Purpose: To report early results of combined accelerated corneal collagen
crosslinking (CXL) and intrastromal Kerarings implantation by
femtosecond laser in a case of advanced superior keratoconus.
Methods: The patient was a 27-year-old male with left eye grade
keratoconus with superior cone. He was diagnosed by Sirius Scheimpflug
corneal topography (CSO, Florence, Italy). The right eye had previously ,
been subjected to penetrating keratoplasty. The uncorrected visual ,
acuity (UCVA) in the right eye (RE) was 1.2 LogMAR, best corrected ,
visual acuity (BCVA) was 0.8 by a refraction of –7.50Ds –3.00Dc @12.
The UCVA in the left eye (LE) was 1.2 LogMAR, BCVA was 0.9 by a refraction
of –8.50 Ds –5.50Dc @169. Intrastromal Kerarings implantation
by femtosecond laser was carried out by IntraLase (iFS, Abbott) along
with accelerated transepithelial corneal collagen crosslinking by KXL
system (Avedro, USA) in the same session. Follow-up was done for a
period of 12 months after surgery.
Results: The patient was followed up for 12 months with improvement
of visual acuity as regards UCVA and BCVA and improvement of corneal
topographic parameters including keratometry and front and back elevations.
Conclusion: Combined accelerated corneal collagen crosslinking and
intrastromal Kerarings implantation by femtosecond laser is an effective
method in the treatment of this uncommon type of keratoconus.