1Department of Applied Physics (Optometry), University of Santiago de Compostela, Spain
2Ophthalmology Service, University Hospital Complex of Santiago de Compostela, Spain
3Department of Surgery (Ophthalmology), University of Santiago de Compostela, Spain
*Corresponding author:Javier González- Pérez, Department of Applied Physics (Optometry), University of Santiago de Compostela, Spain
Submission: November 11, 2023;Published: January 29, 2024
ISSN: 2578-0360Volume3 Issue3
Aim: This study evaluates the topographic and aberrometric changes induced by ICRS in patients with
moderate and severe keratoconus and analyzes pre-operative factors affecting the refractive and visual
outcomes.
Methods: This retrospective, observational, nonrandomized, and single-center case series, included
21 keratoconic eyes of 21 patients implanted with Keraring ICRS (Mediphacos, Belo Horizonte, Brazil),
using the manual tunnelization technique and vacuum device. All subjects were examined after 6 months
following surgery, including the measurement of uncorrected visual acuity (UCVA), best-Corrected
Distance Visual Acuity (CDVA), refractive data, pachymetry, corneal topography, and aberrometry.
Results: The mean age of 21 patients was 31.14±10.65 years, eleven (52%) were male. Kerarings were
successfully implanted in all eyes. After 6-month from implantation, significant increase was found in
mean UCVA (P<0.01) and CDVA (P<0.01). There was a statistically significant reduction in refractive
cylinder (P<0.01), corneal cylinder (P=0.020), Kmax (P<0.01) and BFS (P=0.02). Statistically significant
differences were found in several aberrometric parameters for 6-mm pupil, RMS HOA (P=0.045), oblique
astigmatism (P=0.009), vertical coma (P=0.02), and oblique trefoil (P=0.018).
Conclusion: Analysis of the visual outcomes after Keraring ICRS implantation showed a significant
postoperative corneal flattening with a subsequent increase in UCVA and CDVA. Visual, refractive,
topographic and aberrometric parameters remarkably change in the 6-month period after Kerarings
implantation. Kerarings in this sample have shown to provide a mild visual rehabilitation between 2 and
3 lines, particularly in more advanced cases. Furthermore, flattening of the anterior segment induced by
the surgery might be beneficial for contact lens fitting.
Keywords:Keratoconus; Intrastromal corneal ring segments; Keraring; Vacuum system; K astigmatism; Spherical aberration; Coma; Corneal thickness