{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T10:18:51Z","timestamp":1787653131064,"version":"build-2736575974"},"reference-count":45,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Ophthalmology"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate the Intrastromal corneal ring segment (ICRS) implantation for visual rehabilitation in pediatric patients with keratoconus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients aged \u226418 years with keratoconus who underwent ICRS implantation were included. Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, manifest refraction and keratometry were recorded preoperatively and at 1\u20135\u20137\u2013 and 10\u2013year postoperatively. Treatment was categorized as success, qualified success or failure based on short-term visual and refractive improvement, the visual and refractive stability and the comparison between the long-term follow-up and the preoperative.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      One hundred seven eyes (85 patients) were included. All eyes were examined 1 year postoperatively, 89 at 5 years, 69 at 7 years and 36 at 10 years. UDVA (logMAR) changed from 0.64\u2009\u00b1\u20090.38 preoperatively to 0.34\u2009\u00b1\u20090.24 one year postoperatively (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u20090.0001). CDVA (logMAR) rose from 0.19\u2009\u00b1\u20090.15 to 0.08\u2009\u00b1\u20090.08 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u20090.0001). No eyes lost lines of CDVA 1 year postoperatively compared to preoperative, and 74.8% of the eyes gained lines. Preoperatively, 61.7% of the eyes had a refractive cylinder \u22653.00 D; one year postoperatively, 76.6% had &lt;3.00 D. The treatment was successful in most cases at 5\u2013, 7\u2013 and 10\u2013year follow-ups (84.3%, 85.5%, and 88.9%, respectively), qualified success in around 8% of the eyes, and treatment failed in 6 eyes represented a cumulative rate over the 10 years &lt;10%\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ICRS implantation induced significant visual and refractive improvements, and in most eyes with available long-term follow-up, visual and refractive improvements were maintained, supporting ICRS as a long-term visual rehabilitation option in pediatric keratoconus.<\/jats:p>\n                  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