Clinical Outcomes of Two Symmetrical Kera-rings Implantation in Grade Three Keratoconus

a retrospective non- randomized controlled clinical study. The study included twenty-three grade 3 keratoconic eyes of twenty-three patients, the keratoconus staging was based on Amsler-Krumeich classification The ICRS surgery was performed with the patient under topical anesthesia. A tunnel channel was created by femtosecond laser using a 60-kHz infrared neodymium glass femtosecond laser at a wavelength of 1053 nm (Abbott Laboratories Inc., Abbott Park, Illinois, USA). Two symmetrical kerarings (Mediphacos Inc., Belo Horizonte, Brazil), were implanted in all cases with 160° arc and 0.25, 0.30 mm according to corneal thickness in implantation site. After surgery, the patients had a full ocular evaluation on days 1, 7, and 14, and again after a month. For a period of 1-year, corneal topography readings were taken quarterly.

Inclusion criteria

• stable keratoconus.
• corneal cross-linking performed at least 6 months.
• contact lens intolerance
• minimum corneal thickness of 350 μm at the thinnest point (TP)
• mean keratometry (K mean) value less than 59 D

Exclusion criteria

• any other associated ocular or systemic pathology could affect the vision.