Name

069 - Anneau intracornéen dans le kératocône, analyse du remodelage cornéen post opératoire et recherche de nouveaux facteurs prédictifs de succès : étude de façon prospective sur 60 yeux

To evaluate stromal and epithelial corneal remodeling and predictive factors of success of intrastromal corneal ring segment (ICRS) implantation in keratoconus.

This observational prospective study included 60 eyes. The preoperative and 6-month postoperative uncorrected (UDVA) and corrected (CDVA) distance visual acuities, spherical equivalent (SE), corneal and refractive astigmatism, keratometry (K) readings, and Q value using topography images were acquired. Pachymetric stromal and epithelial measurements were analyzed preoperatively at 6 months and at 12 months. Predictors of success were assessed by subgroup analysis: responder group(group 1) and non-responder group(group 2).

The postoperative UDVA, CDVA, SE, corneal and refractive astigmatisms, K readings, and Q value were statistically better than the preoperative parameters (P < .05). The predictive factors of success found are preoperative UDVA, CDVA, the sphere, the stage of keratoconus (1 and 2 Krumeich).

During the first postoperative year, the OCT analysis showed that the central thickness increased during the first 6 months but also between the 6th and 12th month, significantly (p <0.05). Stromal pachymetry increases at the place of insertion of the ICRS. The epithelial thickness tends to increase at the site of the ICRS and to decrease outside the site of the ring.

The progressive remodeling of the cornea could be correlated to the steeply declined of the spherical equivalent after ICRS implantation

Preoperative UDVA, CDVA, sphere and stage of keratoconus are predictive factors of success. Corneal remodeling after ICRS concerns the stroma at the site of implantation but also the epithelium with an increase in thickness at the site of implantation and in parallel a decrease outside the site and must be taken into account preoperatively.