Intracorneal rings to correct corneal ectasia after laser in situ keratomileusis.

PURPOSE

To evaluate the potential of using intrastromal corneal ring technology (Intacs, KeraVision) to correct posterior ectasia after laser in situ keratomileusis (LASIK) for myopia.

SETTING

Department of Cornea and Refractive Surgery, Instituto Oftalmológico de Alicante, and Miguel Hernández University School of Medicine, Alicante, Spain.

METHODS

In this prospective noncomparative intervention case series, Intacs segments were implanted in 3 eyes that developed posterior ectasia after myopic LASIK with clear central corneas. Posterior ectasia and corneal thickness were tested using the Orbscan II Slit Scanning Corneal Topography/Pachymetry System (Orbtek Inc.). Segment thickness varied based on corneal topography analysis and refraction. The mean follow-up was 8.3 months (range 7 to 11 months).

RESULTS

The cases showed marked improvement after Intacs segment implantation. Postoperatively, there was a reduction in the magnitude of the posterior and anterior corneal surface steepening or ectasia and an increase in the topographical regularity index. In addition, the significantly enlarged optical zones resulted in a favorable visual outcome. In 2 eyes, the uncorrected visual acuity (UCVA) was 20/40 postoperatively. In the third eye, there was a residual refractive error; the UCVA was 20/50 and the best spectacle-corrected visual acuity, 20/40.

CONCLUSIONS

Intacs intrastromal corneal rings used as a mechanical device may alter the biomechanical properties of the cornea for the correction of iatrogenic keratectasia and the associated residual myopia.