Clinical Outcomes of a New Type of Continuous Intrastromal Corneal Ring for Treatment of Keratoconus

Purpose: The purpose of this study was to evaluate the efficacy and safety of implantation of a new continuous corneal ring in keratoconic corneas of an Iranian population. Methods: This study was conducted on 95 contact lens-intolerant keratoconic eyes with clear central corneas. A continuous corneal ring, annular intrastromal corneal inlay (AICI), was inserted using femtosecond laser in all cases. Patients were followed up for 1, 3, and 12 months postsurgery. Visual and subjective refractive outcomes were evaluated in each examination. Besides, keratometry and aberrometric values were recorded before and 12 months after surgery. Finally, vector analysis of refractive astigmatism was performed using the Alpins method. Results: The uncorrected and corrected distance visual acuities improved significantly 12 months after surgery from 0.91 +/- 0.39 to 0.38 +/- 0.22 (P < 0 0.001) and 0.33 +/- 0.21 to 0.13 +/- 0.11 logMAR (P < 0.001), respectively. Moreover, spherical and cylindrical refractive components reduced from -2.52 +/- 2.62 to -0.76 +/- 1.78 D (P < 0.001) and -4.14 +/- 1.64 to -1.91 +/- 1.18 D (P < 0.001), respectively. The mean anterior keratometry had a significant reduction 12 months after AICI insertion (P< 0.001). Primary coma and spherical aberration values showed a significant increase (both, P < 0.05). Our results showed 100% safety (safety index: 1.8) and 45% efficacy (efficacy index: 1). Conclusions: AICI implantation seemed to be a safe and effective procedure for improving visual acuity and refractive outcomes in subjects with keratoconus.

Automated summary

The purpose of this study was to evaluate the efficacy and safety of implantation of a new continuous corneal ring in keratoconic corneas of an Iranian population. The results showed that this implantation method effectively improved visual acuity and refractive outcomes, and had a high level of safety.