Combined Intracorneal Ring Segments and Corneal- Collagen Crosslinking

Keratoconus (KCN) is a bilateral, progressive, non-inflammatory corneal disease of which etiology is not completely understood. If left untreated, it may lead to significant visual impairment due to irregular astigmatism. Corneal crosslinking (CXL) is currently the only treatment option that halts the progression of the disease and may help avoid corneal transplantation. Although it may not improve visual acuity (VA), CXL can be combined with refractive procedures such as intracorneal ring segment (ICRS) implantation to achieve a better postoperative outcome. The sequence of treatment is a cause of discussion. Some believe sequence is not important with halted progression and improvement in refractive outcome achieved regardless, while different studies have shown the superiority of ICRS implantation followed by either concurrent of sequential CXL.

Keywords:Corneal crosslinking; Intracorneal rings; Keratoconus

Abbreviations: CXL: Corneal Cross-Linking; DCVA: Distance Corrected Visual Acuity; ICRS: Intracorneal Ring Segment; I-S: Inferior-Superior; KCN: Keratoconus; Kmax: Maximal Keratometry; MRSE: Mean Refraction Spherical Equivalent; OD: Right Eye; UVA: Ultraviolet A; VA: Visual Acuity