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Intrastromal Corneal Ring Segments Implantation And Corneal Cross-Linking For Keratoconus In Children With Vernal Keratoconjunctivitis – Three-Year Results

Authors Abozaid MA, Hassan AAA, Abdalla A

Received 17 June 2019

Accepted for publication 27 September 2019

Published 5 November 2019 Volume 2019:13 Pages 2151—2157


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 4

Editor who approved publication: Dr Scott Fraser

Video abstract presented by Mortada Ahmed Abozaid.

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Mortada Ahmed Abozaid,1 Amin Abo-Ali Hassan,1 Abdelsalam Abdalla2

1Department of Ophthalmology, Faculty of Medicine, Sohag University, Sohag, Egypt; 2Department of Ophthalmology, Faculty of Medicine, Assiut University, Assiut, Egypt

Correspondence: Mortada Ahmed Abozaid
Ophthalmology Department, Faculty of Medicine, Sohag University, Sohag, Egypt
Tel +20932309244
Fax +20932325531

Purpose: To assess the 3-year safety and efficacy of femtosecond laser-assisted intrastromal corneal ring segments’ (ICRS) implantation followed or accompanied by transepithelial accelerated corneal collagen cross-linking (TE-ACXL) as a treatment of keratoconus in children with vernal keratoconjunctivitis (VKC).
Patients and methods: Fifty two eyes of 28 children with keratoconus and vernal VKC were included in this study. Cases were divided into 2 groups; the first group had been treated with femtosecond laser-assisted ICRS (Keraring) implantation accompanied or followed by TE-ACXL, while the second group had been treated by TE-ACXL only and all cases completed a follow-up period of 3 years.
Results: In group 1: the mean uncorrected (UCVA) and best-corrected (BCVA) visual acuity, spherical equivalent, K-max and Q-value improved markedly from 0.97 ± 0.19, 0.67 ± 0.18, −8.75 ± 4.55, 60.41 ± 4.98, and −1.18 ± 0.54 preoperatively to 0.61 ± 0.27, 0.39±0.21, −3.25 ± 3.56, 55.22 ± 5.72, and −0.44 ± 0.68 postoperatively respectively. While in group 2: the preoperative mean UCVA, BCVA, spherical equivalent, K-max and Q-values were 0.68 ± 0.28, 0.38 ± 0.24, −2.84 ± 2.59, 50.29 ± 4.04, and-0.58 ± 0.23 respectively while their corresponding postoperative values were 0.58 ± 0.34, 0.19 ± 0.17, −2.35 ± 2.07, 49.58 ± 3.26, and −0.57 ± 0.25. Only one case in group 1 required repeat cross-linking.
Conclusion: Although the long-term safety and efficacy of femtosecond laser-assisted ICRS implantation accompanied or followed by TE-ACXL in children with keratoconus and VKC is high, some cases still may need repeat cross-linking.

Keywords: accelerated transepithelial cross-linking, Keraring, pediatric keratoconus, spring catarrh

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