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Year : 2019  |  Volume : 32  |  Issue : 1  |  Page : 375-379

Evaluation of femtosecond laser-assisted implantation of intracorneal ring segments in cases of keratoconus

Department of Ophthalmology, Faculty of Medicine, Menoufia University, Shebin El-Kom, Egypt

Correspondence Address:
Alia M Nagy
Alsheikh Zayed City, Giza Governorate
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/mmj.mmj_45_18

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Objective To evaluate the clinical outcomes after implantation of the intracorneal ring segments (ICRSs) by means of femtosecond laser technology in eyes with keratoconus. Background Corneal modeling by inserting intrastromal implants has been proposed and investigated as an alternative treatment option in corneal ectasia. Femtosecond laser technology allows the surgeon to program a corneal stromal dissection at a predetermined depth with an extremely high degree of accuracy, which avoids the potential inaccuracies of a mechanical dissection. Patients and methods A total of 35 eyes of 28 patients were included in the study. All cases presented with reduced best spectacle corrected visual acuity, contact lens intolerance, and pachy apex of more than 380 μm. ICRSs, selected according to special nomogram depending on spherical and cylindrical correction and site of cone, were implanted in all cases into an intrastromal corneal tunnel created by means of femtosecond technology. Visual, refractive, corneal topography, and pachymetric changes were evaluated during a 1-month follow-up. Results Significant improvement in best-corrected visual acuity was observed after surgery (P = 0.0001), which was consistent with the significant reduction in sphere (P = 0.001) and cylinder (P = 0.001). Furthermore, a significant corneal flattening of a mean value of 2.68 D was found (P = 0.001). Corneal thickening was also observed postoperatively in the pachy apex, which was statistically significant (P = 0.001). Conclusion ICRSs implantation using femtosecond technology in keratoconus allows significant improvement in visual, refractive, and keratometric outcomes.

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