Combining ring segments and cross-linking yields good results

Implantation of intracorneal ring segments (ICR) can be combined with a UV cross-linking procedure, according to Omid Kermani and colleagues from a private eye clinic in Schildergasse, Germany.

Between 2005 and 2006, four keratoconic eyes underwent combined UV collagen cross-linking and ICR implantation. Following femtosecond laser assisted preparation of the corneal tunnel, ICRs were implanted. Two to six months later, if visual acuity (VA) and refraction were stable, a cross-linking procedure was performed.

ICR implantation resulted in an average best corrected visual acuity (BCVA) gain of two lines and an average uncorrected visual acuity (UCVA) gain of six lines. Collagen cross-linking did not change UCVA by three months postoperatively but BCVA increased by an average of one line. Although the results were stable initially, two eyes did demonstrate a decrease in effect from the ICR implants. In these cases, the single ring segment was replaced by two thicker segments, which helped improve VA by up to three lines.

The results demonstrate that ICR implantation and UV cross-linking can be combined, however, further studies are needed to show which combination of these procedures produces the best results.