Intracorneal Ring Segment Implantation and Corneal Crosslinking
Although ICRS implantation flattens the cone and regularizes the corneal topography, the procedure might not halt the progression of the ectatic process. Combining ICRS implantation and CCL may achieve both goals, however. Variations in technique relate to the number of segments used, the location of the segments, and the timing of the procedures.
One study reported that inferior-segment Intacs (CorneaGen, Seattle, WA) implantation with CCL resulted in better keratoconus improvement than Intacs implantation alone. Another study demonstrated that ICRS implantation followed by CCL resulted in better outcomes than CCL followed by ICRS.
Chan CC, Sharma M, Wachler BS. Effect of inferior-segment Intacs with and without C3-R on keratoconus. J Cataract Refract Surg. 2007;33(1):75–80.
Coskunseven E, Jankov MR 2nd, Hafezi F, Atun S, Arslan E, Kymionis GD. Effect of treatment sequence in combined intrastromal corneal rings and corneal collagen crosslinking for keratoconus. J Cataract Refract Surg. 2009;35(12):2084–2091.
Excerpted from BCSC 2020-2021 series: Section 13 - Refractive Surgery. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.