Intra corneal Ring segments

PURPOSE: To compare the efficacy of phakic intra-ocular lenses in isolation or in combination with corneal crosslinking (CXL) and/or intra-stromal corneal ring segments (ICRS) in keratoconus. METHODS: Data extracted from the publications meeting the selection. The outcome parameters included mean pre- and post-operative uncorrected distance visual acuity, corrected distance visual acuity (CDVA), sphere and cylinder of refraction and complications. Available data analyzed with Cochrane Review Manager...

Post-laser in situ keratomileusis (post-LASIK) ectasia (PLE) is one of the most serious complications after refractive surgery, mainly manifested as progressive thinning and trembling thinning of the cornea, accompanied by increased myopia and astigmatism. The mechanisms behind mainly include genetic risk factors and external environmental factors such as eye rubbing and cornea surgery. In order to achieve the goal of reducing the incidence of ectasia, preoperative screening strategies need to be continuously improved, through the collection and assessment of genetic and environmental risk factors...

PURPOSE: To evaluate the safety and visual outcomes of intrastromal corneal ring segment (ICRS) implantation followed by transepithelial phototherapeutic keratectomy (te-PTK) and corneal cross-linking (CXL) in patients with mild keratoconus. METHODS: Patients with mild keratoconus and contact lens intolerance who underwent sequential ICRS implantation followed by phototherapeutic keratectomy and corneal CXL between April 2015 and July 2018 were retrospectively included in the study...

PURPOSE: To assess the outcome of isolated Bowman's layer transplantation (BLT) in advanced keratoconus in the patients not suitable for ultra violet cross-linking and intra stromal corneal ring segments. STUDY DESIGN: Nonrandomized Quasi-Experimental. MATERIALS AND METHODS: Mid corneal stromal dissection followed by implantation of manually isolated bowman layer from a donor into the recipient stromal pocket was performed in the Department of Ophthalmology Khyber Teaching Hospital Peshawar from September 2018 to October 2018 and followed up over 18 months...

Intracorneal ring segments (ICRS), used in the management of keratoconus since the 2000s, have enjoyed significant technological development. Various types of ICRS exist, whose arc length, thickness, and diameter can be chosen according to the desired effect on the spherical equivalent, keratometry and asphericity. Individualized implantation strategies, based on each patient's topographic and tomographic pattern, are constantly evolving. The surgical procedure is standardized, and complications remain very rare...

Contact lens-assisted corneal cross-linking (CACXL) was introduced by Jacob et al. in 2012 for treating thin keratoconic corneas using riboflavin soaked soft contact lens to artificially increase the functional corneal thickness. It is advantageous over other thin corneal cross-linking techniques as it works independent of swelling properties of the cornea, is an epi-off technique and does not require additional time, additional expensive equipments or special solutions. The only additional requirement as compared to all other techniques is a UV barrier-free soft contact lens (SoflensTM , B&L) which is easily available and inexpensive...

PURPOSE: To evaluate the safety and efficacy of intra corneal ring segment (ICRS) implantation combined with crosslinking (CXL) using a Small Incision Lenticule Extraction (SMILE) lenticule for intraoperative stromal augmentation in thin corneas. OBSERVATIONS: The procedure was performed in three eyes of progressive keratoconus or post refractive surgery corneal ectasia, with a preoperative mean thinnest pachymetry of 389.34 ± 5.5 μm. Keratometry flattening (preoperative mean maximum keratometry of 63...

PURPOSE: The aim of this study was to assess the potential risk factors and causes of infectious and sterile keratitis after accelerated collagen cross-linking. METHODS: Case records of 968 eyes that underwent accelerated corneal collagen cross-linking (ACXL) over the period of 4 years were reviewed retrospectively. ACXL was done using (Avedro KXL® system, Waltham, MA, USA) 9 mW/cm2 for 10 min protocol providing total energy of 5.4 J/cm2 . RESULTS: Of 968 eyes, a total of three eyes developed infectious keratitis and seven eyes developed sterile infiltrates...

A review of 31 eyes with keratoconus who developed cataract and underwent phacoemulsification. Visual acuities were measured 1mo postoperatively. Six eyes with a history of good corrected distance visual acuity (CDVA) and a similar refractive and topographic astigmatic axis were implanted with toric intraocular lenses (IOLs). The mean postoperative uncorrected distance visual acuity (UDVA) was 0.2 logMAR with a spherical equivalent (SE): 0.75D. Eleven eyes with a history of good CDVA and different refractive and topographic axis were implanted with monofocal IOL+/-Toric implantable collamer lenses to treat anisometropia and ametropia; mean UDVA was 0...

PURPOSE: To investigate effects of Rose K2 XL semi-scleral contact lenses (Menicon Co.) on visual acuity and higher-order aberrations in eyes with irregular corneas. METHODS: One hundred and twelve eyes of 84 patients fitted with Rose K2 XL lenses were analysed. Participants were in 4 clinical groups: keratoconus, intra-corneal ring segments, radial keratotomy, and penetrating keratoplasty. Corrected distance visual acuity and ocular aberrations were determined before lens wear and 60 min into lens wear...

Purpose : To compare the incidence of complications between manual and femtosecond-laser assisted surgery for intrastromal corneal ring segments (ICRS) implantation. Material and methods : This study included keratoconus patients who had ICRS implantation using manual dissection and using the femtosecond laser with a minimum follow-up of 12 months. Uncorrected (UDVA) corrected (CDVA) distance visual acuity (CDVA), refraction, corneal topography and aberrometry, pachymetry map and slit-lamp microscopy were assessed before and after surgery...

PURPOSE: To evaluate the efficacy of the functional, keratometric, and refractive postoperative parameters of intracorneal ring segment (ICRS) implantation in keratoconus and its association with collagen cross-linking (CXL), photorefractive keratectomy (PRK), and intraocular lenses (IOLs). METHODS: We conducted a systematic review and meta-analysis on case series published between 2007 and 2017. RESULTS: We included 95 case series with a total of 4560 patients...

PURPOSE: To determine the changes in the depth of the demarcation line in the central to peripheral cornea following accelerated compared to standard corneal cross-linking (CXL). METHODS: In this prospective, non-randomized study, 60 eyes with progressive keratoconus underwent accelerated or standard CXL (30 in each group). Anterior segment optical coherence tomography (AS-OCT) was done one month later by two independent masked examiners to measure the depth of the demarcation line in the central cornea and on peripheral rings...

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...

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...

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...

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...

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...

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...

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...