Corneal intra-stromal implantation surgery (cisis) for the treatment of keratoconus

Gutsehen Eye Center Ybbs and Department of Ophthalmology, Medical University Inssbruck, Austria
  
  Purpose — to evaluate the long term results of CISIS for the treatment of Keratoconus.
  
  Methods. CISIS is characterized by the formation of an intra-corneal pocket of 9 mm in diameter at 300 microns depth using the PocketMaker Microkeratome (DIOPTEX GmbH, Austria). After formation of the intra-corneal pocket a flexible continous MyoRing implant (DIOPTEX GmbH, Austria) is inserted into the intra-corneal pocket via a small incission tunnel of about 4 mm width. The nomogram depends exclussively on the average central K-reading. Fifteen eyes of 11 patients with moderate to severe Keratoconus with a mean age of 35 years (range 22 to 60 years) were included into the study. Postoperative Follow-up was 1 year.
  
  Results. The mean average central K-reading decreased by 5.75 Diopters (D) from 48.95 D to 43.20 D. The uncorrected visual acuity (UCVA) improved by almost 10 lines from 0.07 to 0.56 after 1 year. The best spectacle corrected visual acuity improved by almost 3 lines from 0.42 to 0.77. Mean sphere reduced from –5.13 D to 0.1 D and mean cylinder from –3.5 D to –1.27 D. No relevant intra — or postoperative complication occured. Side effects include glare and night-vision problems in some patients.
  
  Conclusion. Treatment of Keratoconus using the PocketMaker Microkeratome and the MyoRing intracorneal implant is safe and effective.