Intrastromal corneal ring segment implantation for ectasia after refractive surgery

Arq Bras Oftalmol. 2015 Jul-Aug;78(4):212-5. doi: 10.5935/0004-2749.20150055.

Abstract

Purpose: To evaluate the clinical outcomes of intrastromal corneal ring segment (ICRS) implantation to correct ectasia in eyes with prior refractive surgery.

Methods: Forty-one eyes of 25 patients (13 men, 12 women; mean age, 28.66 years) with ectasia after refractive surgery [photorefractive keratectomy (PRK) or laser in situ keratomileusis (LASIK)] were included in a nonrandomized, retrospective, observational case series. Corneal tunnels were created by mechanical dissection in all eyes. Main outcome measures included uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BCVA), refraction, keratometry, and computerized analysis of corneal topography. Patients were divided into two groups by the type of refractive surgery (Group A: PRK, Group B: LASIK).

Results: The mean preoperative manifest astigmatism decreased from -1.88 to -0.84 D in Group A (p=0.096) and -3.18 to -1.77 D in Group B (p=0.000). The mean keratometric astigmatism decreased from -2.58 to -1.66 D in Group A (p=0.010) and -4.80 to -2.78 D in Group B (p=0.000). The mean spherical equivalent decreased from -2.97 to -2.05 D in Group A (p=0.065) and -3.31 to -2.42 D in Group B (p=0.014). No significant between-group differences were noted on the comparison of preoperative and postoperative results. No intraoperative or postoperative complications were observed.

Conclusion: ICRS implantation is a useful treatment option for ectasia following refractive surgery, and it has significantly reduced the refractive cylinder and increased best spectacle-corrected visual acuity.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Corneal Diseases / etiology
  • Corneal Diseases / physiopathology
  • Corneal Diseases / surgery*
  • Corneal Stroma / surgery
  • Corneal Topography
  • Female
  • Humans
  • Keratoconus / etiology*
  • Keratoconus / surgery*
  • Keratomileusis, Laser In Situ / adverse effects*
  • Male
  • Middle Aged
  • Photorefractive Keratectomy / adverse effects*
  • Prostheses and Implants
  • Prosthesis Implantation*
  • Refraction, Ocular / physiology
  • Retrospective Studies
  • Treatment Outcome
  • Visual Acuity / physiology
  • Young Adult