Corneal Collagen Cross-linking with Riboflavin (C3-R) Combined with Intrastromal Ring Segment Implantation and Overnight Contact Lens Molding in Keratoconus

Aim: The aim of this study was to assess and compare the visual, refractive, and topographic outcomes of keratoconic eyes treated with corneal collagen cross-linking combined with and without same day intrastromal corneal ring segment over the first 12 months. Methods: This prospective randomized study analyzed 38 eyes of 30 consecutive keratoconus patients aged 26.21 ± 6.97 (range = 15–41) years. A total of 20 eyes were treated with collagen cross-linking alone, and 18 eyes underwent collagen cross-linking combined with simultaneous femtosecond laser-assisted intrastromal corneal ring segment. Visual acuity, manifest refraction, and corneal topography (using a rotating Scheimpflug topographer) were assessed and compared between the two groups at baseline, 6, and 12 months. Results: On an average follow-up duration of 12.2 ± 0.50 (range = 11–13) months, both collagen cross-linking alone and collagen cross-linking with simultaneous intrastromal corneal ring segment implantation were effective. However, collagen cross-linking plus intrastromal corneal ring segment resulted in an additional improvement of uncorrected distance visual acuity of 0.16 (95% confidence interval = 0.01 to 0.32) logarithm of the minimum angle of resolution units (p = 0.035), cylindrical power by 1.16 D (95% confidence interval = 0.25 to 2.06, p = 0.014), and spherical equivalent by 1.40 D (95% confidence interval = −2.71 to −0.08, p = 0.038) at 1 year. During the study period, no serious intraoperative or postoperative complications were noted in either group. Conclusion: One-year follow-up results suggest that collagen cross-linking with simultaneously combined intrastromal corneal ring segment implantation could yield an additive visual and refractive outcome. The combined procedure is safe and merits consideration for the treatment of progressive keratoconus to achieve better visual rehabilitation.

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Combined femtosecond laser-assisted intracorneal ring segment implantation and corneal collagen cross-linking for correction of keratoconus

Clinical Ophthalmology ◽

10.2147/opth.s97158 ◽

2016 ◽

pp. 521 ◽

Cited By ~ 2

Author(s):

Amr Said ◽

Osama Ibrahim ◽

Ahmed Elmassry ◽

Ihab Osman ◽

HAZEM EL HENNAWI ◽

...

Keyword(s):

Femtosecond Laser ◽

Cross Linking ◽

Ring Segment ◽

Intracorneal Ring Segment ◽

Collagen Cross Linking ◽

Corneal Collagen

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Corneal Collagen Cross-Linking in Pellucid Marginal Degeneration: 2 Patients, 4 Eyes

Case Reports in Ophthalmological Medicine ◽

10.1155/2015/840687 ◽

2015 ◽

Vol 2015 ◽

pp. 1-4 ◽

Cited By ~ 3

Author(s):

Serife Bayraktar ◽

Zafer Cebeci ◽

Merih Oray ◽

Nilufer Alparslan

Keyword(s):

Visual Acuity ◽

Long Term Results ◽

Cross Linking ◽

Specular Microscopy ◽

Distance Visual Acuity ◽

Uncorrected Distance Visual Acuity ◽

Ring Segment ◽

The Right ◽

Collagen Cross Linking ◽

Corneal Collagen

Purpose. To report the long-term results of corneal collagen cross-linking (CXL) with riboflavin and ultraviolet-A irradiation in 4 eyes of 2 patients affected by pellucid marginal degeneration (PMD).Methods. This study involved the retrospective analysis of 4 eyes of 2 patients with PMD that underwent CXL treatment. Of the eyes, three had only CXL treatment and one had CXL treatment after an intrastromal corneal ring segment implantation. We have pre- and postoperatively evaluated uncorrected distance visual acuity (UDVA), best corrected distance visual acuity (BCDVA), corneal topography (Pentacam), specular microscopy, and pachymetry.Results. Patient 1 was a woman, aged 35, and Patient 2 was a man, aged 33. The right eye of Patient 1 showed an improvement in her BCDVA, from 16/40 to 18/20 in 15 months, and her left eye improved from 12/20 to 18/20 in 20 months. Patient 2’s right eye showed an improvement in his BCDVA, from 18/20 to 20/20 in 43 months, and his left eye improved from 16/20 to 18/20 in 22 months. No complications were recorded during or after the treatment.Conclusion. CXL is a safe tool for the management of PMD, and it can help to stop the progression of this disease.

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