Femtosecond assisted intrastromal corneal ring (ISCR) implantation for the treatment of corneal ectasia

Abstract

Purpose: To assess the outcomes of intrastromal corneal ring (ISCR) implantation for the treatment of corneal ectasia. Methods: Thirty-five consecutive patients with secondary corneal ectasia treated with keraring intrastromal corneal ring segment implantation aided by intralaser femtosecond technique (K-ICRS-FS) were evaluated. Visual acuity (logMAR), refraction and astigmatism vector analysis were measured preoperatively and 3 months postoperatively using vector analysis as described by some authors. Conclusion:Intrastromal corneal ring implantation with the use of a femtosecond laser was a safe procedure, with low risk of complications and significant improvement on visual acuity and topographic data in this seeting of patients with secondary corneal ectasia. de 0,40 ± 0,20 para 0,25 ± 0,13 (p=0,0002), com diminuição do equivalente esférico de 5,41 ± 4,78 D no préop. para 2,83 ± 3,29 D no pósop. (p=0,0002) 51,65 ± 5,83 D para 48,58 ± 5,54 D (p=0,000) e o K mínimo de 45,92 ± 4,64 D para 43,96 ± 5,06 D (p=0,0041 Keywords

Intrastromal corneal ring segments delay corneal grafting in patients with keratoconus

“…Similarly, in a 35-eye study, Coimbra et al demonstrated that Keraring ICRS improved visual acuity and topographic data in patients with secondary corneal ectasia at a 3-month postoperative follow-up (11) . However, to the best of our knowledge, no reports on the use of Keraring ICRS as a treatment for patients who have already been triaged for corneal transplantation are available.…”

“…There are several commercially available ICRS that vary with regard to curvature, width, and zone of implantation (3) . (10)(11)(12)(13)(14) . Although previous studies have evaluated ICRS efficacy in patients who were intolerant to rigid contact lenses (and therefore potential candidates for a corneal transplant) (15)(16)(17) , to the best of our knowledge, there are no published data regarding Keraring ICRS efficacy in patients with keratoconus who were already scheduled for penetrating keratoplasty.…”

Indications and visual outcomes of intrastromal corneal ring segment implantation in a large patient series

“…Corneal ring implants were initially used to treat low myopia 4,5, but current applications include treatments for keratoconus, irregular astigmatism induced by penetrating keratoplasty, post-refractive surgery ectasia, post-radial keratotomy ectasia, pellucid marginal degeneration and post-traumatic corneal irregularities 6-8.…”

“…Many authors have emphasized the advantages of the implants, including their removable nature and their stability and security due to the lack of need for an intraocular procedure 6-11.…”

“…Surgery using this technology appears to result in fewer complications than does surgery based on mechanical (exclusively manual) techniques 6,13-15. Femtosecond-assisted implantation can even be combined with other procedures, such as crosslinking and refractive ablation 16,17.…”