In refractive surgery, the use of intracorneal implants, including intracorneal ring segments (ICRS) and corneal inlays, offer the specific advantage of not removing corneal tissue. As such, they are removable and may preserve options for ametropia or presbyopia correction with current or future modalities. 1,2 However, there are unique intraoperative and postoperative complications that can occur with their implantation that need to be recognized and managed. The following review will focus on the incidence and management of complications from the use of intracorneal implants in refractive surgery. '
ICRS for Correction of MyopiaICRS are polymethylmethacrylate segments implanted in the deep corneal stroma to modify the corneal curvature based on their geometric profile and diameter. Although initially approved for low myopia in the United States in 1999, 2 the technology was soon after used for the treatment of keratoconus. 3 The creation of channels for the placement of ICRS can be performed either mechanically using semicircular dissectors or with a femtosecond laser. Although the femtosecond laser creates channels with a high degree of precision, no published studies have demonstrated higher complications or inferior refractive outcomes for myopia with mechanical channel creation. For the treatment of myopia, ICRS offer the advantage over ablational laser refractive surgery of sparing the visual axis with very low risk of central corneal haze or scarring, and the effects may be reversible with removal of the segments. 2,4,5 Although corneal excimer laser refractive surgery has largely replaced the use of ICRS for myopia due to the excellent outcomes, there may still be a role for ICRS for the treatment of low