Sequential Intrastromal Corneal Rings implantation and Cataract Surgery in Severe Keratoconus Patient with Cataract

1. Seung Jae Lee¹
2. Hyun Seok Kwon¹
3. Il wan Koh¹

¹SU Yonsei Eye Clinic, Seoul, Korea

Purpose: We introduce new treatment option for severe keratoconus and cataract with sequential intrastromal corneal rings implantation and cataract surgery.

Methods: A 49-year-old man with 0.02 of uncorrected visual aucity (UCVA), 0.05 of Best spectacle-corrected visual acuity (BSCVA), K1=59.88×82°/K2=45.88×172° and inferior steepening consistent with keratoconus in his left eye was treated with clear-cornea phacoemulsification and intraocular lens (IOL) implantation after Keraring intrastromal corneal ring segments (Mediphacos, Belo Horizonte, Brazil) for severe keratoconus with cataract. . Asymetrical pair of kerarings were implanted assisted by femtosecond laser in September 2008 ; the one and the other segment was 250 ㎛ and 150 ㎛ at 70°. After 3 month, clear-cornea phacoemulsification and IOL implantation was performed on the left eye.

Results: After surgery, UCVA and BSCVA improved by 8 lines in the left eye. After 1 month, postoperative central keratometry showed a decrease of 7.35 diopters in the left eye. Postoperative refraction(-0.75 -0.75 ×60°), keratometric reading (K1=50.05×93°/K2=48.83×3°) has remained stable for 1 year.

Conclusions: Sequential intrastromal corneal rings implantation and cataract surgery can be considered as a treatment option in patients with severe keratoconus and cataract.