Impression cytologic analysis after corneal cross-linking and insertion of corneal ring segments for keratoconus: two-year results Citologia de impressão após “cross-linking” corneano e inserção dos segmentos de anéis corneanos para ceratocone: dois anos de seguimento

INTRODUCTION Keratoconus is a noninflammatory cone-like ectasia of the cornea that can be managed by glasses, contact lenses, keratoplasty, crosslin king (CXL), and intrastromal corneal ring segment (ICRS) insertion, based on the stage of the disease and the patient’s symptoms. Despite being an evolutive disease, CXL has recently been utilized as a therapeutic option for stabilizing the cornea. An optical microscopic study demonstrated that the morphology grade of the most superficial epithelial cells obtained by impression cytology (IC) from the cornea and bulbar conjunctiva did not change after CXL using riboflavin and ultraviolet-A (UVA) light in the treat ment of keratoconus. Some patients have been pretreated with CXL, and ICRS can be performed in conjunction to the produce, flattening the central corneal curvature, which decreases corneal irregularity and improves visual acuity. To the authors’ knowledge, no report on the cytological features of the ocular surface epithelium after CXL and ICRS insertion in the treatment of keratoconus currently exists in the literature. The aim of this study was to report the IC features of the conjun cti va and cornea after CXL and ICRS insertion in the treatment of keratocoImpression cytologic analysis after corneal cross-linking and insertion of corneal ring segments for keratoconus: two-year results