Keraring ™ Instrastromal Corneal Ring

HALTING THE DEBILITATING EFFECTS OF KERATOCONUS

What are corneal rings?

Corneal rings are curved pieces of perspex designed to be placed at a precise depth within the cornea. They were originally developed to treat myopia - the placement of a ring in the mid-periphery of the cornea causes flattening of the central part of the cornea.

There are two kinds of corneal ring available - Kerarings  and INTACs. Kerarings have been specifically designed to treat keratoconus and we’ve found them very safe and effective. We no longer use INTACs.

Apart from keratoconus, Kerarings also treat:

  • Pellucid marginal degeneration
  • Post-LASIK ectasia

Who do Kerarings ™ help?

Kerarings ™ are particularly beneficial for treating mild to moderate keratoconus. Research we conducted at Leeds Teaching Hospitals demonstrated that 95% of patients with mild to moderate keratoconus benefitted from Keraring ™ implantation.

The results were less predictable for advanced keratoconus but still worth considering in patients who would otherwise need a corneal transplant to restore vision.

How do you treat keratoconus?

James Ball explains the different treatment options for treating keratoconus, including corneal cross-linking, intrastromal corneal rings and how he’d like to make corneal transplants for keratoconus no longer needed.

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How do Kerarings ™ work?

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.

Advantages and disadvantages of Kerarings ™?

Advantages

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.

Disadvantages

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.

Options and alternatives to Kerarings ™

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.

Read more about keratoconus surgery

Results at a glance

Laser procedures
Cataract procedures
%
Better than the national average of complication rates

My eyesight following the operation is brilliant and better than I thought possible, and this is all down to your excellent surgeon Mr James Ball and not to forget all the very dedicated people around him who make these operations possible.

Keith Garlick

Two of the best decisions I ever made in my life were firstly to have lens exchange and secondly to have Mr James Ball carry out my operation.

Patricia Walton

Within minutes I could tell there was a difference. But now, only a couple of months later, my sight is better than it was seven years ago! I can even read the really tiny print on the car sales ads! If you want that confidence you probably felt when you were younger, this is the ideal solution. Thanks to the treatment, I feel rejuvenated, independent and much younger!

John Hazelgreave

Many thanks for all your care and kindness. To me it appears a miracle that I can see so well. I feel very grateful. It is impossible to fully express my thanks.

Grace C.

May I offer grateful thanks for your expertise in operating on my eyes. It was intimated to me that you were the best, and from the results I am now enjoying, I am convinced that this is correct.

Jean D.

You are truly innovative. Thank you very much for curing the problems I have been having with my reading and near vision.

Sala M.

My work was becoming almost impossible. I had refractive lens exchange to both eyes with multifocal lens implants last July. I can now see better than 20/20 for distance and can read the tiniest print in newspapers - all without glasses! I have started reading for pleasure again, and I feel that my performance both at work and on the golf course has improved.

John

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My eyesight following the operation is brilliant and better than I thought possible, and this is all down to your excellent surgeon Mr James Ball and not to forget all the very dedicated people around him who make these operations possible.

Keith Garlick

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About our surgeons

Mr James Ball | Consultant Ophthalmic Surgeon

MA (Cantab) MB BChir FRCOphth CertLRS

I am a Consultant Ophthalmic Surgeon at Custom Vision Clinic, St James’s University Hospital, and Nuffield Hospital. My major interest is in refractive surgery and finding the best treatment suitable for each patient.

Mr Jack Gormley | Consultant Ophthalmic Surgeon

MB ChB (Hons) FRCOphth CertLRS

I am a Consultant Ophthalmic Surgeon at Custom Vision Clinic and York Teaching Hospital, where I lead the Corneal and Refractive service. I have completed over 2,000 surgical and laser eye procedures.