Long-Term Follow-up of Intrastromal Corneal Ring Segment Implantation in Pediatric Keratoconus.

PURPOSE: To evaluate efficacy, safety, and stability of Ferrara-type intrastromal corneal ring segment (ICRS) implantation for visual rehabilitation in pediatric patients with keratoconus.

METHODS

This study included patients with keratoconus aged 18 years or younger who had received Ferrara-type ICRS implantation. The uncorrected and corrected distance visual acuities, residual refractive errors, and root mean square for coma-like aberration were recorded preoperatively and at 6 months, 1, 3, and 5 years postoperatively.

RESULTS

One hundred eighteen eyes of 88 patients (mean age 16.1 ± 1.89; range 10-18) were studied. All patients were examined at a 6-month follow-up after ICRS implantation, and at the 12-, 36-, and 60-month follow-ups, 97, 71, and 23 eyes were evaluated, respectively. Mean uncorrected distance visual acuity (logarithm of minimum angle of resolution) changed from 0.67 ± 0.37 preoperatively to 0.37 ± 0.30, 6 months after ICRS implantation (P < 0.0001). Mean corrected distance visual acuity increased in turn from 0.19 ± 0.15 to 0.10 ± 0.12 (P < 0.0001). The percentage of eyes with a refractive cylinder ≤2.00 D increased from 30.5% before surgery to 70.3% 6 months later, and the root mean square for corneal coma-like aberration showed a statistically significant decrease (P < 0.001). At the follow-up visits, refractive and visual values remained stable compared with those of the 6-month visit.

CONCLUSIONS

Our long-term results suggest that Ferrara-type ICRS implantation is a safe, effective, and stable procedure for restoring vision in pediatric patients with keratoconus.