“355° experience”

KC; Bilateral, Progressive, Non-inflammatory disease

Exact etiology is unknown

ICRS shown to be very effective

Keraring 355º, a new option for ring selection

Specifically designed for nipple type KC

Keraring 355º implantation

Analysis

BEHRC

Keratoconic &PMD

Patients

Baseline ophthalmology exam

•>20 years old

• Confirm diagnosis

• Min CT 360 µ

• Mean k 45 to 52 D

• UCVA ≤ 20/50

• Without h/o severe

ocular & systemic

pathologies

• hyperopia

To determine

efficacy and

safety of

Keraring 355º

implantation

for a 6 months

duration

1 day, 1,3 &6 months

The Bina Eye Hospital Research Center Study data set

contains information on 105 subjects with Keraring 355º

implantation

Patients with keratoconic eyes and pellucid marginal

degeneration cases that completed at least 6 months follow-

up were extracted

Keraring 355º ICR Dimension

spherical equivalent Diameter (mm) Thickness(µm)

< 6 D 5.7mm 200µm

> 6 D. 5.7mm 300µm

Keraring 355º ICR Dimension

Myopia Diameter (mm) Thickness(µm)

< -3 D 5.7mm 200µm

> -3D 5.7mm 300µm

DEMOGRAPHIC DATA for KERATOCONUS PATIENTS

Number of Eyes 15

OD (%) 7 (46.7%)

OS (%) 8 (53.3%)

Sex

Male (%) 12 (80%)

Female (%) 3 (20%)

Age

Mean (SD) 27.87 (6.94)

Range 21-49

Preoperative 1 Months

Postoperatio

n

3 Months

Postoperatio

n

6 Months

Postoperatio

n

p-value

3 vs. pre p-value

6 vs. pre

p-value

6 vs. 3

UCVA

(LogMAR)

Mean (SD)0.79 (0.48) 0.50 (0.26) 0.44 (0.25) 0.28 (0.15) 0.005** 0.001** 0.002**

BSCVA

(LogMAR)

Mean (SD) 0.36 (0.21) 0.34 (0.19) 0.29 (0.17) 0.18 (0.09) 0.19 0.009** 0.007**

Sphere (D)

Mean (SD) -2.38 (1.85) -0.33 (2.34) -0.62 (2.79) -0.25 (2.27) 0.052 0.019* 0.242

Cylinder (D)

Mean (SD) -4.27 (1.25) -2.18 (0.82) -1.78 (1.22) -1.88 (0.95) <0.001** <0.001** 0.714

SE (D)

Mean (SD) -5.46 (1.52) -2.35 (1.67) -2.09 (2.19) -2.01 (1.63) <0.001** <0.001** 0.822

Preoperative 6 Months

Postoperation

p-value

K.Max Value (D)

Mean (SD)

50.39 (2.14) 44.22 (2.17)

<0.001**

K.Min Value(D)

Mean (SD)

45.85 (1.94) 42.14 (2.53)

<0.001**

K.Mean Value (D)

Mean (SD)

48.11 (1.95) 43.31 (2.31)

<0.001**

A B

Satisfaction Score

(N=15)

Frequency (%) Mean (SD)

No 0.0 (0.0%)

4.27 (1.16)

Very little 2.0 (13.3%)

Little 0.0 (0.0%)

Moderate 7.0 (46.7%)

Much 4.0 (26.7%)

Very much 2.0 (13.3%)

Characteristic Patient 1 Patient 2 Patient 3 Patient 4 Patient 5 Patient 6

Demographics

Sex Male Male Male Male Male female

Age,yr 21 36 29 30 40 33

Eye Os OD OS Os Os Os

Diagnosis PMD PMD PMD PMD PMD PMD

Characteristic Patient 1 Patient 2 Patient 3 Patient 4 Patient 5 Patient 6

UCVA

Pre op. 0.05 0.1 0.05 0.3

1 M post op. 0.6 0.4 0.5 0.2

3 M post op. 0.7 0.7 0.6 0.4

6 M post op. 0.9 0.6 0.5 0.5

BCVA

Pre op. 0.5 0.3 0.6 0.6

1 M post op. 0.6 0.5 0.7 0.4

3 M post op. 0.7 0.8 0.7 0.7

6 M post op. 0.9 0.7 0.9 0.7

Sphere (D)

Pre op. -3.25 -2 -2 -2 -1

1 M post op. 0 0.5 1 -2 2

3 M post op. 1.5 1 2 1.5 1.5

6 M post op. 1.5 1.5 2 2 1.5

Cylinder (D)

Pre op. -2 -6 -3.25 -6 -4

1 M post op. -3 -1.5 -3 -3 -3.5

3 M post op. -2 -1 -2 -3 -3.5

6 M post op. -1 -1 -3 -3 -3

K.Max (D)

Pre op. 50.8 51 49.9 46.5 50.6

1 M post op. 39.8 39.2 40 37.8 41.6

3 M post op. 42.2 38.5 42.9 40.2 43.4

6 M post op. 44 37.3 43.3 40.6 43

K.Min(D)

Pre op. 47.7 45.1 46.7 38.7 44.7

1 M post op. 36 36.2 37.6 36.1 38.3

3 M post op. 38.9 37.2 39.7 36.6 40.1

6 M post op. 39.4 35.7 39.8 37.1 39.1

K.Mean (D)

Pre op. 49.1 48.5 48.3 46 47.6

1 M post op. 37.9 37.7 38.8 36.9 39.9

3 M post op. 40.5 37.8 41.3 38.4 41.7

6 mo postoperative 41.7 41.5 36.7 41.5 38.8 41

Satisfaction Score (N=6) Frequency (%) Median (25th,75th)

No 0.0 (0.0%)

3.5 (1.25,5.00)

Very little 2.0 (25.0%)

Little 1.0 (12.5%)

Moderate 1.0 (12.5%)

Much 1.0 (12.5%)

Very much 3.0(37.0%)

Pre-OP UCVA: 1/10

-2 -6 *124 BCVA: 4/10

Post-OP UCVA: 7/10

-0.5 *110 BCVA: 10/10

ICRS (KeraRing 355°) implantation appears to be an efficient

and minimally invasive procedure in keratoconic & PMD

patients .

Further follow-up and additional cases are needed to draw

final conclusions

Pocket better than tunnel

Location of incision adjust to steep meridian

Surgury must be performed in the operating room

especially with surgical microscope

Centralization of ring should be done with

keratoscope(not pupil centre)

Last but not least for beter astigmatism

correction make use of arcuate incision

Comparison between Myoring and Keraring 355° Implantation for treatment of

Keratoconus: A Randomised, Double-blind, Two Parallel-groups clinical trial

Clinical Outcomes After Keraring 355° Implantation in post-LASIK Corneal

Ectasia Using the pocket maker microkeratom Technology: one year follow-up

Comparison of manual and pocket maker surgical techniques

Clinical Outcomes After Keraring 355° Implantation in pellucid marginal

degeneration Using the pocket maker microkeratom Technology: one year follow-

up

Modelling of intraocular lens power calculation after implantation of ICRS

Aberrometric Outcomes of Intrastromal Corneal Ring(KeraRing 355) in

Patients with Keratoconus

THANK YOU