Visual and keratometry outcomes of combined corneal collagen cross-linking and intrastromal corneal ring segment surgery in keratoconus patients

Context: To see the outcomes of combined corneal collagen cross-linking (C3R) and intrastromal corneal ring segment surgery (ICRS) in keratoconus patients in the Indian population. Aim: The long-term 12-month overall and specific corneal topographic and visual acuity changes among patients who underwent C3R with ICRS due to progressive keratoconus. Settings and Design: The medical records of consecutive progressive keratoconus patients who underwent C3R with ICRS procedure. Retrospective, hospital-based, single-arm cohort study. Methods and Material: The study included 72 eyes of 53 patients, with a mean age of 28.26 ± 6.76 years old. Keratoconus was diagnosed based on clinical features and tomographic findings. The progression of the disease depends upon the change in keratometry values over 6 months to 1 year. Patients with a history of previous corneal scarring, procedures, and trauma were excluded. Results: Among our population were 72 eyes of 53 patients (39 males and 14 females) with a mean age of 28.26 ± 6.67 (ranges from 17 to 48) years old. The statistical analysis was performed using SPSS software version 19.0. In addition, the Wilcoxon signed rank nonparametric test was used to compute the mean values of the outcome of the parameters. The mean values of maximum keratometry (Kmax) and mean keratometry (Km) significantly decreased from preoperative to postoperative 1-month follow-up visit ( P = 0.003 and P = 0.015). They then stabilized from 3 months to 6 months. The best corrected visual acuity significantly improved up to 1 year of follow-up visits. Conclusions: The visual acuity and topographical results revealed that the C3R with ICRS procedure is safe and effective in stabilizing corneal topography and visual acuity parameters up to a long-term 12-month follow-up in patients with progressive keratoconus.