Clinical outcomes after implantation of a combination of intrastromal corneal ring segments in different optical zones in advanced keratoconus.

PURPOSE: To evaluate the efficacy and safety of combined intrastromal corneal ring segment (ICRS) implantation in different optical zones for advanced keratoconus.

METHODS

This retrospective study analyzed 32 eyes from 30 patients who underwent combined implantation of an ICRS (320° arc, 200 µm) in the 5-mm zone and a high-myopia ICRS (400 µm) in the 6-mm zone. Pre- and postoperative (6 months) assessments included best-corrected distance visual acuity (BCVA), manifest refraction spherical equivalent (MRSE), keratometry (K), and asphericity (Q-value).

RESULTS

A total of 32 eyes from 30 patients (mean age: 31.1 ± 10.43 years) were analyzed. Significant postoperative improvements were observed in BCVA ( P = 0.002), MRSE ( P < 0.001), K1, K2, mean K ( P < 0.001), maximum K, tomographic astigmatism, and Q-value ( P < 0.001). No intraoperative or postoperative complications were reported.

CONCLUSIONS

Combined ICRS and high-myopia ICRS implantation improves visual acuity, reduces refractive error, and enhances corneal topography in advanced keratoconus. Further studies are needed to confirm long-term stability and safety.