Intracorneal ring segments in the management of corneal ectasia: a 10 year review

Session Details

Session Title: Cornea - Surgical III

Session Date/Time: Sunday 06/09/2015 | 14:15-16:15

Paper Time: 15:37

Venue: Room 16

First Author: : E.Hughes IRELAND

Co Author(s): :    P. Condon   S. Daya                 

Abstract Details

Purpose:

The management of corneal ectasia can be challenging in the setting of contact lens intolerance and progressive disease. Intracorneal ring segment (ICR) insertion in an option in selected cases, alone or as an adjunct to other treatments, with good outcomes. Here we describe the ten year experience of outcomes of this surgery in one practice.

Setting:

This review encompasses all cases of corneal ectasia treated with ICR insertion in one private ophthalmology practice in Ireland over a 10 year period. Mater Misericordiae University Hospital, Eccles St, Dublin 7 and the private practice of Mr Patrick Condon, Waterford Eye Specialists, 4 Parnell St, Waterford.

Methods:

Retrospective review of all patients who underwent ICR insertion between 2002 and 2012. Parameters recorded included diagnosis and previous treatment, indication for surgery, pre-operative and post-operative unaided visual acuity, best corrected visual acuity, refractive error, and corneal topography (mean k values), complications and subsequent procedures.

Results:

Between 2002 and 2012, 23 eyes of 21 patients underwent ICR insertion. 22 patients had an underlying diagnosis of keratoconus, 1 had post-LASIK ectasia. ICR insertion was performed in East Grimstead, UK and all follow-up by the original referring ophthalmologist in Ireland. Surgical technique included Intralase Femtosecond assisted ICR insertion. 10 eyes underwent previous riboflavin corneal cross linking (CXL) treatment. 7 eyes required further surgery over the course of the review- 3 had subsequent CXL, and 4 had deep anterior lamellar keratoplasty. 1 eye required removal of the ICR for extrusion. Topography and refractive outcomes are also discussed.

Conclusions:

ICR insertion can be an effective surgical treatment for corneal ectasia progression. 70% of patients who underwent ICR insertion did not require further operative intervention over the course of their follow-up to date (mean 6.3 years +/- 3.5 years). Insertion is not contraindicated by previous CXL, nor does it preclude subsequent surgical intervention.

Financial Interest:

NONE