Intracorneal ring implantation using Intralase® with partial coverage of the cone in a patient after an alkaline injury
Hanefi Cakir1, Canan Asli Utine2, Mehmet Baykara3
1Turkiye Hospital Eye Clinic, Istanbul, 2Department of Ophthalmology, Yeditepe University, Istanbul, 3Department of Ophthalmology, Uludag University, Bursa, Turkey
Purpose: To report the use of intracorneal ring segment (ICRS) implantation in a case of severe corneal thinning and irregularity secondary to alkali burn.
Case report: A 33-year-old man who had a history of ocular alkali burn in the right eye was admitted. His best corrected visual acuity was 0.16 with manifest refraction of +5.00 (-7.00 × 180°). Orbscan II® revealed steepening of >53 D superiorly, excessive thinning inferiorly with thinnest pachymetric reading of 269 µm. Two KeraRing® segments, 200 µm thick and 90° arced, were implanted. During intrastromal channel creation by Intralase®, the inferior half of the applanating cone was covered by a gelatinous paper to prevent the penetration of the laser beam into the anterior chamber. In the first year postoperation, best corrected visual acuity was 0.7 with manifest refraction of +1.50 (-3.50 × 35°). Visante® opticial coherence tomography displayed ICRS at a depth of ~370 µm.
Conclusion: ICRS implantation with this novel approach may be an option in eyes with severe corneal irregularity and thinning.
Keywords: alkali burn, ectasia, intrastromal corneal ring segments
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