Dr. LIONAL RAJ

Abstract

Purpose: To compare the efficacy of sequential CXL to implantation of Corneal Ring Segments(ICRS) in moderate keratoconus

Methods: Comparative clinical trial. Group(Gr)1 underwent ICRS with Epi-off CXL on same day. Group(Gr) 2 underwent ICRS alone. Pre & 18 months postop Vision, Astigmatism, KMax, KMean, Thinnest Pachymetry(CCT) values were analyzed & demarcation line (DL) at 1 month in Gr1 measured for CXL efficacy.

Results: 13 eyes in Gr1, 19 in Gr2. UCVA, BCVA improved by 3 and 2 lines in Gr1 & 2. Astigmatism reduced by 6.03 ±1.44D in Gr1, 5.69±1.94D in Gr2. Corneas flattened in both groups. CCT was maintained in Gr1, reduced by 24 mic(p=0.007) in Gr2. DL in Gr1 was 214.34±24.81mic. In Gr2 one had extrusion(5.26%). One progressed to advanced Keratoconus

Conclusion: ICRS reverses irregular astigmatism. CXL prevents progression, with additional benefit to prevent keratolysis & device extrusion. This rational combination is effective and acts as a proof of ‘Better together’ concept