Abstract
The short-term safety and efficacy of intracorneal ring segment (ICRS) implantation in keratoconus eyes of children are investigated in this study. A retrospective interventional case series study including a total of 33 keratoconus eyes (age 8 to 17 years) that had undergone ICRS (Keraring segments, Mediphacos) implantation was conducted. Information about visual, refractive, pachymetric, corneal topographic and aberrometric, and corneal endothelial changes during a 3-month follow-up were extracted and analysed. A significant improvement was observed in logMAR corrected distance visual acuity (p = 0.005), combined with a statistically significant reduction in keratometric readings (p < 0.001). A reduction in the magnitude of corneal astigmatism of ≥1 D was observed in 52.8% of eyes. No significant changes were observed in corneal endothelial density (p = 0.317). Significant changes were found in the anterior vertical coma component (p = 0.002) as well as in the spherical aberration of the posterior corneal surface (p = 0.004). Only two relevant complications were described: one corneal microperforation with penetration of the ring segment into the anterior chamber (1 eye, 2.8%), and a case of ring extrusion (1 eye, 2.8%). ICRS implantation in children keratoconus eyes allows a reduction of corneal astigmatism, irregularity, and aberrations, leading to a significant visual improvement.
Highlights
Keratoconus is a degenerative corneal disease that is commonly manifested during puberty, with the possibility of progressing until the third or fourth decade of life [1].This condition is characterized by a significant corneal thinning, corneal protrusion and induction of myopic astigmatism, with development of corneal opacity and hydrops in some cases [1]
The prognosis of keratoplasty has been shown to be good in keratoconus, this procedure is more complex in children as the cornea is thinner and less rigid compared to adults, with more significant inflammatory reaction and more risks of infection and corneal graft rejection [10]
The implantation of intracorneal ring segment (ICRS) in children is a safe procedure, which is not exempt from complications like the two reported cases, related to manipulation of the eyes, despite having been warned not to do it and that they were solved without problems
Summary
Keratoconus is a degenerative corneal disease that is commonly manifested during puberty, with the possibility of progressing until the third or fourth decade of life [1].This condition is characterized by a significant corneal thinning, corneal protrusion and induction of myopic astigmatism, with development of corneal opacity and hydrops in some cases [1]. Keratoconus is a degenerative corneal disease that is commonly manifested during puberty, with the possibility of progressing until the third or fourth decade of life [1]. Children often manipulate their eyes with their fingers, and the medical accompaniment and care of family members in avoiding the factors that trigger the allergy is not always adequate. This mechanical stress on the cornea is a factor that may promote the progression and development of the disease [7]
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