KeraRing Intrastromal Corneal Ring Segments for Correction of Keratoconus

PURPOSE: Intrastromal corneal ring segments (ICRSs) are small arc-like implants that are being used increasingly as a minimally invasive treatment for patients with keratoconus. This study assessed the effectiveness of KeraRing implants, a type of ICRS, to treat keratoconus. METHODS: Retrospective case series descriptive study of 43 patients (55 eyes) with keratoconus who underwent KeraRing implantation from February 2008 to June 2009. Patients who had intraoperative or postoperative complications and/or did not complete at least 6 months of follow-up were excluded. All patients underwent complete ophthalmologic examinations that included measurement of the uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), manifest refraction, and keratometry before and 2 days, 2 weeks, 1 month, and 3 and 6 months after surgery. The ring segments were chosen based on a nomogram from the manufacturer. RESULTS: Six months postoperatively, the mean UCVA increased significantly (P < 0.05) from 0.10 ± 0.11 to 0.32 ± 0.25 and the mean BSCVA increased from 0.36 ± 0.23 to 0.57 ± 0.24 (P < 0.05). The mean spherical refractive error significantly (P < 0.05) improved from -4.85 ± 2.90 diopters (D) to -1.89 ± 2.68 D, and the mean cylindrical refractive error significantly (P < 0.05) improved from -3.65 ± 1.70 D to -2.60 ± 1.62 D. The mean spherical equivalent significantly (P < 0.05) decreased from -6.68 ± 2.93 D to -3.19 ± 2.75 D, and the mean keratometry value decreased from 51.83 ± 4.14 D to 47.27 ± 3.68 D. The improvement in the UCVA and BSCVA continued over the 6-month postoperative period, but significant changes occurred only during the first 3 months. These changes occurred in patients with all grades of keratoconus. CONCLUSIONS: KeraRing implantation provided significant improvement in visual acuity, spherical equivalent, and keratometry results. This ICRS is an effective treatment for managing keratoconus and might delay or even avoid the need for penetrating keratoplasty.