Single intrastromal corneal ring segment implantation using the femtosecond laser after radial keratotomy in a keratoconic patient

Abstract

A 33-year-old woman with irregular astigmatism 6 years after radial keratotomy (RK) for keratoconus was treated with implantation of a single intrastromal corneal ring segment (Keraring) using the femtosecond laser. The segment (0.150 mm thick with a 160-degree arc) was inserted in the steepest area (inferior) with no intraoperative or postoperative complications. Six months postoperatively, the uncorrected visual acuity had improved from 20/40 to 20/25 and the best spectacle-corrected visual acuity, from 20/32 to 20/20. The mean manifest astigmatic correction decreased from -2.50 diopters (D) to -0.75 D, and corneal topography showed improved inferior steepening and less irregular astigmatism. Although the results are encouraging, the long-term effect of this approach in post-RK patients is not known.

PROSE treatment of corneal ectasia

“…Contact lens fitting after penetrating or deep anterior lamellar keratoplasty or after refractive surgery presents additional difficulties [24]. Intra-stromal corneal rings and collagen cross-linking [25,26] may help eyes with mild or moderate ectasia, but even after these procedures, contact lenses may be required for good vision [27]. In our cohort of patients, 89.83% had worn contact lenses, but only 28% were wearing contact lenses of any type at the time of initial consultation.…”

Effects of Corneal Cross-linking on Contrast Sensitivity, Visual Acuity, and Corneal Topography in Patients With Keratoconus

“…These results suggest that to predict a greater CXL efficacy, it may be more important to determine the position of the keratometric apex than to use a classification based on the mean central keratometric values. Although the authors believe that the main objective of CXL is to stabilize the progression of the ectatic disease, changes in BSCVA are expected, and the fact that they differ according to the keratometric apex location can be used as a predictor of greater CXL efficacy and might be relevant when considering whether other surgical techniques, such as surface customized refractive surgery 25 or intrastromal corneal rings, 26,27 should be combined with CXL to achieve a final satisfactory BSCVA.…”

Intracorneal Ring Segment Applications: Review

“…[11][12][13][20][21][22][23] Erken evre keratokonusta gözlük ya da yumuşak kontakt lens kullanmak istemeyen hastada KİHS ile iyi bir görme seviyesi sağlanabilir. Ancak orta ve ileri keratokonusta, yani sert kontakt lens (SKL) kullanması gereken hastalarda segment implantasyonu SKL'nin sağladığı görsel kaliteyi sağlayamaz.…”