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Intra corneal Ring segments

Gaëlle Ho Wang Yin, Louis Hoffart
Postoperative visual acuity can be limited by post-keratoplasty astigmatism, even with a clear corneal graft. Astigmatism management can be performed by selective suture removal, adjustment of sutures, optical correction, photorefractive procedures, wedge resection, intra-ocular lens implantation, intracorneal ring segments, relaxing incisions with or without compression sutures and repeated keratoplasty. Relaxing incisions can be made in the graft, graft-host interface or host cornea. Despite the unpredictability of the method because the flat and steep meridians are usually not orthogonal after penetrating keratoplasty, with asymmetric power distribution, all the studies showed an overall reduction of refractive, keratometric or topographic astigmatism, ranging from 30% to 72% with manual or femtosecond-assisted techniques...
2017: Eye and Vision (London, England)
M El-Husseiny, L Daas, A Langenbucher, B Seitz
BACKGROUND AND PURPOSE: Implantation of intracorneal ring segments (ICRS) using a femtosecond laser is a minimally invasive procedure which represents a reliable option to widen the spectrum of the stage-related therapy of keratoconus in patients with contact lens intolerance, or with post-LASIK-keratectasia or pellucide marginale degeneration (PMD). METHODS: From August 2011 to September 2015, 84 eyes of 69 patients were implanted with ICRS. 74 eyes were implanted with INTACS-SK (Intacs, Addition Technology, Inc...
June 2016: Klinische Monatsblätter Für Augenheilkunde
Rafic Antonios, Ali Dirani, Ali Fadlallah, Elias Chelala, Adib Hamadeh, Elias Jarade
This case report describes a 15-year-old male with allergic conjunctivitis and keratoconus, who underwent uneventful intra-corneal ring segment (ICRS) implantation and corneal collagen cross-linking (CXL) in the right eye. During the follow-up periods, the patient was noted to have several episodes of allergic conjunctivitis that were treated accordingly. At the 2 years postoperatively, he presented with another episode of allergic conjunctivitis and progression of keratoconus was suspected on topography. However, the patient was lost to follow-up, until he presented with acute hydrops at 3 years postoperatively...
January 2016: Middle East African Journal of Ophthalmology
Rohit Shetty, Luci Kaweri, Natasha Pahuja, Harsha Nagaraja, Kareeshma Wadia, Chaitra Jayadev, Rudy Nuijts, Vishal Arora
Keratoconus is a slowly progressive, noninflammatory ectatic corneal disease characterized by changes in corneal collagen structure and organization. Though the etiology remains unknown, novel techniques are continuously emerging for the diagnosis and management of the disease. Demographical parameters are known to affect the rate of progression of the disease. Common methods of vision correction for keratoconus range from spectacles and rigid gas-permeable contact lenses to other specialized lenses such as piggyback, Rose-K or Boston scleral lenses...
January 2015: Indian Journal of Ophthalmology
Noa Avni-Zauberman, David S Rootman
OBJECTIVES: To review and summarize relevant studies on combined use of corneal crosslinking and intracorneal ring segments (ICRS) for the treatment of corneal ectasia. METHODS: A literature search was performed using the key words "corneal collagen cross-linking" and "intra-corneal ring segments." RESULTS: Crosslinking is a well-accepted treatment option for corneal ectasia and can be combined with corneal ICRS insertion as needed. The advent of crosslinking has dramatically reduced the number of corneal transplants performed for patients with keratoconus or postrefractive ectasia...
November 2014: Eye & Contact Lens
Sue Ormonde
Traditionally, keratoconus has been managed with glasses when mild, contact lenses when moderate and keratoplasty when severe. When cornea-based refractive surgery was first developed it appeared to be a useful option for keratoconus until reports of post-operative progressive ectasia emerged and thus keratoconus was considered a contraindication to refractive surgery. However, improvements in older techniques and the development of new techniques mean that there are now several viable options to avoid keratoplasty in contact lens-intolerant patients...
March 2013: Clinical & Experimental Optometry: Journal of the Australian Optometrical Association
Kristine Dalton, Luigina Sorbara
Keratoconus is a bilateral degenerative disease characterized by a non-inflammatory, progressive central corneal ectasia (typically asymmetric) and decreased vision. In its early stages it may be managed with spectacles and soft contact lenses but more commonly it is managed with rigid contact lenses. In advanced stages, when contact lenses can no longer be fit, have become intolerable, or corneal damage is severe, a penetrating keratoplasty is commonly performed. Alternative surgical techniques, such as the use of intra-stromal corneal ring segments (INTACS) have been developed to try and improve the fit of rigid contact lenses in keratoconic patients and avoid penetrating keratoplasties...
December 2011: Contact Lens & Anterior Eye: the Journal of the British Contact Lens Association
F-X Kouassi, C Buestel, B Raman, D Melinte, D Touboul, A Gallois, J Colin
UNLABELLED: Comparison of the depth predictability of intracorneal ring segment implantation by mechanical versus femtosecond laser-assisted techniques using optical coherence tomography (OCT Visante(®)). PURPOSE: To compare the depth predictability of intracorneal ring segment implantation by mechanical versus femtosecond laser-assisted techniques using OCT Visante(®). METHODS: This observational prospective study included, after patients' consent, 76 keratoconic eyes, of which 31 eyes (group 1) were operated using the mechanical technique and 45 eyes (group 2) with the femtosecond laser-assisted technique...
February 2012: Journal Français D'ophtalmologie
Ildikó Máté-lsván, D Nicula, Angela Borda, Florina Vultur
We report the case of a 19-year-old male diagnosed with progressive keratoconus in both eyes. The therapeutic option was: intrastromal ring segment implantation in both eyes, followed by corneal collagen cross-linking with riboflavin and ultraviolet type A at left eye. The postoperative results were favorable: early improvement of vision, no intra- or postoperative complications and without signs of disease progression.
2010: Oftalmologia
Mirko R Jankov Ii, Vesna Jovanovic, Ljubisa Nikolic, Jonathan C Lake, Georgos Kymionis, Efekan Coskunseven
Corneal collagen cross-linking (CXL) with riboflavin and ultraviolet-A (UVA) is a new technique of corneal tissue strengthening by using riboflavin as a photosensitizer and UVA to increase the formation of intra and interfibrillar covalent bonds by photosensitized oxidation.Keratocyte apoptosis in the anterior segment of the corneal stroma all the way down to a depth of about 300 microns has been described and a demarcation line between the treated and untreated cornea has been clearly shown. It is important to ensure that the cytotoxic threshold for the endothelium has not been exceeded by strictly respecting the minimal corneal thickness...
January 2010: Middle East African Journal of Ophthalmology
Hanefi Cakir, Canan Asli Utine
PURPOSE:To evaluate the results of combined intracorneal ring (Keraring, Mediphacos Ltd) and anterior chamber, iris-fixated, phakic intraocular lens (pIOL) (Artisan and Artiflex, Ophtec BV) implantation in patients with ectatic corneal conditions and secondary high myopic and astigmatic refractive error. METHODS:Ten eyes of eight consecutive patients with different ectatic corneal diseases underwent sequential intracorneal Keraring and iris-fixated pIOL implantation. Two eyes with keratoconus, one eye with pellucid marginal degeneration, and one eye with iatrogenic corneal ectasia were implanted with the Artisan pIOL; six eyes with keratoconus were implanted with the Artiflex pIOL...
April 28, 2010: Journal of Refractive Surgery
Wen-juan Yu, Cheng Wang, Qiu-shi Ren, Wan-rong Li
The function of photo-decomposing of femtosecond laser makes it useful in creating precise "cuts" at arbitrary locations within the corneal of almost any conceivable geometry. The applications of femtosecond laser include intrastromal photorefractive keratectomy, creating the pre-cut channels for intra-corneal ring segment, creating lamellar flaps for laser in situ keratomileusis, performing femtosecond lamellar keratoplasty, which represent an entirely new approach for the correction of refractive errors.
September 2006: [Zhonghua Yan Ke za Zhi] Chinese Journal of Ophthalmology
Dorota Wygledowska-Promieńska, Stanisława Gierek-Ciaciura, Ewa Mrukwa-Kominek
Implantation of intrastromal corneal rings segments is a new refractive procedure. INTACS consists of 2 separate segments placed in the midperipheral cornea, in specially preparing lamellar channels. Polymethylo methacrylate rings, which flatter the anterior curvature of the cornea. The peripheral localization of these rings leaves the central cornea untouched. The 2 main advantages of the INTACS are, that it preserves the corneal center and is removable. Segments serve for the reduction of myopia from -1.00 D to -5...
2003: Klinika Oczna
N Ehlers, J O Hjortdal
Myopia can today be reduced or eliminated by refractive surgery. Excimer laser surgery of the cornea by surface sculpturing (photorefractive keratectomy) or intrastromal tissue removal (LASIK) are the most widely used techniques, although implantation of intra corneal ring segments for low myopia also appears promising. Treatment of high myopia (> 10 diopters) is still difficult although epikeratoplasty or phakic IOL implantation are present possibilities. The perfect surgery for myopia remains to be developed, but the existing techniques will without doubt be further optimised...
October 2, 2000: Ugeskrift for Laeger
J Ruckhofer, J Stoiber, E Alzner, G Grabner
BACKGROUND: Since 1996 Intrastromal Corneal Ring Segments (Intacs, KeraVision, Inc., Fremont, CA, USA) have been used for the correction of mild to moderate myopia at the Salzburg Eye Clinic. Aim of this study was to evaluate the stability, reversibility and adjustability of this new method. PATIENTS AND METHODS: Our experiences and final results of 54 surgeries--30 eyes with a minimum follow-up of 2 years--, as well as the potential reversibility (3 explanations, 2 of them followed by PRK) and adjustability (3 exchanges) are reported in detail...
March 2000: Klinische Monatsblätter Für Augenheilkunde
D Barach, B Mortemousque, F Bertel, C Diemer, N Dorot, P Verin
PURPOSE: Refractive surgery is meant to provide early stable and good uncorrected visual acuity. Our main concern in this study was to take special interest in fluctuation in uncorrected acuity within the first three months after implantation of Schanzlin intracorneal ring segments (ICRS) produced by Keravision. PATIENTS AND METHODS: Ten eyes in 6 patients underwent implantation of 2 intrastromal corneal segments for myopias ranging from -1.00 to -3.50 Dipoters...
April 1999: Journal Français D'ophtalmologie
J Ruckhofer, E Alzner, G Grabner
BACKGROUND: The advantages of the Intrastromal Corneal Ring Segments (ICRS) as compared to the frequently used methods for the correction of low to moderate myopia (RK, PRK, LASIK) are the intact optical zone and nearly complete reversibility. PATIENTS AND METHODS: Two ICR-Segments, made of PMMA (with an arc length of 150 degrees each) are placed in the deep stromal layers via a small radial incision. At the Landesaugenklinik Salzburg 25 continuous surgeries were performed as part of the European "MECCA-trial"...
September 1998: Klinische Monatsblätter Für Augenheilkunde
B Cochener, G Le Floch, J Colin
OBJECTIVES OF THE STUDY: Intra-stromal rings (ICR) represent a new method for low myopic correction. An indirect central flattening is induced by a peripheral steepening related to the segments. This surgery was recently approved in Europe, but is still under evaluation in the multicenter study controlled by the FDA (Food and Drug Administration). We took part in that protocol and report our results at one year follow-up. MATERIAL AND METHOD: Twenty-five patients were included in the study with 47 operated eyes and a follow-up between 3 to 18 months...
March 1998: Journal Français D'ophtalmologie
G Grabner, J Ruckhofer, C Tratter, E Alzner
For the correction of low myopia several competing surgical methods have been developed over the last two decades: radial keratotomy (RK) and photorefractive keratectomy (PRK) are used clinically on a very large scale. Both techniques are basically irreversible. RK does structurally weaken the cornea and PRK has to be applied directly at the optical center. Both disadvantages can to a large extent be avoided by the recently introduced Intrastromal Corneal Ring (ICR) that is now implanted worldwide following a long experimental and clinical development phase...
1997: Wiener Medizinische Wochenschrift
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