BCVA, with a significant reduction in refractive error and mean keratometry values (p<0.001). There was a statistically significant improvement in T.RMS, 6-Trefoil,7-Coma & 8-coma coefficients (p<0.001) after 6 months. Only Coma 7 progressively improved till 24month. Very small but insignificant regression in mean K-values in 12 months follow-up, stabilized at 24 months.


ICRS implantation reduces corneal irregular steepening in Keratoconus. CXL improves corneal rigidity and halts the progression of the disease. Locking-up corneas with CXL after ICRS implantation is an effective, safe and predictable method for improving and stabilizing visual, keratometric, aberrometric and biomechanical values in Keratoconus. Order 7 coma (HOA) showed exclusively, progressive significant improvement until 24 months.

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