Combination of bandage lamellar-optical keratoplasty and intracorneal ring segment for advanced keratoconus: case report

Introduction: This case report describes a novel hybrid approach combining bandage lamellar-optical keratoplasty (BLOK) with intracorneal ring segments (ICRSs) in the treatment of advanced keratoconus (KC). Patient and Clinical Findings: A 32-year-old woman presented with progressive advanced KC in both eyes with significant visual impairment. She underwent BLOK in the right eye and a hybrid BLOK–ICRS procedure in the left eye. Diagnosis, Intervention, and Outcomes: After BLOK in the right eye, visual improvement was observed, but residual astigmatism persisted. The hybrid BLOK–ICRS treatment of the left eye showed improved visual acuity, with significant astigmatism reduction and corneal regularity. Conclusions: The BLOK–ICRS combination provides a promising treatment for advanced KC, with further studies recommended to validate these findings.