Posters

Has the advent of intrastromal corneal ring segments really shaped the surgical management of keratoconus?

Poster Details

First Author: V. Ramjiani UNITED KINGDOM

Co Author(s):    M. Edwards   M. Raynor                 

Abstract Details

Purpose:

To report the incidence of corneal grafts for keratoconus before and after the introduction of intrastromal corneal ring segments (ICRS) at one U.K. hospital.

Setting:

Sheffield Teaching Hospitals, United Kingdom

Methods:

All data was retrospectively retrieved from the U.K. national transplant registry. The study period was from the 1st January 2003 to 31st December 2015. The annual number of first corneal grafts for keratoconus was retrieved. Grafts were either deep anterior lamellar keratoplasties, or penetrating keratoplasties.

Results:

The mean annual number of corneal grafts for keratoconus, before the introduction of ICRS, was 6.67 (95% CI ±2.85) during 2003-2005. The annual mean was 10 (95% CI ± 1.75) during the use of INTACS (Addition Technology™, Inc. USA) with manual blade cut tunnel formation (2006-2012). Following the switch from INTACS to KeraRing (Mediphacos, Brazil) implants with Femtosecond Laser (Zeiss Visumax) tunnel creation the annual mean dropped to 5 (95% CI ± 1.30) during 2013 to 2015.

Conclusions:

A significant reduction was observed in the incidence of corneal grafts after the introduction of KeraRing implants but not with INTACS. A direct comparison between ICRS segments cannot be made as the tunnel creation methods were different. Manual tunnel creation is a likely significant limitation, due to more unpredictable outcomes and intolerance to inadvertent superficial placement of ICRS. Possible limitations to the use of INTACS (during 2006 – 2012) include a lack of safety and outcome data for central corneal thickness <480µm and the larger plastic size requiring more corneal thickness to contain them.

Financial Disclosure:

NONE