Continuous intracorneal ring implantation for keratoconus using a femtosecond laser

摘要

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.