July 01, 2013
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Three-step approach improves high myopic astigmatism, keratoconus progression

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A three-step surgical approach slowed keratoconus progression and improved vision in eyes with keratoconus and high myopic astigmatism, according to a study.

Patients underwent implantation of a Keraring SI-5 intrastromal corneal ring segment (Mediphacos), corneal collagen cross-linking and implantation of a Visian Implantable Collamer Lens (ICL, STAAR Surgical).

The prospective study included 14 eyes of nine patients.

An IntraLase femtosecond laser (Alcon) was used to create the ring channels. The mean interval between Keraring implantation and cross-linking was 7 months, and the mean interval between cross-linking and Visian ICL implantation was 8.4 months.

Mean uncorrected distance visual acuity improved from 0.01 to 0.44, and mean corrected distance visual acuity improved from 0.14 to 0.57.

Mean manifest refraction spherical equivalent decreased from –16.4 D to –0.8 D. Mean refractive astigmatism decreased from –4.73 D to –0.96 D.

Mean steep keratometry values decreased from 60.57 D to 54.48 D; mean flat keratometry values decreased from 56.16 D to 53.57 D.

All changes in visual acuity, refraction and keratometry were statistically significant (P < .0001).

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