Combined intracorneal ring implantation, cross-linking enhances corneal biomechanics in keratoconus

SAN DIEGO — Combined femtosecond-laser assisted implantation of intracorneal rings and cross-linking increases corneal strength and enhances visual acuity and quality in patients with moderate keratoconus, according to a speaker at the World Cornea Congress.

“[The femtosecond laser] can give us a tailored tunnel,” Moones F. Abdalla, MD, said, giving findings of a prospective, non-comparative, multicenter case series of patients treated in the same setting with cross-linking and ICRs implanted using femtosecond laser (VisuMax, Carl Zeiss Meditec).

With femtosecond laser, the depth of the tunnel and parameters of the inner and outer depth of the ring can be controlled “very accurately,” he said.

Combining implantation of ICRs and cross-linking is intended to provide biomechanical stability that is lacking with ICRs and to augment the effect of the ICRs, according to Abdalla.

Biomechanical stability improved as measured by percent of change in corneal hysteresis and corneal resistance factor, which both increased significantly, he said.

In the study of 1,182 eyes over 1-year follow-up, mean spherical equivalent was reduced and remained stable, mean keratometric value decreased from 54 D to 47 D, and mean uncorrected vision significantly improved and remained stable, Abdalla said. — by Patricia Nale

Disclosure: Abdalla reports no relevant financial disclosures.