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This abstract is assigned to session AOB Free Papers
Presentation typeOral presentation
TitleMorphological characterization and clinical effects of stromal alterations after intracorneal ring segments (ICRS) implantation in keratoconus
PurposeTo analyze the stromal tissue changes after ICRS implantation and their refractive and topographic effects in patients with keratoconus.
MethodsThis retrospective case series included 15 patients with clinical peri-segmental lamellar channel deposits after ICRS implantation for keratoconus. The stromal changes were investigated using in-vivo confocal microscopy. Two patients underwent a penetrating keratoplasty after ICRS implantation, the explanted corneas were processed for histopathology and transmission electron microscopy (TEM). Refractive and topographic effects were investigated comparing the uncorrected (UDVA) and corrected (CDVA) distance visual acuity, spherical equivalent (SE), flat (K1), steep (K2) and steepest (Kmax) keratometry before and after detection of lamellar channel deposits.
ResultsIn-vivo confocal microscopy revealed diffuse linear and focal granular hyperreflective structures. Histologically, there was mild proliferation of fibroblasts and fibrosis. TEM demonstrated focal accumulations of degenerated keratocytes with cytoplasmic lipid inclusions. There were no significant changes for UDVA (Δ = 0.0 ± 0.2 logMAR; p = 0.67), CDVA (Δ = 0.0 ± 0.1 logMAR; p = 0.32), SE (Δ 0.1 ± 0.9 D; p = 0.22), K1 (Δ = 0.3 ± 1.0 D; p = 0.28), K2 (Δ = 0.1 ± 0.9 D; p = 0.51) and Kmax (Δ = 0.3 ± 1.5 D; p = 0.17).
ConclusionTwo types of structural stromal changes were identified: (1) diffuse peri-segmental fibrosis and (2) lamellar channel deposits. These structural changes showed no evidence of refractive or topographic effect.
Conflict of interestNo
Authors 1
Last nameHAMON
DepartmentUniversitätsklinikum des Saarlandes
Authors 2
Last nameSchlötzer-Schrehardt
DepartmentUniversitätsklinikum Erlangen
Authors 3
Last nameFlockerzi
DepartmentUniversitätsklinikum des Saarlandes
Authors 4
Last nameSeitz
DepartmentUniversitätsklinikum des Saarlandes
Authors 5
Last nameDaas
DepartmentUniversitätsklinikum des Saarlandes
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