DOI: 10.4103/ijo.ijo_2245_25 ISSN: 0301-4738

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

Jordana S B Soares, Mateus L dos Santos, Leonardo T Costa, Edna M Almodin, Bernardo K Moscovici, Guilherme Ferrara, Sandro A Coscarelli, Paulo Ferrara

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.

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