Simultaneous Complete Intracorneal Ring Implantation with Intrapocket Collagen Cross- Linking for Treatment of Keratoconus


ABSTRACT: BACKGROUND: Keratoconus is a progressive non inflammatory bilateral (usually asymmetric) ectatic corneal disease characterized by paraxial stromal thinning ,weakening that lead to corneal surface distortion ,vision loss primarily from irregular astigmatism and myopia and secondly from corneal scar.OBJECTIVE: To evaluate visual and refractive outcomes after intracorneal continuous ring (ICCR) implantation combined with intrapocket corneal collagen cross linking in patient with keratoconus.Setting: Eye Specialty Private Hospital, Baghdad, Iraq. METHODS: This study assessed the results of implantation of Myoring ICCR combined with CXL in 40 eyes with KC. Outcome measures include UDVA,CDVA(spectacle correction),refraction, complications and side effects. Postoperative follow- up was up to 1 year.RESULTS: The study evaluated 40 eyes of 34 patients with a mean age of 25.75 years. Preoperatively, the pachymetry at thinnest location range from (367_555ϻm) and the mean keratometry (K) readings 50.51± 3.94D. Post operatively ,there was statistically significant improvement in the UDVA,CDVA,K reading ,manifest spherical and cylindrical refractive errors ,and spherical equivalent (p<.05).The mean UDVA improved by 13 lines ,CDVA improved by 3.5 lines and the mean K reading decreased by 7.14 D .No serious intraoperative complications occurred .Side effects includes glare and night vision problems.CONCLUSION: Treatment of KC with simultaneous ICCR implantation and intrapocket collagen cross linking significantly improved visual and refractive outcomes .the UDVA and CDVA continuously improved during the 1st year postoperatively.