corneal rings considered one of the new surgical procedures for the treatment of keratoconus, femtosecond laser allow precise location of the tunnel deep in stroma and also precise heigt that prevent dislocation of the rings during surgery
ICRS are cintra indicated in :
1- Hydrops
2- opaque apex or Descemet’s folds
3- Keratometric readings above 64 Diopters
4- Thickness of the center less than 400
As the rings have limited values in regulating the irregular corneal surface
As Dr. El-Massry mention: severe keratoconus almost always have below 400microns corneal thickness.
Nowadays with the longer arc rings (more than 320) , if the patient has no corneal opacity, and more than 400 micras on the tunnel location i explain the limits and prognosis of the surgery, and if the patient agree , i proceed with the surgery
ICRS are only mechanical devices that support the diseased corneal tissues by the induced corneal flattening effect thus improving dramatically the refractive and visual outcomes. However, ICRS have no role in halting KC progression, so that ICRS are only valid when CXL is valid. In other words, every keratoconic cornea not valid for CXL, then ICRS are of no use
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