Sequential intrastromal corneal ring segment and monofocal intraocular lens implantation for keratoconus and cataract: Long-term follow-up

Abstract

To evaluate the efficacy, safety, predictability, and stability of sequential Ferrara intrastromal corneal ring segment (ICRS) and intraocular lens (IOL) implantation in patients with keratoconus and cataract. Fernández-Vega Ophthalmological Institute, Oviedo, Spain. Retrospective case series. This study comprised patients with keratoconus and cataract who had ICRS implantation followed 6months later by IOL implantation. The uncorrected (UDVA) and corrected (CDVA) distance visual acuities and residual refractive errors, analyzed using vector analysis, were recorded preoperatively, 6months after ICRS implantation, 6months after IOL implantation, and 3years and 5years thereafter. Seventy eyes of 47 patients were studied. The mean UDVA was 1.08 logMAR ± 0.24 (SD) preoperatively, 0.95±0.31 logMAR 6months after ICRS implantation (P=.03), and 0.44±0.29 logMAR 6months after IOL implantation (P<.0001). The mean CDVA changed from 0.35±0.23 logMAR before surgery to 0.28±0.22 logMAR 6months after ICRS implantation (P<.0001) and to 0.11±0.16 logMAR 6months after IOL implantation (P<.0001). The UDVA and CDVA were stable over the period after the second procedure (P>.05). The spherical equivalent (SE) and the refractive cylinder declined steeply after IOL implantation (P<.001) and then were stable (P>.05). Sequential ICRS and IOL implantation provided good visual and refractive outcomes and was an effective, safe, predictable, and stable procedure for the treatment of patients with keratoconus and cataract.