Intracorneal ring segments implantation followed by same-day photorefractive keratectomy and corneal collagen cross-linking in keratoconus

J Refract Surg. 2011 Dec;27(12):915-8. doi: 10.3928/1081597X-20111103-03. Epub 2011 Nov 10.

Abstract

Purpose: To evaluate the efficacy of intrastromal corneal ring segments implantation followed by same-day photorefractive keratectomy (PRK) and ultraviolet-A/riboflavin collagen cross-linking (CXL) in patients with keratoconus.

Methods: Four patients (five eyes) were included in the study. All patients first underwent femtosecond laser-enabled placement of intracorneal ring segments (Intacs, Addition Technology). Uncorrected (UDVA) and corrected distance visual acuity (CDVA) and keratometry readings remained stable for 6 months. Same-day PRK and CXL were subsequently performed in all patients.

Results: Six months after Intacs plus PRK/CXL, significant improvements were noted for UDVA, CDVA, spherical equivalent refraction, keratometry, and total aberrations. No patient lost lines of CDVA or developed haze.

Conclusions: The combination of intracorneal ring segments implantation followed by sequential same-day PRK/CXL may be a reasonable option for improving visual acuity in select patients with keratoconus.

MeSH terms

  • Adult
  • Collagen / metabolism*
  • Combined Modality Therapy
  • Corneal Stroma / metabolism
  • Corneal Stroma / surgery*
  • Corneal Topography
  • Cross-Linking Reagents / therapeutic use*
  • Humans
  • Keratoconus / drug therapy*
  • Keratoconus / physiopathology
  • Keratoconus / surgery*
  • Lasers, Excimer / therapeutic use
  • Male
  • Middle Aged
  • Photorefractive Keratectomy*
  • Photosensitizing Agents / therapeutic use
  • Prostheses and Implants
  • Prosthesis Implantation*
  • Riboflavin / therapeutic use
  • Treatment Outcome
  • Ultraviolet Rays
  • Visual Acuity / physiology

Substances

  • Cross-Linking Reagents
  • Photosensitizing Agents
  • Collagen
  • Riboflavin