Continuous intracorneal ring implantation for keratoconus using a femtosecond laser

J Cataract Refract Surg. 2013 Jul;39(7):1081-7. doi: 10.1016/j.jcrs.2013.02.054. Epub 2013 May 22.

Abstract

Purpose: To assess the clinical outcomes after continuous intracorneal ring (ICR) implantation for the management of keratoconus using femtosecond laser technology.

Setting: Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Design: Prospective nonrandomized consecutive case series.

Methods: All patients presented with reduced visual acuity, contact lens intolerance, and a central corneal thickness of more than 360 μm. A Myoring ICR was inserted in an intrastromal pocket created by a femtosecond laser. The visual, refractive, aberrometric, and corneal biomechanical outcomes were measured preoperatively as well as 1, 3, and 6 months and 1 year postoperatively.

Results: The study comprised 98 keratoconic eyes of 98 patients with a mean age of 30.7 years ± 9.01 (SD). Fifteen eyes (15.3%) had grade I keratoconus, 37 eyes (37.7%) had grade II keratoconus, 24 eyes (24.5%) had grade III keratoconus, and 22 eyes (22.4%) had grade IV keratoconus. The uncorrected and corrected distance visual acuities and spherical and cylindrical errors improved 1 month after surgery (P<.001); however, no changes were detected thereafter (P>.05). The mean keratometry and corneal astigmatism decreased 1 month after surgery (P<.001); however, no significant change was observed at the 3-month or 1-year visits compared with the 1-month values (P>.05). Primary coma decreased significantly (P=.03), and spherical aberrations increased significantly (P<.001) postoperatively.

Conclusion: Continuous ICR implantation in keratoconus appears to be an acceptable substitute for keratoplasty in advanced keratoconus.

Financial disclosure: No author has a financial or proprietary interest in any material or method mentioned.

MeSH terms

  • Aberrometry
  • Adolescent
  • Adult
  • Biomechanical Phenomena
  • Corneal Pachymetry
  • Corneal Stroma / physiopathology
  • Corneal Stroma / surgery*
  • Corneal Surgery, Laser / methods*
  • Corneal Topography
  • Female
  • Humans
  • Keratoconus / physiopathology
  • Keratoconus / surgery*
  • Male
  • Middle Aged
  • Prospective Studies
  • Prostheses and Implants*
  • Prosthesis Implantation / methods*
  • Refraction, Ocular / physiology
  • Treatment Outcome
  • Visual Acuity / physiology
  • Young Adult