Treatment of keratoconus by intra-corneal rings and cross-linking: about 10 cases treated

Purpose Keratoconus is a noninflammatory corneal ectasia resulting in a gradual loss of vision due to the appearance of irregular astigmatism and myopia. We present a prospective study on the treatment of 10 patients with keratoconus treated with cross-linking and intracorneal rings (ICR). Methods This is a monocentric and prospective study concerning thirteen eyes of ten patients, the average age is 29 years. The gender distribution is of eight men (80%) and two women (20%). Only four patients were treated in both eyes by this protocol and one patient had on his fellow eye a penetrating keratoplasty. The monitoring elements are: the best spectacle-corrected visual acuity (BSCVA), the spherical equivalent, the average keratometry and the pachymetry. The follow up is six months. The treatment is done in two steps: first step the cross-linking, second step three months later, insertion of Ferrara ICR, using a Femtosecond laser. The ICR strategy is established with Ferrara normogram achieved with the steeper meridian and design of the ectacic area in preoperative topography. Results The results of this on going study show a stabilization of keratoconus after cross-linking. Then, after ICR, there is an improvement in best spectacle-corrected visual acuity with a decrease in spherical equivalent of about 1.8 diopters and an average decrease of two diopters of mean keratometry and ectasia apex recentration. Conclusion The synergistic combination of both techniques seems to be effective in slowing the development and reshaping the cornea.