Photo Credit: Sruilk

The following is a summary of “Effects and safety of combined corneal collagen crosslinking and intrastromal corneal ring segment treatment in patients with keratoconus: a retrospective study,” published in the October 2024 issue of Ophthalmology by Dal et al. 

Researchers conducted a retrospective study to evaluate the safety and efficacy of different time-point combinations of intrastromal corneal ring segment (ICRS) and corneal colxclagen crosslinking (CXL) for treating moderate-to-severe keratoconus (KCC). 

They examined 69 eyes from 69 patients with keratoconus who underwent ICRS and CXL treatment at an Eye Hospital between March 2020 and March 2023. Patients were divided into 2 groups: Group 1 (n = 33 eyes of 33 patients), which received ICRS and CXL in a single session, and Group 2 (n = 36 eyes of 36 patients), which had ICRS treatment at least 6 months after CXL. The Preoperative and postoperative evaluations involved visual acuity, autorefractometer refraction, corneal tomographic measurements using the Sirius (CSO) Scheimpflug camera and the TONOREF™ III device, along with documentation of observed complications. Uncorrected visual acuity (UCVA) and best-corrected spectacle visual acuity (BCVA) were measured for each eye individually, with visual acuity assessed using the logarithm of the minimum angle of resolution (logMAR). 

The results showed that in Group 1, the mean UCVA improved from 0.81 ± 0.34 to 0.45 ± 0.25 (P < 0.01), while the mean BCVA increased from 0.76 ± 0.35 to 0.38 ± 0.20 (P < 0.01). In Group 2, mean UCVA rose from 0.71 ± 0.32 to 0.43 ± 0.30 (P < 0.01), and mean BCVA improved from 0.65 ± 0.25 to 0.31 ± 0.23 (P < 0.01). Both groups experienced significant reductions in manifest spherical and cylindrical refraction (P < 0.01). Group 1 demonstrated greater reductions in maximum keratometry (Kmax), flat keratometry (K1), and steep keratometry (K2) (P < 0.05), as well as in astigmatic aberration compared to Group 2 (P < 0.01). The concurrent or separate application of CXL and ICRS did not significantly raise the incidence of complications. 

They concluded both combined and separate CXL and ICRS treatments improved visual acuity and reduced refractive error, with simultaneous treatment yielding more significant corneal topographic changes. 

Source: bmcophthalmol.biomedcentral.com/articles/10.1186/s12886-024-03745-7