To report the efficacy and safety of intrastromal corneal ring segment (ICRS) implantation
using a femtosecond laser in the management of advanced keratoconus.
Private laser center, Toronto, Ontario, Canada.
In this retrospective nonrandomized study, Intacs SK ICRS were implanted using an
IntraLase femtosecond laser in eyes with moderate to severe keratoconus. Evaluation
included uncorrected (UDVA) and corrected (CDVA) distance visual acuity, manifest
refraction, slitlamp examination, corneal topography, and wavefront analysis of higher-order
aberrations. Postoperative visits were at 1, 7, and 30 days and 3 and 6 months.
The study evaluated 10 eyes of 8 patients with a mean age of 28 years (range 21 to
42 years). The mean UDVA was significantly better 6 months postoperatively than preoperatively
(0.66 logMAR +/- 0.21 [SD] versus 1.19 +/- 0.57 logMAR) (P = .004), as was the mean
CDVA (0.25 +/- 0.15 logMAR versus 0.51 +/- 0.20 logMAR) (P = .018). The mean spherical
equivalent refractive error was -8.08 diopters (D) preoperatively and -5.03 D at 6
months (P = .65); the mean refractive astigmatism, -5.05 D and -3.90 D, respectively
(P = .22); and the mean simulated keratometry value, 57.94 D and 50.07 D, respectively
(P = .15). The mean total aberration improved significantly, from 13.48 +/- 4.64 mum
preoperatively to 9.42 +/- 1.80 mum postoperatively (P = .007). There were no complications.
Implantation of ICRS for advanced keratoconus was safe and effective, leading to significant
improvement in UDVA, CDVA, and total aberrations.
No author has a financial or proprietary interest in any material or method mentioned.
Copyright 2010 ASCRS and ESCRS. All rights reserved.