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Cohort studyVision (Basel, Switzerland) · 2026

Three-Year Visual, Tomographic, and Corvis ST-Derived Biomechanical Outcomes After Combined Intrastromal Ring Implantation and Corneal Collagen Cross-Linking for Keratoconus.

Radu-Nicolae Pop, Patricia Ariadna Nicula, Cristina Ariadna Nicula … Bianca Pop

OphthalmologyCohort study

Uncorrected vision better than baseline three years after corneal ring implantation with collagen cross-linking

Three-Year Visual, Tomographic, and Corvis ST-Derived Biomechanical Outcomes After Combined Intrastromal Ring Implantation and Corneal Collagen Cross-Linking for Keratoconus.

Radu-Nicolae Pop … Bianca Pop

Vision (Basel, Switzerland) · 2026

Purpose

Combined intrastromal corneal ring segment implantation with corneal collagen cross-linking (CXL) aims to improve optical regularity and reduce the risk of ectatic progression in selected eyes with keratoconus.

Methods

In this retrospective, single-center, complete-case longitudinal series, 58 eyes from 40 patients treated at OCULENS Ophthalmology Clinic between 2019 and 2022 were analyzed after same-session KeraRing implantation and conventional epithelium-off CXL, with baseline and 6-, 12-, 24-, and 36-month follow-up data.

n = 58 eyes

Results

vision without glasses three years after treatment; this lower score means clearer eyesight

0.56logMAR

UDVA baseline

0.469logMAR

UDVA 36 months

More results

Kmax decreased from 56.11 ± 3.17 D to 54.87 ± 2.86 D, BAD-D improved from 5.62 ± 1.89 to 4.70 ± 1.75, and thinnest pachymetry measured 440.7 ± 21.9 µm at 36 months, corresponding to 97.0% of baseline thickness.

More results

Corvis ST-derived deformation behavior shifted toward lower deformation amplitude and higher stiffness parameter at first applanation (SP-A1), but these device-derived parameters should be interpreted as indirect deformation response metrics rather than as direct tissue stiffness measurements.

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Conclusion

The findings support sustained 36-month visual, tomographic, and Corvis ST-derived changes after combined treatment, while interpretation remains limited by the retrospective complete-case design, unavailable denominator for cases excluded because of incomplete follow-up, eye-level analysis with bilateral cases, lack of a control group, and indirect nature of Corvis ST-derived biomechanical assessment.

Post

Three-Year Visual, Tomographic, and Corvis ST-Derived Biomechanical Outcomes After Combined Intrastromal Ring Implantation and Corneal Collagen Cross-Linking for Keratoconus.

Uncorrected vision better than baseline three years after corneal ring implantation with collagen cross-linking

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