Intrastromal corneal ring segments: visual outcomes from a large case series

BACKGROUND: To evaluate the clinical safety and efficacy of implanted Ferrara intrastromal corneal ring segments in a large sample of patients with ectatic corneal disease. DESIGN: Retrospective, consecutive case series. SAMPLES: A total of 1073 eyes of 810 patients consecutively operated from January 2006 to July 2008 were evaluated. METHODS: Two groups were created according to the type of ring implanted: Group 1 - patients implanted with the 160° of arc ring - and Group 2 - patients implanted with the 210° of arc ring. MAIN OUTCOME MEASURES: Uncorrected visual acuity, best-corrected visual acuity, keratometry, asphericity and pachymetry at the thinnest point of the cornea. All patients were evaluated using a corneal tomography (Pentacam, Oculus, Inc., Lynnwood, WA, USA). RESULTS: For Group 1 patients, uncorrected visual acuity increased to 20/80, best-corrected visual acuity increased to 20/40, asphericity decreased to -0.35, spherical equivalent decreased to -2.26 D and keratometry decreased to 45.72 D (P < 0.001 for each compared with preoperative values). For Group 2 patients, uncorrected visual acuity increased to 20/130, best-corrected visual acuity increased to 20/60, asphericity decreased to -0.56, spherical equivalent decreased to -4.14 D and keratometry decreased to 48.10 D (P < 0.001 for each compared with preoperative values). The 210° intrastromal corneal ring segments reduced keratometry and asphericity more than the 160° intrastromal corneal ring segments did. The complication rate was 3.82%. CONCLUSIONS: Ferrara intrastromal corneal ring segments implantation is safe and effective and has a low complication rate. It can effectively reduce the corneal steepening and improve uncorrected visual acuity and best-corrected visual acuity in patients with keratoconus.