The short answer is that no one is entirely sure.
Based on our studies we think that the following mechanism is the most important. The Keraring ™ seems to be most effective when it is able to bridge from stronger cornea through the cone to stronger cornea on the other side. A bit like an RSJ (rolled steel joint) used in building. The ring pulls the cone back in line with the rest of the cornea and lifts the steepest part of cornea onto the visual axis. This means that the part of the cornea which the patient is looking through is more regular and is able to give them better vision.
Keraring ™ is a rapid and painless treatment. We use a femtosecond laser to make a precise tunnel in the cornea. This takes just 8 seconds. We then slide the Keraring ™ segment(s) into the tunnel. This takes a couple of minutes. The whole procedure usually takes just five minutes.
Keraring ™ has a rapid recovery. The eye may be a little sore and scratchy the evening of the treatment but settles very quickly. Any improvement in vision is usually evident within a few days but may take up to three months.
Keraring ™ is reversible. If the Keraring ™ does not provide any improvement it can easily be removed and the cornea returns to its previous state.
Keraring ™ has less predictable results for advanced keratoconus. Some patients experience a mild glare effect from the Keraring ™ in certain light conditions, although this settles over time.
Spectacles and contact lenses can work well for mild to moderate keratoconus.
Keraring ™ implantation does not prevent progression of keratoconus. In many patients, the keratoconus stabilises with natural age-related cross-linking but many patients, particularly younger patients may require C3-R cross-linking treatment.
Some patients may benefit from toric phakic IOL implantation after Keraring ™ implantation in order to unlock further improvement in vision.
At the preliminary Examination
A preliminary examination and measurement of your eyes is performed. This examination lasts about two hours.
Before this preliminary examination you should not have worn soft contact lenses for one week, and hard contact lenses for two weeks.
On the Day of Your Keraring ™ Treatment
We recommend that you wear comfortable clothes on the day of treatment. You can eat and drink normally on the treatment day, but please do not smoke. For hygiene reasons, it is important that you wash your face thoroughly prior to treatment, completely remove makeup, and avoid perfume.
You will be given anaesthetic eye drops to numb the surface of the eye, and you should feel no discomfort during the procedure. The surgery will be carried out as an outpatient procedure. Sunglasses are recommended after the procedure.
The total duration of the surgery (one eye) lasts approximately 10-15 minutes.
You are not allowed to drive a vehicle after the procedure.
The Keraring ™ Procedure – Step by Step
First, a tunnel is prepared in the cornea for the ring to be inserted into. At St James, we use the femtosecond laser – which makes the precise incision within 16 seconds.
The ring is inserted into the tunnel, and carefully positioned. The rings “tighten” the corneal cone and creates a more regular corneal surface.
After the Keraring ™ Surgery
The eye can be a little red – please do not rub your eyes. Eye drops will be given that prevent swelling and inflammation. The use of the eye drops will be discussed with you before you leave.
You can return to work after 2 days, resume sports activities after approximately 3 days, swimming and sauna after approximately 2 weeks.
You will receive a post-operative follow-up examination after 1 day, 1 week and 1 month.
You may drive a vehicle again only with the doctor’s permission, normally after the first post-operative examination.