{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T01:55:54Z","timestamp":1789091754055,"version":"build-2803163510"},"reference-count":28,"publisher":"Wiley","license":[{"start":{"date-parts":[[2019,10,9]],"date-time":"2019-10-09T00:00:00Z","timestamp":1570579200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Ophthalmology"],"published-print":{"date-parts":[[2019,10,9]]},"abstract":"<jats:p><jats:italic>Purpose<\/jats:italic>. To evaluate the outcomes of femtosecond laser-assisted implantation of a 355-degree intracorneal ring (ICR) (Keraring) in patients with keratoconus in the three-year follow-up. <jats:italic>Setting<\/jats:italic>. Future Femtolaser Center, Sohag, Egypt. <jats:italic>Design<\/jats:italic>. Prospective interventional case series. <jats:italic>Patients and Methods<\/jats:italic>. A prospective case series of 38 eyes of 26 patients with keratoconus had implantation of the 355-degree ICR keraring after tunnel creation with a femtosecond laser. The uncorrected visual acuities (UCVA) and best-corrected visual acuities (BCVA), sphere, cylinder, and manifest refraction spherical equivalent (SE), and mean keratometry (<jats:italic>K<\/jats:italic>), <jats:italic>K<\/jats:italic> max, and <jats:italic>K<\/jats:italic> min were evaluated preoperatively and 3, 6, 12, 24, and 36 months postoperatively, and all complications were reported. <jats:italic>Results<\/jats:italic>. 38 eyes of 26 patients with mean age 25.92\u2009\u00b1\u20095.44 years were enrolled in the study, 11 were males (<jats:bold>42.3%<\/jats:bold>). The mean UCVA improved from 0.93\u2009\u00b1\u20090.21 to 0.63\u2009\u00b1\u20090.21 logMAR (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\"><mml:mrow><mml:mi>P<\/mml:mi><mml:mo>\u2264<\/mml:mo><mml:mn>0.001<\/mml:mn><\/mml:mrow><\/mml:math>) and the mean BCVA from 0.67\u2009\u00b1\u20090.22 to 0.43\u2009\u00b1\u20090.26 logMAR (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\"><mml:mrow><mml:mi>P<\/mml:mi><mml:mo>&lt;<\/mml:mo><mml:mn>0.001<\/mml:mn><\/mml:mrow><\/mml:math>). The mean sphere, cylinder, and spherical equivalent have been changed dramatically from preoperative to 3 month postoperative, which is statistically significant (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\"><mml:mrow><mml:mi>P<\/mml:mi><mml:mo>\u2264<\/mml:mo><mml:mn>0.001<\/mml:mn><\/mml:mrow><\/mml:math>), and the changes between 1 and 2 years and 2 and 3 years are also considerable and statistically significant; the <jats:italic>K<\/jats:italic> max and <jats:italic>K<\/jats:italic> min and <jats:italic>K mean<\/jats:italic> improved and the changes were statistically significant (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\"><mml:mrow><mml:mi>P<\/mml:mi><mml:mo>\u2264<\/mml:mo><mml:mn>0.001<\/mml:mn><\/mml:mrow><\/mml:math>), and the changes between one, two, and three years were also statistically significant. The safety and efficacy indices were changed through the three-year follow-up. The complications were corneal neovascularization (36.84%), corneal melting (26.3%), and ring extrusion (31.5%) at the end of the study. <jats:italic>Conclusions<\/jats:italic>. Implantation of a 355-degree intracorneal keraring using femtosecond laser improved the visual, refractive, and topographic parameters in keratoconus patients, with a high rate of ICR extrusion and instability. The study has been registered for the Pan African Clinical Trial Registry (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.pactr.org\">http:\/\/www.pactr.org<\/jats:ext-link>) database within No: <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/PACTR201810796878908\">PACTR201810796878908<\/jats:ext-link> on 29 October 2018.<\/jats:p>","DOI":"10.1155\/2019\/6783181","type":"journal-article","created":{"date-parts":[[2019,10,9]],"date-time":"2019-10-09T19:33:57Z","timestamp":1570649637000},"page":"1-7","source":"Crossref","is-referenced-by-count":16,"title":["Femtosecond Laser Implantation of a 355-Degree Intrastromal Corneal Ring Segment in Keratoconus: A Three-Year Follow-Up"],"prefix":"10.1155","volume":"2019","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0261-6856","authenticated-orcid":true,"given":"Marwa 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