Combined Intrastromal Corneal Ring Implantation and Corneal CXL in Patients With Progressive Keratoconus: 30-Month Outcomes
Narrative Responses:
Purpose
To evaluate 30 months visual and therapeutic outcomes of simultaneous ultraviolet/riboflavin-mediated crosslinking (CXL) and intrastromal corneal ring segment (ICRS) implantation for treatment of patients with progressive keratoconus.
Methods
This Retrospective - Case Series study comprised eyes that underwent combined ICRS implantation and CXL performed simultaneously. Inclusion criteria included progressive Keratoconus with K values between 46 and 56 Diopters, contact lens intolerance, no corneal scaring, pachymetry greater than 400 µm and age older than 18 years old. Refraction, uncorrected (UDVA) and corrected (CDVA) distance visual acuities, Keratometry (K) values and corneal topography were assessed preoperatively, 1, 6, 12, 18, 24 and 30 months postoperatively.
Results
This study comprised 28 eyes with a mean follow-up of 25.8 months (range 6 to 30 months). After that time the mean UCVA improved from 6.786 MAR ± 8.876 (SD) to 1.237 MAR ± 0.3278 (SD) (P 0.0108), considered to be significant. The mean CDVA also improved significantly from 2.036 MAR ± 1.665 (SD) to 1.237 MAR ± 0.3278 (SD) (P 0.0251). The mean topographic K2 values decreased extremely significantly from 49.569 ± 3.616 (SD) to 45.545± 2.176 (SD) (P<0.0001). An endothelial cell recount performed in 14 of the 28 eyes showed no significant loss of endothelial cells (P 0.3451).
Conclusion
According to our study simultaneous ICRS and CXL is considered to be effective and safe to treat progressive keratoconic eyes. It significantly improved the UDVA, CDVA and Topography K2 values.