Case Reports

Double intracorneal ring segment & implantable collamer lens (ICL©): a singular refractive approach

Case Report Details

First Author: C.Bouza Miguens SPAIN

Co Author(s):    F. González-López   J. Gutiérrez   M. Djodeyre   J. Beltrán   J. Baviera        

Abstract Details

Purpose:

To improve the visual quality of a patient with bilateral keratoconus through a double intracorneal ring segment (ICRS) and ICL© implantation.

Setting:

Clínica Baviera, Spain.

Report of Case:

Patient with advanced asymmetric bilateral keratoconus treated previously with corneal crosslinking and ICRS (Intacs©), attended the consultation requesting a refractive solution. At the first exploration, the OD presented a central keratoconus grade 3 (Amsler-Krumeich (AK) classification) and a spherical equivalent (SE) of -11,50 diopters (D), while the OI had a bow-tie keratoconus pattern grade 2 (AK classification), with a SE of -1,25 D. Our actions focused on trying to correct the anisometropia of the OD and regularize the cornea of the OI. For this purpose, a spherical phakic posterior chamber lens (ICL©) was implanted in the OD (size 13.2; power -12D), while an ICRS Keraring© (160º; 150 microns) was implanted internally to the Intacs© in the OI. To our knowledge, this is the first reported case of double parallel ICSR insertion for correction of a keratoconus.

Conclusion/Take Home Message:

Keratoconus patients should be addressed not only from a therapeutic point of view but also from a refractive perspective. Parallel double ICRS implantation shows to be a safe procedure. ICL© implantation can correct anisometropia in cases of advanced bilateral keratoconus.

Financial Disclosure:

None