Intrastromal corneal ring segment implantation in pediatric keratoconus: Up to 10 years of follow-up

Area of Science:

• Ophthalmology
• Corneal Surgery
• Pediatric Eye Care

Background:

• Keratoconus is a progressive corneal ectasia causing visual impairment.
• Pediatric patients with keratoconus require effective visual rehabilitation strategies.
• Intrastromal corneal ring segments (ICRS) offer a potential solution for improving vision in these patients.

Purpose of the Study:

• To evaluate the efficacy of Intrastromal corneal ring segment (ICRS) implantation for visual rehabilitation in pediatric patients diagnosed with keratoconus.
• To assess the long-term visual and refractive outcomes following ICRS implantation in this patient group.

Main Methods:

• A cohort of 107 eyes (85 patients) aged 18 years or younger with keratoconus underwent ICRS implantation.
• Preoperative and 1-, 5-, 7-, and 10-year postoperative data including uncorrected (UDVA) and corrected (CDVA) distance visual acuities, manifest refraction, and keratometry were collected.
• Treatment success was defined by visual and refractive improvement and stability over time.

Main Results:

• Significant improvements in UDVA (logMAR 0.64 to 0.34) and CDVA (logMAR 0.19 to 0.08) were observed one year postoperatively (P < 0.0001).
• 74.8% of eyes gained lines of CDVA, and 76.6% achieved a refractive cylinder <3.00 D one year postoperatively.
• High success rates (84.3%-88.9%) were maintained at 5-, 7-, and 10-year follow-ups, with less than 10% cumulative failure over 10 years.

Conclusions:

• ICRS implantation provides significant and durable visual and refractive benefits for pediatric keratoconus patients.
• The procedure is a safe and effective long-term visual rehabilitation option, maintaining improvements over a decade.
• ICRS implantation demonstrates a favorable safety profile with low cumulative failure rates in this pediatric cohort.