[Deep anterior lamellar keratoplasty in extrusion of an incomplete intrastromal corneal ring segment (clinical observation)].

Intrastromal corneal ring segments (ICRS) of in various shapes are used to correct structural changes in the cornea and improve visual acuity in keratoconus (KC). The most serious complications of the technology infection, vascular ingrowth, and extrusion. In this study a 44-year-old patient underwent deep anterior lamellar keratoplasty (DALK) 5 years after implantation of ICRS in the shape of an incomplete ring to treat its extrusion of up to 30%, vascular ingrowth into the cornea and corneal syndrome. The following DALK technique was used: excision of the free part of the corneal segment, removal of the remaining part of the corneal segment, excision of 80% of thickness of the corneal block with a 8.5-mm trepan, pneumatic dissection of the stroma down to the Descemet membrane (DM), removal of the remaining stroma on the viscoelastic pillow, laying and suture fixation of the donor graft. There were no complications during the postoperative period, the graft remained transparent for up to 10 months. Uncorrected visual acuity (UCVA) increased from 0.01 to 0.4, best corrected visual acuity (BCVA) increased from 0.3 to 0.7. The number of endothelial cells decreased from 2980 to 2670 cells/mm (10.4%). This clinical case demonstrates that DALK surgery can be a reliable method of patient rehabilitation in cases of extrusion of ICRS in the shape of an incomplete ring and vascular ingrowth.