A 53-year-old man had implantation of 2 intrastromal corneal ring segments (Intacs, Addition Technology Inc.) in the left eye. Several days after the lower segment was exchanged, an infiltrate was present at the corneal incision site. This progressed to a lower channel infection followed by diffuse keratitis. Culture from the conjunctiva was positive for Staphylococcus epidermidis, but cultures from the cornea were negative for microorganisms. Later, 2 gas bubbles appeared at the interface. The patient was treated with topical and subconjunctival antibiotics and channel irrigation. The keratitis resolved, leaving a neovascularized opacity at the nasal part of the lower channel.

Infectious keratitis is a significant, visual threatening complication of overnight orthokeratology. Eye care practitioners should be aware of this complication and educate their patients of the importance of lens hygiene and prompt medical care when symptoms or signs of keratitis appear.

PURPOSE: To present intracorneal ring segments for potential management of pellucid marginal degeneration. METHODS: A 41-year-old man with pellucid marginal degeneration with poor visual acuity due to irregular astigmatism was treated with lntacs microthin insert (Kera Vision, Fremont, Calif) in the left eye. RESULTS: Uncorrected visual acuity improved from 2/60 to 6/60 following the procedure. The procedure completely eliminated myopia of -8.00 diopters and improved the irregularity of the astigmatism, although it did not change its magnitude. CONCLUSIONS: Insertion of the intracorneal ring segment improves visual acuity in pellucid marginal degeneration by flattening the central corneal protrusion, thus reducing myopia and improving the astigmatism irregularity. [J Refract Surg. 2005;21:296-298.]

Implantation of Intacs in eyes with myopic regression after LASIK and PRK resulted in a good refractive outcome and an improvement in uncorrected visual acuity.