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Published Online:https://doi.org/10.3928/1081597X-20131112-01Cited by:1

Abstract

PURPOSE:

To describe a patient with refractive and topographic fluctuations 5 years after intracorneal ring segments (ICRS) implantation for the management of corneal ectasia after LASIK.

METHODS:

Case report.

RESULTS:

A 48-year-old woman presented complaining of intermittent decreased vision over 1 year that improved with eye rubbing. Slit-lamp and optical coherence tomography (OCT) examinations revealed overriding ring segments that could be restored to normal position after minor corneal massage. Topographic and refractive findings were significantly influenced by the ICRS positioning and caused decreased visual function when overriding. To avoid ICRS override, surgical dissection of the corneal tunnel along with ring segment repositioning was performed. A suture was placed through the ring’s positioning hole to stabilize the ICRS at its optimal position and to avoid recurrence of this phenomenon.

CONCLUSIONS:

Patients undergoing femtosecond laser-assisted ICRS implantation may experience ring segment migration and override of the segments that could lead to decreased visual function. Proper surgical repositioning and ring segment fixation may address this complication and offer satisfactory visual and refractive outcomes along with avoidance of ICRS migration and override.

[J Refract Surg. 2014;30(2):140–142.]

  • 1.Schanzlin DJ, Asbell PA, Burris TE, Durrie DS. The intrastromal corneal ring segments: phase II results for the correction of myopia. Ophthalmology. 1997; 104:1067–1078.10.1016/S0161-6420(97)30183-3

    Crossref MedlineGoogle Scholar
  • 2.Kymionis GD, Grentzelos MA, Diakonis VF, Pallikaris AI, Pallikaris IG. Nine-year follow-up of intacs implantation for keratoconus. Open Ophthalmol J. 2009; 3:77–81.10.2174/1874364100903010077

    Crossref MedlineGoogle Scholar
  • 3.Piñero DP, Alio JL, Uceda-Montanes A, El Kady B, Pascual I. Intracorneal ring segment implantation in corneas with post-laser in situ keratomileusis keratectasia. Ophthalmology. 2009; 116:1665–1674.10.1016/j.ophtha.2009.05.030

    Crossref MedlineGoogle Scholar
  • 4.Alió JL, Shabayek MH, Belda JI, Correas P, Feijoo ED. Analysis of results related to good and bad outcomes of Intacs implantation for keratoconus correction. J Cataract Refract Surg. 2006; 32:756–761.10.1016/j.jcrs.2006.02.012

    Crossref MedlineGoogle Scholar
  • 5.Piñero D, Alio JL. Intracorneal ring segments in ectatic corneal disease-a review. Clin Experiment Ophthalmol. 2010; 38:154–167.10.1111/j.1442-9071.2010.02197.x

    Crossref MedlineGoogle Scholar
  • 6.Rabinowitz YS, Li X, Ignacio TS, Maguen E. INTACS inserts using the femtosecond laser compared to the mechanical spreader in the treatment of keratoconus. J Refract Surg. 2006; 22:764–771.

    LinkGoogle Scholar
  • 7.Kubaloglu A, Sari ES, Cinar Y, et al.Comparison of mechanical and femtosecond laser tunnel creation for intrastromal corneal ring segment implantation in keratoconus: prospective randomized clinical trial. J Cataract Refract Surg. 2010; 36:1556–1561.10.1016/j.jcrs.2010.04.028

    Crossref MedlineGoogle Scholar
  • 8.Kymionis GD, Kankariya VP, Plaka AD, Reinstein DZ. Femto-second laser technology in corneal refractive surgery: a review. J Refract Surg. 2012; 28:912–920.10.3928/1081597X-20121116-01

    LinkGoogle Scholar
  • 9.Randleman JB, Dawson DG, Larson PM, Russell B, Edelhauser HF. Chronic pain after intacs implantation. J Cataract Refract Surg. 2006; 32:875–878.10.1016/j.jcrs.2006.01.078

    Crossref MedlineGoogle Scholar
  • 10.Boxer Wachler BS, Christie JP, Chandra NS, Chou B, Korn T, Nepomuceno R. Intacs for keratoconus. Ophthalmology. 2003; 110:1031–1040.10.1016/S0161-6420(03)00094-0

    Crossref MedlineGoogle Scholar
  • 11.Coskunseven E, Kymionis GD, Tsiklis NS, et al.Complications of intrastromal corneal ring segment implantation using a femtosecond laser for channel creation: a survey of 850 eyes with keratoconus. Acta Ophthalmol. 2011; 89:54–57.10.1111/j.1755-3768.2009.01605.x

    Crossref MedlineGoogle Scholar

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