Comparison of intrastromal corneal ring segment implantation only and in combination with collagen crosslinking for keratoconus.

OBJECTIVE

To compare visual outcomes, corneal astigmatism, and keratometric readings in patients with progressive keratoconus undergoing intrastromal corneal ring implantation (ICRSI) only and in combination with ultraviolet A riboflavin mediated corneal collagen crosslinking (CXL).

METHODS

In this retrospective comparative study, there were 2 groups of keratoconus patients. Group 1 consisted of only ICRSI patients. Group 2 consisted of combined ICRSI-CXL patients. Preoperative and postoperative uncorrected distance visual acuity (UCDVA) and best-corrected distance visual acuity (BCDVA), spherical error, cylindrical error, and mean keratometry were compared.

RESULTS

The study evaluated 166 eyes of 121 patients with a mean age of 24.74 years. The UCDVA improved from 0.24 to 0.37 in group 1 and from 0.24 to 0.42 in group 2 at the last visit. The BCDVA improved from 0.34 to 0.62 in group 1 and from 0.31 to 0.67 in group 2. Spherical error decreased from -5.05 D to -1.65 D in group 1 and from -4.82 D to -1.52 D in group 2. Cylindrical error decreased from -6.06 D to -3.47 D in group 1 and from -5.66 D to -3.20 D in group 2. Mean keratometry values decreased from 51.89 D to 47.96 D in group 1 and from 50.89 D to 46.91 D in group 2. p Value was >0.05 in group comparisons. Ring explantation due to corneal melting was applied in 3 eyes.

CONCLUSION

Both combined ICRSI-CXL and ICRSI-only groups experienced favorable outcomes, without statistical difference in any studied effect of both treatment strategies.