Outcomes of Keratoconus Treated With Combination of CXL, Conductive Keratoplasty, and Intrastromal Corneal Ring Segments
Narrative Responses:
Purpose
To evaluate collagen crosslinking as an adjuvant therapy to conductive keratoplasty and intrastromal corneal ring segments in patients with keratoconus.
Methods
Single-centered, retrospective, comparative case series of patients with a diagnosis of keratoconus who were treated with conductive keratoplasty and intrastromal corneal ring segments. Of these patients, those that also received collagen crosslinking were identified. Primary outcome measures, including pre- and post-op maximum keratometry, refractive astigmatism, and best uncorrected visual acuity were recorded at various time points including 3 months, 6 months, and 1 year following treatment.
Results
To date, 23 eyes from 20 patients with keratoconus have been reviewed. All eyes received combination of collagen crosslinking, conductive keratoplasty, and intrastromal corneal ring segments. At 3 months, 72% of patients had topographic flattening of at least 1.0 D (average flattening 3.10 D) and by 6 months 86% had over a diopter of flattening (average flattening 4.39 D). Also at 6 months, best uncorrected visual acuity improved at least 2 lines in 52% of subjects – while it did not change in 34% of cases.
Conclusion
In our practice, the average flattening resulting from treatment with combined conductive keratoplasty, intrastromal corneal ring segments, and collagen crosslinking is greater than with conductive keratoplasty and ring segments alone. Progressive topographic flattening continues over the course of several months following combination treatment.