To assess the visual and refractive outcomes of one segment and two-segment femtolaser assisted intrastromal corneal ring segment implantation in keratoconus.

In this study one or two segments of Intacs SK were implanted using femtosecond laser in eyes with Stage I- IV KCN. Visual, refractive, corneal tomography changes were analyzed over a 6-month follow-up.

Seventy-one eyes of fifty-five patients with keratoconus (single ICRS: 36 eyes; paired ICRS: 35 eyes) were included in the study. At 6 months, the spherical equivalent decreased by a mean of 1.15 and 2.98 D, the mean sphere decreased 0.63 and 2.37 D and the mean cylinder decreased 1.03 and 1.25 D in 1SG and 2SG respectively. The mean Pre-op LogMAR UCVA was 0.75 that increased to 0.37 and 0.98 to 0.54 in 1SG and 2SG respectively. The mean Pre-op LogMAR CDVA was 0.48 that increased to 0.19 and 0.62 to 0.36. K-flat and K-steep decreased by a mean of 1.08 and 3.00 D and 2.15 and 3.83 D in 1SG and 2SG respectively (p<0.001). 36 eyes (100%) and 32 eyes (92%) of patients gain 1-6 lines in UCVA in one-segment and double-segment group, respectively

Femtolaser assisted implantation of one or two segment Intacs SK ICRS for keratoconus was safe and effective, leading to significant improvement in UDVA, CDVA, and refractive error but double-segment maybe more effective and have better refractive outcomes