Comparison of 2 intrastromal corneal ring segment models in the management of keratoconus

Abstract

Although both ICRS models were effective and safe in managing keratoconus, the Keraring ICRS led to more improvement in CDVA and UDVA and a greater reduction in the maximum K value.

Intrastromal corneal ring segment implantation in 219 keratoconic eyes at different stages

“…There are several reports that show the efficacy and safety of ICRS to improve cornea shape and visual quality of keratoconic patients [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]. Depending on their arc, thickness and zone of implantation, surgeons can find different types of ICRS.…”

“…KeraRing ICRS can be implanted more centrally than Intacs and, theoretically, for this reason they may have a greater effect than Intacs. Recently, Kubaloglu et al [9] confirmed this hypothesis. They compared the results of implantation of Keraring and Intacs ICRSs in keratoconic eyes and they found that Keraring ICRS led to more improvement in best corrected distance visual acuity (CDVA) and UDVA and a greater reduction in the maximum K value.…”

“…The corneal thinning induces irregular astigmatism, myopia, and ectasia, leading to a decrease from mild to severe of the visual quality [1,2]. Recent studies have shown that intrastromal corneal ring segment (ICRS) implantation is an effective method for improving the corneal shape, reducing the astigmatism and corneal high order aberrations (HOAs) in patients with clear cornea and contact lens intolerance [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22].…”

New clinical pathways for keratoconus

“…Intrastromal corneal ring segments (ICRS) are effective in flattening the corneal shape and improving vision for most recipients with keratoconus, but the magnitude of effect is highly variable; and inclusion of different implantation techniques, different types of ICRS, and patients with late stage disease in earlier studies [43][44][45][46] makes the existing evidence base for ICRS harder to interpret.…”

“…[43][44][45][46][52][53][54][55][56] We would therefore argue for gross shape correction with ICRS implantation followed by CXL, fine shape correction with PRK if necessary, then finally pIOL implantation as a logical pathway to visual rehabilitation in grade II-III keratoconus (Figure 4). …”