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Yasmine Maher Shaaban,1,2,* Tamer Abdelfattah Badran1,3,* 1Department of Ophthalmology, Faculty of Medicine, Ain Shams University, Cairo, 1181, Egypt; 2Ain Shams University Hospitals and Ain Shams Specialized Hospital, Cairo, 11588, Egypt; 3The Eye Subspeciality Center (ESC), Cairo, 11402, Egypt*These authors contributed equally to this workCorrespondence: Yasmine Maher Shaaban, Department of Ophthalmology, Faculty of Medicine, Ain Shams University, Cairo, 1181, Egypt, Tel +20 1227123242, Fax +20224346753 ; +20224346041, Email yasminemaher0@gmail.comPurpose: To study the compensatory corneal epithelial changes after femtolaser-assisted intracorneal ring segment (ICRS) implantation in early and moderate cases of keratoconus (KC) using anterior segment optical coherence tomography (AS-OCT).Patients and Methods: A prospective observational non-randomized study of 40 eyes with mild to moderate KC received femtolaser-assisted ICRS implantation. Ferrara ICRS with different arc lengths and thicknesses were used according to the patients’ tomographic pattern. Patients had a clear central cornea, keratometry reading < 60 diopters, and corneal thickness > 400 microns. AS-OCT was performed preoperatively and at 1, 3, and 6 months after surgery. Corneal epithelial thickness (CET) was measured over 17 points (2 mm central and 16 points on 2– 5 mm and 5– 7 mm annular zones) over the pupil center. All data were collected and analyzed.Results: Comparing the preoperative and postoperative data, there was a statistically significant increase in the CET postoperatively throughout the 6-month follow-up period in all zones (p< 0.001). The epithelial thickness (ET) was noticed shortly around and central to the ring ridges by the first month (5– 7 mm zone). By the third month, the flattened central cornea (2 mm zone) and the 2– 5 mm zone showed a significant increase in ET up to the 6th month.Conclusion: ICRS implantation in KC results in a thicker and more regular epithelium in the central corneal zone as a secondary response to the corneal stromal changes induced by the implants.Keywords: keratoconus, Ferrara rings, epithelial thickness, AS-OCT |
