Evaluation of simultaneous femtosecond-assisted myoring implantation and intrastromal pocket corneal collagen cross-linking for management of progressive post lasik ectasia

Purpose: To evaluate femtosecond assisted implantation of MyoRing and Corneal Collagen Cross-Linking in an Intrastromal Pocket in One Session for management of progressive post Lasik ectasia. Methods: In this study, 20 eyes of 14 patients with progressive post Lasik ectasia a MyoRing (Dioptex, GmbH, Austria) was implanted using a femtosecond laser and Corneal Collagen Cross-Linking in an Intrastromal Pocket in One Session. Uncorrected and corrected distance visual acuity, refraction, keratometry, central corneal thickness, corneal biomechanical profile, and corneal aberrometry were evaluated preoperatively and at 1, 3, and 6 months, and 1 year postoperatively. Results: Twelve months postoperatively there was a statistically significant improvement in Uncorrected distance visual acuity and Corrected distance visual acuity (1.01 ± 0.31, 0.50 ± 0.11 to 0.29 ± 0.01, 0.3 ± 0.14 respectively) (P<0.001). Mean keratometry changed significantly from 51.18±4.82 to 42.91±2.91 (P< 0.001), and sphere (-4.97± 3.06 diopters Improved to -0.55 ±1.63 diopters (P 0.001). Cor¬neal hysteresis and corneal resistance factor showed no significant change during follow up Mean ± SD follow-up was 13±5 months. Conclusions: Combination of these two minimally invasive MyoRring and Corneal Collagen Cross-Linking in an Intrastromal Pocket in One Session procedures had the capability in halting the progression of post Lasik ectasia and can be considered an acceptable method to achieve corneal remodeling and alternative to lamellar or penetrating lamellar keratoplasty.