Complications of intrastromal corneal ring segment implantation using a femtosecond laser for channel creation: a survey of 850 eyes with keratoconus

Abstract

ABSTRACT.Purpose: To report complications after the implantation of intrastromal corneal ring segments (Keraring; Mediphacos, Belo Horizonte, Brazil) in keratoconic eyes using a femtosecond laser (IntraLase; Advanced Medical Optics, Santa Ana, California, USA) for channel creation. Methods: Retrospective chart review of 531 patients (850 eyes) who underwent Keraring insertion using a femtosecond laser for channel creation. Intraoperative and postoperative complications were recorded. Results: Intraoperatively, there were 22 (2.7%) cases of incomplete channel formation. The rest of the intraoperative complications were galvo lag error (system malfunction) [five eyes (0.6%)], endothelial perforation [five eyes (0.6%)] and incorrect entry of the channel [two eyes (0.2%)]. Postoperatively, there were 11 (1.3%) cases of segment migration, two (0.2%) cases of corneal melting and one (0.1%) case of mild infection. The overall complication rate was 5.7% (49 cases out of 850 eyes). Conclusion: In this study, intracorneal ring segment implantation using a femtosecond laser for channel creation was related to a number of complications. The most common complications were incomplete channel creation (intraoperatively) and segment migration (postoperatively).

New clinical pathways for keratoconus

“…The authors also do not state the follow-up period studied or whether these were consecutive cases. Nonetheless, data from this and smaller prospective series 47,49 indicate that sightthreatening complications are rare. Very little long-term data are available for ICRS, and any effect of ICRS implantation on disease progression remains uncertain.…”

“…Femtosecond laser channel cutting has, by ensuring a consistent cut depth, both facilitated and enhanced safety in ICRS implantation. 47 Flattening of central curvature with ICRS implantation increases with smaller ring diameter and greater segment thickness. The penalty for using a smaller diameter ring is a greater potential for dysphotopsia.…”

“…A recent multicenter retrospective review 47 of 850 eyes with femtosecond Keraring ICRS implantation using an Intralase femtosecond laser for ring channel creation reported a 5.7% overall complication rate. a Convex anteriorly and concave posteriorly.…”

Cross-linking e segmento de anel corneano intraestromal

“…Entretanto, há relatos de complicações. Coskunseven et al (54) analisando 850 olhos com ceratocone que foram submetidos à inserção do Keraring pelo laser de femtosegundo, observaram que a criação incompleta do túnel foi a complicação intraoperatória mais frequente, e migração do segmento de anel a complicação pós-operatória mais frequente. A razão geral de complicações foi de 5,7% (49 casos).…”

Femtosecond Laser-Assisted Astigmatism Correction

“…The www.intechopen.com reference point is set as the point of thinnest pachymetry at the channel locations. Endothelial perforation can be prevented by stopping channel creation as soon as the complication is recognized before the incision (Coskunseven et al, 2011).…”