Intrastromal Corneal Ring Segment and intraocular lens implantation in patients with keratoconus and cataract

Resumen

PURPOSE: To evaluate the e cacy, safety and predictability of sequential KeraRing Intrastromal corneal ring segment (ICRS) and intraocular lens (IOL) implantation with opposite clear corneal incisions in patients with keratoconus and cataract. SETTING: Fernandez-Vega Ophthalmological Institute (Oviedo, Spain). METHODS:  is study comprised patients with keratoconus and cataract who had ICRS implantation , followed 6 months later by IOL implantation with corneal relaxing incisions.  e uncorrected (UDVA) and corrected (CDVA) distance visual acuities and residual refractive errors, analyzed using vector analysis, were recorded preoperatively, 6 months after ICRS implantation, and 6 months after IOL implantation. RESULTS:  e study enrolled 32 eyes (21 patients).  e mean UDVA (Snellen decimal) was 0.02 ± 0.02 preoperatively, 0.06 ± 0.05 six months after ICRS implantation (P = 0.004), and 0.53 ± 0.22 six months after IOL implantation (P < 0.0001).  e CDVA changed from 0.46 ± 0.22 before surgery to 0.54 ± 0.21 six months after KeraRing ICRS implantation (P = 0.0002) and to 0.71 ± 0.19 six months after IOL implantation (P < 0.0001). Six months after IOL implantation, the e cacy index was 1.15 and the safety index, 1.54. At 6 months, 70.97% of eyes were within ± 1.00 diopter (D) of the desired refraction and 45.16% were within ± 0.50 D.  e mean spherical equivalent after IOL implantation was –0.53 ± 1.13 D. CONCLUSION: Sequential KeraRing ICRS and IOL implantation plus corneal relaxing incisions provides good visual and refractive outcomes, indicating that it is a predictable procedure for patients with keratoconus and cataracts.