Combined femtosecond laser-assisted intrastromal corneal ring segments implantation and corneal collagen cross-linking for treatment of pellucid-like keratoconus

Purpose To evaluate the safety and efficacy of combined femtosecond laser-assisted intrastromal corneal ring segments implantation plus accelerated transepithelial corneal collagen cross-linking (ATE-CXL) in cases of pellucid-like keratoconus (PLK). Patients and methods This retrospective study included 25 eyes of 13 patients with PLK. Cases were divided into two groups: group 1 consisted of 13 eyes (seven patients) that had been treated by femtosecond laser-assisted Kerarings implantation and ATE-CXL in the same session, whereas group 2 included 12 eyes (six patients) that had been treated with ATE-CXL alone. Results After 1 year of surgery, the mean uncorrected visual acuity (UCVA) of group 1 improved from 0.94±23 (logMAR) to 0.73±18, whereas the mean best-corrected visual acuity improved from 0.75±16 to 0.49±0.22. The mean preoperative maximum keratometry (Kmax) was 65.23±5.03 D, whereas the mean postoperative Kmax was 53.92±4.21 D. However, in group 2, the preoperative mean UCVA was 0.63±0.31 and the postoperative UCVA was 0.55±0.29, whereas the mean best-corrected visual acuity changed from 0.31±0.26 to 0.23±0.19. The mean preoperative Kmax was 51.38±3.73 D, whereas the mean postoperative Kmax was 48.43±2.98 D. Conclusion Combined femtosecond laser-assisted Kerarings implantation and ATE-CXL is safe and effective in the treatment of PLK.