PurposeTo evaluate the Intrastromal corneal ring segment (ICRS) implantation for visual rehabilitation in pediatric patients with keratoconus.MethodsPatients aged ≤18 years with keratoconus who underwent ICRS implantation were included. Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, manifest refraction and keratometry were recorded preoperatively and at 1-5-7- and 10-year postoperatively. Treatment was categorized as success, qualified success or failure based on short-term visual and refractive improvement, the visual and refractive stability and the comparison between the long-term follow-up and the preoperative.ResultsOne hundred seven eyes (85 patients) were included. All eyes were examined 1 year postoperatively, 89 at 5 years, 69 at 7 years and 36 at 10 years. UDVA (logMAR) changed from 0.64 ± 0.38 preoperatively to 0.34 ± 0.24 one year postoperatively (P P < 0.0001). No eyes lost lines of CDVA 1 year postoperatively compared to preoperative, and 74.8% of the eyes gained lines. Preoperatively, 61.7% of the eyes had a refractive cylinder ≥3.00 D; one year postoperatively, 76.6% had <3.00 D. The treatment was successful in most cases at 5-, 7- and 10-year follow-ups (84.3%, 85.5%, and 88.9%, respectively), qualified success in around 8% of the eyes, and treatment failed in 6 eyes represented a cumulative rate over the 10 years <10%ConclusionICRS implantation induced significant visual and refractive improvements, and in most eyes with available long-term follow-up, visual and refractive improvements were maintained, supporting ICRS as a long-term visual rehabilitation option in pediatric keratoconus.
Fernandez-Vega-Cueto et al. (Thu,) studied this question.