الفهرس 
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Abstract
Keratoconus correction has always been a challenge especially in
Advanced cases with severe corneal irregularity and stromal opacities.
Intrastromal corneal ring segments have been recently proposed and
investigated as an additive surgical procedure for keratoconus correction
The aim of this work is to study the efficacy and safety of intracorneal
stromal ring implantation in treatment of keratoconus either by
manual dissection or femtosecond laser.
Thirty eyes of twenty patients had a moderate to sever keratoconus.
Were selected from the outpatient’s clinic of Benha University from the
period of June 2013 to June 2014. These patients were randomly assigned
into two groups, in (group 1) 15 of them the tunnel was created
mechanically and in (group 2) 15 of them the tunnel was created by using
femtosecond laser, all patients were followed up at 1 month, 3 month and 6
month postoperatively.
Uncorrected visual acuity (UCVA), BCVA, K reading and rate of
complication (Incomplete channel formation, Segment displacement,
Segment extrusion, corneal vascularization), were collected and monitored
all through the 6 months follow-up and the results were tabulated and
statistically analyzed for each group and compared
The mean age of the patients was 27.6 ± 10.9 years (range, 21–35
years) with 13 (43.3%) men and 17 (56.7%) women. Group (1) had a mean
age of 26.5 ± 7.2 (range: 21-32 years), while group (2) had a mean of 28.2
± 11.7 (range: 22-35 years).
After one month visual acuity in LogMAR value in group (1)
preoperative UCVA was 1.5 ± 0.25 improved to 0.70 ± 0.12, BCVA was
Summary and Conclusion
►120◄
0.8 ± 0.51 improved to 0.40 ± 0.01, while in group (2) UCVA was 1.6 ±
0.22 improved to 0.59 ± 0.23, and BCVA was 0.9 ± 0.42 improved to 0.30
± 0.09. The two groups show a statistically significant improvement (P
<0.05). The improvement extends to the next 3 months (P <0.01) and 6
months (p <0.001).
The same improvement was obtained in keratometry in group (1)
Kmax it was 54.4 ± 2.35 improved to D 48.3 ± 2.05 D, while in group (2)
Kmax it was 57.3 ± 3.12 D 35 and improved to 47.1 ± 1.22 D. The two
groups show a statistically significant value (P <0.05) after the first month.
After 3 months group (1) Kmax was 45.3 ± 1.44 D, while in group (2) Kmax
decreased to 43.8 ± 1.52 D (P <0.01). After 6 months group (1) Kmax
decreased to 45.2 ± 1.32, while in group (2) Kmax was decreased to 43.2 ±
1.27 (P <0.01).
The complications of group (1) were 46.7% while in group (2) were
26.7%, while they were statistically non-significant (P > 0.05). Incomplete
channel formation was found in 13.3% and 6.67% of the patients in group
(1) and (2), respectively. Segment displacement was found in 20% and
6.67% of patients in group (1) and (2), respectively. Segment extrusion and
corneal vascuilarization were found in one patient each of group (1), while
in group (2) galvanometer lag error, corneal melting and segment migration
are found in one patient each.